Hca healthcare reports third quarter 2020 results
Nashville, tenn.--(business wire)--hca healthcare, inc. (nyse: hca) today announced its completed financial and operating results for the third quarter ended september 30, 2020. key third quarter metrics (all percentage changes compare 3q 2020 to 3q 2019 unless otherwise noted): revenues totaled $13.311 billion net income attributable to hca healthcare, inc. totaled $668 million, or $1.95 per diluted share adjusted ebitda totaled $2.053 billion results include reversal of $822 million, or $1.72 per diluted share, in government stimulus income from cares act funds cash flows from operating activities totaled $2.717 billion same facility admissions and same facility equivalent admissions declined 3.8 percent and 9.0 percent, respectively consistent with the company’s preview of third quarter 2020 results, revenues in the third quarter of 2020 increased to $13.311 billion, compared to $12.694 billion in the third quarter of 2019. net income attributable to hca healthcare, inc. totaled $668 million, or $1.95 per diluted share, compared to $612 million, or $1.76 per diluted share, in the third quarter of 2019. results for the third quarter of 2020 include a reversal of $822 million, or $1.72 per diluted share, in government stimulus income recorded in the second quarter of 2020 related to general distribution funds received from the provider relief fund established by the coronavirus aid, relief, and economic security (“cares”) act and $14 million, or $0.03 per diluted share, of gains on sales of facilities. third quarter of 2019 results included losses on retirement of debt of $211 million, or $0.47 per diluted share. for the third quarter of 2020, adjusted ebitda totaled $2.053 billion, compared to $2.285 billion in the third quarter of 2019. adjusted ebitda is a non-gaap financial measure. a table providing supplemental information on adjusted ebitda and reconciling net income attributable to hca healthcare, inc. to adjusted ebitda is included in this release. same facility admissions and equivalent admissions declined 3.8 percent and 9.0 percent, respectively, in the third quarter of 2020, compared to the prior year period. same facility emergency room visits declined 20.3 percent in the third quarter of 2020, compared to the prior year period. same facility inpatient surgeries declined 6.8 percent, and same facility outpatient surgeries declined 6.3 percent in the third quarter of 2020, compared to the same period of 2019. same facility revenue per equivalent admission increased 14.8 percent in the third quarter of 2020, compared to the third quarter of 2019, due to increases in acuity of patients treated and favorable payer mix in the quarter. nine months ended september 30, 2020 revenues for the nine months ended september 30, 2020 totaled $37.240 billion, compared to $37.813 billion in the same period of 2019. net income attributable to hca healthcare, inc. was $2.328 billion, or $6.79 per diluted share, compared to $2.434 billion, or $6.98 per diluted share, for the first nine months of 2019. results for the nine months ended september 30, 2020 include losses on sales of facilities of $6 million, or $0.03 per diluted share, and losses on retirement of debt of $295 million, or $0.66 per diluted share. results for the nine months ended september 30, 2019 included gains on sales of facilities of $17 million, or $0.04 per diluted share, and losses on retirement of debt of $211 million, or $0.47 per diluted share. balance sheet and cash flows from operations as of september 30, 2020, hca healthcare, inc.’s balance sheet reflected cash and cash equivalents of $6.588 billion, total debt of $30.964 billion, and total assets of $51.016 billion. during the third quarter of 2020, capital expenditures totaled $489 million, excluding acquisitions. cash flows provided by operating activities in the third quarter totaled $2.717 billion, compared to $2.126 billion in the third quarter of 2019. cares act during the early days of the pandemic, the company took a conservative approach which included a number of actions to meet the operational and financial challenges this global health crisis was expected to present. many aspects of our approach were outlined in our first quarter release. as noted in our october 8, 2020 release, hca healthcare will return, or repay early, all of its share of provider relief fund distributions of approximately $1.6 billion and approximately $4.4 billion in medicare accelerated payments. the company is working with the appropriate government agencies to arrange the payment of these funds. the company expects to fund the entire amount of such payments from available cash and future cash flows from operations. earnings conference call hca healthcare will host a conference call for investors at 9:00 a.m. central daylight time today. all interested