Buoyed by sturdy admissions and income progress, the leaders of HCA Healthcare Inc. have boosted their 2024 capital tasks price range by about $500 million from final 12 months to proceed to develop their community, significantly for outpatient providers.
Nashville-based HCA plans to spend between $5.1 billion and $5.3 billion this 12 months, versus $4.7 billion in 2023, on inpatient, outpatient and know-how additions or upgrades. Talking after he and his staff reported fourth-quarter outcomes—internet revenue of $1.86 billion on greater than $17 billion in revenues—CEO Sam Hazen had a easy message on capex: Extra of the identical.
“We’re fairly constant in our allocation of capital. It’s not disproportionately oriented to anybody class of our enterprise,” Hazen mentioned. “It’s allowed us to satisfy the demand expectations that exist available in the market and it’s additionally responded to our physicians in a means that created the capability or allowed for the medical know-how that they want […] We’re stepping it up as a result of we now have a rising occupancy on the inpatient facet after which we now have alternatives within the outpatient facet to increase our networks.”
HCA completed 2023 with 186 hospitals and 124 freestanding surgical procedure facilities in its portfolio. These services dealt with practically 975,000 equal admissions within the fourth quarter, a rise of 4.6 % from late 2022. Income per equal admissions popped much more, climbing 6.8 % 12 months over 12 months—and exhibiting the opposite facet of the upper utilization dynamic that has dinged the outlooks of a number of well being insurers of late.
HCA’s work to construct on that momentum this 12 months will tilt a bit of extra towards new outpatient websites. Hazen mentioned a big improvement pipeline there’ll result in extra spending and extra opening in 2024 and 2025 in comparison with the previous two years. On the hospital facet, the variety of beds to be added to HCA’s system—the corporate counted practically 49,600 licensed beds on the finish of 2023—will likely be in step with final 12 months’s roughly 300.
CFO Invoice Rutherford—who final week introduced he’ll retire Might 1 and be succeeded by Senior Vice President of Finance Mike Marks—mentioned he expects admissions progress this 12 months will likely be between 3 % and 4 %, not fairly final 12 months’s tempo however nonetheless comfortably forward of HCA’s historic expertise. Serving to drive demand, he mentioned, had been sturdy medical insurance alternate enrollment progress in most of the states the place HCA does quite a lot of enterprise.
HCA’s progress final quarter outpaced that of Tenet Healthcare Corp., the place the variety of ambulatory surgical procedure circumstances climbed 3.9 % 12 months over 12 months however adjusted hospital admissions ticked up solely 0.1 % from late 2022.
Chairman and CEO Saum Sutaria, whose staff just lately closed on the sale of three South Carolina hospitals and signed a deal to promote 4 others in California, final week instructed analysts his spending priorities haven’t modified: First up, Tenet’s USPI outpatient surgical procedure division will get some $250 million of capital and that will likely be adopted by investments in hospital progress tasks.
“Particularly on USPI, we speak about traditionally $200 million to $250 million, now nearer to $250 million, in capital allocation yearly,” Sutaria mentioned. “However the truth is, should you return during the last 5 years and simply have a look at what we’ve spent and common it out […] it’s been fairly a bit greater than $200 million to $250 million. We […] clearly are comfy going above the $200 million to $250 million if these alternatives exist.”