[10-Q] HCA Healthcare, Inc. Quarterly Earnings Report
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Form
(Mark One)
For the quarterly period ended
Or
For the transition period from to
Commission file number
(Exact name of registrant as specified in its charter)
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(I.R.S. Employer Identification No.) |
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(Address of principal executive offices) |
(Zip Code) |
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(Registrant’s telephone number, including area code)
Not Applicable
(Former name, former address and former fiscal year, if changed since last report)
Securities registered pursuant to Section 12(b) of the Act:
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Title of each class
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Trading Symbol(s)
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Name of each exchange on which registered
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Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
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Accelerated filer |
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Non-accelerated filer |
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Smaller reporting company |
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Emerging growth company |
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If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No
Indicate the number of shares outstanding of each of the issuer’s classes of common stock as of the latest practicable date.
Class of Common Stock |
Outstanding at July 31, 2025 |
Voting common stock, $.01 par value |
HCA HEALTHCARE, INC.
Form 10-Q
June 30, 2025
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Page of |
Part I. |
Financial Information |
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Item 1. |
Financial Statements (Unaudited): |
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Condensed Consolidated Income Statements — for the quarters and six months ended June 30, 2025 and 2024 |
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Condensed Consolidated Comprehensive Income Statements — for the quarters and six months ended June 30, 2025 and 2024 |
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Condensed Consolidated Balance Sheets — June 30, 2025 and December 31, 2024 |
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Condensed Consolidated Statements of Stockholders’ Equity (Deficit) — for the quarters and six months ended June 30, 2025 and 2024 |
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Condensed Consolidated Statements of Cash Flows — for the six months ended June 30, 2025 and 2024 |
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Notes to Condensed Consolidated Financial Statements |
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Item 2. |
Management’s Discussion and Analysis of Financial Condition and Results of Operations |
18 |
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Item 3. |
Quantitative and Qualitative Disclosures About Market Risk |
32 |
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Item 4. |
Controls and Procedures |
32 |
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Part II. |
Other Information |
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Item 1. |
Legal Proceedings |
32 |
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Item 1A. |
Risk Factors |
32 |
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Item 2. |
Unregistered Sales of Equity Securities and Use of Proceeds |
34 |
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Item 5. |
Other Information |
35 |
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Item 6. |
Exhibits |
35 |
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Signatures |
36 |
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2
HCA HEALTHCARE, INC.
CONDENSED CONSOLIDATED INCOME STATEMENTS
FOR THE QUARTERS AND SIX MONTHS ENDED JUNE 30, 2025 AND 2024
Unaudited
(Dollars in millions, except per share amounts)
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Quarter |
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Six Months |
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2025 |
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2024 |
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2025 |
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2024 |
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Revenues |
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$ |
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$ |
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$ |
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$ |
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Salaries and benefits |
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Supplies |
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Other operating expenses |
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Equity in (earnings) losses of affiliates |
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Depreciation and amortization |
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Interest expense |
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Losses (gains) on sales of facilities |
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Income before income taxes |
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Provision for income taxes |
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Net income |
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Net income attributable to noncontrolling interests |
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Net income attributable to HCA Healthcare, Inc. |
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$ |
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$ |
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$ |
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$ |
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Per share data: |
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Basic earnings |
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$ |
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$ |
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$ |
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Diluted earnings |
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$ |
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$ |
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Shares used in earnings per share calculations (in millions): |
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Basic |
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Diluted |
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The accompanying notes are an integral part of the condensed consolidated financial statements.
3
HCA HEALTHCARE, INC.
CONDENSED CONSOLIDATED COMPREHENSIVE INCOME STATEMENTS
FOR THE QUARTERS AND SIX MONTHS ENDED JUNE 30, 2025 AND 2024
Unaudited
(Dollars in millions)
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Quarter |
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Six Months |
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2025 |
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2024 |
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2025 |
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2024 |
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Net income |
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$ |
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$ |
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$ |
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$ |
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Other comprehensive income (loss) before taxes: |
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Foreign currency translation |
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Unrealized gains (losses) on available-for-sale securities |
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Other comprehensive income (loss) before taxes |
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Income taxes (benefits) related to other comprehensive income items |
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Other comprehensive income (loss) |
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Comprehensive income |
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Comprehensive income attributable to noncontrolling interests |
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Comprehensive income attributable to HCA Healthcare, Inc. |
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$ |
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$ |
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$ |
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$ |
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The accompanying notes are an integral part of the condensed consolidated financial statements.
