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Item 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS
Forward-Lookin****g Statements
This quarterly report on Form 10-Q includes certain disclosures that contain “forward-looking statements” within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements include statements regarding expected capital expenditures, expected dividends, expected share repurchases, expected net claim payments, expected inflationary pressures, expected labor costs and all other statements that do not relate solely to historical or current facts, and 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 or business conditions nationally and regionally in our markets, including inflation, and the impact of trade policies, including changes in, or the imposition of, tariffs and/or trade barriers; changes in revenues resulting from declining patient volumes; changes in payer mix (including increases in uninsured and underinsured patients); potential increased expenses related to labor, pharmaceuticals, supply chain or other expenditures; workforce disruptions; supply and pharmaceutical shortages and disruptions (including as a result of tariffs or geopolitical disruptions); and the impact of potential federal government shutdowns, holds on or cancellations of congressionally authorized spending and interruptions in the distribution of governmental funds, (2) the impact of current and future health care public policy developments and the implementation of new, and possible changes to existing, federal, state or local laws and regulations affecting the health care industry, including the expiration of enhanced premium tax credits (“EPTCs”) for individuals eligible to purchase insurance coverage through federal and state-based health insurance marketplaces, changes in the structure and administration of, and funding for, federal and state agencies and programs, and effects of the One Big Beautiful Bill Act (the “OBBBA”), (3) the impact of our significant indebtedness and the ability to refinance such indebtedness on acceptable terms, (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 that may be required under the Pay-As-You-Go Act of 2010 as a result of the federal budget deficit impact of the OBBBA, 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) the ability to achieve operating and financial targets, develop and execute resiliency plans to offset to the extent possible impacts from the OBBBA, the scheduled expiration of EPTCs and tariffs, attain expected levels of patient volumes and revenues, and control the costs of providing services, (6) possible reductions or other changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs, Medicaid waiver programs and state directed payment (“SDP”) arrangements, any of which may negatively impact reimbursements to health care providers and insurers and the size of the uninsured or underinsured population, (7) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (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, (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 involving us or our vendors and other third parties, (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, including Hurricanes Milton and Helene, physical risks from changing global weather patterns or similar events beyond our control on our assets and activities and the communities we serve, (24) changes in U.S. federal, state, or foreign tax laws, interpretations of tax laws by taxing authorities, other standard setting bodies or judicial decisions, (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, 2024 and our other filings with the Securities and Exchange Commission. As a consequence, current plans, anticipated actions and future financial position and results of operations may differ from those expressed in any forward-looking statements made by or on behalf of HCA. You are cautioned not to unduly rely on such forward-looking statements when evaluating the information presented in this report, which forward-looking statements reflect management’s views only as of the date of this report. We undertake no obligation to revise or update any forward-looking statements, whether as a result of new information, future events or otherwise.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Second Quarter 2025 Operations Summary
Revenues increased to $18.605 billion in the second quarter of 2025 from $17.492 billion in the second quarter of 2024. Net income attributable to HCA Healthcare, Inc. totaled $1.653 billion, or $6.83 per diluted share, for the quarter ended June 30, 2025, compared to $1.461 billion, or $5.53 per diluted share, for the quarter ended June 30, 2024. Second quarter results for 2025 and 2024 include losses on sales of facilities of $3 million, or $0.01 per diluted share, and gains on sales of facilities of $12 million, or $0.03 per diluted share, respectively. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes. Shares used for diluted earnings per share were 241.911 million shares for the quarter ended June 30, 2025 and 264.071 million shares for the quarter ended June 30, 2024. During 2024 and the first six months of 2025, we repurchased 17.798 million shares and 14.793 million shares, respectively, of our common stock.
Revenues increased 6.4% on a consolidated basis and 5.8% on a same facility basis for the quarter ended June 30, 2025, compared to the quarter ended June 30, 2024. The increase in consolidated revenues can be primarily attributed to the combined impact of a 3.9% increase in revenue per equivalent admission and a 2.3% increase in equivalent admissions. The same facility revenues increase primarily resulted from the combined impact of a 4.0% increase in same facility revenue per equivalent admission and a 1.7% increase in same facility equivalent admissions.
During the quarter ended June 30, 2025, consolidated admissions increased 2.1% and same facility admissions increased 1.8% compared to the quarter ended June 30, 2024. Inpatient surgical volumes increased 0.2% on a consolidated basis and declined 0.3% on a same facility basis during the quarter ended June 30, 2025, compared to the quarter ended June 30, 2024. Outpatient surgical volumes declined 0.2% on a consolidated basis and 0.6% on a same facility basis during the quarter ended June 30, 2025, compared to the quarter ended June 30, 2024. Emergency department visits increased 1.0% on a consolidated basis and 1.3% on a same facility basis during the quarter ended June 30, 2025, compared to the quarter ended June 30, 2024. Consolidated and same facility uninsured admissions increased 1.1% and 0.4%, respectively, for the quarter ended June 30, 2025, compared to the quarter ended June 30, 2024.
Cash flows from operating activities increased $2.239 billion, from $1.971 billion for the second quarter of 2024 to $4.210 billion for the second quarter of 2025. The increase in cash provided by operating activities was primarily related to a $216 million increase in net income, excluding the non-cash impact of losses and gains on sales of facilities, favorable working capital changes of $1.186 billion, including increased collections on accounts receivable, as well as a decline in income taxes paid of $862 million related to an IRS deferral of quarterly estimated income tax payments for Tennessee-based taxpayers until the fourth quarter of 2025.
