Core Insights - L1 Capital International Fund reported a return of 2.6% in Q3 2025, underperforming the benchmark MSCI World Net Total Return Index, which returned 6.1% [1] - The fund highlighted HCA Healthcare, Inc. as a significant investment, noting a one-month return of 2.05% and a 52-week gain of 53.65% [2] Company Analysis - HCA Healthcare, Inc. operates hospitals and related healthcare entities, with a market capitalization of $112.867 billion as of December 11, 2025 [2] - The fund has reduced its investment in HCA Healthcare due to strong share price appreciation, indicating that it is no longer a top 10 holding [3] - The fund has historically capitalized on market pessimism regarding regulatory risks affecting HCA, but current expectations for operating conditions are more balanced, leading to a less favorable risk-adjusted return assessment [3] Market Sentiment - HCA Healthcare is not among the 30 most popular stocks among hedge funds, with 73 hedge fund portfolios holding the stock at the end of Q3, unchanged from the previous quarter [4] - There is a belief that certain AI stocks may offer greater upside potential compared to HCA Healthcare, suggesting a shift in investment focus [4]

Legislative Impact - The failure to extend Affordable Care Act (ACA) subsidies is expected to lead to significantly higher monthly premiums for millions of enrollees starting in January [6][7] - The legislative deadlock occurred on a 51-48 vote, effectively ending Democratic efforts to prevent price hikes during the current session [5][6] Company Impact - Major health insurers, particularly those heavily exposed to ACA exchanges such as Centene Corp., Molina Healthcare Inc., and Oscar Health Inc., are expected to face headwinds due to the legislative impasse [7] - Hospital operators like HCA Healthcare Inc. and Tenet Healthcare Corp. may encounter increased risks, as a potential drop in coverage due to rising premiums could lead to a surge in uncompensated care and bad debt [8]

Core Insights - The article emphasizes the rarity of companies that provide benefits to both society and investors, highlighting the importance of screening the U.S. stock market for stocks that can generate alpha [1]. Group 1 - The ability to identify the best and worst stocks based on proven criteria is presented as a unique strength of the company [1].

Core Insights - HCA Healthcare, Inc. announced a donation of $4.8 million to Pepperdine University to establish a School of Nursing within the College of Health Science [1] - This initiative is part of HCA Healthcare's broader commitment to address the national nursing shortage [1] - The investment in nursing education is viewed as essential for the future of healthcare by HCA Healthcare [1]

Group 1: HCA Healthcare - HCA Healthcare has seen significant financial growth, with Q3 revenue increasing by 9.6% year over year to $19.2 billion and net income rising by 29.4% to $1.6 billion [3] - The company benefits from rising demand for medical services, with same-facility admissions up by 2.1% and same-facility revenue per equivalent admission increasing by 6.6% to $18,390 [3] - HCA Healthcare's market share has grown from 24% in 2012 to 27% in 2022, with a goal to reach 29% by 2030, supported by a diversified network and technology investments [6][7] Group 2: CVS Health - CVS Health is undergoing a multiyear plan to cut costs and is scaling back its Medicare Advantage offerings to focus on profitable growth [8][9] - The company has a strong ecosystem that includes pharmacy, insurance, and primary care services, and has expanded through acquisitions and new subsidiaries [11] - CVS Health is well-positioned to benefit from an aging population and increasing demand for prescription drugs, making its stock attractive for long-term holding [13]

