HCA Healthcare Today | --- | --- | |-----------------------|-------| | | | | | | | | | | HCA HCA Healthcare | | | $358.73 | | | +3.95 (+1.11%) | | | 52-Week Range $215.96 | | | ▼ | | | $361.12 | | | Dividend Yield 0.74% | | | P/E Ratio 17.88 | | | Price Target $341.12 | | | Add to Watchlist | | The nation's largest hospital operator, HCA Healthcare Inc. NYSE: HCA, surged to all-time highs following its strong Q2 2024 earnings results. The dramatic growth in acute care services has driven hospital stocks to ...

Part I. Financial Information [Item 1. Financial Statements](index=3&type=section&id=Item%201.%20Financial%20Statements) This section presents HCA Healthcare's unaudited condensed consolidated financial statements for periods ended June 30, 2024, detailing income, balance sheet, cash flows, and equity, with notes on accounting policies and key activities [Condensed Consolidated Income Statements](index=4&type=section&id=Condensed%20Consolidated%20Income%20Statements) Revenues for Q2 2024 increased to $17.49 billion, a 10.3% rise from Q2 2023, with net income attributable to HCA growing to $1.46 billion, or $5.53 per diluted share Q2 Financial Performance (2024 vs. 2023) | Metric | Q2 2024 | Q2 2023 | Change | | :--- | :--- | :--- | :--- | | **Revenues** | $17,492 M | $15,861 M | +10.3% | | **Net Income Attributable to HCA** | $1,461 M | $1,193 M | +22.5% | | **Diluted EPS** | $5.53 | $4.29 | +28.9% | Six Months Financial Performance (2024 vs. 2023) | Metric | Six Months 2024 | Six Months 2023 | Change | | :--- | :--- | :--- | :--- | | **Revenues** | $34,831 M | $31,452 M | +10.7% | | **Net Income Attributable to HCA** | $3,052 M | $2,556 M | +19.4% | | **Diluted EPS** | $11.47 | $9.14 | +25.5% | [Condensed Consolidated Balance Sheets](index=8&type=section&id=Condensed%20Consolidated%20Balance%20Sheets) As of June 30, 2024, total assets were $57.38 billion, total debt stood at $40.88 billion, and stockholders' deficit improved to $1.60 billion Balance Sheet Summary (in millions) | Account | June 30, 2024 | Dec 31, 2023 | | :--- | :--- | :--- | | **Total Current Assets** | $15,173 | $14,927 | | **Total Assets** | $57,379 | $56,211 | | **Total Current Liabilities** | $14,301 | $12,655 | | **Long-term Debt** | $36,306 | $37,169 | | **Stockholders' Deficit (HCA)** | ($1,600) | ($1,774) | [Condensed Consolidated Statements of Cash Flows](index=12&type=section&id=Condensed%20Consolidated%20Statements%20of%20Cash%20Flows) Net cash from operating activities for the first six months of 2024 was $4.44 billion, with significant cash used in investing and financing activities, including share repurchases and dividends Six-Month Cash Flow Summary (in millions) | Activity | Six Months 2024 | Six Months 2023 | | :--- | :--- | :--- | | **Net Cash from Operations** | $4,440 | $4,278 | | **Net Cash used in Investing** | ($2,235) | ($2,408) | | **Net Cash used in Financing** | ($2,309) | ($1,923) | | **Change in Cash** | ($104) | ($46) | - Key financing activities in the first six months of 2024 included **$2.55 billion** in share repurchases and **$356 million** in dividend payments[46](index=46&type=chunk) [Notes to Condensed Consolidated Financial Statements](index=14&type=section&id=Notes%20to%20Condensed%20Consolidated%20Financial%20Statements) The notes detail accounting policies and financial activities, including revenue recognition, acquisitions, debt, and segment performance, with the company operating 188 hospitals and other facilities - As of June 30, 2024, HCA and its affiliates owned and operated **188 hospitals**, **123 freestanding surgery centers**, and **23 freestanding endoscopy centers** across 20 states and England[49](index=49&type=chunk) Revenue by Payer - Six Months Ended June 30 (in millions) | Payer | 2024 | % of Total | 2023 | % of Total | | :--- | :--- | :--- | :--- | :--- | | Managed care and insurers | $17,094 | 49.0% | $15,453 | 49.2% | | Managed Medicare | $5,939 | 17.0% | $5,100 | 16.2% | | Medicare | $5,459 | 15.7% | $5,305 | 16.9% | | Medicaid | $2,108 | 6.1% | $1,477 | 4.7% | | Managed Medicaid | $2,011 | 5.8% | $1,807 | 5.7% | | Other | $1,392 | 4.0% | $1,558 | 4.9% | | International | $828 | 2.4% | $752 | 2.4% | | **Total Revenues** | **$34,831** | **100.0%** | **$31,452** | **100.0%** | - The estimated cost of total uncompensated care for the first