Recent Developments
The OBBBA is the federal budget reconciliation bill enacted into law on July 4, 2025. The OBBBA includes significant health care policy changes that are expected to decrease access to health insurance and result in reductions to federal health care spending, particularly within the Medicaid program. The law limits eligibility for Medicaid by imposing work or community engagement requirements for adults under 65 in the Medicaid expansion states, including states with waiver-based expansions, subject to limited exceptions, and requires eligibility redeterminations at least every six months for the Medicaid expansion state population, with state compliance required by December 31, 2026. In addition, the law makes significant changes to Medicaid financing mechanisms, including restrictions intended to reduce the federal matching funds received by state Medicaid programs. The OBBBA prohibits states from establishing new provider taxes or increasing rates of existing provider taxes for state fiscal years beginning after October 1, 2026, while also limiting the structure and applicability of such taxes, with greater restrictions in states that have expanded Medicaid. For example, beginning in federal fiscal year 2028, the OBBBA reduces this 6% tax limit by 0.5% annually in states that have expanded Medicaid under the Affordable Care Act, until the safe harbor limit in those states reaches 3.5% in federal fiscal year 2032, subject to certain exceptions. The law also directs the Department of Health and Human Services to revise regulations governing SDP arrangements, which many states have implemented to direct certain Medicaid managed care expenditures. These regulations must cap total payment rates paid by Medicaid managed care organizations for specified services, including hospital services, by tying caps to Medicare payment rates instead of average commercial rates and imposing lower caps in Medicaid expansion states. The revised regulations will apply to SDPs made for services furnished in the rating periods beginning on or after July 4, 2025. However, the OBBBA grandfathers certain SDP arrangements, including those for which an application form was submitted to the Centers for Medicare & Medicaid Services (“CMS”) prior to July 4, 2025, for the rating period occurring within 180 days of July 4, 2025, and those that received approval or made a good faith effort to receive approval from CMS prior to May 1, 2025. Beginning January 1, 2028, grandfathered payments will be reduced by 10 percentage points annually until they reach the allowable payment limits. The law also contains provisions requiring pre-enrollment verification of Medicaid eligibility.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Recent Developments (continued)
The OBBBA also makes changes that are expected to impact insurance coverage obtained through federal and state-based health insurance marketplaces (“Exchanges”) by effectively ending automatic renewals of enrollment by requiring pre-enrollment verification and annual re-verification of tax credit eligibility, among other measures. In addition, CMS issued in June 2025 a final rule that standardizes and shortens the open enrollment period for individual market coverage both on and off the Exchanges, imposes limitations on eligibility for enrollment through the Exchanges and for EPTCs, and requires stricter income verification measures, among other changes. This rule is currently the subject of legal challenges. The provisions directly impacting Exchanges under the OBBBA and the final rule take effect at various times over the next three years.
We are monitoring and engaged in advocacy efforts around these and other health care policy changes and reform initiatives. In addition, we are working to develop and implement resiliency plans designed to enhance efficiency and reduce costs in response to the potential impact of these developments, as well as the scheduled expiration of EPTCs for individuals eligible to purchase coverage through federal and state health insurance marketplaces and potential impacts of changes to U.S. trade policy and tariff levels. However, our ability to develop and implement such plans and to offset to the extent possible impacts from these matters is subject to known and unknown risks and uncertainties. See Item 1A, “Risk Factors” from our Annual Report on Form 10-K for the year ended December 31, 2024 for additional information.
The OBBBA also included a number of tax provisions, including permanently reinstating the 100% bonus depreciation provisions of the Tax Cuts and Jobs Act of 2017 that allow businesses to immediately deduct the full cost of qualifying property placed into service on or after January 20, 2025.
Results of Operations
Revenue/Volume Trends
Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the health insurance exchanges), and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals.
Revenues increased 6.4% from $17.492 billion in the second quarter of 2024 to $18.605 billion in the second quarter of 2025. Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual adjustments under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured and other discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay revenues at the estimated amounts we expect to collect. Patients treated at our hospitals for non-elective care, who have income at or below 400% of the federal poverty level, are eligible for charity care. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. Our revenues by primary third-party payer classification and other (including uninsured patients) for the quarters and six months ended June 30, 2025 and 2024 are summarized in the following table (dollars in millions):
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Revenue/Volume Trends (continued)
| Quarter | ||||||||||||||||
| 2025 | Ratio | 2024 | Ratio | |||||||||||||
| Medicare | $ | 2,803 | 15.1 | % | $ | 2,621 | 15.0 | % | ||||||||
| Managed Medicare | 3,352 | 18.0 | 2,913 | 16.7 | ||||||||||||
| Medicaid | 1,440 | 7.7 | 1,166 | 6.7 | ||||||||||||
| Managed Medicaid | 899 | 4.8 | 1,033 | 5.9 | ||||||||||||
| Managed care and insurers | 9,124 | 49.1 | 8,549 | 48.7 | ||||||||||||
| International (managed care and insurers) | 461 | 2.5 | 416 | 2.4 | ||||||||||||
| Other | 526 | 2.8 | 794 | 4.6 | ||||||||||||
| Revenues | $ | 18,605 | 100.0 | % | $ | 17,492 | 100.0 | % | ||||||||
| Six Months | ||||||||||||||||
| 2025 | Ratio | 2024 | Ratio | |||||||||||||
| Medicare | $ | 5,698 | 15.4 | % | $ | 5,459 | 15.7 | % | ||||||||
| Managed Medicare | 6,651 | 18.0 | 5,939 | 17.0 | ||||||||||||
| Medicaid | 2,630 | 7.1 | 2,189 | 6.3 | ||||||||||||
| Managed Medicaid | 1,778 | 4.8 | 2,011 | 5.8 | ||||||||||||
| Managed care and insurers | 18,165 | 49.2 | 17,094 | 49.0 | ||||||||||||
| International (managed care and insurers) | 906 | 2.5 | 828 | 2.4 | ||||||||||||
| Other | 1,098 | 3.0 | 1,311 | 3.8 | ||||||||||||
| Revenues | $ | 36,926 | 100.0 | % | $ | 34,831 | 100.0 | % |
Consolidated and same facility revenue per equivalent admission increased 3.9% and 4.0%, respectively, in the second quarter of 2025, compared to the second quarter of 2024. Consolidated and same facility equivalent admissions increased 2.3% and 1.7%, respectively, in the second quarter of 2025, compared to the second quarter of 2024. Consolidated and same facility outpatient surgeries declined 0.2% and 0.6%, respectively, in the second quarter of 2025, compared to the second quarter of 2024. Consolidated and same facility inpatient surgeries increased 0.2% and declined 0.3%, respectively, in the second quarter of 2025, compared to the second quarter of 2024. Consolidated and same facility emergency department visits increased 1.0% and 1.3%, respectively, in the second quarter of 2025, compared to the second quarter of 2024.
