Financial Data and Key Metrics Changes - The company reported a 42% growth in diluted earnings per share as adjusted compared to the previous year [5] - Revenue increased by 9.6%, driven by broad-based volume growth, improved payer mix, and additional revenue from Medicaid supplemental programs [5][10] - Adjusted EBITDA increased by approximately $240 million due to Medicaid state supplemental payments [12][15] Business Line Data and Key Metrics Changes - Same-facility equivalent admissions increased by 2.4% year-over-year [10] - Same-facility inpatient surgical volume grew by 1.4%, while outpatient surgical volume increased by 1.1% [10] - Same-facility visits rose by 1.3% compared to the prior year [10] Market Data and Key Metrics Changes - Commercial and Medicare visits combined increased by 4.1%, while Medicaid and self-pay visits declined [10] - Same-facility total commercial equivalent admissions rose by 3.7%, with exchanges growing by 8% [11] - Medicare admissions increased by 3.4%, and Medicaid admissions grew by 1.4% [11][72] Company Strategy and Development Direction - The company is focused on enhancing care through increased access, advanced digital tools, and staff training [6][8] - There is an emphasis on improving operational efficiency and service offerings through strategic investments [8] - The company plans to maintain high performance levels and has strengthened its management team and systems [8] Management's Comments on Operating Environment and Future Outlook - Management expects solid demand for healthcare services, with volumes anticipated to grow within a long-term range of 2%-3% [7] - Operating costs are expected to remain stable, with some pressures in certain areas [7] - The company is well-positioned to sustain performance levels and navigate future challenges [8][99] Other Important Information - Cash flow from operations was $4.4 billion, with $1.3 billion in capital expenditures and $2.5 billion in share repurchases [14] - The company updated its full-year guidance, expecting revenues between $75 billion and $76.5 billion and adjusted EBITDA between $15.25 billion and $15.65 billion [15] Q&A Session Summary Question: Can you remind us what states are still pending for grandfathered programs? - Management mentioned Florida, Georgia, and Virginia as states with pending applications, but they do not expect approvals during the current shutdown [20][22] Question: Are you seeing early scheduling for elective surgeries? - Management noted that it is too early to size the potential impact of upcoming enrollment periods and that they are prepared to assist patients with coverage navigation [26][27] Question: Can you provide a bridge from Q3 into Q4 guidance? - Management indicated that the implied growth rate for Q4 is expected to be in the high single-digits, considering hurricane impacts and state supplemental payment declines [32] Question: How much did you recognize in the fourth quarter for Tennessee specifically? - Tennessee was the largest driver of net benefit in Q3, with Texas and Kansas also contributing to the overall increase [36][38] Question: How do you expect professional fees to trend going into 2026? - Professional fees increased by 11% year-over-year, with expectations for continued financial improvement as integration efforts mature [82][84] Question: How is the company preparing for potential volume growth in Q4? - Management expressed confidence in their capacity to handle increased demand, citing improved staffing and operational initiatives [88][90] Question: What is the outlook for hurricane-impacted facilities? - Management expects to recover approximately $100 million of the $250 million headwind from hurricanes in 2025, with ongoing challenges in North Carolina [95][96] Question: What gives you confidence in achieving long-term volume growth? - The company has experienced 18 consecutive quarters of volume growth and anticipates continued demand driven by capital investments and outpatient facility expansions [99]