Full Press Release Details
| FOR IMMEDIATE RELEASE | ||
| INVESTOR CONTACT: | MEDIA CONTACT: | |
| Frank Morgan | Harlow Sumerford | |
| 615-344-2688 | 615-344-1851 |
HCA HEALTHCARE REPORTS FIRST QUARTER 2024 RESULTS
Nashville, Tenn., April 26, 2024 HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the first quarter ended March 31, 2024.
Key first quarter metrics (all percentage changes compare 1Q 2024 to 1Q 2023 unless otherwise noted):
The strong fundamentals we saw in our business this past year continued into the first quarter of 2024. This momentum generated strong financial results that were driven primarily by broad-based volume growth, said Sam Hazen, Chief Executive Officer of HCA Healthcare.
Revenues in the first quarter of 2024 totaled $17.339 billion, compared to $15.591 billion in the first quarter of 2023. Net income attributable to HCA Healthcare, Inc. totaled $1.591 billion, or $5.93 per diluted share, compared to $1.363 billion, or $4.85 per diluted share, in the first quarter of 2023. Results for the first quarter of 2024 include gains on sales of facilities of $201 million, or $0.57 per diluted share, primarily related to the sale of a hospital facility in California. Results for the first quarter of 2023 include losses on sales of facilities of $15 million, or $0.08 per diluted share. During the first quarter of 2023, we recorded $145 million of revenues, or $0.40 per diluted share, related to resolving certain disputed claims from prior years with a commercial payer.
For the first quarter of 2024, Adjusted EBITDA totaled $3.353 billion, compared to $3.172 billion in the first quarter of 2023. Adjusted EBITDA is a non-GAAP financial measure. A table providing supplemental information on Adjusted EBITDA and reconciling net income attributable to HCA Healthcare, Inc. to Adjusted EBITDA is included in this release.
Same facility admissions increased 6.2 percent while same facility equivalent admissions increased 5.2 percent in the first quarter of 2024, compared to the prior year period. Same facility emergency room visits increased 7.2 percent in the first quarter of 2024, compared to the prior year period. Same facility inpatient surgeries increased 1.7 percent, and same facility outpatient surgeries declined 2.1 percent in the first quarter of 2024, compared to the same period of 2023. Same facility revenue per equivalent admission increased 3.5 percent in the first quarter of 2024, compared to the first quarter of 2023.
Balance Sheet and Cash Flows from Operations
As of March 31, 2024, HCA Healthcare, Inc. s balance sheet reflected cash and cash equivalents of $1.284 billion, total debt of $40.191 billion, and total assets of $56.962 billion. During the first quarter of 2024, capital expenditures totaled $1.118 billion, excluding acquisitions. Cash flows provided by operating activities in the first quarter of 2024 totaled $2.469 billion, compared to $1.803 billion in the first quarter of 2023.
During the first quarter of 2024, the Company repurchased 3.894 million shares of its common stock at a cost of $1.180 billion. The Company had $5.595 billion remaining under its repurchase authorization as of March 31, 2024. As of March 31, 2024, the Company had $7.987 billion of availability under its credit facilities.
HCA today announced that its Board of Directors declared a quarterly cash dividend of $0.66 per share on the Company s common stock. The dividend will be paid on June 28, 2024 to stockholders of record at the close of business on June 14, 2024.
The declaration and payment of any future dividend will be subject to the discretion of the Board of Directors and will depend on a variety of factors, including the Company s financial condition, results of operations, and contractual restrictions. Future dividends are expected to be funded by cash balances and future cash flows from operations.
Today, the Company reaffirmed its 2024 estimated guidance ranges issued on January 30, 2024.
The Company s 2024 guidance contains a number of assumptions, including, among others, the Company s current expectations regarding patient volumes and payor mix as well as general economic conditions, including inflation, and excludes the impact of items such as, but not limited to, gains or losses on sales of facilities, losses on retirement of debt, legal claims costs and impairment of long-lived assets.
Adjusted EBITDA is a non-GAAP financial measure. A table reconciling forecasted net income attributable to HCA Healthcare, Inc. to forecasted Adjusted EBITDA is included in this release.