investors are invited to access a live audio broadcast of the call via webcast. the broadcast also will be available on a replay basis beginning this afternoon. the webcast can be accessed at: https://investor.hcahealthcare.com/events-and-presentations. about the company as of september 30, 2020, hca healthcare operated 187 hospitals and approximately 2,000 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics, in 21 states and the united kingdom. forward-looking statements this press release contains forward-looking statements within the meaning of the federal securities laws, which involve risks and uncertainties. forward-looking statements include the company’s capital allocation, as well as other statements that do not relate solely to historical or current facts. forward-looking statements can be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “plan,” “initiative” or “continue.” these forward-looking statements are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and expectations and our future financial position and results of operations. these factors include, but are not limited to, (1) developments related to covid-19, including, without limitation, related to the length and severity of the pandemic; the volume of canceled or rescheduled procedures and the volume of covid-19 patients cared for across our health systems; measures we are taking to respond to the covid-19 pandemic; the impact and terms of government and administrative regulation and stimulus (including the families first coronavirus response act, the cares act, the paycheck protection program and health care enhancement act and other enacted legislation); changes in revenues due to declining patient volumes, changes in payor mix and deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients); potential increased expenses related to labor, supply chain or other expenditures; workforce disruptions; supply shortages and disruptions; and the timing and availability of effective medical treatments and vaccines, (2) the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, as well as risks associated with disruptions in the financial markets and the business of financial institutions as the result of the covid-19 pandemic which could impact us from a financial perspective, (3) the impact of the patient protection and affordable care act, as amended by the health care and education reconciliation act of 2010 (collectively, the “affordable care act”), including the effects of court challenges to, any repeal of, or changes to, the affordable care act or additional changes to its implementation, the possible enactment of additional federal or state health care reforms and possible changes to other federal, state or local laws or regulations affecting the health care industry, including single-payer proposals (often referred to as “medicare for all”), and also including any such laws or governmental regulations which are adopted in response to the covid-19 pandemic, (4) the effects related to the continued implementation of the sequestration spending reductions required under the budget control act of 2011, and related legislation extending these reductions, and the potential for future deficit reduction legislation that may alter these spending reductions, which include cuts to medicare payments, or create additional spending reductions, (5) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (6) the ability to achieve operating and financial targets, and attain expected levels of patient volumes and control the costs of providing services, (7) possible changes in medicare, medicaid and other state programs, including medicaid supplemental payment programs or medicaid waiver programs, that may impact reimbursements to health care providers and insurers and the size of the uninsured or underinsured population, (8) the highly competitive nature of the health care business, (9) changes in service mix, revenue mix and surgical volumes, including potential declines in the population covered under third-party payer agreements, the ability to enter into and renew third-party payer provider agreements on acceptable terms and the impact of consumer-driven health plans and physician utilization trends and practices, (10) the efforts of health insurers, health care providers, large employer groups and others to contain health care costs, (11) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (12) increases in wages and the ability to attract and retain qualified management and personnel, including affiliated physicians, nurses and medical and technical support personnel, (13) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (14) changes in accounting practices, (15) changes in general economic conditions nationally and regionally in our markets, including economic and business conditions (and the impact thereof on the financial markets and banking