HCA Healthcare Reports Third Quarter 2022 Results
HCA Healthcare reported third-quarter 2022 results, revealing revenues of $14.971 billion, a decrease from $15.276 billion in Q3 2021. Net income fell to $1.134 billion, or $3.91 per diluted share, compared to $2.269 billion, or $7.00 per diluted share, last year. Adjusted EBITDA was $2.902 billion, down from $3.224 billion. Same facility admissions declined by 1.5%, while equivalent admissions increased 2.3%. Hurricane Ian impacted operations with estimated costs of $35 million. The company also declared a quarterly dividend of $0.56 per share, payable on December 28, 2022.
- Revenues for 9 months reached $44.736 billion, an increase from $43.688 billion in the prior year.
- Cash flows from operating activities rose to $3.020 billion, compared to $2.277 billion in Q3 2021.
- The company repurchased 3.361 million shares at a cost of $698 million, with $3.106 billion remaining under repurchase authorization.
- Net income decreased significantly from $2.269 billion to $1.134 billion year-over-year.
- Adjusted EBITDA fell from $3.224 billion to $2.902 billion compared to the previous year.
- Same facility revenue per equivalent admission dropped by 3.5%.
Key third quarter metrics (all percentage changes compare 3Q 2022 to 3Q 2021 unless otherwise noted):
-
Revenues totaled
$14.97 1 billion -
Net income attributable to
HCA Healthcare, Inc. totaled , or$1.13 4 billion per diluted share$3.91 -
Adjusted EBITDA totaled
$2.90 2 billion -
Cash flows from operating activities totaled
$3.02 0 billion - Same facility admissions declined 1.5 percent while same facility equivalent admissions increased 2.3 percent
“Despite a difficult comparison to the prior year due to the
Revenues in the third quarter of 2022 totaled
For the third quarter of 2022, Adjusted EBITDA totaled
Results for the third quarter 2022 include Hurricane Ian’s impact, primarily on our
Same facility admissions declined 1.5 percent while same facility equivalent admissions increased 2.3 percent in the third quarter of 2022, compared to the prior year period. Same facility emergency room visits declined 1.3 percent in the third quarter of 2022, compared to the prior year period. Same facility inpatient surgeries increased 5.6 percent, and same facility outpatient surgeries increased 2.0 percent in the third quarter of 2022, compared to the same period of 2021. Same facility revenue per equivalent admission declined 3.5 percent in the third quarter of 2022, compared to the third quarter of 2021. Year over year comparisons were impacted by significantly higher COVID-19 volumes in the prior year, when COVID-19 represented 12.7 percent of same-facility admissions versus 5.2 percent in the current year quarter.
Nine Months Ended
Revenues for the nine months ended
Balance Sheet and Cash Flows from Operations
As of
During the third quarter of 2022, the Company repurchased 3.361 million shares of its common stock at a cost of
Dividend
HCA today announced that its Board of Directors declared a quarterly cash dividend of
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 cash balances and future cash flows from operations.