six months of 2024 was **$2.08 billion**, up from **$1.73 billion** in the same period of 2023[30](index=30&type=chunk)[54](index=54&type=chunk) - During the first six months of 2024, the company paid **$50 million** to acquire two hospitals in Texas and **$81 million** for nonhospital entities, while receiving **$297 million** from the sale of a California hospital[31](index=31&type=chunk)[83](index=83&type=chunk) - In February 2024, HCA issued **$4.5 billion** in senior notes and in March 2024, repaid **$2.0 billion** of senior notes at maturity[67](index=67&type=chunk) - The company repurchased **8.111 million** shares of common stock in the first six months of 2024, with **$4.228 billion** remaining available under the January 2024 repurchase authorization[97](index=97&type=chunk) [Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations](index=23&type=section&id=Management's%20Discussion%20and%20Analysis%20of%20Financial%20Condition%20and%20Results%20of%20Operations) Management discusses Q2 and H1 2024 financial results, highlighting a 10.3% Q2 revenue increase driven by admissions and revenue per admission, covering revenue, volume, expenses, liquidity, and market risks [Results of Operations](index=24&type=section&id=Results%20of%20Operations) For Q2 2024, revenue grew 10.3% year-over-year, driven by increased admissions and revenue per admission, with net income rising 22.5% and improved salary and benefits as a percentage of revenue Key Performance Indicators - Q2 2024 vs Q2 2023 (% Change) | Metric | Consolidated Change | Same Facility Change | | :--- | :--- | :--- | | **Revenues** | +10.3% | +9.9% | | **Admissions** | +6.0% | +5.8% | | **Equivalent Admissions** | +6.0% | +5.2% | | **Revenue per Equivalent Admission** | +4.1% | +4.4% | - Salaries and benefits as a percentage of revenues improved to **43.9%** in Q2 2024 from **45.9%** in Q2 2023, primarily due to a **25.7%** year-over-year decline in contract labor costs[116](index=116&type=chunk) - Other operating expenses increased as a percentage of revenue to **20.7%** in Q2 2024 from **19.2%** in Q2 2023, mainly due to higher costs for professional fees and state provider fees[117](index=117&type=chunk) - The effective tax rate for Q2 2024 was **27.4%**, up from **24.9%** in Q2 2023, primarily due to adjustments to the liability for unrecognized tax benefits[169](index=169&type=chunk) [Revenue/Volume Trends](index=24&type=section&id=Revenue%2FVolume%20Trends) In Q2 2024, consolidated admissions grew by 6.0% and emergency department visits increased by 5.3%, with the estimated cost of total uncompensated care rising to $1.07 billion Volume Trends - Q2 2024 vs Q2 2023 (Consolidated % Change) | Metric | % Change | | :--- | :--- | | **Admissions** | +6.0% | | **Emergency Department Visits** | +5.3% | | **Inpatient Surgeries** | +2.6% | | **Outpatient Surgeries** | -1.8% | | **Uninsured Admissions** | +4.0% | - The estimated cost of total uncompensated care rose to **$1.072 billion** in Q2 2024 from **$899 million** in Q2 2023, and for the first six months, it was **$2.082 billion** in 2024 compared to **$1.730 billion** in 2023[109](index=109&type=chunk)[133](index=133&type=chunk) - Hospitals in Texas and Florida generated **51%** of the company's revenues and **59%** of its admissions in Q2 2024[111](index=111&type=chunk) [Liquidity and Capital Resources](index=35&type=section&id=Liquidity%20and%20Capital%20Resources) The company generated $4.44 billion in cash from operations in H1 2024, with planned capital expenditures of $5.1 to $5.3 billion for the full year, confirming sufficient liquidity - Cash provided by operating activities for the first six months of 2024 was **$4.440 billion**, an increase of **$162 million** from the prior year period[124](index=124&type=chunk) - Capital expenditures are planned to be between **$5.1 billion** and **$5.3 billion** for the full year 2024[124](index=124&type=chunk) - As of June 30, 2024, HCA had **$7.137 billion** available under its senior secured credit facilities[124](index=124&type=chunk) - Management confirms that cash flows from operations, available credit, and access to debt markets are expected to be sufficient to meet liquidity needs for the foreseeable future[177](index=177&type=chunk) [Item 3. Quantitative and Qualitative Disclosures About Market