To quantify the total impact of the trends related to uninsured patient accounts, we believe it is beneficial to view total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. A summary of the estimated cost of total uncompensated care for the quarters and six months ended June 30, 2025 and 2024 follows (dollars in millions):
| Quarter | Six Months | |||||||||||||||
| 2025 | 2024 | 2025 | 2024 | |||||||||||||
| Patient care costs (salaries and benefits, supplies, other operating expense and depreciation and amortization) | $ | 15,638 | $ | 14,761 | $ | 31,104 | $ | 29,540 | ||||||||
| Cost-to-charges ratio (patient care costs as percentage of gross patient charges) | 9.7 | % | 10.1 | % | 9.6 | % | 10.1 | % | ||||||||
| Total uncompensated care | $ | 11,625 | $ | 10,611 | $ | 22,618 | $ | 20,613 | ||||||||
| Multiply by the cost-to-charges ratio | 9.7 | % | 10.1 | % | 9.6 | % | 10.1 | % | ||||||||
| Estimated cost of total uncompensated care | $ | 1,116 | $ | 1,072 | $ | 2,171 | $ | 2,082 |
Same facility uninsured admissions increased 0.4% in the second quarter of 2025 compared to the second quarter of 2024. Same facility uninsured admissions declined 0.7% in the first quarter of 2025 compared to the first quarter of 2024. Same facility uninsured admissions in 2024, compared to 2023, increased 0.1% in the fourth quarter, declined 1.8% in the third quarter, increased 3.5% in the second quarter and increased 2.4% in the first quarter.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Revenue/Volume Trends (continued)
The approximate percentages of our admissions related to Medicare, managed Medicare, Medicaid, managed Medicaid, managed care and insurers and the uninsured for the quarters and six months ended June 30, 2025 and 2024 are set forth in the following table.
| Quarter | Six Months | |||||||||||||||
| 2025 | 2024 | 2025 | 2024 | |||||||||||||
| Medicare | 19 | % | 20 | % | 20 | % | 20 | % | ||||||||
| Managed Medicare | 27 | 26 | 27 | 26 | ||||||||||||
| Medicaid | 4 | 4 | 4 | 4 | ||||||||||||
| Managed Medicaid | 11 | 11 | 11 | 11 | ||||||||||||
| Managed care and insurers | 32 | 32 | 32 | 32 | ||||||||||||
| Uninsured | 7 | 7 | 6 | 7 | ||||||||||||
| 100 | % | 100 | % | 100 | % | 100 | % |
The approximate percentages of our inpatient revenues related to Medicare, managed Medicare, Medicaid, managed Medicaid, managed care and insurers for the quarters and six months ended June 30, 2025 and 2024 are set forth in the following table.
| Quarter | Six Months | |||||||||||||||
| 2025 | 2024 | 2025 | 2024 | |||||||||||||
| Medicare | 20 | % | 20 | % | 20 | % | 20 | % | ||||||||
| Managed Medicare | 20 | 18 | 20 | 19 | ||||||||||||
| Medicaid | 12 | 10 | 11 | 10 | ||||||||||||
| Managed Medicaid | 5 | 7 | 5 | 7 | ||||||||||||
| Managed care and insurers | 43 | 45 | 44 | 44 | ||||||||||||
| 100 | % | 100 | % | 100 | % | 100 | % |
At June 30, 2025, we had 102 hospitals in the states of Texas and Florida. During the quarter ended June 30, 2025, 59% of our admissions and 52% of our revenues were generated by these hospitals. Uninsured admissions in Texas and Florida represented 73% of our uninsured admissions during the quarter ended June 30, 2025.
We receive a significant portion of our revenues from government health programs, principally Medicare and Medicaid, which are highly regulated and subject to frequent and substantial changes. Some states make additional payments to providers through the Medicaid program that are separate from base payments. These payments may be in the form of payments, such as upper payment limit payments, that are intended to address the difference between Medicaid fee-for-service payments and Medicare reimbursement rates, or payments under other programs that vary by state under Section 1115 waivers. In addition, many states have implemented SDP arrangements to direct certain Medicaid managed care plan expenditures. These payments are generally authorized by CMS and subject to periodic extension or reapproval. Most states in which we receive payment have adopted statewide or local provider taxes to fund the non-federal share of Medicaid programs. These additional payments supplement Medicaid base rates that, when taken together, are insufficient to cover the cost of care provided to Medicaid beneficiaries combined with the state or local provider taxes levied.
We are aware these payment programs are currently being reviewed by certain government agencies, and some states requested modifications of their existing supplemental payment programs during the annual renewal process with CMS. It is possible these reviews and requests will result in the restructuring of such supplemental payment programs and could result in the payment programs being reduced or eliminated. Because deliberations about these programs are ongoing, we are unable to estimate the financial impact the program structure modifications, if any, may have on our results of operations.
The health care industry is subject to changing political, regulatory and other influences, including health care reform efforts at the federal and state levels and the OBBBA. For example, the EPTCs for individuals eligible to purchase insurance coverage through federal and state-based health insurance marketplaces are scheduled to expire at the end of 2025, and further extension is uncertain. We are monitoring and engaged in advocacy efforts around potential health care policy changes and reform. See the "Recent Developments" section of this Quarterly Report on Form 10-Q and Item 1A, “Risk Factors” from our Annual Report on Form 10-K for the year ended December 31, 2024 for additional information.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Key Performance Indicators
We present certain metrics and statistical information that management uses when assessing our results of operations. We believe this information is useful to investors as it provides insight to how management evaluates operational performance and trends between reporting periods. Information on how these metrics and statistical information are defined is provided in the following tables summarizing operating results and operating data.