Core Insights - HCA Healthcare has consistently grown profits for over a decade, outperforming the S&P 500 while remaining undervalued with strong upside potential [3][4] - The company is well-positioned to benefit from the aging U.S. population and increasing healthcare spending [5][6] Industry Trends - The U.S. population aged 65 and older increased by 3.1% year-over-year in 2024, while the population under 18 decreased by 0.2% [6] - The share of the population aged 65 and older has risen from 12% in 2004 to 18% in 2024, indicating a significant demographic shift [6][7] - Healthcare spending is strongly correlated with age, with per capita spending for those aged 85 or older being 8.5 times higher than for children under 18 [9] Company Positioning - HCA Healthcare operates the largest healthcare system in the U.S., with over 190 hospitals and 2,400 ambulatory sites, positioning it for continued profit growth [5][12] - The company has increased its hospital count from 166 in 2014 to 191 by the end of Q3 2025, and its licensed bed count from over 43,000 to over 50,500 [16] Financial Performance - HCA Healthcare has achieved a compounded annual growth rate (CAGR) of 6% in revenue and 7% in net operating profit after tax (NOPAT) since 2007 [18] - The company's Core Earnings grew 14% CAGR from $598 million in 2007 to $6.5 billion in the TTM ended Q3 2025 [19] - HCA Healthcare generated a cumulative $50.4 billion in free cash flow (FCF) from 2014 through Q3 2025, with $10.5 billion generated in the TTM alone [23] Shareholder Returns - HCA Healthcare has paid $4.3 billion in cumulative dividends since 2018 and has increased its quarterly dividends from $0.35 per share in Q1 2018 to $0.72 per share in Q4 2025 [25] - The company repurchased $35.6 billion of shares from 2018 through Q3 2025, with a new $10 billion share repurchase program authorized in January 2025 [26] Challenges - The healthcare industry faces ongoing labor shortages, with projections indicating a global healthcare worker shortage of 10 million by 2030 [29] - Despite rising labor costs, HCA Healthcare has managed to reduce salaries and benefits as a percentage of revenue from 46% in 2020 to 44% in the TTM ending Q3 2025 [31]

Core Insights - HCA Healthcare, Inc. is the largest non-governmental operator of acute care hospitals in the U.S. with a market cap of $117.5 billion, providing various medical and surgical services [1][2] Financial Performance - HCA's stock reached an all-time high of $520 recently, with a 28.1% increase over the past three months, outperforming the Health Care Select Sector SPDR Fund's (XLV) 15.6% returns [3] - Year-to-date, HCA's stock has surged 71.5%, and 56.5% over the past 52 weeks, significantly exceeding XLV's gains of 15.2% and 8.4% respectively [4] - Following the release of better-than-expected Q3 results on October 24, HCA's stock gained 1.6%. The company's revenue for the quarter increased by 9.6% year-over-year to $19.2 billion, surpassing expectations by 3.6%. Adjusted EPS rose 42% year-over-year to $6.96, exceeding consensus estimates by 23.2% [5] Market Position and Analyst Ratings - HCA has slightly underperformed compared to Tenet Healthcare Corporation's 72.2% surge in 2025 but has outpaced Tenet's 49.3% gains over the past 52 weeks [6] - Among 26 analysts covering HCA, the consensus rating is a "Moderate Buy," although the stock is currently trading above the mean price target of $480.61 [6]

Core Insights - The American Century U.S. Quality Growth ETF (QGRO) has made significant adjustments to its holdings, reflecting the flexibility of ETF managers in response to market movements [1][3][6] Fund Overview - QGRO was launched in September 2018 and charges 29 basis points for investing in U.S. firms with high growth potential and strong fundamentals [2] - The fund tracks the American Century U.S. Quality Growth Index, which screens for factors like income and quality using metrics such as cash flow and profitability [2] Recent Changes in Holdings - Notable changes in QGRO's portfolio include the dropping of at least two stocks and the addition of two new stocks, along with adjustments to the weights of six existing stocks [3] - Major tech companies such as Alphabet (GOOGL), Meta Platforms (META), and Amazon (AMZN) saw their weights decrease by 1.22%, 1.32%, and 1.74% respectively between November 21 and 24 [3] - Conversely, Amphenol Corporation (APH), Ralph Lauren Corporation (RL), and Expedia Group, Inc. (EXPE) experienced weight increases of 3.53%, 2.1%, and 1.33% respectively [4] Specific Stock Adjustments - The two stocks that were dropped from QGRO included Itron Inc. (ITRI) and Booz Allen Hamilton Holding Corporation (BAH), which had weights of 0.76% and 0.72% respectively before being removed [5] - The largest additions to the fund were Cardinal Health, Inc. (CAH) and HCA Healthcare, Inc. (HCA), with weights of 1.08% and 1.25% respectively [5] Performance Metrics - QGRO has achieved a year-to-date return of 12.4%, focusing on quality and growth-oriented companies [6] - The recent reduction in weight for three major tech stocks may attract investors looking to diversify into other rising companies [6]