4
HCA HEALTHCARE, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
Unaudited
(Dollars in millions)
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June 30, |
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December 31, |
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ASSETS |
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Current assets: |
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Cash and cash equivalents |
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$ |
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$ |
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Accounts receivable |
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Inventories |
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Other |
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Property and equipment, at cost |
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Accumulated depreciation |
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Investments of insurance subsidiaries |
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Investments in and advances to affiliates |
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Goodwill and other intangible assets |
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Right-of-use operating lease assets |
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Other |
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$ |
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$ |
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LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY |
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Current liabilities: |
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Accounts payable |
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$ |
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$ |
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Accrued salaries |
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Other accrued expenses |
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Short-term borrowings and long-term debt due within one year |
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Long-term debt, less debt issuance costs and discounts of $ |
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Professional liability risks |
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Right-of-use operating lease obligations |
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Income taxes and other liabilities |
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Stockholders’ (deficit) equity: |
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Common stock $ |
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Accumulated other comprehensive loss |
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Retained deficit |
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Stockholders’ deficit attributable to HCA Healthcare, Inc. |
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Noncontrolling interests |
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$ |
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$ |
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The accompanying notes are an integral part of the condensed consolidated financial statements.
5
HCA HEALTHCARE, INC.
CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY (DEFICIT)
FOR THE QUARTERS AND SIX MONTHS ENDED JUNE 30, 2025 AND 2024
Unaudited
(Dollars in millions)
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Equity (Deficit) Attributable to HCA Healthcare, Inc. |
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Capital |
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Accumulated |
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Equity |
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Common Stock |
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in Excess |
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Other |
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Attributable to |
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Shares |
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Par |
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of Par |
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Comprehensive |
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Retained |
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Noncontrolling |
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(in millions) |
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Value |
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Value |
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Loss |
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Deficit |
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Interests |
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Total |
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Balances, December 31, 2023 |
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$ |
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$ |
— |
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$ |
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$ |
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$ |
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$ |
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Comprehensive income (loss) |
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Repurchase of common stock |
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Share-based benefit plans |
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Cash dividends declared |
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Distributions |
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Other |
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Balances, March 31, 2024 |
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— |
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Comprehensive income |
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— |
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Repurchase of common stock |
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Share-based benefit plans |
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Cash dividends declared |
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Distributions |
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Other |
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Balances, June 30, 2024 |
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— |
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Comprehensive income |
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Repurchase of common stock |
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Share-based benefit plans |
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Cash dividends declared |
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Distributions |
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Other |
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Balances, September 30, 2024 |
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— |
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Comprehensive income (loss) |
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Repurchase of common stock |
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Share-based benefit plans |
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Cash dividends declared |
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Distributions |
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Other |
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Balances, December 31, 2024 |
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— |
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Comprehensive income |
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Repurchase of common stock |
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Share-based benefit plans |
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Cash dividends declared |
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Distributions |
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Other |
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Balances, March 31, 2025 |
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— |
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Comprehensive income |
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Repurchase of common stock |
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( |
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Share-based benefit plans |
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
Cash dividends declared |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
( |
) |
|
|
|
|
|
( |
) |
|||||
Distributions |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
( |
) |
|
|
( |
) |
|||||
Other |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
Balances, June 30, 2025 |
|
|
|
|
$ |
|
|
$ |
— |
|
|
$ |
( |
) |
|
$ |
( |
) |
|
$ |
|
|
$ |
( |
) |
|||
The accompanying notes are an integral part of the condensed consolidated financial statements.