The Company s guidance is based on current plans and expectations and is subject to a number of known and unknown uncertainties and risks, including those set forth below in the Company s Forward-Looking Statements.
Earnings Conference Call
HCA Healthcare will host a conference call for investors at 9:00 a.m. Central Time today. All interested investors are invited to access a live audio broadcast of the call via webcast. The broadcast also will be available on a replay basis beginning this afternoon. The webcast can be accessed through the Company s Investor Relations web page at https://investor.hcahealthcare.com/events-and-presentations/default.aspx .
About the Company
As of March 31, 2024, HCA operated 188 hospitals and approximately 2,400 ambulatory sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics, in 20 states and the United Kingdom.
Forward-Looking Statements
This press release contains forward-looking statements within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements include the Company s financial guidance for the year ending December 31, 2024, as well as other statements that do not relate solely to historical or current facts. Forward-looking statements can be identified by the use of words like may, believe, will, expect, project, estimate, anticipate, plan, initiative or continue. These forward-looking statements are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and expectations and our future financial position and results of operations. These factors include, but are not limited to, (1) changes in or related to general economic conditions nationally and regionally in our markets, including inflation and economic and business conditions (and the impact thereof on the economy, financial markets and banking industry); changes in revenues due to declining patient volumes; changes in payer mix (including increases in uninsured and underinsured patients); potential increased expenses related to labor, supply chain or other expenditures; workforce disruptions; supply shortages and disruptions (including as a result of geopolitical disruptions); and the impact of potential federal government shutdowns, (2) the impact of our significant indebtedness and the ability to refinance such indebtedness on acceptable terms, (3) the impact of current and future federal and state health reform initiatives and possible changes to other federal, state or local laws and regulations affecting the health care industry, including, but not limited to, proposals to expand coverage of federally-funded insurance programs as an alternative to private insurance or establish a single-payer system (such reforms often referred to as Medicare for All ), (4) the effects related to the implementation of sequestration spending reductions required under the Budget Control Act of 2011, related legislation extending these reductions and those required under the Pay-As-You-Go Act of 2010 as a result of the federal budget deficit impact of the American Rescue Plan Act of 2021, and the potential for future deficit reduction legislation that may alter these spending reductions, which include cuts to Medicare payments, or create additional spending reductions, (5) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (6) the ability to achieve operating and financial targets, attain expected levels of patient volumes and revenues, and control the costs of providing services, (7) possible changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs, Medicaid waiver programs or state directed payments, that may impact reimbursements to
health care providers and insurers and the size of the uninsured or underinsured population, (8) personnel-related capacity constraints, increases in wages and the ability to attract, utilize and retain qualified management and other personnel, including affiliated physicians, nurses and medical and technical support personnel, (9) the highly competitive nature of the health care business, (10) changes in service mix, revenue mix and surgical volumes, including potential declines in the population covered under third-party payer agreements, the ability to enter into and renew third-party payer provider agreements on acceptable terms and the impact of consumer-driven health plans and physician utilization trends and practices, (11) the efforts of health insurers, health care providers, large employer groups and others to contain health care costs, (12) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (13) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (14) changes in accounting practices, (15) the emergence of and effects related to pandemics, epidemics and outbreaks of infectious diseases or other public health crises, including but not limited to developments related to COVID-19, (16) future divestitures which may result in charges and possible impairments of long-lived assets, (17) changes in business strategy or development plans, (18) delays in receiving payments for services provided, (19) the outcome of pending and any future tax audits, disputes and litigation associated with our tax positions, (20) the impact of known and unknown government investigations, litigation and other claims that may be made against us, (21) the impact of actual and potential cybersecurity incidents or security breaches, including the data security incident disclosed in July 2023, (22) our ongoing ability to demonstrate meaningful use of certified electronic health record technology and the impact of interoperability requirements, (23) the impact of natural disasters, such as hurricanes and floods, physical risks from climate change or similar events beyond our control, (24) changes in U.S. federal, state, or foreign tax laws including interpretive guidance that may be issued by taxing authorities or other standard setting bodies, (25) the results of our efforts to use technology and resilience initiatives, including artificial intelligence and machine learning, to drive efficiencies, better outcomes and an enhanced patient experience, and (26) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2023 and our other filings with the Securities and Exchange Commission. Many of the factors that will determine our future results are beyond our ability to control or predict. In light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management s views only as of the date hereof. We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise. All references to Company, HCA and HCA Healthcare as used throughout this release refer to HCA Healthcare, Inc. and its affiliates.