Earnings Conference Call
About the Company
As of
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 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) developments related to COVID-19, including, without limitation, the length and severity of its impact and the spread of virus strains with new epidemiological characteristics; the volume of canceled or rescheduled procedures and the volume and acuity of COVID-19 patients cared for across our health systems; measures we are taking to respond to COVID-19; the impact and terms (including the termination or expiration) of government and administrative regulation and stimulus and relief measures (including the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security (“CARES”) Act, the Paycheck Protection Program and Health Care Enhancement Act, the Consolidated Appropriations Act, 2021, the American Rescue Plan Act of 2021 (“ARPA”) and other enacted and potential future legislation) and whether various stimulus and relief programs continue or new similar programs are enacted in the future; changes in revenues due to declining patient volumes, changes in payer mix, deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients) and capacity constraints; potential increased expenses related to inflation or labor, supply chain or other expenditures; supply shortages and disruptions; and the timing, availability and adoption of effective medical treatments and vaccines (including boosters), (2) the impact of our substantial 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, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the “Affordable Care Act”), and the effects of additional changes to the Affordable Care Act, its implementation, or interpretation (including through executive orders and court challenges), and 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”), and also including any such laws or governmental regulations which are adopted in response to COVID-19, (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 (“PAYGO Act”) as a result of the federal budget deficit impact of the ARPA, 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, and attain expected levels of patient volumes and control the costs of providing services, (7) 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, (8) 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, and workforce disruptions, (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) changes in general economic conditions nationally and regionally in our markets, including inflation and economic and business conditions (and the impact thereof on the economy and financial markets) resulting from COVID-19 or other factors, (16) the emergence of and effects related to pandemics, epidemics and infectious diseases, (17) future divestitures which may result in charges and possible impairments of long-lived assets, (18) changes in business strategy or development plans, (19) delays in receiving payments for services provided, (20) the outcome of pending and any future tax audits, disputes and litigation associated with our tax positions, (21) potential adverse impact of known and unknown government investigations, litigation and other claims that may be made against us, (22) the impact of potential cybersecurity incidents or security breaches, (23) our ongoing ability to demonstrate meaningful use of certified electronic health record (“EHR”) technology and the impact of interoperability requirements, (24) the impact of natural disasters, such as hurricanes and floods, physical risks from climate change or similar events beyond our control, (25) changes in
Condensed Consolidated Comprehensive Income Statements | |||||||||||
Third Quarter | |||||||||||
Unaudited | |||||||||||
(Dollars in millions, except per share amounts) | |||||||||||