6
HCA HEALTHCARE, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
FOR THE SIX MONTHS ENDED JUNE 30, 2025 AND 2024
Unaudited
(Dollars in millions)
|
|
2025 |
|
|
2024 |
|
||
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 |
|
|
|
|
|
( |
) |
|
Inventories and other assets |
|
|
( |
) |
|
|
( |
) |
Accounts payable and accrued expenses |
|
|
( |
) |
|
|
( |
) |
Depreciation and amortization |
|
|
|
|
|
|
||
Income taxes |
|
|
|
|
|
( |
) |
|
Losses (gains) on sales of facilities |
|
|
|
|
|
( |
) |
|
Amortization of debt issuance costs and discounts |
|
|
|
|
|
|
||
Share-based compensation |
|
|
|
|
|
|
||
Other |
|
|
|
|
|
|
||
Net cash provided by operating activities |
|
|
|
|
|
|
||
Cash flows from investing activities: |
|
|
|
|
|
|
||
Purchase of property and equipment |
|
|
( |
) |
|
|
( |
) |
Acquisition of hospitals and health care entities |
|
|
( |
) |
|
|
( |
) |
Sales of hospitals and health care entities |
|
|
|
|
|
|
||
Change in investments |
|
|
|
|
|
( |
) |
|
Other |
|
|
|
|
|
( |
) |
|
Net cash used in investing activities |
|
|
( |
) |
|
|
( |
) |
Cash flows from financing activities: |
|
|
|
|
|
|
||
Issuance of long-term debt |
|
|
|
|
|
|
||
Net change in short-term borrowings and revolving credit facilities |
|
|
|
|
|
( |
) |
|
Repayment of long-term debt |
|
|
( |
) |
|
|
( |
) |
Distributions to noncontrolling interests |
|
|
( |
) |
|
|
( |
) |
Payment of debt issuance costs |
|
|
( |
) |
|
|
( |
) |
Payment of dividends |
|
|
( |
) |
|
|
( |
) |
Repurchase of common stock |
|
|
( |
) |
|
|
( |
) |
Other |
|
|
( |
) |
|
|
( |
) |
Net cash used in financing activities |
|
|
( |
) |
|
|
( |
) |
Effect of exchange rate changes on cash and cash equivalents |
|
|
|
|
|
|
||
Change in cash and cash equivalents |
|
|
( |
) |
|
|
( |
) |
Cash and cash equivalents at beginning of period |
|
|
|
|
|
|
||
Cash and cash equivalents at end of period |
|
$ |
|
|
$ |
|
||
Interest payments |
|
$ |
|
|
$ |
|
||
Income tax payments, net |
|
$ |
|
|
$ |
|
||
The accompanying notes are an integral part of the condensed consolidated financial statements.
7
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES
Reporting Entity
HCA Healthcare, Inc. is a holding company whose affiliates own and operate hospitals and related health care entities. The term “affiliates” includes direct and indirect subsidiaries of HCA Healthcare, Inc. and partnerships and joint ventures in which such subsidiaries are partners. At June 30, 2025, these affiliates owned and operated
Basis of Presentation
The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete consolidated financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included and are of a normal and recurring nature.
The majority of our expenses are “costs of revenues” items. Costs that could be classified as general and administrative would include our corporate office costs, which were $
Revenues
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.
8
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES (continued)
Revenues (continued)
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 these revenues at the estimated amounts we expect to collect. Patients treated at our hospitals for non-elective care, who have income at or below
|
|
Quarter |
|
|||||||||||||
|
|
2025 |
|
|
Ratio |
|
|
2024 |
|
|
Ratio |
|
||||
Medicare |
|
$ |
|
|
|
% |
|
$ |
|
|
|
% |
||||
Managed Medicare |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Medicaid |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Managed Medicaid |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Managed care and insurers |
|
|
|
|
|
|
|
|
|
|
|
|
||||
International (managed care and insurers) |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Other |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Revenues |
|
$ |
|
|
|
% |
|
$ |
|
|
|
% |
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
Six Months |
|
|||||||||||||
|
|
2025 |
|
|
Ratio |
|
|
2024 |
|
|
Ratio |
|
||||
Medicare |
|
$ |
|
|
|
% |
|
$ |
|
|
|
% |
||||
Managed Medicare |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Medicaid |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Managed Medicaid |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Managed care and insurers |
|
|
|
|
|
|
|
|
|
|
|
|
||||
International (managed care and insurers) |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Other |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Revenues |
|
$ |
|
|
|
% |
|
$ |
|
|
|
% |
||||
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.
