HCA - Earnings call transcript Q3 2024

Due to licensing restrictions, you must log in to view earnings call transcripts.

Operator

Hello. Welcome to the HCA Healthcare Third Quarter 2024 Earnings Conference Call. Today's call is being recorded. At this time, for opening remarks and introductions, I would like to turn the call over to the Vice President of Investor Relations, Mr. Frank Morgan. sir. ahead, go Please

Frank Morgan

remarks welcome is on and our and some Marks. and take me CFO, call. this Sam prepared provide will morning CEO, Mike then to morning, we'll today's questions. everyone With Mike and Good Sam Hazen;

turn on to Sam, the other numerous expressed uncertainties management's release that current be remind More let materially are filings. statements from our forward-looking factors over those contain and forward-looking call expectations, today's cause any call and may information various actual that I results statements might me on everyone to differ listed Before should that in are based and SEC today. these factors today's press risks, in

EBITDA, Inc. supplemental be that, a is table and attributable to On release. of measure. A recorded today's on call which the replay the information Sam. morning's later being to financial this is reconciling call, over as is HCA may available This morning's call non-GAAP included net providing we now turn EBITDA reference in adjusted call and measures today. income Shareholder adjusted will a I'll With such

Samuel Hazen

morning All everybody. to right. Good

and for get recently X share for want results Before the major facilities. the hurricanes as X responded weeks, of people the I communities heroic some quarter, to we to our financial in than efforts our they to less impacted that

hospitals during HCA has capabilities Healthcare support developed disasters. years, the our enterprise Over industry-leading to

like learnings key and approach used for hurricanes. from conducted to training, with systematic events vendors to have We a partnerships experiences, major responding built create extensive and past to strong preparing

in dedication, were patients multiple and by to as of in storms these hospitals these our leadership without But and, is remarkable to people even these days past safe. more unwavering company were teams our and many the colleagues in instances, outstanding These worked few with outstanding use path put results for resources the our who impressive what's storms. the over rest throughout demonstrated the weeks bravery, were ensure

fundamentally and it support Leveraging now Way. itself the worked communities storms. for hurricanes. Asheville evident impacted corporate area in to times, capabilities We our by success. effectively were It This significantly is few these it has HCA in committed in A of call works normal well proven is well these in our our in pandemic, Tampa formula facilities people Pete. of and again especially it the St. the parts

have our we Given in there communities for the to the not thing. veered right role we duty doing have basic infrastructure we them be play the from these situations, and in

of all improvement humbled show truly they for the proud honored continually they patients, to how them, determination I'm and and else, care human above circumstances they and the want up deliver tremendously positive I'm do that with life, difficult teamwork their are, by outcomes this of make and to communities. other, our great. for They thank them be what in of each HCA company people. to and I I'm and associated demonstrate committed to

results for $X.XX the expenses These $X.XX. results. additional XX% third and and include solid growth lost first increased the caused reflected year, estimated results as earnings share, revenue [indiscernible]. impact an Diluted Now share and half by to improvement. of to were quarter's the quarter the per the revenue from of adjusted, Like strong margin per Hurricane

storms. path operational, storms to aftereffects fully deal of facilities in the are we our that the the and rest of have of with continue X hospitals the hospitals the While outpatient

significant patient operate primarily in even water. and which provide care is hospital First, that's in continued with Mission city affected was area the Hospital, and the it has only Asheville by disrepair, Helene, high-quality infrastructure HCA Hurricane and to

remainder the revenue lost we of this issues consequence of the anticipate related year. incurring significant and a expenses to storm, throughout As these

also some but manageable XXXX. impact into expect we We continued, think,

As It Largo quarter hospital because flooded. will the Hospital currently in October, Florida in of be was closed which this addition HCA Florida fourth losing it repair anticipate hit incurred during pertains building's is infrastructure. revenue. at our Hurricane expenses We damage significant to Milton, to the to

however, clock more reopen can hospitals aftereffects and major of we HCA as produce numerous results these are have than teams, move believe with we December. performance. where productive these in from X Healthcare in time it Our late working has recovered beyond the from around examples hospitals hurricanes past I storms. pre-storm storms to most the similar our become recent

affected increased room including visits surgeries solid were inpatient major was categories, our admissions Inpatient modestly admissions, volumes the X.X%. up by was markets Other the X.X%. lines, Hurricane as inpatient procedures, rehab grew that down declined. and and Emergency growth. X%. It category During On surgery service only cardiac strong across a admissions volume the had Outpatient also prior was service broad-based. obstetric Adjusted compared grew X.X% year. volume Helene, while and X.X%. quarter, growth basis, same-facilities to

revenue and in service increased line X% the because acuity However, mix. of this payer

within growth mix improved other X.X%. factors quarter. helped of These service lines in and generate the services Payer inpatient across acuity same-facilities revenue