Operating Results Summary
The following is a comparative summary of results of operations for the quarters and six months ended June 30, 2025 and 2024 (dollars in millions):
| Quarter | ||||||||||||||||
| 2025 | 2024 | |||||||||||||||
| Amount | Ratio | Amount | Ratio | |||||||||||||
| Revenues | $ | 18,605 | 100.0 | $ | 17,492 | 100.0 | ||||||||||
| Salaries and benefits | 8,138 | 43.7 | 7,685 | 43.9 | ||||||||||||
| Supplies | 2,844 | 15.3 | 2,634 | 15.1 | ||||||||||||
| Other operating expenses | 3,793 | 20.4 | 3,623 | 20.7 | ||||||||||||
| Equity in (earnings) losses of affiliates | (19 | ) | (0.1 | ) | — | — | ||||||||||
| Depreciation and amortization | 863 | 4.7 | 819 | 4.7 | ||||||||||||
| Interest expense | 568 | 3.0 | 506 | 2.9 | ||||||||||||
| Losses (gains) on sales of facilities | 3 | — | (12 | ) | (0.1 | ) | ||||||||||
| 16,190 | 87.0 | 15,255 | 87.2 | |||||||||||||
| Income before income taxes | 2,415 | 13.0 | 2,237 | 12.8 | ||||||||||||
| Provision for income taxes | 524 | 2.8 | 550 | 3.2 | ||||||||||||
| Net income | 1,891 | 10.2 | 1,687 | 9.6 | ||||||||||||
| Net income attributable to noncontrolling interests | 238 | 1.3 | 226 | 1.2 | ||||||||||||
| Net income attributable to HCA Healthcare, Inc. | $ | 1,653 | 8.9 | $ | 1,461 | 8.4 | ||||||||||
| % changes from prior year: | ||||||||||||||||
| Revenues | 6.4 | % | 10.3 | % | ||||||||||||
| Income before income taxes | 8.0 | 23.7 | ||||||||||||||
| Net income attributable to HCA Healthcare, Inc. | 13.1 | 22.5 | ||||||||||||||
| Admissions(a) | 2.1 | 6.0 | ||||||||||||||
| Equivalent admissions(b) | 2.3 | 6.0 | ||||||||||||||
| Revenue per equivalent admission | 3.9 | 4.1 | ||||||||||||||
| Same facility % changes from prior year(c): | ||||||||||||||||
| Revenues | 5.8 | 9.9 | ||||||||||||||
| Admissions(a) | 1.8 | 5.8 | ||||||||||||||
| Equivalent admissions(b) | 1.7 | 5.2 | ||||||||||||||
| Revenue per equivalent admission | 4.0 | 4.4 |
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Operating Results Summary (continued)
| Six Months | ||||||||||||||||
| 2025 | 2024 | |||||||||||||||
| Amount | Ratio | Amount | Ratio | |||||||||||||
| Revenues | $ | 36,926 | 100.0 | $ | 34,831 | 100.0 | ||||||||||
| Salaries and benefits | 16,135 | 43.7 | 15,392 | 44.2 | ||||||||||||
| Supplies | 5,608 | 15.2 | 5,305 | 15.2 | ||||||||||||
| Other operating expenses | 7,638 | 20.7 | 7,229 | 20.8 | ||||||||||||
| Equity in (earnings) losses of affiliates | (37 | ) | (0.1 | ) | 2 | — | ||||||||||
| Depreciation and amortization | 1,723 | 4.7 | 1,614 | 4.6 | ||||||||||||
| Interest expense | 1,115 | 3.0 | 1,018 | 2.9 | ||||||||||||
| Losses (gains) on sales of facilities | 2 | — | (213 | ) | (0.6 | ) | ||||||||||
| 32,184 | 87.2 | 30,347 | 87.1 | |||||||||||||
| Income before income taxes | 4,742 | 12.8 | 4,484 | 12.9 | ||||||||||||
| Provision for income taxes | 1,026 | 2.7 | 995 | 2.9 | ||||||||||||
| Net income | 3,716 | 10.1 | 3,489 | 10.0 | ||||||||||||
| Net income attributable to noncontrolling interests | 453 | 1.3 | 437 | 1.2 | ||||||||||||
| Net income attributable to HCA Healthcare, Inc. | $ | 3,263 | 8.8 | $ | 3,052 | 8.8 | ||||||||||
| % changes from prior year: | ||||||||||||||||
| Revenues | 6.0 | % | 10.7 | % | ||||||||||||
| Income before income taxes | 5.8 | 20.2 | ||||||||||||||
| Net income attributable to HCA Healthcare, Inc. | 6.9 | 19.4 | ||||||||||||||
| Admissions(a) | 2.4 | 6.4 | ||||||||||||||
| Equivalent admissions(b) | 2.7 | 6.5 | ||||||||||||||
| Revenue per equivalent admission | 3.2 | 4.0 | ||||||||||||||
| Same facility % changes from prior year(c): | ||||||||||||||||
| Revenues | 5.9 | 9.4 | ||||||||||||||
| Admissions(a) | 2.3 | 6.0 | ||||||||||||||
| Equivalent admissions(b) | 2.3 | 5.2 | ||||||||||||||
| Revenue per equivalent admission | 3.6 | 3.9 |
(a)
Represents the total number of patients admitted to our hospitals and is used by management and certain investors as a general measure of inpatient volume.
