HCA Healthcare (HCA) investor relations material

Year in review and operational performance

• 2025 is projected to deliver revenue and earnings growth above long-term guidance, supported by policy tailwinds and operational initiatives like caseload and service line optimization.

• Sustained 2%-3% volume growth is driven by strong markets, network expansion, and capital investments, with $4–$5 billion deployed annually and $6.7 billion of capital in flight.

• Outpatient network expansion is a key strategy, with a goal to reach 20 outpatient facilities per hospital by the end of the decade.

• Operational excellence is achieved through scale, shared service platforms, and cost management, resulting in strong margin performance.

• Quality, patient experience, and employee engagement metrics have shown positive trends through the first nine months of the year.

Resiliency and cost optimization initiatives

• Three resiliency domains: workforce development (including Galen College of Nursing and GME programs), network/operational investments, and financial strategies.

• Asset utilization improvements, such as a 2% reduction in length of stay, add capacity without capital outlay.

• Revenue integrity efforts focus on denials and underpayments, with digital tools and AI enhancing administrative and clinical platforms.

• Shared service platforms are leveraged for process improvement and efficiency.

• Preparedness for policy changes, such as EPTC extensions or expirations, is a core focus.

Policy and regulatory environment

• Medicaid reforms from recent legislation are phased in from 2028 over five to seven years, with 60% of Medicaid revenue in less-impacted non-expansion states.

• Five key states filed for supplemental payment program approvals; three have been approved, with others under active review.

• No significant demand pull-forward observed in Q3 due to subsidy concerns; future shifts in beneficiary mix expected if subsidies expire.

• Medicare Advantage comprises 58% of Medicare business, with continued enrollment growth expected due to demographic trends.

• Utilization management by payers remains high, with incremental changes anticipated.