of our believe investments our to have are XXX care patients this approximately year, inpatient of XXX new we sites We making our the X,XXX. total to for and network and the bringing By in facilities, value organization. drive the added over we outpatient to development continue agenda beds end expect

care of create for online add under Currently, the few anticipate networks, has development. our will growing allowing next investments, projects services us years, company access over markets. across and meet which we come capacity the These our around to more greater demand in should $X health billion the

few call thoughts the with early want XXXX. to a I close Mike, to on turn I Before

so it our assessment long-term these X% the the we demand exceed predict [indiscernible]. preliminary would been business, will has went the assumptions various respect to of With throughout hurricane-related impact, to year into of not certainty volume fact planning of Our that I includes our my with which change. believing with completed is X% [ caveat year to may growth comments and difficult process, continuing always this components the views and ], that

assumption elevated growth X% to As in look the our we outlook given range strong to earnings to we should for slightly With earnings levels diluted the coupled share adjusted growth at year, year. X% near anticipated XXXX, assume of the continue with growth and end next respect earnings environment, volume for both for ranges operating will volume the generate our or stable target an upper above mostly of long-term per EBITDA.

will our provide usual, As the And that, January, XXXX. to we I'll call with guidance for with you Mike. turn in

Mike Marks

margins, storm on the in September the with XX hurricanes. We the the considering our storms Helene produced path expenses had and impacted during that of a We details prepare a And hospitals of and preparation area when of had during of I'll impacted response seen and XX We third operations Thank the and the Bend the the storm loss Florida, were communities us with you, in good have Florida impact additional few Big financially, good respond. incurred Carolina. to North Sam, in and start which made revenue morning, phases. Georgia, quarter. the pleased everyone. we of and growth and Hurricane and landfall volume X recently. especially

is of Mission and water weeks. Hospital be to expecting to facilities Hurricane spend not And As we to supply health projected care Mission supply reestablished other example, the October. our on are at city Helene related at $XX Hospital several for potable an to month water million least through more

million As Hurricane quarter the impacted $XX per estimate third we Sam share. noted, that diluted Helene $X.XX by or

the a under of impacted on portion large to and Milton hit Florida still just October of path repair. the and X. Florida, prepare It had hospitals which south HCA storm Hurricane Florida Hospital, in the that Sarasota respond, of peninsula. including this We west Largo XX coast of is had over

to of This the impacts during impact $XXX additional in the $X.XX and North any expenses ongoing about recoveries may hurricanes, loss of to do XXXX. not Carolina in hospitals think our quarter million include in These and major insurance relates future. company primarily revenue or anticipate Hospital the fourth $XXX estimates will Florida. per we Largo receive diluted our share million to be both the As of approximately we $X.XX

I would the collectively prayers physicians for and impacted support colleagues people and is and who my recover true and concern and appreciation It communities. these like colleagues teams storms, to our provided our these and we add respond. to the honor with to serve communities the a and HCA my our as all to of care during work

Now let me transition to our XXXX guidance.

noted XXXX As our estimated our release, reaffirmed guidance in we ranges.

that hurricanes results the provided. Given the the to the be estimate lower half of are the the ongoing year, of X likely in impact we of the remainder ranges major on

Adjusted quarter. improved prior the on improved revenue margin I results XXX costs growth year. of over prior our XX to year. operating revenue resulted volumes, Sam in Labor points a so points strong reviewed quarter. over quarter the in focus the will in of the percent in basis as X.X% basis costs which the prior year, from the Now quarter for EBITDA

We the results contract cost. consistent see Supply cost over as total points prior revenue represented which basis year labor, sequentially. increased year XX improved percent continue from labor relatively a XX% prior to on good X.X% the of but and of were

prior a had increased year. costs Hurricane quarter. increased Helene. revenue supplemental had expense Medicaid was over over flat 'XX maintenance growth programs and with XX% points our as second cost to provided results. prior to percent Medicaid programs, the year sequentially moderated benefit operating modest We a Other to associated Professional we basis to XX fee payment quarter supplemental the costs third overall payment of and growth repair related and

this growth the EBITDA, strong adjusted was across our XX% lot So with driven core moving in solid but markets. a of of portfolio in performance quarter operating quarter over parts a by

allocation. capital to Moving

billion strategy billion, Cash We totaled operations flow the of we quarter. of creation. continued to repurchased shares in and deploy $X.XX expenditures from value for the balanced $X.XX billion capital quarter. our was allocating long-term outstanding $X.X during a Capital

dividends. also paid in $XXX million We

positioned debt leverage end guidance range, Our we and from of the to stated EBITDA believe we well low balance our remains perspective. are sheet at a adjusted

XXXX the opportunities billion. that, approximately we This capital for to for continue is noted as and Frank, in I to With our business. investing in $X our timing capital of to for the due you lower see now estimate Finally, turn projects, call we be questions. estimate over good to release, expenditures will primarily