industry) resulting from the covid-19 pandemic, (16) the emergence of and effects related to other pandemics, epidemics and infectious diseases, (17) future divestitures which may result in charges and possible impairments of long-lived assets, (18) changes in business strategy or development plans, (19) delays in receiving payments for services provided, (20) the outcome of pending and any future tax audits, disputes and litigation associated with our tax positions, (21) potential adverse impact of known and unknown government investigations, litigation and other claims that may be made against us, (22) the impact of potential cybersecurity incidents or security breaches, (23) our ongoing ability to demonstrate meaningful use of certified electronic health record (“ehr”) technology and the impact of interoperability requirements, (24) the impact of natural disasters, such as hurricanes and floods, or similar events beyond our control, (25) changes in the u.s. federal, state, or foreign tax laws including interpretive guidance that may be issued by taxing authorities or other standard setting bodies, and (26) other risk factors described in our annual report on form 10-k for the year ended december 31, 2019, our quarterly report on form 10-q for the quarter ended june 30, 2020 and our other filings with the securities and exchange commission. many of the factors that will determine our future results are beyond our ability to control or predict. in light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management’s views only as of the date hereof. we undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise. all references to “company” and “hca healthcare” as used throughout this release refer to hca healthcare, inc. and its affiliates. 2020 2019 $ 13,311 100.0 % $ 12,694 100.0 % 6,097 45.8 5,971 47.0 2,128 16.0 2,090 16.5 2,251 16.9 2,352 18.5 822 6.2 - - (40 ) (0.3 ) (4 ) - 694 5.2 647 5.1 385 2.9 448 3.5 (14 ) (0.1 ) - - - - 211 1.7 12,323 92.6 11,715 92.3 988 7.4 979 7.7 209 1.5 215 1.7 779 5.9 764 6.0 111 0.9 152 1.2 $ 668 5.0 $ 612 4.8 $ 1.95 $ 1.76 343.346 347.487 $ 715 $ 582 2020 2019 amount ratio amount ratio $ 37,240 100.0 % $ 37,813 100.0 % 17,545 47.1 17,455 46.2 5,999 16.1 6,249 16.5 6,825 18.3 7,013 18.6 (48 ) (0.1 ) (23 ) (0.1 ) 2,059 5.6 1,902 4.9 1,201 3.2 1,386 3.7 6 - (17 ) - 295 0.8 211 0.6 33,882 91.0 34,176 90.4 3,358 9.0 3,637 9.6 665 1.8 765 2.0 2,693 7.2 2,872 7.6 365 0.9 438 1.2 $ 2,328 6.3 $ 2,434 6.4 $ 6.79 $ 6.98 343.014 348.712 $ 2,273 $ 2,354 september 30, june 30, december 31, 2020 2020 2019 $ 6,588 $ 4,638 $ 621 6,433 6,139 7,380 1,950 1,834 1,849 1,295 1,420 1,346 16,266 14,031 11,196 48,775 48,484 47,235 (25,834 ) (25,413 ) (24,520 ) 22,941 23,071 22,715 390 364 315 335 275 249 8,570 8,578 8,269 1,972 1,863 1,834 542 527 480 $ 51,016 $ 48,709 $ 45,058 $ 3,270 $ 2,882 $ 2,905 1,971 1,631 1,775 2,843 3,181 2,932 6,123 4,999 - 172 163 145 14,379 12,856 7,757 30,792 30,779 33,577 1,434 1,485 1,370 1,635 1,531 1,499 1,477 1,490 1,420 (974 ) (1,786 ) (2,808 ) 2,273 2,354 2,243 1,299 568 (565 ) $ 51,016 $ 48,709 $ 45,058 2020 2019 $ 2,693 $ 2,872 930 (93 ) (36 ) (95 ) 542 (118 ) 6,123 - 2,059 1,902 (114 ) 51 6 (17 ) 295 211 22 23 229 263 66 98 12,815 5,097 (2,087 ) (2,884 ) (380 ) (1,592 ) 68 49 (40 ) 35 (44 ) 17 (2,483 ) (4,375 ) 2,700 6,451 (2,480 ) (30 ) (3,403 ) (5,289 ) (393 ) (404 ) (35 ) (71 ) (153 ) (414 ) (441 ) (759 ) (156 ) (145 ) (4,361 ) (661 ) (4 ) (4 ) 5,967 57 621 502 $ 6,588 $ 559 $ 1,230 $ 1,492 $ 779 $ 714 2020 2019 2020 2019 187 184 187 184 121 125 121 125 49,473 48,588 49,473 48,588 49,479 48,535 49,333 48,335 506,756 527,284 1,487,992 1,568,733 -3.9 % -5.1 % 835,576 918,964 2,477,747 2,712,339 -9.1 % -9.8 % $ 15,930 $ 13,814 $ 15,214 $ 13,941 15.3 % 9.1 % $ 16,265 $ 14,192 $ 15,531 $ 14,297 14.6 % 8.6 % 2,593,139 2,530,221 7,476,794 7,667,666 2.5 % -2.5 % 4,275,481 4,410,715 12,299,326 13,257,395 -3.1 % -7.2 % 133,492 143,215 387,228 421,051 -6.8 % -8.0 % 232,493 249,177 629,723 743,464 -6.7 % -15.3 % 1,813,661 2,269,364 5,594,484 6,810,141 -20.1 % -17.9 % 35.5 % 39.0 % 35.0 % 38.7 % 5.117 4.799 5.025 4.888 57.0 % 56.7 % 55.3 % 58.1 % 493,466 513,170 1,448,444 1,529,423 -3.8 % -5.3 % 809,284 889,324 2,371,103 2,630,608 -9.0 % -9.9 % $ 15,721 $ 13,691 $ 15,024 $ 13,836 14.8 % 8.6 % $ 16,239 $ 14,209 $ 15,525 $ 14,325 14.3 % 8.4 % 129,831 139,345 376,189 409,556 -6.8 % -8.1 % 224,496 239,530 607,904 716,274 -6.3 % -15.1 % 1,767,372 2,217,713 5,467,829 6,668,965 -20.3 % -18.0 % 2020 2019 2020 2019 $ 13,311 $ 12,694 $ 37,240 $ 37,813 $ 668 $ 612 $ 2,328 $ 2,434 (10 ) - 9 (13 ) - 162 227 162 658 774 2,564 2,583 694 647 2,059 1,902 385 448 1,201 1,386 205 264 730 810 111 152 365 438 $ 2,053 $ 2,285 $ 6,919 $ 7,119 15.4 % 18.0 % 18.6 % 18.8 % $ 1.95 $ 1.76 $ 6.79 $ 6.98 (0.03 ) - 0.03 (0.04 ) - 0.47 0.66 0.47 $ 1.92 $ 2.23 $ 7.48 $ 7.41 343.346 347.487 343.014 348.712