(b)
Equivalent admissions are used by management and certain investors as a general measure of combined inpatient and outpatient volume. Equivalent admissions are computed by multiplying admissions (inpatient volume) by the sum of gross inpatient revenues and gross outpatient revenues and then dividing the resulting amount by gross inpatient revenues. The equivalent admissions computation “equates” outpatient revenues to the volume measure (admissions) used to measure inpatient volume, resulting in a general measure of combined inpatient and outpatient volume.
(c)
Same facility information excludes the operations of hospitals and their related facilities which were either acquired or divested during the current and prior period.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Quarters Ended June 30, 2025 and 2024
Revenues increased to $18.605 billion in the second quarter of 2025 from $17.492 billion in the second quarter of 2024. Net income attributable to HCA Healthcare, Inc. totaled $1.653 billion, or $6.83 per diluted share, for the quarter ended June 30, 2025, compared to $1.461 billion, or $5.53 per diluted share, for the quarter ended June 30, 2024. Second quarter results for 2025 and 2024 include losses on sales of facilities of $3 million, or $0.01 per diluted share, and gains on sales of facilities of $12 million, or $0.03 per diluted share, respectively. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes. Shares used for diluted earnings per share were 241.911 million shares for the quarter ended June 30, 2025 and 264.071 million shares for the quarter ended June 30, 2024. During 2024 and the first six months of 2025, we repurchased 17.798 million shares and 14.793 million shares, respectively, of our common stock.
Revenues increased 6.4% on a consolidated basis and 5.8% on a same facility basis for the quarter ended June 30, 2025, compared to the quarter ended June 30, 2024. The increase in consolidated revenues can be primarily attributed to the combined impact of a 3.9% increase in revenue per equivalent admission and a 2.3% increase in equivalent admissions. The same facility revenues increase primarily resulted from the combined impact of a 4.0% increase in same facility revenue per equivalent admission and a 1.7% increase in same facility equivalent admissions.
Salaries and benefits, as a percentage of revenues, were 43.7% in the second quarter of 2025 and 43.9% in the second quarter of 2024. Salaries and benefits per equivalent admission increased 3.5% in the second quarter of 2025, compared to the second quarter of 2024. Same facility salaries and benefits per full time equivalent increased 3.4% for the second quarter of 2025, compared to the second quarter of 2024.
Supplies, as a percentage of revenues, were 15.3% in the second quarter of 2025 and 15.1% in the second quarter of 2024. Supply costs per equivalent admission increased 5.5% in the second quarter of 2025, compared to the second quarter of 2024. Supply costs per equivalent admission increased 10.2% for medical devices and 2.1% for general medical and surgical items and declined 0.3% for pharmacy supplies in the second quarter of 2025, compared to the second quarter of 2024. The increase in supply costs per equivalent admission for medical devices is primarily related to cardiovascular technologies.
Other operating expenses, as a percentage of revenues, were 20.4% in the second quarter of 2025 and 20.7% in the second quarter of 2024. Other operating expenses are primarily comprised of contract services, professional fees, repairs and maintenance, rents and leases, utilities, insurance (including professional liability insurance) and nonincome taxes. We have seen inflation have a negative impact on certain of these expenses and expect inflationary pressures will continue to impact operating expenses in the future.
Equity in earnings of affiliates was $19 million and less than $1 million in the second quarters of 2025 and 2024, respectively.
Depreciation and amortization increased $44 million, from $819 million in the second quarter of 2024 to $863 million in the second quarter of 2025. The increase in depreciation relates primarily to capital expenditures at our existing facilities.
Interest expense was $568 million in the second quarter of 2025 and $506 million in the second quarter of 2024. Our average debt balance was $44.506 billion for the second quarter of 2025, compared to $40.292 billion for the second quarter of 2024. The average effective interest rate for our debt was 5.1% for both of the quarters ended June 30, 2025 and 2024.
During the second quarters of 2025 and 2024, we recorded losses on sales of facilities of $3 million and gains on sales of facilities of $12 million, respectively.
The effective tax rates were 24.1% and 27.4% for the second quarters of 2025 and 2024, respectively. The effective tax rate computations exclude net income attributable to noncontrolling interests as it relates to consolidated partnerships. The decline in the effective tax rate for the quarter ended June 30, 2025 is related primarily to adjustments to our liability for unrecognized tax benefits recorded in the second quarter of 2024.
Net income attributable to noncontrolling interests increased from $226 million for the second quarter of 2024 to $238 million for the second quarter of 2025. The increase in net income attributable to noncontrolling interests related primarily to the operations of one of our Texas markets.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Six Months Ended June 30, 2025 and 2024
Revenues increased to $36.926 billion in the first six months of 2025 from $34.831 billion in the first six months of 2024. Net income attributable to HCA Healthcare, Inc. totaled $3.263 billion, or $13.28 per diluted share, for the six months ended June 30, 2025, compared to $3.052 billion, or $11.47 per diluted share, for the six months ended June 30, 2024. Results for the first six months of 2025 and 2024 include losses on sales of facilities of $2 million, or $0.01 per diluted share, and gains on sales of facilities of $213 million, or $0.61 per diluted share, respectively. Our provision for income taxes for the first six months of 2025 and 2024 included tax benefits of $33 million, or $0.13 per diluted share, and $79 million, or $0.30 per diluted share, respectively, related to employee equity award settlements. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes. Shares used for diluted earnings per share were 245.654 million shares for the six months ended June 30, 2025 and 266.044 million shares for the six months ended June 30, 2024. During 2024 and the first six months of 2025, we repurchased 17.798 million shares and 14.793 million shares, respectively, of our common stock.
Revenues increased 6.0% on a consolidated basis and 5.9% on a same facility basis for the six months ended June 30, 2025, compared to the six months ended June 30, 2024. The increase in consolidated revenues can be primarily attributed to the combined impact of a 3.2% increase in revenue per equivalent admission and a 2.7% increase in equivalent admissions. The same facility revenues increase resulted from the combined impact of a 3.6% increase in same facility revenue per equivalent admission and a 2.3% increase in same facility equivalent admissions.