HCA Healthcare, Inc.
Condensed Consolidated Comprehensive Income Statements
(Dollars in millions, except per share amounts)
| 2024 | 2023 | |||||||||||||||
| Amount | Ratio | Amount | Ratio | |||||||||||||
| Revenues | $17,339 | 100.0 | % | $15,591 | 100.0 | % | ||||||||||
| Salaries and benefits | 7,707 | 44.4 | 7,084 | 45.4 | ||||||||||||
| Supplies | 2,671 | 15.4 | 2,423 | 15.5 | ||||||||||||
| Other operating expenses | 3,606 | 20.9 | 2,894 | 18.7 | ||||||||||||
| Equity in losses of affiliates | 2 | - | 18 | 0.1 | ||||||||||||
| Depreciation and amortization | 795 | 4.5 | 756 | 4.8 | ||||||||||||
| Interest expense | 512 | 3.0 | 479 | 3.1 | ||||||||||||
| Losses (gains) on sales of facilities | (201) | (1.2) | 15 | 0.1 | ||||||||||||
| 15,092 | 87.0 | 13,669 | 87.7 | |||||||||||||
| Income before income taxes | 2,247 | 13.0 | 1,922 | 12.3 | ||||||||||||
| Provision for income taxes | 445 | 2.6 | 379 | 2.4 | ||||||||||||
| Net income | 1,802 | 10.4 | 1,543 | 9.9 | ||||||||||||
| Net income attributable to noncontrolling interests | 211 | 1.2 | 180 | 1.2 | ||||||||||||
| Net income attributable to HCA Healthcare, Inc. | $1,591 | 9.2 | $1,363 | 8.7 | ||||||||||||
| Diluted earnings per share | $5.93 | $4.85 | ||||||||||||||
| Shares used in computing diluted earnings per share (millions) | 268.016 | 280.961 | ||||||||||||||
| Comprehensive income attributable to HCA Healthcare, Inc. | $1,583 | $1,383 |
HCA Healthcare, Inc.
Condensed Consolidated Balance Sheets
(Dollars in millions)
| March 31, | December 31, | |||||||
| 2024 | 2023 | |||||||
| ASSETS | ||||||||
| Current assets: | ||||||||
| Cash and cash equivalents | $1,284 | $935 | ||||||
| Accounts receivable | 10,044 | 9,958 | ||||||
| Inventories | 1,903 | 2,021 | ||||||
| Other | 2,051 | 2,013 | ||||||
| 15,282 | 14,927 | |||||||
| Property and equipment, at cost | 59,440 | 58,548 | ||||||
| Accumulated depreciation | (31,344 | ) | (30,833 | ) | ||||
| 28,096 | 27,715 | |||||||
| Investments of insurance subsidiaries | 471 | 477 | ||||||
| Investments in and advances to affiliates | 736 | 756 | ||||||
| Goodwill and other intangible assets | 9,967 | 9,945 | ||||||
| Right-of-use operating lease assets | 2,211 | 2,207 | ||||||
| Other | 199 | 184 | ||||||
| $56,962 | $56,211 | |||||||
| LIABILITIES AND STOCKHOLDERS EQUITY | ||||||||
| Current liabilities: | ||||||||
| Accounts payable | $4,735 | $4,233 | ||||||
| Accrued salaries | 1,759 | 2,127 | ||||||
| Other accrued expenses | 3,619 | 3,871 | ||||||
| Long-term debt due within one year | 3,028 | 2,424 | ||||||
| 13,141 | 12,655 | |||||||
| Long-term debt, less debt issuance costs and discounts of $381 and $333 | 37,163 | 37,169 | ||||||
| Professional liability risks | 1,571 | 1,557 | ||||||
| Right-of-use operating lease obligations | 1,912 | 1,903 | ||||||
| Income taxes and other liabilities | 1,905 | 1,867 | ||||||
| Stockholders equity: | ||||||||
| Stockholders deficit attributable to HCA Healthcare, Inc. | (1,615 | ) | (1,774 | ) | ||||
| Noncontrolling interests | 2,885 | 2,834 | ||||||
| 1,270 | 1,060 | |||||||
| $56,962 | $56,211 |
HCA Healthcare, Inc.
