HCA(HCA) - 2024 Q4 - Annual Results

HCA Healthcare Fourth Quarter 2024 Earnings Release Financial and Operating Highlights HCA Healthcare achieved strong 2024 financial performance with increased revenues and net income, despite Q4 impacts Fourth Quarter 2024 Performance Q4 2024 revenues grew to $18,285 million, but net income decreased to $1,438 million due to special items and hurricane impacts Q4 2024 Key Financial Metrics vs. Q4 2023 (in millions) | Metric | Q4 2024 | Q4 2023 | | :--- | :--- | :--- | | Revenues | $18,285 | $17,303 | | Net Income Attributable to HCA | $1,438 | $1,607 | | Diluted EPS | $5.63 | $5.93 | | Adjusted EBITDA | $3,712 | $3,618 | - Q4 2024 results include losses on sales of facilities of $195 million, or $0.59 per diluted share, primarily from a pending sale in California[2] Q4 2024 Same Facility Operating Metrics (YoY Change) | Metric | % Change YoY | | :--- | :--- | | Admissions | +3.0% | | Equivalent Admissions | +3.1% | | Emergency Room Visits | +2.4% | | Inpatient Surgeries | +2.8% | | Outpatient Surgeries | -1.3% | | Revenue per Equivalent Admission | +2.9% | Full Year 2024 Performance Full year 2024 revenues grew 8.7% to $70,603 million, with net income at $5,760 million and Adjusted EBITDA at $13,882 million Full Year 2024 Key Financial Metrics vs. Full Year 2023 (in millions) | Metric | FY 2024 | FY 2023 | | :--- | :--- | :--- | | Revenues | $70,603 | $64,968 | | Net Income Attributable to HCA | $5,760 | $5,242 | | Diluted EPS | $22.00 | $18.97 | | Adjusted EBITDA | $13,882 | $12,726 | Financial Position and Shareholder Returns HCA maintained a strong balance sheet with $59.513 billion in assets, demonstrating commitment to shareholder returns through significant stock repurchases Balance Sheet Summary (as of Dec 31, 2024, in billions) | Item | Amount | | :--- | :--- | | Cash and cash equivalents | $1.933 billion | | Total Assets | $59.513 billion | | Total Debt | $43.031 billion | - The Board of Directors authorized a new share repurchase program for up to $10 billion of the company's outstanding common stock[9] - A quarterly cash dividend of $0.72 per share was declared, payable on March 31, 2025[10] - In Q4 2024, the company repurchased 4.739 million shares for $1.700 billion, with $764 million remaining under the previous authorization[8] Special Items and Future Outlook Hurricanes Helene and Milton impacted Q4 2024 by $200 million, with HCA's 2025 guidance projecting revenues between $72.80 billion and $75.80 billion - Hurricanes Helene and Milton caused an estimated $200 million in lost revenues and additional expenses in Q4 2024, impacting diluted EPS by approximately $0.60[12] - The total impact of the hurricanes for the full year 2024 was estimated at $250 million, or $0.73 per diluted share[13] 2025 Full Year Guidance | Metric | 2025 Guidance Range | | :--- | :--- | | Revenues | $72.80 - $75.80 billion | | Net Income Attributable to HCA | $5.85 - $6.29 billion | | Adjusted EBITDA | $14.30 - $15.10 billion | | EPS (diluted) | $24.05 - $25.85 | | Capital Expenditures | $5.0 - $5.2 billion | Corporate Information and Disclosures HCA operates 190 hospitals and 2,400 ambulatory sites, with its 2025 annual stockholders' meeting on April 24, and forward-looking statements subject to risks - As of December 31, 2024, HCA operated 190 hospitals and approximately 2,400 ambulatory sites of care across 20 states and the United Kingdom[19] - The 2025 annual stockholders' meeting is scheduled to be held virtually on April 24, 2025[17] - The press release contains forward-looking statements based on current plans and expectations, which are subject to significant risks and uncertainties detailed in the document and SEC filings[20][21] Consolidated Financial Statements HCA's consolidated financial statements for Q4 and full-year 2024 show revenue growth, increased assets and liabilities, and strong operating cash flow Condensed Consolidated Comprehensive Income Statements Q4 2024 revenues were $18,285 million with $1,438 million net income; full year 2024 revenues reached $70,603 million with $5,760 million net income Q4 2024 vs Q4 2023 Income Statement Highlights (in millions) | Account | Q4 2024 | Q4 2023 | | :--- | :--- | :--- | | Revenues | $18,285 | $17,303 | | Salaries and benefits | $7,917 | $7,570 | | Other operating expenses | $3,873 | $3,559 | | Income before income taxes | $2,133 | $2,345 | | Net Income Attributable to HCA | $1,438 | $1,607 | Full Year 2024 vs 2023 Income Statement Highlights (in millions) | Account | FY 2024 | FY 2023 | | :--- | :--- | :--- | | Revenues | $70,603 | $64,968 | | Salaries and benefits | $31,170 | $29,487 | | Other operating expenses | $14,819 | $12,875 | | Income before income taxes | $8,523 | $7,706 | | Net Income Attributable to HCA | $5,760 | $5,242 | Condensed Consolidated Balance Sheets As of December 31, 2024, HCA's total assets increased to $59,513 million, with cash and property growth, and a rise in total liabilities Balance Sheet Comparison (in millions) | Account | Dec 31, 2024 | Dec 31, 2023 | | :--- | :--- | :--- | | Cash and cash equivalents | $1,933 | $935 | | Total Current Assets | $16,414 | $14,927 | | Property and equipment, net | $29,414 | $27,715 | | Total Assets | $59,513 | $56,211 | | Long-term debt | $38,333 | $37,169 | | Total Liabilities | $58,958 (a) | $55,151 (a) | | Total Stockholders' Equity | $555 | $1,060 | (a) Calculated as Total Assets - Total Stockholders' Equity Condensed Consolidated Statements of Cash Flows Net cash from operating activities for 2024 was $10,514 million, funding significant investing and financing activities, including $6,042 million in stock repurchases Cash Flow Summary for Full Year (in millions) | Activity | FY 2024 | FY 2023 | | :--- | :--- | :--- | | Net cash provided by operating activities | $10,514 | $9,431 | | Net cash used in investing activities | ($4,933) | ($5,317) | | Net cash used in financing activities | ($4,582) | ($4,094) | | Change in cash and cash equivalents | $998 | $27 | - Key uses of cash in financing activities for 2024 included $6.042 billion for stock repurchases and $690 million for dividend payments[26] Operating Statistics HCA expanded to 190 hospitals in 2024, with full-year same-facility admissions and equivalent admissions showing positive growth Full Year 2024 Same Facility Key Metrics (% Change YoY) | Metric | % Change YoY | | :--- | :--- | | Admissions | +4.9% | | Equivalent Admissions | +4.5% | | Revenue per Equivalent Admission | +3.2% | | Inpatient Surgery Cases | +2.2% | | Outpatient Surgery Cases | -1.6% | | Emergency Room Visits | +4.9% | Q4 2024 Same Facility Key Metrics (% Change YoY) | Metric | % Change YoY | | :--- | :--- | | Admissions | +3.0% | | Equivalent Admissions | +3.1% | | Revenue per Equivalent Admission | +2.9% | | Inpatient Surgery Cases | +2.8% | | Outpatient Surgery Cases | -1.3% | | Emergency Room Visits | +2.4% | Supplemental Non-GAAP Disclosures HCA uses non-GAAP Adjusted EBITDA for performance assessment, reporting $13,882 million for FY 2024 and forecasting $14,300 million to $15,100 million for 2025 Reconciliation of Adjusted EBITDA Q4 2024 Adjusted EBITDA was $3,712 million (20.3% margin), with full-year 2024 reaching $13,882 million (19.7% margin) Adjusted EBITDA Performance (in millions) | Period | Adjusted EBITDA | Adjusted EBITDA Margin | | :--- | :--- | :--- | | Q4 2024 | $3,712 | 20.3% | | Q4 2023 | $3,618 | 20.9% | | FY 2024 | $13,882 | 19.7% | | FY 2023 | $12,726 | 19.6% | - Management uses Adjusted EBITDA as a primary measure to assess the operating performance of its healthcare facilities[31][32] 2025 Operating Results Forecast (Non-GAAP) The 2025 forecast projects Net Income Attributable to HCA between $5,850 million and $6,290 million, with Adjusted EBITDA ranging from $14,300 million to $15,100 million 2025 Forecast Reconciliation: Net Income to Adjusted EBITDA (in millions) | Metric | Low Range | High Range | | :--- | :--- | :--- | | Net income attributable to HCA | $5,850 | $6,290 | | Depreciation and amortization | $3,495 | $3,565 | | Interest expense | $2,230 | $2,320 | | Provision for income taxes | $1,800 | $1,950 | | Net income attributable to noncontrolling interests | $925 | $975 | | Adjusted EBITDA | $14,300 | $15,100 | - The company does not forecast certain items like gains/losses on sales of facilities, legal costs, or impairments due to the inability to predict them with sufficient accuracy[38]