Frank Morgan

you [Operator Jeremy, instructions you, now ask may to question. a like those Instructions] give who'd Thank Mike. to

Operator

Rice A.J. from Instructions] from of line Credit First the comes question Suisse. [Operator

Albert J. Rice

Just a point of clarification then question. maybe one

So on take billion grow take your X% the for up hurricane of $XXX $XXX we high range, guidance, 'XX outlook that of to X% off the something million the of like impact with million to if your midpoint then my come then comments of in and walking and we sure framework. end $XX make and question 'XX, the $XX.X to to then from out that want be just what I your you're on hurricane 'XX saying? And right volume would we're that. on we layer with of strength. broader recovery billion all top away just that throw at Is

last post year? You now have out was saw particular pickup lines last service anniversaried remaining strong strong anniversary volume of pandemic the calling that there you areas worth trends year. Are that are as in what are even we

Mike Marks

is This Mike. A.J. Thanks,

our we lingering of be upper being Tampa We account are ongoing slightly manageable, that in growth As it And XXXX. be the the or end near these will me we, potential primarily when relates into Carolina XXXX to in this end of said, hurricanes facility which our XXXX into range. operational let generally effects of we believe XXXX effects North long-term storms think this. we as expect by to the the our above Sam the and took set as commentary, say we

give noted on Sam we our well, in formal much as As January. details and more guidance context will 'XX

admissions And that strong I that to relates point QX to made from thing XXXX, is As that increase only the it sequential point sequential the of the volume relative might X.X%. QX you increased last year we with same-facility past is addition part volume, trend. of in line pickups to our last in in sequentially to by

of So volume. that's our sense

Samuel Hazen

Yes. me And add let to that, A.J.

agenda. our communities. most in growing emergency to to important our well. room solution invest a we people think I really think it. the to And And to improve And continues continue it of be our continues continue are our with categories and outcomes optimization we patient in grow for service we ER broadly, very

continue our very company, with had of the our in important business We well across see as the will, across growth the good as if you And across challenges, said, cardiac broadly to of I we've markets the few geography strength broad-based organization. company.

Operator

next Hendrix from the RBC comes line from Our Capital. question of Ben

Benjamin Hendrix

July, to I then you A two-midnight-related noted back lot related this to early on season around discussion two-midnight claims you the denial broadly. And in of could were if from earnings denial claim year. just trends was specifically, activity. adjudication that claims in beginning touch wondering of see you

adjudication can there any As how seeing may of view when on process changes admissions? observations offer you informing we approach we the payers is you're and around your those behavioral year-end, short-stay among And anything they two-midnight? activity see

Mike Marks

certainly denial have But year. growth investment seen given the this talk about denial years. denial impact we our as we've to revenue payers past over been the two-midnight from the working generally several and activities to we we'll integrated pivot their quarter. on diligently mitigation have me cycle then past strategies Investor up in Let rate areas, Ben, of level of these denials first, moderate intensity in years. prior and and able been our our year the several ramp focus Day, noted through write-offs the over We in

not of were update Medicare two-midnight rule on a to the quick material impact third HCA XXXX. A in quarter adoption. denials Advantage So

Medicare basically admission the approximately XX%, admissions to in we growth approximately the over remained quarter. the were admissions coming basis Advantage Advantage This of admissions rule in our two-midnight XX flat. of is increased equivalent admits points total X% and XX% attribute overall Traditional from same-facility growth Medicare and impact. has were Medicare X.X% Medicare Our year. up that consistent

we prior As few have your large prior two-midnights that denials. to think payers with way for or -- authorization in a we driving as question impact, to these to a the significant we the are denial compared far And outliers two-midnight about do on we accounts rule, Advantage But the continue have so denial greater continue modest see I trends in Medicare denials. many too year still XXXX. reduction

me two-midnight Advantage higher rule. Advantage now with significantly a represents Medicare even Advantage let X Medicare, Medicare. of the of than implementation context, still Medicare past total the mix inpatients traditional to Medicare to The now Medicare observation the highlight of For couple of volume. months is comparisons traditional XX% of

is ratio Lastly, than Advantage Medicare, burdens Medicare traditional drive CMI-adjusted These the driven cost discharge higher by payer-driven length-of-stay approximately providers. XX% lays. to

Medicare burden. we're and this with trying we're X address our the We're really things. denial as Advantage working to burden So payers, address trying to cost

And denials you now to think dispute resolution. the about those quarter's we get the the way starting are all through process, process, -- if we and through adjudication adjudication through pursuing through so the first are

resolution dispute complete. fully we've X a talked As take to year before, to about can years

to And so we are we as pursue going to have that strategy to forward. move continue