Company Overview - HCA Healthcare is the largest for-profit operator of acute care hospitals in the U.S. with 191 hospitals and a network of 2,400 sites of care across 20 states and the U.K. [1] - In 2024, HCA Healthcare oversaw 44 million patient encounters, highlighting its significant presence in the healthcare sector [1]. Conference Details - The presentation took place during the Stephens 2025 Annual Investment Conference in Nashville, with Raj Kumar serving as the health care services analyst [1]. - Mike Marks, Executive Vice President and CFO of HCA Healthcare, was present to discuss the company's performance and future outlook [1].

HCA Healthcare FY Conference Summary Company Overview - HCA Healthcare is the largest for-profit operator of acute care hospitals in the U.S. with 191 hospitals and 2,400 sites of care across 20 states and the U.K. [1] - The company oversaw 44 million patient encounters in 2024 [1] Key Points and Arguments Financial Performance and Guidance - HCA is expected to deliver revenue and earnings growth above long-term guidance for 2025, supported by policy tailwinds and operational initiatives [3][4] - The company anticipates 2%-3% volume growth due to strong market demand and operational excellence [6][11] - HCA has deployed $4 billion to $5 billion in capital annually, with $6.7 billion in capital projects currently in progress [9][10] Operational Initiatives - HCA is focusing on network development, increasing outpatient facilities from 10 to 14 per hospital, aiming for 20 by the end of the decade [10] - The company has implemented a length of stay management plan, achieving a 2% reduction in length of stay, enhancing capacity without additional capital expenditure [14][15] Resiliency Initiatives - HCA's resiliency strategy includes workforce development, operational investments, and revenue cycle improvements [13][16] - The company is addressing denials and underpayments from payers to enhance revenue integrity [16][40] Policy and Regulatory Environment - HCA is preparing for potential changes in Medicaid supplemental payment programs, with 60% of its Medicaid revenue coming from non-expansion states [20][21] - The company is optimistic about managing Medicaid reforms and believes it will not derail long-term plans [21] Medicare and Exchange Dynamics - HCA expects continued enrollment growth in Medicare Advantage, driven by the aging population [34] - Exchange enrollments increased by 30% in 2024, correlating with a 40% increase in volume [32] Cost Management - Professional fees have risen by about 10%, primarily in anesthesia and radiology, but HCA is managing these pressures through strategic initiatives [63][64] - The company has successfully navigated supply chain challenges, maintaining margin improvements despite inflationary pressures [69][70] Workforce Development - HCA is expanding its Galen College of Nursing, aiming for 30 campuses by 2030, which will significantly increase the supply of nurses in its markets [75][76] Capital Investment and M&A Strategy - HCA plans to continue adding inpatient beds and expanding outpatient facilities, with a disciplined approach to acquisitions [55][56][58] - The company has completed two tuck-in acquisitions this year and remains focused on outpatient capacity [58] Other Important Insights - HCA's long-term plan for net revenue per equivalent admission growth is 2%-3%, influenced by payer rates, acuity, and denials [42] - The company is leveraging AI and digital tools to enhance operational efficiency, particularly in supply chain management [72] This summary encapsulates the key insights from the HCA Healthcare FY Conference, highlighting the company's strategic focus on growth, operational efficiency, and workforce development while navigating a complex regulatory environment.