Condensed Consolidated Statements of Cash Flows
(Dollars in millions)
| 2024 | 2023 | |||||||
| Cash flows from operating activities: | ||||||||
| Net income | $1,802 | $1,543 | ||||||
| Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||
| Increase (decrease) in cash from operating assets and liabilities: | ||||||||
| Accounts receivable | (90 | ) | 238 | |||||
| Inventories and other assets | 77 | (214 | ) | |||||
| Accounts payable and accrued expenses | (517 | ) | (1,066 | ) | ||||
| Depreciation and amortization | 795 | 756 | ||||||
| Income taxes | 444 | 372 | ||||||
| Losses (gains) on sales of facilities | (201 | ) | 15 | |||||
| Amortization of debt issuance costs and discounts | 9 | 9 | ||||||
| Share-based compensation | 87 | 77 | ||||||
| Other | 63 | 73 | ||||||
| Net cash provided by operating activities | 2,469 | 1,803 | ||||||
| Cash flows from investing activities: | ||||||||
| Purchase of property and equipment | (1,118 | ) | (1,197 | ) | ||||
| Acquisition of hospitals and health care entities | (96 | ) | (115 | ) | ||||
| Sales of hospitals and health care entities | 310 | 165 | ||||||
| Change in investments | 2 | (13 | ) | |||||
| Other | (1 | ) | 9 | |||||
| Net cash used in investing activities | (903 | ) | (1,151 | ) | ||||
| Cash flows from financing activities: | ||||||||
| Issuances of long-term debt | 4,483 | |||||||
| Net change in revolving credit facilities | (1,880 | ) | 1,240 | |||||
| Repayment of long-term debt | (2,066 | ) | (550 | ) | ||||
| Distributions to noncontrolling interests | (152 | ) | (187 | ) | ||||
| Payment of debt issuance costs | (40 | ) | (3 | ) | ||||
| Payment of dividends | (185 | ) | (175 | ) | ||||
| Repurchase of common stock | (1,180 | ) | (846 | ) | ||||
| Other | (196 | ) | (204 | ) | ||||
| Net cash used in financing activities | (1,216 | ) | (725 | ) | ||||
| Effect of exchange rate changes on cash and cash equivalents | (1 | ) | 7 | |||||
| Change in cash and cash equivalents | 349 | (66 | ) | |||||
| Cash and cash equivalents at beginning of period | 935 | 908 | ||||||
| Cash and cash equivalents at end of period | $1,284 | $842 | ||||||
| Interest payments | $538 | $574 | ||||||
| Income tax payments, net | $1 | $7 |
HCA Healthcare, Inc.