Risk](index=36&type=section&id=Quantitative%20and%20Qualitative%20Disclosures%20About%20Market%20Risk) HCA is exposed to market risks from interest rate changes on its variable-rate debt and market value fluctuations of securities held by its insurance subsidiaries, with a hypothetical 1% interest rate increase reducing pretax earnings by $21 million annually - The company is exposed to interest rate risk, with **$2.125 billion** of its debt subject to variable rates as of June 30, 2024[178](index=178&type=chunk) - A hypothetical **1%** increase in interest rates would result in an estimated potential annualized reduction to future pretax earnings of approximately **$21 million**[178](index=178&type=chunk) - Investments held by insurance subsidiaries, valued at **$587 million**, are exposed to market value and illiquidity risks, with **$31 million** in unrealized losses as of June 30, 2024[178](index=178&type=chunk) [Item 4. Controls and Procedures](index=41&type=section&id=Controls%20and%20Procedures) Management, including the CEO and CFO, concluded that the company's disclosure controls and procedures were effective as of June 30, 2024, with no material changes in internal control over financial reporting - The CEO and CFO concluded that HCA's disclosure controls and procedures were effective as of June 30, 2024[184](index=184&type=chunk) - No changes in internal control over financial reporting occurred during the quarter that have materially affected, or are reasonably likely to materially affect, internal controls[185](index=185&type=chunk) Part II. Other Information [Item 1. Legal Proceedings](index=41&type=section&id=Item%201.%20Legal%20Proceedings) The company operates in a highly regulated and litigious industry, subject to various lawsuits, claims, and governmental investigations, including whistleblower suits, which could materially affect financial results - As a healthcare company, HCA is subject to numerous lawsuits, claims, and legal proceedings, including government investigations and whistleblower suits, which are inherent to the industry[96](index=96&type=chunk)[160](index=160&type=chunk) [Item 1A. Risk Factors](index=41&type=section&id=Item%201A.%20Risk%20Factors) No material changes were reported to the risk factors previously disclosed in the company's Annual Report on Form 10-K for the year ended December 31, 2023 - No material changes were reported to the risk factors disclosed in the 2023 Annual Report on Form 10-K[161](index=161&type=chunk) [Item 2. Unregistered Sales of Equity Securities and Use of Proceeds](index=41&type=section&id=Item%202.%20Unregistered%20Sales%20of%20Equity%20Securities%20and%20Use%20of%20Proceeds) During Q2 2024, HCA repurchased 4.22 million shares for $1.37 billion, with $4.228 billion remaining under authorization, and declared a quarterly dividend of $0.66 per share Share Repurchases - Q2 2024 | Month | Shares Purchased | Average Price Paid | | :--- | :--- | :--- | | April 2024 | 1,306,069 | $321.58 | | May 2024 | 1,784,870 | $317.63 | | June 2024 | 1,125,922 | $337.51 | | **Total Q2** | **4,216,861** | **$324.16** | - As of June 30, 2024, **$4.228 billion** of repurchase authorization was available under the January 2024 program[162](index=162&type=chunk) - On July 22, 2024, the Board of Directors declared a quarterly dividend of **$0.66 per share**, payable on September 30, 2024[163](index=163&type=chunk) [Item 6. Exhibits](index=42&type=section&id=Item%206.%20Exhibits) This section lists the exhibits filed with the Form 10-Q, including CEO and CFO certifications and financial statements formatted in Inline XBRL - The exhibits include CEO and CFO certifications pursuant to Sections 302 and 906 of the Sarbanes-Oxley Act, and financial data formatted in Inline XBRL[165](index=165&type=chunk)[192](index=192&type=chunk)

Relative % Price change – 4 weeks greater than 0 Current Price greater than or equal to $5 and Average 20-day Volume greater than or equal to 50,000: A minimum price of $5 is a good standard to screen low-priced stocks, while a high trading volume would imply adequate liquidity. Notably, the Zacks Consensus Estimate for Seagate Technology's fiscal 2025 earnings per share indicates 352.7% year-over-year growth. The firm has a market capitalization of $22.1 billion. STX shares have gone up 89% in a year. Inte ...