Salaries and benefits, as a percentage of revenues, were 43.7% in the first six months of 2025 and 44.2% in the first six months of 2024. Salaries and benefits were favorably impacted by a 4.6% decline in contract labor during the six months ended June 30, 2025, compared to the six months ended June 30, 2024. Salaries and benefits per equivalent admission increased 2.1% in the first six months of 2025, compared to the first six months of 2024. Same facility salaries and benefits per full time equivalent increased 2.8% for the first six months of 2025, compared to the first six months of 2024.
Supplies, as a percentage of revenues, were 15.2% in each of the first six months of 2025 and 2024. Supply costs per equivalent admission increased 2.9% in the first six months of 2025, compared to the first six months of 2024. Supply costs per equivalent admission increased 7.5% for medical devices and 0.1% for general medical and surgical items and declined 2.2% for pharmacy supplies in the first six months of 2025, compared to the first six months of 2024. The increase in supply costs per equivalent admission for medical devices is primarily related to cardiovascular technologies.
Other operating expenses, as a percentage of revenues, were 20.7% in the first six months of 2025 and 20.8% in the first six months of 2024. Other operating expenses are primarily comprised of contract services, professional fees, repairs and maintenance, rents and leases, utilities, insurance (including professional liability insurance) and nonincome taxes. We have seen inflation have a negative impact on certain of these expenses and expect inflationary pressures will continue to impact operating expenses in the future.
Equity in earnings of affiliates was $37 million in the first six months of 2025, and equity in losses of affiliates was $2 million in the first six months of 2024.
Depreciation and amortization increased $109 million, from $1.614 billion in the first six months of 2024 to $1.723 billion in the first six months of 2025. The increase in depreciation relates primarily to capital expenditures at our existing facilities.
Interest expense was $1.115 billion in the first six months of 2025 and $1.018 billion in the first six months of 2024. Our average debt balance was $44.061 billion for the first six months of 2025 compared to $40.359 billion for the first six months of 2024. The average effective interest rate for our debt was 5.1% for both of the six months ended June 30, 2025 and 2024.
During the first six months of 2025 and 2024, we recorded losses on sales of facilities of $2 million and gains on sales of facilities of $213 million, respectively. The gain for 2024 was primarily related to the sale of a hospital facility in California.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Six Months Ended June 30, 2025 and 2024 (continued)
The effective tax rates were 23.9% and 24.6% for the first six months of 2025 and 2024, respectively. The effective tax rate computations exclude net income attributable to noncontrolling interests as it relates to consolidated partnerships. The decline in the effective tax rate for the six months ended June 30, 2025 is related to adjustments to our liability for unrecognized tax benefits recorded in the second quarter of 2024, offset by a reduction in the amount of deductible share-based compensation for vested employee equity awards. Our provisions for income taxes for the first six months of 2025 and 2024 included tax benefits of $33 million and $79 million, respectively, related to employee equity award settlements.
Net income attributable to noncontrolling interests increased from $437 million for the first six months of 2024 to $453 million for the first six months 2025. The increase in net income attributable to noncontrolling interests related primarily to the operations of two of our Texas markets.
Liquidity and Capital Resources
Cash provided by operating activities totaled $5.861 billion for the first six months of 2025 compared to $4.440 billion for the first six months of 2024. The $1.421 billion increase in cash provided by operating activities, for the first six months of 2025 compared to the first six months of 2024, related primarily to an increase in net income of $392 million, excluding the non-cash impact of losses and gains on sales of facilities, as well as a decline in income taxes paid of $853 million related to an IRS deferral of quarterly estimated income tax payments for Tennessee-based taxpayers until the fourth quarter of 2025. The combination of interest payments and net income tax payments in the first six months of 2025 and 2024 totaled $1.220 billion and $1.942 billion, respectively. We had negative working capital of $376 million at June 30, 2025 and positive working capital of $1.237 billion at December 31, 2024. The decline in working capital is primarily related to the increase in short-term borrowings and long-term debt due within one year and other accrued expenses, as well as a decline in cash and cash equivalents. We have the ability to refinance our outstanding commercial paper notes (short-term borrowings) with our senior unsecured credit facility on a long-term basis. Excluding the impact of our outstanding commercial paper notes, our working capital at June 30, 2025 would have been $1.402 billion.
Cash used in investing activities was $2.283 billion in the first six months of 2025 compared to $2.235 billion in the first six months of 2024. Excluding acquisitions, capital expenditures were $2.167 billion in the first six months of 2025 and $2.399 billion in the first six months of 2024. Planned capital expenditures are expected to be approximately $5.0 billion in 2025. At June 30, 2025, there were projects under construction which had estimated additional costs to complete and equip over the next five years of approximately $5.9 billion. We expect to finance capital expenditures with internally generated and borrowed funds.
Cash used in financing activities totaled $4.584 billion in the first six months of 2025, compared to $2.309 billion in the first six months of 2024. During the first six months of 2025, net cash flows used in financing activities included a net increase of $1.341 billion in our indebtedness, payment of dividends of $351 million, repurchase of common stock of $5.011 billion and distributions to noncontrolling interests of $394 million. During the first six months of 2024, net cash flows used in financing activities included a net increase of $1.184 billion in our indebtedness, payment of dividends of $356 million, repurchase of common stock of $2.547 billion and distributions to noncontrolling interests of $338 million.
During February 2025, we repaid all $2.600 billion aggregate principal amount of 5.375% senior notes due 2025 at maturity. We entered into a new credit agreement that provides for $8.000 billion of senior unsecured revolving credit commitments with a term of five years (“senior unsecured credit facility”). Currently, borrowings under the senior unsecured credit facility bear interest at a rate equal to the Secured Overnight Financing Rate plus 1.250% (plus a 0.10% credit spread adjustment). We concurrently borrowed funds from the senior unsecured credit facility and repaid outstanding borrowings under our $4.500 billion senior secured asset-based revolving credit facility and our senior secured term loan facility of $1.238 billion. We terminated these senior secured credit facilities along with our $3.500 billion senior secured revolving cash flow credit facility.