|
|
Quarter |
|
|
Six Months |
|
||||||||||
|
|
2025 |
|
|
2024 |
|
|
2025 |
|
|
2024 |
|
||||
Patient care costs (salaries and benefits, supplies, other operating |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
||||
Cost-to-charges ratio (patient care costs as percentage of gross |
|
|
% |
|
|
% |
|
|
% |
|
|
% |
||||
Total uncompensated care |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
||||
Multiply by the cost-to-charges ratio |
|
|
% |
|
|
% |
|
|
% |
|
|
% |
||||
Estimated cost of total uncompensated care |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
||||
9
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES (continued)
Revenues (continued)
The total uncompensated care amounts include charity care of $
Reclassifications
NOTE 2 — ACQUISITIONS AND DISPOSITIONS
During the six months ended June 30, 2025, we paid $
During the six months ended June 30, 2025, we received proceeds of $
NOTE 3 — INCOME TAXES
Our provisions for income taxes for the quarters ended June 30, 2025 and 2024 were $
Our gross unrecognized tax benefits were $
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. Depending on the resolution of any federal, state and foreign tax disputes, the completion of examinations by federal, state or foreign taxing authorities, or the expiration of statutes of limitation for specific taxing jurisdictions, we believe it is reasonably possible that our liability for unrecognized tax benefits may significantly increase or decrease within the next 12 months. However, we are currently unable to estimate the range of any possible change.
10
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 4 — EARNINGS PER SHARE
The following table sets forth the computation of basic and diluted earnings per share for the quarters and six months ended June 30, 2025 and 2024 (dollars and shares in millions, except per share amounts):
|
|
Quarter |
|
|
Six Months |
|
||||||||||
|
|
2025 |
|
|
2024 |
|
|
2025 |
|
|
2024 |
|
||||
Net income attributable to HCA Healthcare, Inc. |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Weighted average common shares outstanding |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Effect of dilutive incremental shares |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Shares used for diluted earnings per share |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Earnings per share: |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Basic earnings |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
||||
Diluted earnings |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
||||
NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES
A summary of our insurance subsidiaries’ investments at June 30, 2025 and December 31, 2024 follows (dollars in millions):
|
|
June 30, 2025 |
|
|||||||||||||
|
|
|
|
|
Unrealized |
|
|
|
|
|||||||
|
|
Amortized |
|
|
Gains |
|
|
Losses |
|
|
Fair |
|
||||
Debt securities |
|
$ |
|
|
$ |
|
|
$ |
( |
) |
|
$ |
|
|||
Money market funds and other |
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
$ |
|
|
$ |
|
|
$ |
( |
) |
|
|
|
|||
Amounts classified as current assets |
|
|
|
|
|
|
|
|
|
|
|
( |
) |
|||
Investment carrying value |
|
|
|
|
|
|
|
|
|
|
$ |
|
||||
|
|
December 31, 2024 |
|
|||||||||||||
|
|
|
|
|
Unrealized |
|
|
|
|
|||||||
|
|
Amortized |
|
|
Gains |
|
|
Losses |
|
|
Fair |
|
||||
Debt securities |
|
$ |
|
|
$ |
|
|
$ |
( |
) |
|
$ |
|
|||
Money market funds and other |
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
$ |
|
|
$ |
|
|
$ |
( |
) |
|
|
|
|||
Amounts classified as current assets |
|
|
|
|
|
|
|
|
|
|
|
( |
) |
|||
Investment carrying value |
|
|
|
|
|
|
|
|
|
|
$ |
|
||||
At June 30, 2025 and December 31, 2024, the investments in debt securities of our insurance subsidiaries were classified as “available-for-sale.” Changes in unrealized gains and losses that are not credit-related are recorded as adjustments to other comprehensive income or loss.
11
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES (continued)
Scheduled maturities of investments in debt securities at June 30, 2025 were as follows (dollars in millions):
|
|
Amortized |
|
|
Fair |
|
||
Due in one year or less |
|
$ |
|
|
$ |
|
||
Due after one year through five years |
|
|
|
|
|
|
||
Due after five years through ten years |
|
|
|
|
|
|
||
Due after ten years |
|
|
|
|
|
|
||
|
|
$ |
|
|
$ |
|
||
The average expected maturity of the investments in debt securities at June 30, 2025 was
NOTE 6 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE
Accounting Standards Codification 820, Fair Value Measurements and Disclosures (“ASC 820”), emphasizes fair value is a market-based measurement, and fair value measurements should be determined based on the assumptions market participants would use in pricing assets or liabilities. ASC 820 utilizes a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs classified within Levels 1 and 2 of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy).
Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity.
The investments of our insurance subsidiaries are generally classified within Level 1 or Level 2 of the fair value hierarchy because they are valued using quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price transparency.