Operator

the line ] from [ of Heinz comes question Mizuho. from next Our Sam

Ann Hynes

about This ahead, might just think rule is this two-midnight have compare question Ann. year. I for you pricing this guess I tough part of be my assumptions when you assuming it addressed when I'm a I think because XXXX,

and You nice also some commercial next incremental have Medicaid a from year to DPP. shift had

your Advantage to you guide programs you know initial some get pricing So are maybe next Medicare scenes shift guide, year, maybe in states the your for maybe for side? And benefit behind the a I included have of approved? DPPs when to in do this what continued to observation more think that initial have working incremental status we any on inpatient because

Mike Marks

It's our our to give let as we early say And would and this. growth all those between that revenue planning give call, look we'll I per we're early in think me of a X% planning January in I adjusted to metric. this, a lot details that's around net Ann, you process little of XXXX. say cash somewhere X% details. though, finish on XXXX largely, admission, at our

for And contracting, for update mid-single-digit go that complete give XXXX. XX% XX% just XXXX but this of In exactly tracking in still we're and I'll that XXXX, terms XX% you're ahead and is in of know we're short complete update. complete you don't payer I the where if going, now

update commercial So on that's side. a quick the

Operator

the Our next line question Pito comes Bank. Deutsche from of Chickering from

Pito Chickering

about next Sort I and then you that of year. OpEx, what of you labor think guys are gave assume assuming sort questions year? you that on guide years? that there, any for as guidance for within for X pricing range And OpEx and next DPPs tagging on in Do us you labor here guess, next

Mike Marks

into really our we'll Still into those process, getting our now a the I January getting So repeat be planning be little early to third our details that the we in assumptions call. XXXX margin of for of quarter. profile details yes, have when for would middle

related to So let so happy me give waiver that just for stay that. I'm you though, update, and quarter to there a quick I'll do third here.

the variable and other to As Medicaid covering than patients but patients. Medicaid in of these Medicaid with we've past before, quarter-to-quarter, noted payer the The insurance. over from payment years challenging across short and together are reimbursement are supplemental treat our programs when helped, still historical Medicare our growth been the several historically complex states programs most have without taken has cost

This illustrates quarter these really complexity of variability and programs. the

supplemental 'XX As Medicaid was payment that in new comments, lean the effect Medicaid benefit by generally will but benefit in change quarter programs program, to and We would quarter year million Nevada a versus to tailwind modest of we receiving year. Carolina payment noted in range. program then higher the my This this have given from million last still accruing, offset supplemental prior programs the to produced in quarter a $XXX of the now third benefit prior our versus Florida of project reduction as to to the year that XXXX the in fourth the from net North $XXX kick of end year. modest

Samuel Hazen

respect our as our mentioned for XXXX, to reimbursement spoke generally stable as are then that be demand. assumptions long-term to have demand our trends cost we labor the just suggests of I seen in to of talked reasonable being And somewhat do costs, around inflationary the we of sort me in my pricing the add environment we've Mike in than environment programmed think comments, consistent which line for on let with and consistent and and sort zone we of for that think our Mike, generally is a I with XXXX. operating Pito, just what with something. anticipate sort better XXXX. side about, XXXX. And rest around we assumptions stable

few putting Now on land the point year we're and that we on a as finer a finish things.

we're operating So a stable how characterizing environment. that's

Operator

comes line Mok of Our next Andrew from question from the Barclays.

Andrew Mok

about was like understand deceleration acuity, to underlying want half the per year, inpatient and which in first in just of quarter. from Looks to the revenue third a X.X% there was of the there I strong, drivers that admission very the in rate. mix half between

Mike Marks

in Consistent strong prior year growth good had quarter think revenues the So quarter when of rate third as first well the supplemental below state in had 'XX of driven about rate growth Medicaid you of I in year. the half half is with to kind the to acuity year-to-date we or We NRA program in quarter. the of all payer know, the but the XXXX, in versus of growth quarters X in the of mix programs. year, in XXXX decline prior supplemental the really, third growth by first rate growth first and

Operator

Our comes from next Gajuk question America. the line Bank of Joanna from of

Joanna Gajuk

guess us I maybe guess so quarter. bit little gave quarter. in I So additional commercial Medicare, a terms question the exchange in and the Medicaid of mix, volumes in you volumes the the growth also payer volume on here the

mix growth volume the the by I give you payer. guess, kind payer on additional, data if and point of in can maybe the us So quarter

Mike Marks

Sure.

third growth to equivalent use admission So 'XX quarter I'm prior of same-facility. going year in to

Managed to equivalent And volume XX% short just volumes X%. equivalent down uninsured same-facility year. admissions. down exchange the on volume, X.X% then was X.X%. of excluding And The prior up were X% up run Medicaid up so on let's Medicare growth, exchanges, at care admissions,

the of X.X% in So growth admissions in that total to that equivalent equates quarter.