($ millions, except per share amounts) | 2022 |
2021 |
|||||||||
Amount |
Ratio |
Amount |
Ratio |
||||||||
Revenues |
|
|
100.0 |
|
% |
|
|
100.0 |
|
% |
|
Salaries and benefits | 6,899 |
|
46.1 |
|
7,094 |
|
46.4 |
|
|||
Supplies | 2,320 |
|
15.5 |
|
2,463 |
|
16.1 |
|
|||
Other operating expenses | 2,860 |
|
19.1 |
|
2,530 |
|
16.6 |
|
|||
Equity in earnings of affiliates | (10 |
) |
(0.1 |
) |
(35 |
) |
(0.2 |
) |
|||
Depreciation and amortization | 749 |
|
5.0 |
|
716 |
|
4.7 |
|
|||
Interest expense | 446 |
|
3.0 |
|
398 |
|
2.6 |
|
|||
Losses (gains) on sales of facilities | 3 |
|
- |
|
(1,047 |
) |
(6.9 |
) |
|||
13,267 |
|
88.6 |
|
12,119 |
|
79.3 |
|
||||
Income before income taxes | 1,704 |
|
11.4 |
|
3,157 |
|
20.7 |
|
|||
Provision for income taxes | 360 |
|
2.4 |
|
685 |
|
4.5 |
|
|||
Net income | 1,344 |
|
9.0 |
|
2,472 |
|
16.2 |
|
|||
Net income attributable to noncontrolling interests | 210 |
|
1.4 |
|
203 |
|
1.3 |
|
|||
Net income attributable to |
|
|
7.6 |
|
|
|
14.9 |
|
|||
Diluted earnings per share |
|
|
|
|
|||||||
Shares used in computing diluted earnings per share (millions) | 289.852 |
|
324.029 |
|
|||||||
Comprehensive income attributable to |
|
|
|
|
|||||||
Condensed Consolidated Comprehensive Income Statements | |||||||||||
For the Nine Months Ended |
|||||||||||
Unaudited | |||||||||||
(Dollars in millions, except per share amounts) | |||||||||||
2022 |
|
2021 |
|||||||||
Amount |
Ratio |
|
Amount |
Ratio |
|||||||
Revenues |
|
|
100.0 |
|
% |
|
|
100.0 |
|
% |
|
Salaries and benefits | 20,630 |
|
46.1 |
|
19,780 |
|
45.3 |
|
|||
Supplies | 6,942 |
|
15.5 |
|
7,067 |
|
16.2 |
|
|||
Other operating expenses | 8,305 |
|
18.6 |
|
7,424 |
|
17.0 |
|
|||
Equity in earnings of affiliates | (29 |
) |
(0.1 |
) |
(78 |
) |
(0.2 |
) |
|||
Depreciation and amortization | 2,219 |
|
4.9 |
|
2,125 |
|
4.8 |
|
|||
Interest expense | 1,288 |
|
2.9 |
|
1,168 |
|
2.7 |
|
|||
Losses (gains) on sales of facilities | 25 |
|
0.1 |
|
(1,057 |
) |
(2.4 |
) |
|||
Losses on retirement of debt | 78 |
|
0.2 |
|
12 |
|
- |
|
|||
39,458 |
|
88.2 |
|
36,441 |
|
83.4 |
|
||||
Income before income taxes | 5,278 |
|
11.8 |
|
7,247 |
|
16.6 |
|
|||
Provision for income taxes | 1,090 |
|
2.4 |
|
1,531 |
|
3.5 |
|
|||
Net income | 4,188 |
|
9.4 |
|
5,716 |
|
13.1 |
|
|||
Net income attributable to noncontrolling interests | 626 |
|
1.4 |
|
574 |
|
1.3 |
|
|||
Net income attributable to |
|
|
8.0 |
|
|
|
11.8 |
|
|||
Diluted earnings per share |
|
|
|
|
|||||||
Shares used in computing diluted earnings per share (millions) | 297.702 |
|
333.248 |
|
|||||||
Comprehensive income attributable to |
|
|
|
|
|||||||
Condensed Consolidated Balance Sheets | |||||||||
Unaudited | |||||||||
(Dollars in millions) | |||||||||
2022 |
2022 |
2021 |
|||||||
ASSETS | |||||||||
Current assets: | |||||||||
Cash and cash equivalents |
|
|
|
|
|
|
|||
Accounts receivable | 8,552 |
|
8,628 |
|
8,095 |
|
|||
Inventories | 2,009 |
|
2,043 |
|
1,986 |
|
|||
Other | 1,921 |
|
2,408 |
|
2,010 |
|
|||
13,481 |
|
13,937 |
|
13,542 |
|
||||
Property and equipment, at cost | 53,730 |
|
52,816 |
|
51,350 |
|
|||
Accumulated depreciation | (28,752 |
) |
(28,229 |
) |
(27,287 |
) |
|||
24,978 |
|
24,587 |
|
24,063 |
|
||||
Investments of insurance subsidiaries | 372 |
|
379 |
|
438 |
|
|||
Investments in and advances to affiliates | 444 |
|
435 |
|
448 |
|
|||
9,651 |
|
9,593 |
|
9,540 |
|
||||
Right-of-use operating lease assets | 2,097 |
|
2,139 |
|
2,113 |
|
|||
Other | 461 |
|
514 |
|
598 |
|
|||
|
|
|
|
|
|
||||
LIABILITIES AND STOCKHOLDERS' (DEFICIT) EQUITY | |||||||||
Current liabilities: | |||||||||
Accounts payable |
|
|
|
|
|
|
|||
Accrued salaries | 1,625 |
|
1,895 |
|
1,912 |
|
|||
Other accrued expenses | 3,780 |
|
3,116 |