The following tables summarize the investments of our insurance subsidiaries measured at fair value on a recurring basis as of June 30, 2025 and December 31, 2024, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):
|
|
June 30, 2025 |
|
|||||||||||||
|
|
|
|
|
Fair Value Measurements Using |
|
||||||||||
|
|
Fair Value |
|
|
Quoted Prices in |
|
|
Significant Other |
|
|
Significant |
|
||||
Debt securities |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
— |
|
|||
Money market funds and other |
|
|
|
|
|
|
|
|
— |
|
|
|
— |
|
||
Investments of insurance subsidiaries |
|
|
|
|
|
|
|
|
|
|
|
— |
|
|||
Less amounts classified as current assets |
|
|
( |
) |
|
|
( |
) |
|
|
— |
|
|
|
— |
|
|
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
— |
|
|||
12
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 6 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE (continued)
|
|
December 31, 2024 |
|
|||||||||||||
|
|
|
|
|
Fair Value Measurements Using |
|
||||||||||
|
|
Fair Value |
|
|
Quoted Prices in |
|
|
Significant Other |
|
|
Significant |
|
||||
Debt securities |
|
$ |
|
|
$ |
— |
|
|
$ |
|
|
$ |
— |
|
||
Money market funds and other |
|
|
|
|
|
|
|
|
— |
|
|
|
— |
|
||
Investments of insurance subsidiaries |
|
|
|
|
|
|
|
|
|
|
|
— |
|
|||
Less amounts classified as current assets |
|
|
( |
) |
|
|
( |
) |
|
|
— |
|
|
|
— |
|
|
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
— |
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
The estimated fair value of our long-term debt was $
NOTE 7 — DEBT
A summary of our debt at June 30, 2025 and December 31, 2024, including related interest rates at June 30, 2025, follows (dollars in millions):
|
June 30, |
|
|
December 31, |
|
||
Short-term borrowings: |
|
|
|
|
|
||
Commercial paper (average life of |
$ |
|
|
$ |
|
||
Long-term debt: |
|
|
|
|
|
||
Senior secured term loan facility |
|
|
|
|
|
||
Other senior secured debt (effective interest rate of |
|
|
|
|
|
||
Senior unsecured credit facilities |
|
|
|
|
|
||
Senior unsecured notes payable through |
|
|
|
|
|
||
Debt issuance costs and discounts |
|
( |
) |
|
|
( |
) |
Total long-term debt (average life of |
|
|
|
|
|
||
Total debt |
|
|
|
|
|
||
Less amounts due within one year |
|
|
|
|
|
||
|
$ |
|
|
$ |
|
||
During February 2025, we repaid all $
13
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 7 — DEBT (continued)
During February 2025, we also issued $
During April 2025 and June 2025, we repaid at maturity, utilizing our senior unsecured credit facility, all $
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 $
NOTE 8 — CONTINGENCIES
We operate in a highly regulated and litigious industry. As a result, various lawsuits, claims and legal and regulatory proceedings have been and can be expected to be instituted or asserted against us. We are also subject to claims and suits arising in the ordinary course of business, including claims for personal injuries or wrongful restriction of, or interference with, physicians’ staff privileges. In certain of these actions the claimants may seek punitive damages against us which may not be covered by insurance. We are also subject to claims by various taxing authorities for additional taxes and related interest and penalties. The resolution of any such lawsuits, claims or legal and regulatory proceedings could have a material, adverse effect on our results of operations, financial position or liquidity.
Health care companies are subject to numerous investigations by various governmental agencies. Under the federal False Claims Act (“FCA”), private parties have the right to bring qui tam, or “whistleblower,” suits against companies that submit false claims for payments to, or improperly retain overpayments from, the government. Some states have adopted similar state whistleblower and false claims provisions. Certain of our individual facilities have received, and from time to time other facilities may receive, government inquiries from, and may be subject to investigation by, federal and state agencies. Depending on whether the underlying conduct in these or future inquiries or investigations could be considered systemic, their resolution could have a material, adverse effect on our results of operations, financial position or liquidity.
We accrue for such contingencies to the extent that it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. If we are a party to any proceeding that, either individually or in the aggregate, is probable or reasonably possible of having a material, adverse effect on the business, our results of operations, financial position or liquidity, we disclose a summary of such contingencies and the amount or range of reasonably possible losses in excess of recorded amounts or that we are unable to reasonably estimate the amount or range of losses.