Operator

Austin ] from comes question from next of the Our [ line Wolfe Research. Garrick

Justin Lake

of that a name to It of about And It's how little year. that's leverage I Xx. -- from got the guidance million? it you how in I the I about Wow, call, about I debt but next Wolfe. are have into the impact thinking hurricane then might like hurricane and year you there. next in anything the that kind within But your and around from know past. potential you're asked and or $XXX reoccurs your apologize, -- looks how about beginning the bit I your ending I X% missed the year know you your of a you're of ask high the the Justin are that Lake thinking wanted or going terms missed thinking long-term and about

Mike Marks

Great, Justin.

working we target third flow, this leverage cash and strong at to had We year we've to are our on doing and at changes and this with budgeting process, relates before. time, planning right the financial the 'XX. end if finance about quarter investment any it end lower range quarter our talked committee we're our and any evaluation as as call. did quarter policies, of those part our really a of So on first we'll of But every in an announce there

year. context will our a comments January. of when Justin, the what being we in our in middle around that XXXX, the facility of policies. kinds end are still be the update that early-look XXXX did formal when our ranges. as just be to or that we're think in bottom ratio. And that hurricanes, effects market the our financial articulated we believe in planning end growth Tampa give primarily are And we do operational to North in So as account, near going are process of the manageable 'XX by that to which it's Carolina long-term and We more hurricanes ongoing at we upper leverage we the slightly our always, of above into lot those details the you look But related at related of we'll guidance of we crafted generally take

Operator

question Brian Tanquilut comes from next Jefferies. from Our

Brian Tanquilut

the color to the disruption, can got? guidance? just on claims that or reimbursement any you with you change that Mike, think I work how communities thinking the the about about you the are then As insurance you're share And CapEx insurance doing and maybe,

Mike Marks

It's and believe in we've insurance sure, this that a fourth we working storms. Related our take to will release, any the not did really estimate of quarter claim noted related that do the noted there point. a we We're quarter third can it's recoveries related of for to this given know, be and still in in and But We still impacts seeing -- bigger include amount. to opportunities We're It's at to the insurance, flow timing now. CapEx, the early. on So to losses are, size the timing projects, recovery projects. long down. lot an the these provide a you that capital we're a position really change in related a just early time timing potential and as hurricanes. implication a of there's little yet, through do estimate these really either anticipate invest These not or But insured the having especially the to there. business. a little an of bit and no up good our there's to

spend And related this being the timing. to so think we're we just CapEx slight going on to decrease year I articulate more what in would

Operator

SVB Our Securities. from next question from comes Whit Mayo

Benjamin Mayo

a on the Sam, big investments. you've AI had focus and technology

there's helpful. wondering investments new efficiencies Just you labor any can would any management around areas that or be that that guys that seeing are learnings, find those encouraging, maybe from share you if you other

Samuel Hazen

outcomes our business, company's AI how management actually our in operational then X presented plan our yesterday, ultimately, administrative advancing over digital particular, the to are we business next the clinical and on X to and for many see And our years. functioning, we we, our and, improve patients. So of into the opportunities approaching agenda our technology full

journey. And early so that we're in

do and, we're areas have promising results in intelligence using relates as We where to seeing more particular, some technology it effectively. artificial

able allocation of Some precise scheduling can been better such. with to demand patient more workforce managers that tools improve we've of and our forecasting, that where capabilities, our is the in the to demand meet use

So that's confidence. little us encouraging and a giving of bit

Mike of have mitigate the into company more forth. so the artificial of receivables intelligence and the effectively and and revenue cycle, manage We as revenue some embedded performance denial of performance pressures the mentioned, to our aspects

organizing in that years, more agenda. our us. all has we it we yet HCA do the few performed resourcing at next incremental results an 'XX push business, a and believe. improvements initiatives. stage as for going Obviously, and we that on are the decade we to set growth at of high are We're see elements early get our They're positive our initiatives the material historically rest yielding particular efforts even view be I We're those growing into not this across So of on good. to mean, expect into mature but inflection it's point. of front. I 'XX has levels and Healthcare our as this we're been around

has margin Our good. been performance

is it and XXXX outcomes performance better quality clinical Our pre to than date in was so pandemic.

So now we've even engagements, that. our respect quality. And advanced to and our we've constituency overall then improved with employees, physicians, community,

because point these So a we're inflection incredible our this And at tools. of in business, see we application. lot of

company. the about potential our agenda particular so for very this presents excited we're And that

Operator

Stephen from Wells Fargo. Baxter comes question next from Our

Stephen Baxter

about for this of year. basis -- last growth was the potentially much year, the I is or XXX quarter, to I or think were just as X%. wanted volume looking XXX exchange your ask assumption X% at the next you I growth points worth maybe as suggested back

Just Does in of of these volume understand about to these guess for Just trying about thinking some more year? unusual that some Medicaid, assumption. is exchanges. it next like your dynamics you the to it Is how headwind think a coverage dynamics trying as stabilized? you're I inside understand keep this And declining year? macro-driven

