HCA HCA Healthcare Inc

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549

FORM 8-K

CURRENT REPORT

Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934

HCA Healthcare, Inc.

(Exact name of Registrant as Specified in Its Charter)

(Former Name or Former Address, if Changed Since Last Report)

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

Securities registered pursuant to Section 12(b) of the Act:

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

Emerging growth company ☐

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. ☐

Item 2.02. Results of Operations and Financial Condition.

On January 24, 2025, HCA Healthcare, Inc. (the “Company”) issued a press release announcing, among other matters, its results of operations for the fourth quarter and year ended December 31, 2024, the text of which is set forth as Exhibit 99.1.

Item 7.01. Regulation FD Disclosure.

On January 24, 2025, the Company issued a press release announcing, among other matters, its results of operations for the fourth quarter and year ended December 31, 2024, the text of which is set forth as Exhibit 99.1.

Item 8.01. Other Events.

On January 24, 2025, the Company announced that its Board of Directors had authorized an additional share repurchase program for up to $10 billion of the Company’s outstanding common stock. Repurchases will be made in accordance with applicable securities laws from time to time in the open market, through privately negotiated transactions, or otherwise.

On January 24, 2025, the Company announced that its Board of Directors had declared a quarterly cash dividend of $0.72 per share of the Company’s common stock. The dividend will be paid on March 31, 2025 to stockholders of record at the close of business on March 17, 2025.

Item 9.01. Financial Statements and Exhibits.

(d) Exhibits:

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 hereunto duly authorized.

FOR IMMEDIATE RELEASE

HCA Healthcare reports FOURTH quarter 2024 results

AND PROVIDES 2025 GUIDANCE

Nashville, Tenn., January 24, 2025 – HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the fourth quarter ended December 31, 2024.

Key fourth quarter metrics (all percentage changes compare 4Q 2024 to 4Q 2023 unless otherwise noted):

"We finished 2024 with strong business fundamentals that were consistent with previous quarters," said Sam Hazen, Chief Executive Officer of HCA Healthcare. "The first half of the current decade, which ended in 2024, proved to be another period of long-term growth for the company and resulted in operational improvements across key performance indicators and greater value for our patients, employees and shareholders. These accomplishments are a testament to the incredible work of our teams, and position us well for the future."

Revenues in the fourth quarter of 2024 totaled $18.285 billion, compared to $17.303 billion in the fourth quarter of 2023. Net income attributable to HCA Healthcare, Inc. totaled $1.438 billion, or $5.63 per diluted share, compared to $1.607 billion, or $5.93 per diluted share, in the fourth quarter of 2023. Results for the fourth quarter of 2024 include losses on sales of facilities of $195 million, or $0.59 per diluted share, primarily related to the pending sale of a hospital facility in California. Results for the fourth quarter of 2023 include gains on sales of facilities of $7 million, or $0.03 per diluted share.

For the fourth quarter of 2024, Adjusted EBITDA totaled $3.712 billion, compared to $3.618 billion in the fourth quarter of 2023. Adjusted EBITDA is a non-GAAP financial measure. A table providing supplemental information on Adjusted EBITDA and reconciling net income attributable to HCA Healthcare, Inc. to Adjusted EBITDA is included in this release.

Same facility admissions increased 3.0 percent and same facility equivalent admissions increased 3.1 percent in the fourth quarter of 2024, compared to the prior year period. Same facility emergency room visits increased 2.4 percent in the fourth quarter of 2024, compared to the prior year period. Same facility inpatient surgeries increased 2.8 percent, and same facility outpatient surgeries declined 1.3 percent in the fourth quarter of 2024, compared to the same period of 2023. Same facility revenue per equivalent admission increased 2.9 percent in the fourth quarter of 2024, compared to the fourth quarter of 2023.

Year Ended December 31, 2024

Revenues for the year ended December 31, 2024 totaled $70.603 billion, compared to $64.968 billion for the year ended December 31, 2023. Net income attributable to HCA Healthcare, Inc. was $5.760 billion, or $22.00 per diluted share, compared to $5.242 billion, or $18.97 per diluted share, for the year ended December 31, 2023. Results for the year ended December 31, 2024 include gains on sales of facilities of $14 million, or $0.04 per diluted share. Results for the year ended December 31, 2023 included losses on sales of facilities of $5 million, or $0.04 per diluted share.

For 2024, Adjusted EBITDA totaled $13.882 billion, compared to $12.726 billion in 2023. Adjusted EBITDA is a non-GAAP financial measure. A table providing supplemental information on Adjusted EBITDA and reconciling net income attributable to HCA Healthcare, Inc. to Adjusted EBITDA is included in this release.

Balance Sheet and Cash Flows from Operations

As of December 31, 2024, HCA Healthcare, Inc.’s balance sheet reflected cash and cash equivalents of $1.933 billion, total debt of $43.031 billion, and total assets of $59.513 billion. During the fourth quarter of 2024, capital expenditures totaled $1.285 billion, excluding acquisitions. Cash flows provided by operating activities in the fourth quarter of 2024 totaled $2.559 billion, compared to $2.674 billion in the fourth quarter of 2023.

During the fourth quarter of 2024, the Company repurchased 4.739 million shares of its common stock at a cost of $1.700 billion. The Company had $764 million remaining under its repurchase authorization as of December 31, 2024. As of December 31, 2024, the Company had $7.986 billion of availability under its credit facilities.

Share Repurchase Program

The HCA Healthcare, Inc. Board of Directors has authorized an additional share repurchase program for up to $10 billion of the Company’s outstanding common stock. Repurchases will be made in accordance with applicable securities laws and may be made at management’s discretion from time to time in the open market, through privately negotiated transactions, or otherwise. The repurchase program has no time limit and may be suspended for periods or discontinued at any time.