NOTE 9 — SHARE REPURCHASE TRANSACTIONS AND OTHER COMPREHENSIVE LOSS
During January 2025 and 2024, our Board of Directors authorized share repurchase programs for up to $
14
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 9 — SHARE REPURCHASE TRANSACTIONS AND OTHER COMPREHENSIVE LOSS (continued)
The components of accumulated other comprehensive loss are as follows (dollars in millions):
|
Unrealized |
|
|
Foreign |
|
|
Defined |
|
|
Total |
|
||||
Balances at December 31, 2024 |
$ |
( |
) |
|
$ |
( |
) |
|
$ |
( |
) |
|
$ |
( |
) |
Unrealized gains on available-for-sale |
|
|
|
|
|
|
|
|
|
|
|
||||
Foreign currency translation adjustments, net |
|
|
|
|
|
|
|
|
|
|
|
||||
Balances at June 30, 2025 |
$ |
( |
) |
|
$ |
( |
) |
|
$ |
( |
) |
|
$ |
( |
) |
NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION
We operate in one line of business, which is operating hospitals and related health care entities. We operate in
Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses and gains on sales of facilities, losses on retirement of debt, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies.
|
Quarter |
|
|
Six Months |
|
||||||||||||||
|
2025 |
|
|||||||||||||||||
|
National |
|
Atlantic |
|
American |
|
|
National |
|
Atlantic |
|
American |
|
||||||
Revenues |
$ |
|
$ |
|
$ |
|
|
$ |
|
$ |
|
$ |
|
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Salaries and benefits |
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Supplies |
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Other operating expenses |
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Equity in earnings of affiliates |
|
— |
|
|
( |
) |
|
( |
) |
|
|
— |
|
|
( |
) |
|
( |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Adjusted segment EBITDA |
$ |
|
$ |
|
$ |
|
|
$ |
|
$ |
|
$ |
|
||||||
15
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)
|
Quarter |
|
|
Six Months |
|
||||||||||||||
|
2024 |
|
|||||||||||||||||
|
National |
|
Atlantic |
|
American |
|
|
National |
|
Atlantic |
|
American |
|
||||||
Revenues |
$ |
|
$ |
|
$ |
|
|
$ |
|
$ |
|
$ |
|
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Salaries and benefits |
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Supplies |
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Other operating expenses |
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Equity in losses (earnings) of affiliates |
|
|
|
( |
) |
|
( |
) |
|
|
|
|
( |
) |
|
( |
) |
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Adjusted segment EBITDA |
$ |
|
$ |
|
$ |
|
|
$ |
|
$ |
|
$ |
|
||||||
|
|
Quarter |
|
|
Six Months |
|
||||||||||
|
|
2025 |
|
|
2024 |
|
|
2025 |
|
|
2024 |
|
||||
Adjusted segment EBITDA: |
|
|
|
|
|
|
|
|
|
|
|
|
||||
National Group |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
||||
Atlantic Group |
|
|
|
|
|
|
|
|
|
|
|
|
||||
American Group |
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Adjustments to reconcile Total Adjusted segment |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Corporate and Other |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Depreciation and amortization |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Interest expense |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Losses (gains) on sales of facilities |
|
|
|
|
|
( |
) |
|
|
|
|
|
( |
) |
||
Income before income taxes |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
||||
|
|
Quarter |
|
|
Six Months |
|
||||||||||
|
|
2025 |
|
|
2024 |
|
|
2025 |
|
|
2024 |
|
||||
Revenues: |
|
|
|
|
|
|
|
|
|
|
|
|
||||
National Group |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
||||
Atlantic Group |
|
|
|
|
|
|
|
|
|
|
|
|
||||
American Group |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Corporate and other |
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
||||
Depreciation and amortization: |
|
|
|
|
|
|
|
|
|
|
|
|
||||
National Group |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
||||
Atlantic Group |
|
|
|
|
|
|
|
|
|
|
|
|
||||
American Group |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Corporate and other |
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
||||
16
HCA HEALTHCARE, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)
|
|
June 30, |
|
|
December 31, |
|
||
Assets: |
|
|
|
|
|
|
||
National Group |
|
$ |
|
|
$ |
|
||
Atlantic Group |
|
|
|
|
|
|
||
American Group |
|
|
|
|
|
|
||
Corporate and other |
|
|
|
|
|
|
||
|
|
$ |
|
|
$ |
|
||
17
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS
Forward-Looking 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.
18
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.
