INVESTOR CONTACT: MEDIA CONTACT: Mark Kimbrough Harlow Sumerford 615-344-2688 615-344-1851 HCA Reports Fourth Quarter 2019 Results and Provides 2020 Guidance Board Authorizes Additional $2 Billion S

HCA Reports Fourth Quarter 2019 Results

and Provides 2020 Guidance

Board Authorizes Additional $2 Billion Share Repurchase Program

and Increases Quarterly Dividend

Nashville, Tenn., January 28, 2020 HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the fourth quarter ended December 31, 2019.

Key fourth quarter metrics (all percentage changes compare 4Q 2019 to 4Q 2018 unless otherwise noted):

Revenues in the fourth quarter of 2019 increased to $13.523 billion, compared to $12.274 billion in the fourth quarter of 2018. Net income attributable to HCA Healthcare, Inc. totaled $1.071 billion, or $3.09 per diluted share, compared to $1.064 billion, or $3.01 per diluted share, in the fourth quarter of 2018. Results for the fourth quarter of 2018 included gains on sales of facilities of $8 million, or $0.02 per diluted share. In the fourth quarter of 2018 we recorded a $67 million, or $0.19 per diluted share, favorable adjustment to our deferred tax assets and liabilities related to the impact of the Tax Cuts and Jobs Act.

For the fourth quarter of 2019, Adjusted EBITDA totaled $2.738 billion, compared to $2.508 billion in the fourth quarter of 2018. 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.

During the fourth quarter of 2018, the Company incurred additional expenses and experienced losses of revenues estimated at $31 million, or $0.07 per diluted share, associated with Hurricane Michael s impact on our Florida panhandle facilities. This amount is prior to any potential insurance recoveries. Also, during the fourth quarter of 2018, the Company recorded a benefit of $49 million, or $0.11 per diluted share, from an insurance recovery related to Hurricane Harvey business interruption losses incurred during 2017.

Same facility admissions and same facility equivalent admissions increased 4.7 percent and 5.0 percent, respectively, in the fourth quarter of 2019 compared to the prior year period. Same facility emergency room visits increased 6.7 percent in the fourth quarter of 2019, compared to the prior year period. Same facility inpatient surgeries increased 2.1 percent, and same facility outpatient surgeries increased 1.8 percent in the fourth quarter of 2019, compared to the same period of 2018. Same facility revenue per equivalent admission increased 1.1 percent in the fourth quarter of 2019, compared to the fourth quarter of 2018.

Salaries and benefits, supplies and other operating expenses totaled $10.805 billion, or 79.8 percent of revenues, in the fourth quarter of 2019, compared to $9.770 billion, or 79.6 percent of revenues, in the fourth quarter of 2018.

Year Ended December 31, 2019

Revenues for the year ended December 31, 2019 totaled $51.336 billion, compared to $46.677 billion in the year ended December 31, 2018. Net income attributable to HCA Healthcare, Inc. was $3.505 billion, or $10.07 per diluted share, compared to $3.787 billion, or $10.66 per diluted share, for the year ended December 31, 2018. Results for the year ended December 31, 2019 include gains on sales of facilities of $18 million, or $0.04 per diluted share, and losses on retirement of debt of $211 million, or $0.47 per diluted share. Results for 2018 included gains on sales of facilities of $428 million, or $0.91 per diluted share, and losses on retirement of debt of $9 million, or $0.02 per diluted share.

For 2019, Adjusted EBITDA totaled $9.857 billion compared to $8.949 billion in 2018. 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.

Balance Sheet and Cash Flows from Operations

As of December 31, 2019, HCA Healthcare, Inc. s balance sheet reflected cash and cash equivalents of $621 million, total debt of $33.722 billion, and total assets of $45.058 billion. During the fourth quarter of 2019, capital expenditures totaled $1.274 billion, excluding acquisitions. Cash flows provided by operating activities in the fourth quarter totaled $2.505 billion, compared to $2.175 billion in the fourth quarter of 2018.

During the fourth quarter of 2019, the Company repurchased 2.069 million shares of its common stock at a cost of $272 million, and during the year ended December 31, 2019, repurchased 7.949 million shares of its common stock at a cost of $1.031 billion. The Company had $1.241 billion remaining under its existing repurchase authorization as of December 31, 2019.