Mike Marks

the estimates X% we XX% have states I next is Maybe Yes, enrollment in enrollment this moderate versus best exchange great will year, to question. over the year. Largely, growth our enrollment in XX%. in think growth was

will of as Medicaid 'XX we redetermination that think certainly. in flatten I factor, bit kind versus out Medicaid one that's through So volumes a 'XX the do sunset process.

say the X are largely, those would So dynamics. biggest I

effect we stable from to think will I XXXX. that the payer as be of mix generally move net XXXX

Operator

Fidel from Scott from comes Stephens. question next Our

Scott Fidel

been environment you on it's around around lot playing cadence on impact outlook, the with a then experiencing can the have there timing dynamic their as those of or that? out of just only 'XX view some preliminary if be the the have the follow-up, margins how and as quick impacts MA Interested been well. And update just of EBITDA separate on recovering Medicare rates just contracting from a early. on plans any of understanding trends Advantage from rule Would plans, of pressure a the of sort just the and and hurricanes the them lot us two-midnight any from and

Mike Marks

Let as renewals Medicare to kind major Medicare speaking, intention in do set your we're then partners of And agreement the That XXXX, space. Advantage come able our second the Advantage we've we've cover to been payer our in and of question. contracted continue we'll contracting the payers. me to normal piece to largely is to done jump Generally that. with across our

are work partners through in where we've and a renewal I renewals past, that we have been in able work contracted. the with cycle. to in Medicare XXXX largely consistent been our we that as contracted fairly to payer through terms which we've And continue network. But is would the their say that we've We provider they challenges have secure Advantage to gone as of our contracting,

by early cadence of trying think to about again, get it's think earnings at into EBITDA, of I in XXXX terms In this point. quarter a to little

when to answer that push together January. in we I'll So come

Operator

comes question Ryan next Langston. Our from

Ryan Langston

this, does those in facilities do maybe maybe sort overly long-term hurricane only the southern and terms but you of I don't geographies, kind couple in years of course, M&A reactive of allocation, of did are life you'd some if but of effects buying affect as capital a I of fact on typically not incrementally? mean, of be strategy outside building, of see as think year, this maybe hurricanes look to ago. even to anything a just activity this somewhat cycle severe, states,

Samuel Hazen

This is Sam.

short is that think to I no. the answer

I'll if in it, event. higher We damaged it facilities, than hurricane actually was an as Port have I hospital Hurricane been hit our And years mentioned and were some will, and Ian. Hurricane significantly hospital just hospital Houston than Michael, was that seen City, flood of performing and comments, recover, and you well. a Harvey, my level actually has of repaired, Panama Ian, Hurricane but also at Florida, which number level you years it Hospital which which Faucette our pre Charlotte, performing and Obviously, a significant a hardened, hurricanes. hit we're higher example. as affected pre-Hurricane storm. a to repaired HCA a that we hit couple is a ago, had give was hardened again ago in at

a has recovered As result, and pre-Harvey our Houston system as also is performance well. exceeding

the Carolina. if the are year we X those our And of asked personal is storm. Category and were to would in you I Georgia, X Katrina. had life. facilities can. We said we a So of company. We the North mean, for experienced Florida, have and experience very similar state -- effects fact, way I so opportunities much with a Asheville, Helene our they Katrina XXX I what we as this never have in years, that of Coast communities Hurricane invest, would very believe was possibly most communities. I me believe Texas still Augusta, as impacted, are, of But forth significant wisely tell and in you, hardened Gulf will

And That's that indicated. that capabilities risk. that with growth, showed we're to think power so long-term storm. diversified markets. for again, respond an its we we're it power the we we dealt very as that. serve company, understand I We we've communities to of the our going well the believe communities got. more of but particular we've result deal the positioned as And of enough unprecedented of We are HCA, think, why associated to hurricane And I and that to risks stronger be a the those with in built importantly, And with think people those we've portfolio across we such.

Operator

the question Fitzgerald. line James from of Sarah next comes Cantor from Our

Sarah James

remained despite that your business you do you clarification just that then Outpatient pressure? surgical do interruption on that a and In lower level trend made. comp. XQ negative stabilizes carry? quick What's driving 'XX or a turns insurance insurance positive? What you of the comment guide, assume And

Samuel Hazen

has outpatient of better a We've uninsured. acuity is has nothing trends indicated, declines entirely X%. So Medicaid our the seen this focused outpatient mix been on case as result. our revenue as from surgical per in and surgery payer in up we've have surgery. The improvement we've our seen service That's The year. also changed been surgery, we and why outpatient seen profitability growth, almost

on So the is volume headline, down.

surgery. line, bottom the On with profits are to respect outpatient up

So we're outcome. with that comfortable

particular different volume don't changes the to year, we that overall any this We we've significant anticipate relates next categories our As includes believe it juncture. at guidance got.