19
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):
20
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 |
|
$ |
15,638 |
|
|
$ |
14,761 |
|
|
$ |
31,104 |
|
|
$ |
29,540 |
|
Cost-to-charges ratio (patient care costs as percentage of gross |
|
|
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.
21
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.
22
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 |
|
|
|
|
||
23
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 |
|
|
|
|
||
_______
24
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.
25
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.
26
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.
27
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.
28
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.
29
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 |
|
|
|
|
|
|
|
|
|
||
30
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 |
% |
|
31
ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
The information called for by this item is provided under the caption “Market Risk” under Item 2, “Management’s Discussion and Analysis of Financial Condition and Results of Operations.”
ITEM 4. CONTROLS AND PROCEDURES
Evaluation of Disclosure Controls and Procedures
HCA’s management, with the participation of HCA’s chief executive officer and chief financial officer, has evaluated the effectiveness of HCA’s disclosure controls and procedures as of June 30, 2025. Based on that evaluation, HCA’s chief executive officer and chief financial officer concluded that HCA’s disclosure controls and procedures were effective as of June 30, 2025.
Changes in Internal Control Over Financial Reporting
During the period covered by this report, there have been no changes in our internal control over financial reporting that have materially affected or are reasonably likely to materially affect our internal control over financial reporting.
PART II. OTHER INFORMATION
ITEM 1. LEGAL PROCEEDINGS
The information set forth in “Note 8 – Contingencies” in the notes to the condensed consolidated financial statements is incorporated herein by reference.
ITEM 1A. RISK FACTORS
Reference is made to the factors set forth under the caption “Forward-Looking Statements” in Part I, Item 2 of this quarterly report on Form 10-Q and other risk factors described in our annual report on Form 10-K for the year ended December 31, 2024, which are incorporated herein by reference. There have not been any material changes to the risk factors previously disclosed in our annual report on Form 10-K for the year ended December 31, 2024 and our quarterly report on Form 10-Q for the quarter ended March 31, 2025, except as set forth below.
Risks related to our indebtedness:
We have significant indebtedness and may incur further indebtedness in the future. Our indebtedness could adversely affect our ability to raise additional capital to fund our operations, limit our ability to react to changes in the economy or our industry, expose us to interest rate risk to the extent of our variable rate debt and prevent us from meeting our obligations.
As of June 30, 2025, our total indebtedness was $44.483 billion. As of June 30, 2025, we had availability of $6.208 billion under our senior unsecured credit facility (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)). Our indebtedness could have important consequences, including:
32
We and our subsidiaries have the ability to incur additional indebtedness in the future, subject to the restrictions contained in our senior unsecured credit facility and the indentures governing our outstanding notes. If new indebtedness is added to our current debt levels, interest rates and the related risks that we now face could intensify.
We may not be able to generate sufficient cash to service all of our indebtedness and may not be able to refinance our indebtedness on favorable terms. If we are unable to do so, we may be forced to take other actions to satisfy our obligations under our indebtedness, which may not be successful.
Our ability to make scheduled payments on or to refinance our debt obligations depends on our financial condition and operating performance, which are subject to prevailing economic and competitive conditions and to certain financial, business and other factors beyond our control. We cannot guarantee we will maintain a level of cash flows from operating activities sufficient to permit us to pay the principal, premium, if any, and interest on our indebtedness.
In addition, we conduct our operations through our subsidiaries. Accordingly, repayment of our indebtedness is dependent on the generation of cash flows by our subsidiaries and their ability to make such cash available to us by dividend, debt repayment or otherwise. Our subsidiaries may not be able to, or may not be permitted to, make distributions to enable us to make payments in respect of our indebtedness. Each subsidiary is a distinct legal entity, and, under certain circumstances, legal and contractual restrictions may limit our ability to obtain cash from our subsidiaries.
We may find it necessary or prudent to refinance our outstanding indebtedness, the terms of which refinancing may not be favorable to us. Our ability to refinance our indebtedness on favorable terms, or at all, is directly affected by the then current global economic and financial conditions which affect the availability of debt financing and the rates at which such financing is available. In addition, our ability to incur secured indebtedness depends in part on the value of our assets, which depends, in turn, on the strength of our cash flows and results of operations, and on economic and market conditions and other factors. Any downgrade in our credit ratings may also negatively affect availability of debt financing and the rates at which such financing is available.