|
3,322 |
|
|||
Long-term debt due within one year | 218 |
|
246 |
|
237 |
|
|||
9,784 |
|
8,999 |
|
9,582 |
|
||||
Long-term debt, less debt issuance costs and discounts of |
37,492 |
|
38,657 |
|
34,342 |
|
|||
Professional liability risks | 1,510 |
|
1,533 |
|
1,514 |
|
|||
Right-of-use operating lease obligations | 1,762 |
|
1,796 |
|
1,755 |
|
|||
Income taxes and other liabilities | 1,714 |
|
1,741 |
|
2,060 |
|
|||
Stockholders' (deficit) equity: | |||||||||
Stockholders' deficit attributable to |
(3,370 |
) |
(3,680 |
) |
(933 |
) |
|||
Noncontrolling interests | 2,592 |
|
2,538 |
|
2,422 |
|
|||
(778 |
) |
(1,142 |
) |
1,489 |
|
||||
|
|
|
|
|
|
||||
Condensed Consolidated Statements of Cash Flows | |||||||
For the Nine Months Ended |
|||||||
Unaudited | |||||||
(Dollars in millions) | |||||||
2022 |
2021 |
||||||
Cash flows from operating activities: | |||||||
Net income |
|
|
|||||
Adjustments to reconcile net income to net cash provided by operating activities: | |||||||
Increase (decrease) in cash from operating assets and liabilities: | |||||||
Accounts receivable | (487) |
(1,312) |
|||||
Inventories and other assets | 53 |
(333) |
|||||
Accounts payable and accrued expenses | (644) |
731 |
|||||
Depreciation and amortization | 2,219 |
2,125 |
|||||
Income taxes | 159 |
185 |
|||||
Losses (gains) on sales of facilities | 25 |
(1,057) |
|||||
Losses on retirement of debt | 78 |
12 |
|||||
Amortization of debt issuance costs and discounts | 22 |
21 |
|||||
Share-based compensation | 258 |
341 |
|||||
Other | 124 |
87 |
|||||
Net cash provided by operating activities | 5,995 |
6,516 |
|||||
Cash flows from investing activities: | |||||||
Purchase of property and equipment | (3,072) |
(2,385) |
|||||
Acquisition of hospitals and health care entities | (176) |
(488) |
|||||
Sales of hospitals and health care entities | 652 |
1,980 |
|||||
Change in investments | 10 |
(38) |
|||||
Other | (10) |
2 |
|||||
Net cash used in investing activities | (2,596) |
(929) |
|||||
Cash flows from financing activities: | |||||||
Issuances of long-term debt | 5,976 |
4,337 |
|||||
Net change in revolving credit facilities | (230) |
500 |
|||||
Repayment of long-term debt | (2,774) |
(3,787) |
|||||
Distributions to noncontrolling interests | (550) |
(501) |
|||||
Payment of debt issuance costs | (53) |
(38) |
|||||
Payment of dividends | (497) |
(476) |
|||||
Repurchase of common stock | (5,481) |
(6,143) |
|||||
Other | (209) |
(241) |
|||||
Net cash used in financing activities | (3,818) |
(6,349) |
|||||
Effect of exchange rate changes on cash and cash equivalents | (33) |
(4) |
|||||
Change in cash and cash equivalents | (452) |
(766) |
|||||
Cash and cash equivalents at beginning of period | 1,451 |
1,793 |
|||||
Cash and cash equivalents at end of period |
|
|
|||||
Interest payments |
|
|
|||||
Income tax payments, net |
|
|
|||||
Operating Statistics | |||||||||||
For the Nine Months | |||||||||||
Third Quarter | Ended |
||||||||||
2022 |
2021 |
2022 |
2021 |
||||||||
Operations: | |||||||||||
Number of Hospitals |
|
182 |
|
183 |
|
182 |
|
183 |
|||
Number of Freestanding Outpatient Surgery Centers* |
|
125 |
|
123 |
|
125 |
|
123 |
|||
Licensed Beds at End of Period |
|
49,179 |
|
48,950 |
|
49,179 |
|
48,950 |
|||
Weighted Average Beds in Service |
|
42,056 |
|
42,088 |
|
41,936 |
|
42,304 |
|||
Reported: | |||||||||||
Admissions |
|
523,092 |
|
536,848 |
|
1,545,161 |
|
1,575,269 |
|||
% Change |
|
- |
|
- |
|||||||
Equivalent Admissions |
|
917,262 |
|
905,627 |
|
2,679,309 |
|
2,654,328 |
|||
% Change |
|
|
|
|
|||||||
Revenue per Equivalent Admission | $ |
16,322 |
$ |
16,868 |
$ |
16,697 |
$ |
16,459 |
|||
% Change |
|
- |
|
|
|||||||
Inpatient Revenue per Admission | $ |
17,387 |
$ |
18,102 |
$ |
17,268 |
$ |