Dividend

HCA today announced that its Board of Directors declared a quarterly cash dividend of $0.72 per share on the Company’s common stock. The dividend will be paid on March 31, 2025 to stockholders of record at the close of business on March 17, 2025.

The declaration and payment of any future dividend will be subject to the discretion of the Board of Directors and will depend on a variety of factors, including the Company’s financial condition, results of operations, and contractual restrictions. Future dividends are expected to be funded by cash balances and future cash flows from operations.

Impact of Hurricanes

During the fourth quarter of 2024, the Company incurred additional expenses and experienced loss of revenues estimated at $200 million, or $0.60 per diluted share, associated with Hurricane Helene's impact on its North Carolina facilities, as well as from Hurricane Milton, which impacted certain facilities in Florida.

For the year ended December 31, 2024, the Company incurred additional expenses and experienced loss of revenues estimated at $250 million, or $0.73 per diluted share, associated with the impact of Hurricanes Helene and Milton on the Company's North Carolina facilities and certain facilities in Florida.

These estimates do not include any insurance recoveries the Company may receive. All facilities impacted by Hurricanes Helene and Milton have resumed normal operations.

2025 Guidance

Today, the Company issued the following estimated guidance for 2025:

Capital expenditures for 2025, excluding acquisitions, are estimated to be approximately $5.0 to $5.2 billion.

The Company’s guidance contains a number of assumptions, including, among others, the Company’s current expectations regarding volume growth coupled with an anticipated mostly stable operating environment, payer mix, and the ongoing impacts of the two major hurricanes, the impact of current and future health care public policy developments, as well as general economic conditions, including inflation, and excludes the impact of items such as, but not limited to, gains or losses on sales of facilities, losses on retirement of debt, legal claims costs and impairment of long-lived assets.

Adjusted EBITDA is a non-GAAP financial measure. A table reconciling forecasted net income attributable to HCA Healthcare, Inc. to forecasted Adjusted EBITDA is included in this release.

The Company’s guidance is based on current plans and expectations and are subject to a number of known and unknown uncertainties and risks, including those set forth below in the Company’s “Forward-Looking Statements.”

Annual Stockholders' Meeting

The Company's 2025 annual stockholders' meeting will be held virtually on April 24, 2025 at 2:00 p.m. Central Time for stockholders of record as of February 24, 2025.

Earnings Conference Call

HCA Healthcare will host a conference call for investors at 9:00 a.m. Central Time today. All interested investors are invited to access a live audio broadcast of the call via webcast. The broadcast also will be available on a replay basis beginning this afternoon. The webcast can be accessed through the Company’s Investor Relations web page at https://investor.hcahealthcare.com/events-and-presentations/default.aspx.

About the Company

As of December 31, 2024, HCA operated 190 hospitals and approximately 2,400 ambulatory sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics, in 20 states and the United Kingdom.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements include the Company’s financial guidance for the year ending December 31, 2025, as well as other statements that do not relate solely to historical or current facts. Forward-looking statements can be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “plan,” “initiative” or “continue.” These forward-looking statements are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and expectations and our future financial position and results of operations. These factors include, but are not limited to, (1) changes in or related to general economic conditions nationally and regionally in our markets, including inflation and economic and business conditions (and the impact thereof on the economy, financial markets and banking industry); changes in revenues due to declining patient volumes; changes in payer mix (including increases in uninsured and underinsured patients); potential increased expenses related to labor, supply chain or other expenditures; workforce disruptions; supply shortages and disruptions (including as a result of geopolitical disruptions); and the impact of potential federal government shutdowns, (2) the impact of our significant indebtedness and the ability to refinance such indebtedness on acceptable terms, (3) the impact of current and future health care public policy developments and possible changes to other federal, state or local laws and regulations affecting the health care industry, including, but not limited to, the expiration of enhanced premium tax credits for individuals eligible to purchase insurance coverage through federal and state-based health insurance marketplaces, (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 the potential for future deficit reduction legislation that may alter these spending reductions, which include cuts to Medicare payments, or create additional spending reductions, (5) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (6) the ability to achieve operating and financial targets, attain expected levels of patient volumes and revenues, and control the costs of providing services, (7) possible changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs, Medicaid waiver programs or state directed payments, that may impact reimbursements to

health care providers and insurers and the size of the uninsured or underinsured population, (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 climate change 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 including interpretive guidance that may be issued by taxing authorities or other standard setting bodies, (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, (26) the impact of recent decisions of the U.S. Supreme Court regarding the actions of federal agencies, and (27) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2023 and our other filings with the Securities and Exchange Commission. Many of the factors that will determine our future results are beyond our ability to control or predict. In light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management’s views only as of the date hereof. We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise. All references to “Company,” “HCA” and “HCA Healthcare” as used throughout this release refer to HCA Healthcare, Inc. and its affiliates.

HCA Healthcare, Inc.

Condensed Consolidated Comprehensive Income Statements

Fourth Quarter

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(Dollars in millions, except per share amounts)

HCA Healthcare, Inc.

Condensed Consolidated Comprehensive Income Statements

For the Years Ended December 31, 2024 and 2023

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(Dollars in millions, except per share amounts)

HCA Healthcare, Inc.

Condensed Consolidated Balance Sheets

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HCA Healthcare, Inc.

Condensed Consolidated Statements of Cash Flows

For the Years Ended December 31, 2024 and 2023

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HCA Healthcare, Inc.

Operating Statistics