If our cash flows and capital resources are insufficient to fund our debt service obligations or we are unable to refinance our indebtedness, we may be forced to reduce or delay investments and capital expenditures, or to sell assets, seek additional capital or restructure our indebtedness. These alternative measures may not be successful and may not permit us to meet our scheduled debt service obligations. If our operating results and available cash are insufficient to meet our debt service obligations, we could face substantial liquidity problems and might be required to dispose of material assets or operations to meet our debt service and other obligations. We may not be able to consummate those dispositions, or the proceeds from the dispositions may not be adequate to meet any debt service obligations then due.
33
ITEM 2. UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS
During January 2025, our Board of Directors authorized a share repurchase program for up to $10 billion of our outstanding common stock. During the quarter ended June 30, 2025, we repurchased 7,031,368 shares of our common stock at an average price of $356.35 per share through market purchases pursuant to the January 2025 authorization. At June 30, 2025, we had $5.753 billion of repurchase authorization available under the January 2025 authorization.
The following table provides certain information with respect to our repurchases of common stock from April 1, 2025 through June 30, 2025 (dollars in billions, except per share amounts).
Period |
|
Total Number |
|
|
Average Price |
|
|
Total Number |
|
|
Approximate |
|
||||
April 1, 2025 - April 30,2025 |
|
|
2,739,878 |
|
|
$ |
335.54 |
|
|
|
2,739,878 |
|
|
$ |
7.339 |
|
May 1, 2025 - May 31, 2025 |
|
|
2,427,757 |
|
|
|
364.92 |
|
|
|
2,427,757 |
|
|
|
6.453 |
|
June 1, 2025 - June 30, 2025 |
|
|
1,863,733 |
|
|
$ |
375.77 |
|
|
|
1,863,733 |
|
|
$ |
5.753 |
|
Total for second quarter 2025 |
|
|
7,031,368 |
|
|
$ |
356.35 |
|
|
|
7,031,368 |
|
|
|
|
|
On July 24, 2025, our Board of Directors declared a quarterly dividend of $0.72 per share on our common stock payable on September 30, 2025 to stockholders of record at the close of business on September 16, 2025. Future declarations of quarterly dividends and the establishment of future record and payment dates are subject to the final determination of our Board of Directors.
34
ITEM 5. OTHER INFORMATION
c) During the three months ended June 30, 2025, no director or officer (as defined in Rule 16a-1(f) of the Securities Exchange Act of 1934 (the “Exchange Act”)) of the Company
On
ITEM 6. EXHIBITS
(a) List of Exhibits:
3.1 |
— |
Amended and Restated Certificate of Incorporation of the Company (restated for SEC filing purposes only) (filed as Exhibit 4.1 to the Company’s Registration Statement on Form S-8 (File No. 333-288235, and incorporated herein by reference). |
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10.1 |
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First Amendment to 2020 Stock Incentive Plan for Key Employees of HCA Healthcare, Inc. and its Affiliates (filed as Exhibit 10.1 to the Company's Current Report on Form 8-K filed on April 29, 2025, and incorporated herein by reference).* |
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22 |
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List of Subsidiary Guarantors and Pledged Securities. |
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31.1 |
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Certification of Chief Executive Officer Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. |
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31.2 |
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Certification of Chief Financial Officer Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. |
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32 |
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Certification Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. |
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101 |
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The following financial information from our quarterly report on Form 10-Q for the quarter ended June 30, 2025 filed with the SEC on August 4, 2025, formatted in Inline Extensible Business Reporting Language: (i) the condensed consolidated balance sheets at June 30, 2025 and December 31, 2024, (ii) the condensed consolidated income statements for the quarters and six months ended June 30, 2025 and 2024, (iii) the condensed consolidated comprehensive income statements for the quarters and six months ended June 30, 2025 and 2024, (iv) the condensed consolidated statements of stockholders’ equity (deficit) for the quarters and six months ended June 30, 2025 and 2024, (v) the condensed consolidated statements of cash flows for the six months ended June 30, 2025 and 2024 and (vi) the notes to condensed consolidated financial statements. The instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document. |
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104 |
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The cover page from the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2025, formatted in Inline XBRL (included in Exhibit 101). |
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*Management compensatory plan or arrangement.
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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
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HCA Healthcare, Inc. |
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By: |
/S/ MICHAEL A. MARKS
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Michael A. Marks |
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Executive Vice President and Chief Financial Officer |
Date: August 4, 2025
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