During February 2025, we also issued $5.250 billion aggregate principal amount of senior notes comprised of (i) $700 million aggregate principal amount of 5.000% senior notes due 2028, (ii) $300 million aggregate principal amount of floating rate senior notes due 2028, (iii) $750 million aggregate principal amount of 5.250% senior notes due 2030, (iv) $750 million aggregate principal amount of 5.500% senior notes due 2032, (v) $1.500 billion aggregate principal amount of 5.750% senior notes due 2035 and (vi) $1.250 billion aggregate principal amount of 6.200% senior notes due 2055. We used the net proceeds to repay borrowings under the senior unsecured credit facility and for general corporate purposes.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Liquidity and Capital Resources (continued)
During April 2025 and June 2025, we repaid at maturity, utilizing our senior unsecured credit facility, all $1.400 billion aggregate principal amount of 5.25% senior notes and $291 million aggregate principal amount of 7.69% senior notes, respectively.
During June 2025, we established a commercial paper program under which we may issue unsecured commercial paper notes from time to time up to a maximum aggregate face or principal amount of $4.000 billion outstanding at any time. Amounts available under the program may be borrowed, repaid and reborrowed from time to time. The maturities of the commercial paper notes borrowings may vary, but will not exceed 397 days from the date of issue, and the proceeds from the program will be used for general corporate purposes. In connection with the commercial paper program, we intend to maintain a minimum available borrowing capacity under our $8.000 billion of senior unsecured credit facility equal to the aggregate amount outstanding under the commercial paper program. At June 30, 2025, we had $1.778 billion of commercial paper outstanding, and there were no borrowings outstanding under our senior unsecured credit facility.
We have significant debt service requirements. Our debt totaled $44.483 billion at June 30, 2025. Our interest expense was $1.115 billion for the first six months of 2025 and $1.018 billion for the first six months of 2024.
In addition to cash flows from operations, available sources of capital include amounts available under our senior unsecured credit facility ($6.208 billion and $6.691 billion available as of June 30, 2025 and July 31, 2025, respectively, after giving effect to all issued and outstanding letters of credit and our intention to maintain a minimum available borrowing capacity under our senior unsecured credit facility equal to the aggregate amount outstanding under the commercial paper program ($1.778 billion as of June 30, 2025 and $1.295 billion as of July 31, 2025)) and anticipated access to public and private debt markets.
Investments of our insurance subsidiaries, held to maintain statutory equity levels and to provide liquidity to pay claims, totaled $632 million and $657 million at June 30, 2025 and December 31, 2024, respectively. An insurance subsidiary maintained net reserves for professional liability risks of $102 million and $127 million at June 30, 2025 and December 31, 2024, respectively. Our facilities are insured by our insurance subsidiary for losses up to $110 million per occurrence; however, this coverage is generally subject, in most cases, to a $15 million per occurrence self-insured retention. Additionally, the insurance subsidiary has entered into reinsurance contracts providing reimbursement for a certain portion of losses in excess of self-insured retentions. Net reserves for the self-insured professional liability risks retained were $1.932 billion and $1.924 billion at June 30, 2025 and December 31, 2024, respectively. Claims payments, net of reinsurance recoveries, during the next 12 months are expected to approximate $565 million. We estimate that approximately $532 million of the expected net claim payments during the next 12 months will relate to claims subject to the self-insured retention.
Management believes that cash flows from operations, amounts available under our senior unsecured credit facility and our anticipated access to public and private debt markets will be sufficient to meet expected liquidity needs for the foreseeable future.
Market Risk
We are exposed to market risk related to changes in market values of securities. The investment securities held by our insurance subsidiaries were recorded at $632 million at June 30, 2025. These investments are carried at fair value, with changes in unrealized gains and losses that are not credit-related being recorded as adjustments to other comprehensive income. At June 30, 2025, we had net unrealized losses of $18 million on the insurance subsidiaries’ investments.
We are exposed to market risk related to market illiquidity. Investments in debt and equity securities held by our insurance subsidiaries could be impaired by the inability to access the capital markets. Should the insurance subsidiaries require significant amounts of cash in excess of normal cash requirements to pay claims and other expenses on short notice, we may have difficulty selling these investments in a timely manner or be forced to sell them at a price less than what we might otherwise have been able to in a normal market environment. We may be required to recognize credit-related impairments on our investment securities in future periods should issuers default on interest payments or should the fair market valuations of the securities deteriorate due to ratings downgrades or other issue-specific factors.
We are also exposed to market risk related to changes in interest rates. With respect to our interest-bearing liabilities, approximately $2.078 billion of our debt at June 30, 2025 was subject to variable rates of interest, while the remaining debt balance of $42.405 billion at June 30, 2025 was subject to fixed rates of interest. Both the general level of interest rates and our leverage affect our variable interest rates. Our variable debt is comprised of outstanding commercial paper notes and the floating rate senior notes due 2028. The average effective interest rate for our debt was 5.1% for both of the six months ended June 30, 2025 and 2024, respectively.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Liquidity and Capital Resources (continued)
The estimated fair value of our long-term debt was $43.201 billion at June 30, 2025. The estimates of fair value are based upon the quoted market prices for the same or similar issues of long-term debt with the same maturities. Based on a hypothetical 1% increase in interest rates, the potential annualized reduction to future pretax earnings would be approximately $21 million. To mitigate the impact of fluctuations in interest rates, we generally target a majority of our debt portfolio to be maintained at fixed rates.
We are exposed to currency translation risk related to our foreign operations. We currently do not consider the market risk related to foreign currency translation to be material to our consolidated financial statements or our liquidity.