Core Insights - Spotify's monthly active users (MAU) are projected to increase by 13 million in Q3, reaching 639 million, while subscribers are expected to rise by 5 million to 251 million [2] - Both HCA Healthcare and Spotify exceeded Q2 earnings expectations, indicating a promising investment opportunity due to their increased profitability [4] - Spotify's Q2 sales reached $4.09 billion, an 18% increase from $3.45 billion in Q2 2023, despite slightly missing estimates [5] - HCA's Q2 EPS increased by 28% to $5.50, surpassing the Zacks EPS Consensus of $4.97 by 10% [10] - Spotify's Q2 EPS was $1.43, a significant improvement from an adjusted loss of -$1.69 in the prior year, exceeding expectations by 32% [12] - Spotify achieved a gross margin of 29.2% and a record free cash flow of approximately $531.74 million [13][14] - Both companies are expected to see upward revisions in earnings estimates, with anticipated double-digit EPS growth for fiscal 2024 and FY25 [16] Company Performance - Spotify's stock has surged over 70% this year, while HCA's stock has increased by 26%, both outperforming the S&P 500's 17% gain [15] - HCA operates various healthcare facilities and has seen strong demand for its services across 20 states and the UK [9]

Core Insights - HCA Healthcare reported increased patient usage of its facilities, leading to sales and profits exceeding forecasts for the second quarter [1][4] - The company raised its full-year adjusted earnings per share (EPS) and revenue guidance [2][8] Financial Performance - HCA Healthcare's second-quarter adjusted EPS was $5.53, surpassing the analyst estimate of $4.86 [7] - Revenue increased by 10.3% to $17.49 billion, also above expectations [7] Patient Metrics - Same-facility admissions rose by 5.8% year-on-year [5] - Same-facility emergency room visits increased by 5.5% [5] - Same-facility inpatient surgeries grew by 2.6% [5] - However, same-facility outpatient surgeries declined by 2.1% [5] Guidance Update - The company raised its full-year adjusted EPS outlook to a range of $21.60 to $22.80, up from $19.70 to $21.20 [8] - Revenue guidance for the year was increased to $69.75 billion to $71.75 billion, up from $67.75 billion to $70.25 billion [8] Stock Performance - HCA Healthcare shares rose by 4.2% to $338.95 in late trading, reaching an intraday high of $348.00 [3] - The stock's record closing high was $343.29, recorded in late June [3]

Financial Data and Key Metrics Changes - The company reported a 28% increase in diluted earnings per share, reaching $5.50 compared to the previous year [68] - Same-facility revenue growth was 10%, driven by broad-based volume growth across markets and service lines [71] - Adjusted EBITDA for the quarter was $3.55 billion, representing a 16% increase year-over-year [76] Business Line Data and Key Metrics Changes - Inpatient admissions grew by 5.8%, equivalent admissions increased by 5.2%, and emergency room visits rose by 5.5% [69] - Inpatient surgeries were up 2.6%, while outpatient surgery cases decreased by 2%, primarily due to lower volumes in Medicaid and self-pay categories [69][70] - The payer mix improved, with commercial volumes representing 36.2% of equivalent admissions [70] Market Data and Key Metrics Changes - Exchange admissions accounted for approximately 7% of total admissions and ER visits, translating to about 9% of revenues [51] - Managed care volumes, including healthcare exchange volumes, were up 12.5% year-over-year [93] - Medicaid volumes were down 10% on equivalent admissions, largely due to Medicaid redeterminations [95] Company Strategy and Development Direction - The company is focused on investing in leadership development, technology, and expanding capacity to meet community needs [5][4] - A disciplined approach to operations and capital allocation is expected to continue producing positive outcomes for stakeholders [72] - The company plans to invest around $5.2 billion in capital expenditures, emphasizing network development and clinical technology [110] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about continued volume growth and strong demand for services, projecting a 4% to 6% growth range for the year [102] - The company anticipates a $100 million to $200 million tailwind from Medicaid supplemental payment programs, a shift from previous expectations of a headwind [105] - Management noted that the operational performance is solid, supported by strong volume and stable wage inflation [38][36] Other Important Information - The company repurchased $1.37 billion of its outstanding shares in the quarter and paid about $170 million in dividends [78] - Capital expenditures totaled $1.28 billion, with a debt-to-adjusted EBITDA leverage near the low end of the stated guidance range [78] Q&A Session Summary Question: Clarification on exchange admissions and outpatient surgeries trends - Exchange volumes were approximately 7% of admissions, with outpatient surgeries down about 2%, primarily due to trends in Medicaid and uninsured patients [7][8] Question: Update on core wage inflation and M&A impact - Wage inflation is expected to remain steady at 2.5% to 3%, with M&A contributing approximately $400 million in revenue but dilutive to earnings by about 1% [12][14] Question: Medicaid supplemental payments and margins evolution - Medicaid margins have improved but still fall short of covering the cost of care; sustainability of supplemental payments is expected [20][17] Question: CapEx outlook and share repurchase plans - The company maintains a CapEx outlook of $5.1 billion to $5.3 billion for 2024, with plans for $6 billion in share repurchases [22][28] Question: Trends in outpatient surgeries and potential impacts - Volume declines in outpatient surgeries are attributed to Medicaid and uninsured categories, with expectations for improvement in the second half of the year [54][55]

Core Viewpoint - HCA Healthcare has demonstrated strong financial performance, surpassing earnings and revenue expectations, indicating a positive outlook for the company and its stock [1][2][8]. Financial Performance - HCA reported quarterly earnings of $5.50 per share, exceeding the Zacks Consensus Estimate of $4.97 per share, and showing an increase from $4.29 per share a year ago [8]. - The company achieved revenues of $17.49 billion for the quarter ended June 2024, surpassing the Zacks Consensus Estimate by 2.22% and reflecting a year-over-year increase from $15.86 billion [2]. - HCA has outperformed consensus revenue estimates four times over the last four quarters [2]. Stock Performance - HCA shares have increased approximately 20.2% since the beginning of the year, outperforming the S&P 500's gain of 16.7% [3]. - The current consensus EPS estimate for the upcoming quarter is $4.46 on revenues of $17.18 billion, and for the current fiscal year, it is $20.97 on revenues of $69.73 billion [5]. Earnings Outlook - The trend for earnings estimate revisions for HCA is favorable, contributing to a Zacks Rank 2 (Buy) for the stock, suggesting expected outperformance in the near future [12]. - The sustainability of the stock's price movement will depend on management's commentary during the earnings call [10]. Industry Context - The Medical - Hospital industry, to which HCA belongs, is currently ranked in the top 5% of over 250 Zacks industries, indicating a strong industry outlook [13]. - Empirical research shows a strong correlation between near-term stock movements and trends in earnings estimate revisions, which can be tracked by investors [4].

HCA Healthcare Second Quarter 2024 Earnings Release [Financial & Operating Highlights](index=1&type=section&id=Financial%20%26%20Operating%20Highlights) HCA Healthcare reported strong Q2 and H1 2024 financial and operational growth, raising full-year guidance [Second Quarter 2024 Performance](index=1&type=section&id=Second%20Quarter%202024%20Performance) Q2 2024 Key Financial Metrics (vs. Q2 2023) | Metric | Q2 2024 | Q2 2023 | Change | | :--- | :--- | :--- | :--- | | Revenues | $17.492 billion | $15.861 billion | +10.3% | | Net Income Attributable to HCA | $1.461 billion | $1.193 billion | +22.5% | | Diluted EPS | $5.53 | $4.29 | +28.9% | | Adjusted EBITDA | $3.550 billion | $3.056 billion | +16.2% | - Q2 2024 results included gains on sales of facilities of **$12 million**, or **$0.03 per diluted share**[3](index=3&type=chunk) Q2 2024 Same Facility Operating Metrics (YoY) | Metric | % Change | | :--- | :--- | | Admissions | +5.8% | | Equivalent Admissions | +5.2% | | Emergency Room Visits | +5.5% | | Inpatient Surgeries | +2.6% | | Outpatient Surgeries | -2.1% | | Revenue per Equivalent Admission | +4.4% | [Year-to-Date 2024 Performance](index=2&type=section&id=Year-to-Date%202024%20Performance) Six Months Ended June 30, 2024 Key Financials (vs. 2023) | Metric | H1 2024 | H1 2023 | Change | | :--- | :--- | :--- | :--- | | Revenues | $34.831 billion | $31.452 billion | +10.7% | | Net Income Attributable to HCA | $3.052 billion | $2.556 billion | +19.4% | | Diluted EPS | $11.47 | $9.14 | +25.5% | - Results for the first six months of 2024 include gains on sales of facilities of **$213 million ($0.61 per diluted share)**, compared to losses of **$14 million ($0.08 per diluted share)** in the same period of 2023[6](index=6&type=chunk) [Balance Sheet and Cash Flow](index=2&type=section&id=Balance%20Sheet%20and%20Cash%20Flow) Key Balance Sheet and Cash Flow Items (as of June 30, 2024) | Item | Amount | | :--- | :--- | | Cash and cash equivalents | $831 million | | Total Debt | $40.880 billion | | Total Assets | $57.379 billion | | Q2 2024 Capital Expenditures | $1.281 billion | | Q2 2024 Cash Flow from Operations | $1.971 billion | - Cash flows from operating activities decreased to **$1.971 billion** in Q2 2024 from **$2.475 billion** in Q2 2023[7](index=7&type=chunk) [Shareholder Returns](index=2&type=section&id=Shareholder%20Returns) - The company repurchased **4.217 million shares** of its common stock for **$1.367 billion** during the second quarter of 2024[8](index=8&type=chunk) - As of June 30, 2024, HCA had **$4.228 billion** remaining under its share repurchase authorization[8](index=8&type=chunk) - The Board of Directors declared a quarterly cash dividend of **$0.66 per share**, payable on September 30, 2024[9](index=9&type=chunk) [2024 Revised Guidance](index=3&type=section&id=2024%20Revised%20Guidance) HCA Healthcare raised its full-year 2024 guidance for key financial metrics, reflecting strong first-half performance Revised 2024 Full-Year Guidance | Metric | Previous Guidance | Revised Guidance | | :--- | :--- | :--- | | Revenues | $67.75 - $70.25 B | $69.75 - $71.75 B | | Net Income Attributable to HCA | $5.20 - $5.60 B | $5.675 - $5.975 B | | Adjusted EBITDA | $12.85 - $13.55 B | $13.75 - $14.25 B | | EPS (diluted) | $19.70 - $21.20 | $21.60 - $22.80 | - Capital expenditures for 2024, excluding acquisitions, are estimated to remain in the range of **$5.1 to $5.3 billion**[12](index=12&type=chunk) - The revised guidance is based on current expectations for patient volumes and payor mix, and excludes potential impacts from items like gains/losses on facility sales or legal costs[13](index=13&type=chunk) [Financial Statements](index=6&type=section&id=Financial%20Statements) This section presents the unaudited condensed consolidated financial statements for Q2 and H1 2024 [Condensed Consolidated Comprehensive Income Statements](index=6&type=section&id=Condensed%20Consolidated%20Comprehensive%20Income%20Statements) Q2 2024 Income Statement Highlights (vs Q2 2023) | Line Item | Q2 2024 ($M) | Q2 2023 ($M) | | :--- | :--- | :--- | | Revenues | 17,492 | 15,861 | | Salaries and benefits | 7,685 | 7,277 | | Income before income taxes | 2,237 | 1,809 | | Net Income Attributable to HCA | 1,461 | 1,193 | H1 2024 Income Statement Highlights (vs H1 2023) | Line Item | H1 2024 ($M) | H1 2023 ($M) | | :--- | :--- | :--- | | Revenues | 34,831 | 31,452 | | Salaries and benefits | 15,392 | 14,361 | | Income before income taxes | 4,484 | 3,731 | | Net Income Attributable to HCA | 3,052 | 2,556 | [Condensed Consolidated Balance Sheets](index=8&type=section&id=Condensed%20Consolidated%20Balance%20Sheets) Balance Sheet Summary (as of June 30, 2024) | Account | June 30, 2024 ($M) | Dec 31, 2023 ($M) | | :--- | :--- | :--- | | Cash and cash equivalents | 831 | 935 | | Total Assets | 57,379 | 56,211 | | Long-term debt (including current portion) | 40,880 | 39,593 | | Total Stockholders' Equity | 1,339 | 1,060 | [Condensed Consolidated Statements of Cash Flows](index=9&type=section&id=Condensed%20Consolidated%20Statements%20of%20Cash%20Flows) Cash Flow Summary (Six Months Ended June 30) | Cash Flow Activity | 2024 ($M) | 2023 ($M) | | :--- | :--- | :--- | | Net cash provided by operating activities | 4,440 | 4,278 | | Net cash used in investing activities | (2,235) | (2,408) | | Net cash used in financing activities | (2,309) | (1,923) | | Change in cash and cash equivalents | (104) | (46) | [Operating Statistics](index=10&type=section&id=Operating%20Statistics) Operating statistics for Q2 and H1 2024 show broad volume growth, with a slight decline in outpatient surgeries Q2 2024 Same Facility Key Metrics (% Change YoY) | Metric | % Change | | :--- | :--- | | Admissions | +5.8% | | Equivalent Admissions | +5.2% | | Revenue per Equivalent Admission | +4.4% | | Inpatient Surgery Cases | +2.6% | | Outpatient Surgery Cases | -2.1% | | Emergency Room Visits | +5.5% | H1 2024 Same Facility Key Metrics (% Change YoY) | Metric | % Change | | :--- | :--- | | Admissions | +6.0% | | Equivalent Admissions | +5.2% | | Revenue per Equivalent Admission | +3.9% | | Inpatient Surgery Cases | +2.2% | | Outpatient Surgery Cases | -2.1% | | Emergency Room Visits | +6.4% | - As of June 30, 2024, HCA operated **188 hospitals**, an increase from **182 in the prior year**[28](index=28&type=chunk) [Supplemental Non-GAAP Disclosures](index=11&type=section&id=Supplemental%20Non-GAAP%20Disclosures) This section reconciles non-GAAP financial measures, including Adjusted EBITDA, for historical and forecasted results [Reconciliation of Historical Results](index=11&type=section&id=Reconciliation%20of%20Historical%20Results) Q2 2024 Adjusted EBITDA Reconciliation | Line Item | Amount ($M) | | :--- | :--- | | Net Income Attributable to HCA | 1,461 | | Provision for income taxes | 547 | | Interest expense | 506 | | Depreciation and amortization | 819 | | Net income attributable to noncontrolling interests | 226 | | Losses (gains) on sales of facilities (net of tax) | (9) | | **Adjusted EBITDA** | **3,550** | - The Adjusted EBITDA margin for Q2 2024 was **20.3%**, an increase from **19.3%** in Q2 2023[31](index=31&type=chunk) [Reconciliation of 2024 Forecast](index=12&type=section&id=Reconciliation%20of%202024%20Forecast) 2024 Forecasted Adjusted EBITDA Reconciliation (Midpoint) | Line Item | Amount ($M) | | :--- | :--- | | Net Income Attributable to HCA | 5,825 | | Depreciation and amortization | 3,270 | | Interest expense | 2,080 | | Provision for income taxes | 1,905 | | Net income attributable to noncontrolling interests | 920 | | **Adjusted EBITDA** | **14,000** | - The company does not forecast certain items like gains/losses on facility sales or legal claim costs due to the inability to predict them with sufficient accuracy[39](index=39&type=chunk)

Company Overview - HCA Healthcare is one of 1025 individual stocks in the Medical sector, currently holding a Zacks Rank of 2 (Buy) [2][3] - Over the past 90 days, the Zacks Consensus Estimate for HCA's full-year earnings has increased by 1.9%, indicating improved analyst sentiment [4] Performance Analysis - HCA Healthcare has achieved a year-to-date return of approximately 19%, outperforming the average gain of 6% in the Medical group [4] - In the Medical - Hospital industry, HCA Healthcare is ranked 17 and has slightly underperformed its industry, which has gained an average of 19.8% this year [6] Comparison with Peers - AnaptysBio, Inc. has outperformed the Medical sector with a year-to-date return of 57.3% and also holds a Zacks Rank of 2 (Buy) [5] - The Medical - Biomedical and Genetics industry, to which AnaptysBio belongs, is currently ranked 71 and has seen a decline of 1.1% year to date [6] Investment Consideration - Investors interested in the Medical sector may want to monitor HCA Healthcare and AnaptysBio, Inc. for their strong performance [7]

The Zacks Consensus Estimate for second-quarter earnings per share of $4.97 indicates a 15.9% increase from the prior-year figure of $4.29. The estimate increased 6 cents in the past 30 days. The consensus estimate for second-quarter revenues of $17.1 billion indicates 7.9% growth from the year-ago reported figure. HCA Healthcare beat the consensus estimate for earnings in three of the prior four quarters, missing once, with the average being 5.6%. Earnings Whispers Earnings ESP: HCA Healthcare has an Earni ...