Our And of efforts on acquisitions. our patients. to advancing hospital-based providing we our continue number environments in for development improve outpatient surgery care and targeted We're better that surgery continue our some through physicians greenfield as well the for our have operations outpatient to advance. better of surgery environments as we centers, company centers

Mike Marks

on And have the in limits property either potential policies insurance thereof. at a certainly insurance program. this provide the business we those the interruption under or our related of to recovery position your really part time, as not coverage timing estimates to we're insurance or But question,

So that's are where now. we

Operator

question Ransom. the John comes line from Our of next

John Ransom

about think Just getting X kind I'm in comes particular, do backing your about Have infections, kickers get to curious, don't contracts years thing what that that we kind hospital-acquired is to and XXXX are now some about But up. anymore. we metrics? care they fee-for-service. value-based you ago are kind they're worried just commercial of versus things I that? other What of of that talk readmissions, that you all I'm things trying kickers what like stuff. know grown? mind then? in for quality And examples And And one of

Samuel Hazen

overall payers. contracts. of have Those inside equation they're or inside Sam. the minimis escalators material And this those revenue but I overall to incremental our de they're revenue is that with won't John, contracts are the of very say we not overall

better and company contracts it's the the outcomes have our But to agenda some the across a our we why the as have for providing than modest part small that mentioned, a as I referenced around you you we service We patients. we have to of organization were aggregate outcomes, mean, those. are improve escalators get. I some when parcel very component And that's quality provisions they to including robust in the a metrics XXXX. that there. at to are And care for patients, better whole, our that of core it our committed

allowed consistent contract of participate contract and that cycle. Chattanooga. major to we a actually sort core Blue their on We've get Kaiser us, in think, payers advanced the pretty a to contracts we signings, it's of I embedded, it. And that's with offering Cross this in and how that's in to then Denver of where we the point approach HCA Tennessee to we number So believe, members. facilities And year and of commercial X

access our very contracts country a It's that participate. result we offerings quality our back facilities. commercial as in our platform So now our as have think we outpatient few we we than across service and the a well handful. of don't capabilities with And where less comprehensive that's provide

John Ransom

know data that When could and tag concept just I If on. to the an define amorphous that's what's you quality, you some changed? has that people. use how I set But

Samuel Hazen

mean, have I around on mean, increasing we I have an to don't we know set this have set that I about the that data quality. quality. data time we John, enough talk around call,

for an I and as a before. I about organization. mortality hospital-acquired for service We line, It to infections mentioned processing, marrow have transplant, go cardiovascular includes insights into for to stay to from better care, specific length bone it on on everything of ER metrics complications it. to can as

integrated teams. state that in of an We comes advanced together all corporately with quality agenda our organization. and for a have very And as leadership hospital us with our an

we about even the as transparent. question As we was to more that the and earlier, get next better efficient it, us at and frontier that more see AI asked allowing think

be to of our fairly sort our are grow out. to it's more in what just day offerings attract comprehensive to and and more our a service use So physicians responsive communities is core quality we to do day complex, that ability really because we've simply program continued to our patients and

Operator

Our next from line question Wilkes of Bernstein. the Lance comes from

Lance Wilkes

improvements Can talk your nurses, In in you bit sort a the some seeing just et cetera, inflation in seeing with you're cleanup, as and Medicaid would result your a particular, about are of little what wage ratio? what contracting just of wage about like currently little rates your compensation debt you've been maybe there? too. And of you growth a just a could redetermination, if bad great, quick expense seeing that then you're looking impacts be talk

Mike Marks

So the generally this across generally come our seeing pretty speaking, we're that markets we've year, rates wage as are stable. through

Sam mentioned, including operating stable And X.X% inflation. the marked somewhere that seeing. for I -- we're fairly if I about next as wage that about anticipating environment, think is we've we're think range X.X% and kind for between what a to before of planning year,

volume as So X%, growth the I volume anticipate be quarter admissions or sense at stable, it's use that. On you as as a pretty stability equivalent about next cost, if the impacts, in bad of debt about in that. that don't of we into we give part the to the But and But would uninsured year. bad go significant of would debt terms example. changes we we just the uninsured noted, think an wage you for

Operator

Our question from from comes line of Morgan Stanley. next Hettenbach Craig the

Craig Hettenbach

resiliency a beyond you are that XXXX how the touch program from of you thinking on just can million and timing $XXX about perspective? Mike, million Just savings? to in $XXX in

Mike Marks

Yes, good question.

which length very of stay here third volume capacity accommodated about, we've growth. Labor our been that as to length of of labor A the quarter. and about work our points our from year, gone think this in this our this output one, managed and helpful resiliency we've both year the which through continue year, I management X.X% management, we agenda, around few as gone resiliency, the would see and As about we've seen case be, our just their reduction good as has results stay we've through of we've where talked a additional program.