17,115 |
|||
% Change |
|
- |
|
|
|||||||
|
2,602,416 |
|
2,865,220 |
|
7,855,462 |
|
8,166,211 |
||||
% Change |
|
- |
|
- |
|||||||
Equivalent |
|
4,565,120 |
|
4,833,197 |
|
13,621,371 |
|
13,760,066 |
|||
% Change |
|
- |
|
- |
|||||||
Inpatient Surgery Cases |
|
132,470 |
|
126,436 |
|
390,311 |
|
390,486 |
|||
% Change |
|
|
|
|
|||||||
Outpatient Surgery Cases |
|
252,026 |
|
249,192 |
|
757,629 |
|
742,527 |
|||
% Change |
|
|
|
|
|||||||
Emergency Room Visits |
|
2,278,782 |
|
2,338,180 |
|
6,559,170 |
|
6,308,386 |
|||
% Change |
|
- |
|
|
|||||||
Outpatient Revenues as a | |||||||||||
Percentage of Patient Revenues |
|
|
|
|
|
|
|
|
|||
Average Length of Stay (days) |
|
4.975 |
|
5.337 |
|
5.084 |
|
5.184 |
|||
Occupancy** |
|
|
|
|
|
|
|
|
|||
Same Facility: | |||||||||||
Admissions |
|
518,597 |
|
526,573 |
|
1,532,798 |
|
1,536,627 |
|||
% Change |
|
- |
|
- |
|||||||
Equivalent Admissions |
|
905,470 |
|
885,169 |
|
2,645,609 |
|
2,579,997 |
|||
% Change |
|
|
|
|
|||||||
Revenue per Equivalent Admission | $ |
16,283 |
$ |
16,874 |
$ |
16,674 |
$ |
16,539 |
|||
% Change |
|
- |
|
|
|||||||
Inpatient Revenue per Admission | $ |
17,428 |
$ |
18,081 |
$ |
17,306 |
$ |
17,168 |
|||
% Change |
|
- |
|
|
|||||||
Inpatient Surgery Cases |
|
131,289 |
|
124,381 |
|
387,339 |
|
382,570 |
|||
% Change |
|
|
|
|
|||||||
Outpatient Surgery Cases |
|
242,276 |
|
237,607 |
|
726,278 |
|
709,535 |
|||
% Change |
|
|
|
|
|||||||
Emergency Room Visits |
|
2,252,569 |
|
2,281,501 |
|
6,486,667 |
|
6,106,868 |
|||
% Change |
|
- |
|
|
|||||||
* Excludes freestanding endoscopy centers (21 centers at both |
|||||||||||
** Reflects the rate of occupancy (patient days and observations) based on weighted average beds in service. | |||||||||||
Supplemental Non-GAAP Disclosures | ||||||||||||||
Operating Results Summary | ||||||||||||||
(Dollars in millions, except per share amounts) | ||||||||||||||
For the Nine Months | ||||||||||||||
Third Quarter | Ended |
|||||||||||||
2022 |
2021 |
2022 |
2021 |
|||||||||||
Revenues |
|
|
|
|
|
|
|
|
||||||
Net income attributable to |
|
|
|
|
|
|
|
|
||||||
Losses (gains) on sales of facilities (net of tax) | 4 |
|
(788 |
) |
28 |
|
(795 |
) |
||||||
Losses on retirement of debt (net of tax) | - |
|
- |
|
60 |
|
9 |
|
||||||
Net income attributable to |
1,138 |
|
1,481 |
|
3,650 |
|
4,356 |
|
||||||
Depreciation and amortization | 749 |
|
716 |
|
2,219 |
|
2,125 |
|
||||||
Interest expense | 446 |
|
398 |
|
1,288 |
|
1,168 |
|
||||||
Provision for income taxes | 359 |
|
426 |
|
1,105 |
|
1,272 |
|
||||||
Net income attributable to noncontrolling interests | 210 |
|
203 |
|
626 |
|
574 |
|
||||||
Adjusted EBITDA (a) |
|
|
|
|
|
|
|
|
||||||
Adjusted EBITDA margin (a) | 19.4 |
% |
21.1 |
% |
19.9 |
% |
21.7 |
% |
||||||
Diluted earnings per share: | ||||||||||||||
Net income attributable to |
|
|
|
|
|
|
|
|
||||||
Losses (gains) on sales of facilities | 0.02 |
|
(2.43 |
) |
0.09 |
|
(2.39 |
) |
||||||
Losses on retirement of debt | - |
|
- |
|
0.20 |
|
0.03 |
|
||||||
Net income attributable to |
|
|
|
|
|
|
|
|
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Shares used in computing diluted earnings per share (millions) | 289.852 |
|
324.029 |
|
297.702 |
|
333.248 |
|
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(a) | Net income attributable to |
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Management and investors review both the overall performance (including net income attributable to |
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Net income attributable to |
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View source version on businesswire.com: https://www.businesswire.com/news/home/20221021005066/en/
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