Share Repurchase Program

The HCA Healthcare, Inc. Board of Directors has authorized an additional share repurchase program for up to $2 billion of the Company s outstanding common stock. Repurchases will be made in accordance with applicable securities laws and may be made at management s discretion from time to time in the open market, through privately negotiated transactions, or otherwise. The repurchase program has no time limit and may be suspended for periods or discontinued at any time.

HCA today announced that its Board of Directors declared a quarterly cash dividend of $0.43 per share on the Company s common stock. The dividend will be paid on March 31, 2020 to stockholders of record at the close of business on March 2, 2020.

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 and results of operations and contractual restrictions. Future dividends are expected to be funded by future cash flows from operations.

Today, HCA issued the following estimated guidance for 2020:

The Company s 2020 guidance contains a number of assumptions 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.

Annual Stockholders Meeting

The Company s 2020 annual stockholders meeting will be held in Nashville, Tennessee on May 1, 2020 at 2:00 p.m. local time for stockholders of record as of March 9, 2020.

Earnings Conference Call

HCA will host a conference call for investors at 9:00 a.m. Central Standard 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 at https://event.webcasts.com/starthere.jsp?ei=1279390&tp_key=c73d4ed596 or through the Company s Investor Relations web page at www.hcahealthcare.com.

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, 2020, 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) the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, (2) the impact of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the Affordable Care Act ), including the effects of court challenges to, any repeal of, or changes to, the Affordable Care Act or additional changes to its implementation, the possible enactment of additional federal or state health care reforms and possible changes to other federal, state or local laws or regulations affecting the health care industry, including single-payer proposals (often referred to as Medicare for All ), (3) the effects related to the continued implementation of the sequestration spending reductions required under the Budget Control Act of 2011, and related legislation extending these reductions, 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, (4) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (5) the ability to achieve operating and financial targets, and attain expected levels of patient volumes and control the costs of providing services, (6) possible changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs or Medicaid waiver programs, that may impact reimbursements to health care providers and insurers and the size of the uninsured or underinsured population, (7) the highly competitive nature of the health care business, (8) 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, (9) the efforts of health insurers, health care providers, large employer groups and others to contain health care costs, (10) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (11) increases in wages and the ability to attract and retain qualified management and personnel, including affiliated physicians, nurses and medical and technical support personnel, (12) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (13) changes in accounting practices, (14) changes in general economic conditions nationally and regionally in our markets, (15) the emergence of and effects related to infectious diseases, (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) potential adverse impact of known and unknown government

investigations, litigation and other claims that may be made against us, (21) the impact of potential cybersecurity incidents or security breaches, (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, or similar events beyond our control, (24) the effects of the 2017 Tax Cuts and Jobs Act, including potential legislation or interpretive guidance that may be issued by federal and state taxing authorities or other standard-setting bodies, and (25) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2018 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 and HCA 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)

HCA Healthcare, Inc.

Condensed Consolidated Comprehensive Income Statements

For the Years Ended December 31, 2019 and 2018

(Dollars in millions, except per share amounts)

HCA Healthcare, Inc.

Condensed Consolidated Balance Sheets

(Dollars in millions)

HCA Healthcare, Inc.

Consolidated Statements of Cash Flows

For the Years Ended December 31, 2019 and 2018

(Dollars in millions)

HCA Healthcare, Inc.

Operating Statistics

HCA Healthcare, Inc.

Supplemental Non-GAAP Disclosures

Operating Results Summary

(Dollars in millions, except per share amounts)

Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities and losses on retirement of debt, and GAAP net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry. It is reasonable to expect that gains on sales of facilities and losses on retirement of debt will occur in future periods, but the amounts recognized can vary significantly from period to period, do not directly relate to the ongoing operations of our health care facilities and complicate period comparisons of our results of operations and operations comparisons with other health care companies.

Net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are not measures of financial performance under GAAP, and should not be considered as alternatives to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are not measurements determined in accordance with GAAP and are susceptible to varying calculations, net income attributable to HCA Healthcare, Inc., excluding gains on sales of facilities and losses on retirement of debt, and Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.

HCA Healthcare, Inc.

Supplemental Non-GAAP Disclosures

2020 Operating Results Forecast

(Dollars in millions, except per share amounts)

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.

Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry.

Adjusted EBITDA is not a measure of financial performance under GAAP and should not be considered as an alternative to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because Adjusted EBITDA is not a measurement determined in accordance with GAAP and is susceptible to varying calculations, Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.