making help support in us stakeholders. and and to the us of contribute about labor in produce allowed tech Our to our returns to we're our program Using 'XX can kind as think resiliency really allow improvement show to and still to have programs that and fund good global innovation set of resiliency actions this we investments margin and beyond.

then be as our we're and say on tech for of Day, And generally the here kind noted So we pay are as move speaking, I'd investments, X, and innovation decade using deeper years next track. largely resiliency status I at to that program current would Investor going resiliency X to of support we be pleased our margins the I'm that challenges and and the status that the deal come. trajectory overall now. a give and would update into our may the for But program, with with to

Craig Hettenbach

on expect then quick just well? that professional basis. leveling in you fees follow-up on And a XXXX sequential off stable as be it. Do a Got to

Mike Marks

detail in operating to Well, 'XX. little encouraged the deal with and world. we a for that pleased our pressures the have early and our Clearly, again, work specifically physician with hospital-based it's be really a teams physician are giving that doing of level to and been services

of to you our the XX% As grew quarter first prior walk year. this kind year, quarters through

stable for growth year. Our think, that's now we're down that, the second part operating sequential to third grew quarter. seeing to I comment prior we're able And work in quarter XX% keep next year to do that second we quarter, fairly given Sam's XX%. And from in results of environment. the third what were of of a to our

that for same get articulate think so until we that I in And now, would, largely environment would fee I concept. I the pro January, to

Operator

Goldman from comes of question from Jamie the Sachs. next line Our Perse

Jamie Perse

on update. the or status thoughts turning timing of can third looking that Valesco you you that potentially and losses are getting get pricing in just a the what breakeven quarter? Where for improved enterprise around to in And latest was of there? are What's I your profitable? when just

Samuel Hazen

to particular pleased Sam. forth. that's from before, X,XXX so systems as On happened into that We able year. assimilate, were management Valesco, with this the mentioned is group integration HCA and This we're we've physicians

financial maybe plan, whole. the performance. material in Valesco but an appropriate company not as a of with to get we ahead objectives it's to it of our are, on fact, it year, level are Our This slightly to

particular integrated are have for ability our results the rigor, that clinical into We this this clinical build more how routines, physician create we mean, a Valesco group we patients quality with more strategic and because by employed turns is have in fully processing. our of HCA. an more outcomes that, physician to we group can as basically with inside improve capability internal to objectives long-term And asset. that standards Our an do base a I

more our leverage efficiency, room, with execute we to agenda on with our these our this us we we strategic accomplish case second how we agenda, forth. can can it manage asset is relationships make improve think and with in to growth thing into emergency building outreach. journey by how think agenda then embed and help The to help our a group us our physicians we us to so And we physicians thirdly, with tech help referring management

we that So those performance financial value see creation group. with aspects of far the Valesco sort the exceed inside of

it the globally reimbursement to elements improve continue we We our think, and relates the to to our to will parcel be provide payers But more value, hospital-based as with physicians. these other core part and organization initiatives.

Frank Morgan

Okay. Jeremy, we'll take X question. more

Operator

of Our Nephron. Raskin from comes from Joshua line last the question

Joshua Raskin

in X.X% admissions heard lives Medicaid the not in It's decline I Medicaid's actually big total adjusted market. in down So as as the the quarter. were

increases I'm these serving strategy So lines curious or to Are service thinking Medicaid specifically? Medicaid sort patients. broad has capacity and around you to if of funding differently about subpayments impacted state additional Medicaid

Samuel Hazen

them in outpatient for care. the The supplemental Mike development services are our no, produce over for beneficiaries opportunities contrary, certain the to to Medicaid past and through this improve situations markets. where environments invest has and offerings Josh, that on Sam. beneficiaries have created Actually, to for payment Medicaid it we in reimbursement some programs capabilities us it of that some is get makes in alluded easier finding help the better to

see that evaluate beneficiary anything continue don't we'll and to that our available to thinking that. has particular services we core provide around changed I So how

Medicaid. evaluate And and, classes process have down year. through use for XX%, piece we to the other. payer around some some adjusted the a that that mostly, will whole, it's broadly the continue It a because are year moved state redetermination our needs a over is indicated Medicaid really to the redetermination decline we've year. That will centered XX% organization. to HCA so from for how cases, this of of The to don't large of to meet our think our allocate funding of we the redeterminations not admissions in communities as one specifically properly I investments next amongst slow as was business our of process

Operator

in All remarks. for so is the I'll Mr. right. all That back questions the queue closing it Frank over Morgan to turn

Frank Morgan

to you for additional have call. today I'm you thank Jeremy, this our everyone I and Good for help around joining weekend. might day. great answer thanks Hope have. afternoon. a you your can questions

Operator

conference. everyone. That a today's day, does conclude Have pleasant

HCA Healthcare (HCA) 25 Oct 242024 Q3 Earnings call transcript