Tax Examinations
At June 30, 2025, the Internal Revenue Service (“IRS”) was examining the Company’s 2022 and 2023 income tax returns and the 2019 income tax returns of certain affiliates. We are subject to examination by the IRS for tax years after 2020, as well as by state and foreign taxing authorities. Management believes HCA Healthcare, Inc. and its subsidiaries and affiliates properly reported taxable income and paid taxes in accordance with applicable laws and agreements established with the IRS, state and foreign taxing authorities and final resolution of any disputes will not have a material, adverse effect on our results of operations or financial position. However, if payments due upon final resolution of any issues exceed our recorded estimates, such resolutions could have a material, adverse effect on our results of operations or financial position.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
| Operating Data | ||||||||
| 2025 | 2024 | |||||||
| Number of hospitals in operation at: | ||||||||
| March 31 | 192 | 188 | ||||||
| June 30 | 191 | 188 | ||||||
| September 30 | 187 | |||||||
| December 31 | 190 | |||||||
| Number of freestanding outpatient surgical centers in operation at: | ||||||||
| March 31 | 125 | 121 | ||||||
| June 30 | 124 | 123 | ||||||
| September 30 | 125 | |||||||
| December 31 | 124 | |||||||
| Licensed hospital beds at(a): | ||||||||
| March 31 | 50,571 | 49,724 | ||||||
| June 30 | 50,485 | 49,844 | ||||||
| September 30 | 49,890 | |||||||
| December 31 | 49,985 | |||||||
| Weighted average beds in service(b): | ||||||||
| Quarter: | ||||||||
| First | 42,862 | 42,564 | ||||||
| Second | 42,858 | 42,624 | ||||||
| Third | 42,640 | |||||||
| Fourth | 42,705 | |||||||
| Year | 42,633 | |||||||
| Average daily census(c): | ||||||||
| Quarter: | ||||||||
| First | 31,518 | 30,567 | ||||||
| Second | 29,399 | 29,259 | ||||||
| Third | 29,247 | |||||||
| Fourth | 29,258 | |||||||
| Year | 29,581 | |||||||
| Admissions(d): | ||||||||
| Quarter: | ||||||||
| First | 576,361 | 560,869 | ||||||
| Second | 566,061 | 554,456 | ||||||
| Third | 562,100 | |||||||
| Fourth | 559,170 | |||||||
| Year | 2,236,595 | |||||||
| Equivalent admissions(e): | ||||||||
| Quarter: | ||||||||
| First | 1,012,090 | 981,521 | ||||||
| Second | 1,017,994 | 994,835 | ||||||
| Third | 1,006,106 | |||||||
| Fourth | 1,007,623 | |||||||
| Year | 3,990,085 | |||||||
| Average length of stay (days)(f): | ||||||||
| Quarter: | ||||||||
| First | 4.9 | 5.0 | ||||||
| Second | 4.7 | 4.8 | ||||||
| Third | 4.8 | |||||||
| Fourth | 4.8 | |||||||
| Year | 4.8 | |||||||
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
| 2025 | 2024 | |||||||
| Emergency room visits(g): | ||||||||
| Quarter: | ||||||||
| First | 2,518,716 | 2,428,914 | ||||||
| Second | 2,439,763 | 2,414,960 | ||||||
| Third | 2,446,962 | |||||||
| Fourth | 2,498,429 | |||||||
| Year | 9,789,265 | |||||||
| Outpatient surgeries(h): | ||||||||
| Quarter: | ||||||||
| First | 246,620 | 252,835 | ||||||
| Second | 258,365 | 258,967 | ||||||
| Third | 249,364 | |||||||
| Fourth | 263,832 | |||||||
| Year | 1,024,998 | |||||||
| Inpatient surgeries(i): | ||||||||
| Quarter: | ||||||||
| First | 133,759 | 133,398 | ||||||
| Second | 136,122 | 135,860 | ||||||
| Third | 135,803 | |||||||
| Fourth | 135,643 | |||||||
| Year | 540,704 | |||||||
| Days revenues in accounts receivable(j): | ||||||||
| Quarter: | ||||||||
| First | 54 | 53 | ||||||
| Second | 51 | 53 | ||||||
| Third | 52 | |||||||
| Fourth | 54 | |||||||
| Outpatient revenues as a % of patient revenues(k): | ||||||||
| Quarter: | ||||||||
| First | 37 | % | 37 | % | ||||
| Second | 38 | % | 38 | % | ||||
| Third | 38 | % | ||||||
| Fourth | 38 | % | ||||||
| Year | 38 | % |
(a)
Licensed beds are those beds for which a facility has been granted approval to operate from the applicable state licensing agency.
(b)
Represents the average number of beds in service, weighted based on periods owned.
(c)
Represents the average number of patients in our hospital beds each day.
(d)
Represents the total number of patients admitted to our hospitals and is used by management and certain investors as a general measure of inpatient volume.
(e)
Equivalent admissions are used by management and certain investors as a general measure of combined inpatient and outpatient volume. Equivalent admissions are computed by multiplying admissions (inpatient volume) by the sum of gross inpatient revenues and gross outpatient revenues and then dividing the resulting amount by gross inpatient revenues. The equivalent admissions computation “equates” outpatient revenues to the volume measure (admissions) used to measure inpatient volume resulting in a general measure of combined inpatient and outpatient volume.
(f)
Represents the average number of days admitted patients stay in our hospitals.
(g)
Represents the number of patients treated in our emergency rooms.
(h)
Represents the number of surgeries performed on patients who were not admitted to our hospitals. Pain management and endoscopy procedures are not included in outpatient surgeries.
(i)
Represents the number of surgeries performed on patients who have been admitted to our hospitals. Pain management and endoscopy procedures are not included in inpatient surgeries.
(j)
Revenues per day is calculated by dividing revenues for the quarter by the days in the quarter. Days revenues in accounts receivable is then calculated as accounts receivable at the end of the quarter divided by revenues per day.
(k)
Represents the percentage of patient revenues related to patients who are not admitted to our hospitals.
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