Operating Statistics
| First Quarter | ||||||||
| 2024 | 2023 | |||||||
| Operations: | ||||||||
| Number of Hospitals | 188 | 180 | ||||||
| Number of Freestanding Outpatient Surgery Centers* | 121 | 126 | ||||||
| Licensed Beds at End of Period | 49,724 | 48,891 | ||||||
| Weighted Average Beds in Service | 42,564 | 41,684 | ||||||
| Reported: | ||||||||
| Admissions | 560,869 | 525,235 | ||||||
| % Change | 6.8% | |||||||
| Equivalent Admissions | 981,521 | 916,535 | ||||||
| % Change | 7.1% | |||||||
| Revenue per Equivalent Admission | $ | 17,666 | $ | 17,011 | ||||
| % Change | 3.9% | |||||||
| Inpatient Revenue per Admission | $ | 18,923 | $ | 17,828 | ||||
| % Change | 6.1% | |||||||
| Patient Days | 2,781,596 | 2,637,903 | ||||||
| % Change | 5.4% | |||||||
| Equivalent Patient Days | 4,867,793 | 4,603,141 | ||||||
| % Change | 5.7% | |||||||
| Inpatient Surgery Cases | 133,398 | 130,460 | ||||||
| % Change | 2.3% | |||||||
| Outpatient Surgery Cases | 252,835 | 255,971 | ||||||
| % Change | -1.2% | |||||||
| Emergency Room Visits | 2,428,914 | 2,252,669 | ||||||
| % Change | 7.8% | |||||||
| Outpatient Revenues as a | ||||||||
| Percentage of Patient Revenues | 36.9% | 37.7% | ||||||
| Average Length of Stay (days) | 4.959 | 5.022 | ||||||
| Occupancy** | 75.2% | 74.0% | ||||||
| Same Facility: | ||||||||
| Admissions | 555,681 | 523,458 | ||||||
| % Change | 6.2% | |||||||
| Equivalent Admissions | 960,772 | 913,434 | ||||||
| % Change | 5.2% | |||||||
| Revenue per Equivalent Admission | $ | 17,569 | $ | 16,981 | ||||
| % Change | 3.5% | |||||||
| Inpatient Revenue per Admission | $ | 18,964 | $ | 17,796 | ||||
| % Change | 6.6% | |||||||
| Inpatient Surgery Cases | 132,274 | 130,010 | ||||||
| % Change | 1.7% | |||||||
| Outpatient Surgery Cases | 247,721 | 253,023 | ||||||
| % Change | -2.1% | |||||||
| Emergency Room Visits | 2,400,190 | 2,238,063 | ||||||
| % Change | 7.2% |
HCA Healthcare, Inc.
Supplemental Non-GAAP Disclosures
Operating Results Summary
(Dollars in millions, except per share amounts)
| First Quarter | ||||||||
| 2024 | 2023 | |||||||
| Revenues | $17,339 | $15,591 | ||||||
| Net income attributable to HCA Healthcare, Inc. | $1,591 | $1,363 | ||||||
| Losses (gains) on sales of facilities (net of tax) | (154) | 22 | ||||||
| Net income attributable to HCA Healthcare, Inc., as adjusted (a) | 1,437 | 1,385 | ||||||
| Depreciation and amortization | 795 | 756 | ||||||
| Interest expense | 512 | 479 | ||||||
| Provision for income taxes | 398 | 372 | ||||||
| Net income attributable to noncontrolling interests | 211 | 180 | ||||||
| Adjusted EBITDA (a) | $3,353 | $3,172 | ||||||
| Adjusted EBITDA margin (a) | 19.3% | 20.3% | ||||||
| Diluted earnings per share: | ||||||||
| Net income attributable to HCA Healthcare, Inc. | $5.93 | $4.85 | ||||||
| Losses (gains) on sales of facilities | (0.57) | 0.08 | ||||||
| Net income attributable to HCA Healthcare, Inc., as adjusted (a) | $5.36 | $4.93 | ||||||
| Shares used in computing diluted earnings per share (millions) | 268.016 | 280.961 |
HCA Healthcare, Inc.
Supplemental Non-GAAP Disclosures
2024 Operating Results Forecast
(Dollars in millions, except per share amounts)
| For the Year Ending | ||||||||
| December 31, 2024 | ||||||||
| Low | High | |||||||
| Revenues | $67,750 | $70,250 | ||||||
| Net income attributable to HCA Healthcare, Inc. (a) | $5,200 | $5,600 | ||||||
| Depreciation and amortization | 3,200 | 3,270 | ||||||
| Interest expense | 1,985 | 2,040 | ||||||
| Provision for income taxes | 1,615 | 1,740 | ||||||
| Net income attributable to noncontrolling interests | 850 | 900 | ||||||
| Adjusted EBITDA (a) (b) | $12,850 | $13,550 | ||||||
| Diluted earnings per share: | ||||||||
| Net income attributable to HCA Healthcare, Inc. | $19.70 | $21.20 | ||||||
| Shares used in computing diluted earnings per share (millions) | 264.000 | 264.000 |
The Company s forecasted guidance range is based on current plans and expectations and is subject to a number of known and unknown uncertainties and risks.