Revenue Growth: Revenues grew 11.2% over the prior year in the quarter.
Same-Facility Volume Growth: Demonstrated broad-based growth with notable increases across key metrics—Inpatient admissions grew 6%, inpatient surgeries up almost 2%, equivalent admissions grew 5%, and emergency room visits increased 7%.
Outpatient Surgery Revenue: Increased year-over-year mainly due to favorable payer mix, despite a total case decline of 2%.
Earnings Per Share: Diluted earnings per share as adjusted increased almost 9% in the first quarter to $5.36.
Adjusted EBITDA: Margin was 19.3% in the quarter, with adjusted EBITDA reaching $3.35 billion, a 5.7% increase over the previous year.
Operating Costs: Overall operating costs were well managed. Labor costs as a percent of revenue improved by 100 basis points from the prior year.
Capital Expenditures: Totaled $1.1 billion for the quarter.
Future Guidance
Reaffirming Full Year 2024 Guidance: HCA Healthcare is reaffirming its full-year 2024 guidance ranges, expressing confidence in operational performance and balanced capital allocation.
Operational Performance: Continued focus on solid operational performance coupled with disciplined capital allocation strategy.
Expectation of Volume Comparisons: Volume comparisons are expected to be slightly more difficult in the second half of the year, with sustained growth anticipated due to strong demand for healthcare services.
Cash Flow and Share Repurchase: Cash flow from operations was just under $2.5 billion in the quarter, with nearly $1.2 billion spent on repurchasing outstanding shares.
Trends, Market Conditions, Sentiment
Broad-Based Volume Growth: Observed across the company, with every division experiencing growth in inpatient admissions.
Payer Mix and Acuity Levels: Improved compared to the prior year, with commercial volumes representing approximately 36% of equivalent admissions.
Health Insurance Exchanges (HIX): HIX volume was up close to 50% in the first quarter, benefiting from Medicaid redeterminations.
Labor Cost Trends: Continued improvement in contract labor expenses, which decreased by 21.7% from the previous year, showcasing effective cost management strategies.
Impact of Medicaid Redeterminations: Observed decrease in Medicaid volume due to the redetermination process, but with a shift towards more favorable payer mix, including increased commercial and HIX volumes.
Two-Midnight Rule: Modest benefit observed from the implementation of the two-midnight rule, with expectations of ongoing positive effects.
Notable Quotes
”The positive fundamentals we saw in our business this past year continued into the first quarter of 2024.” - Samuel Hazen, CEO
”We believe our first quarter performance represents a strong start to the year…” - William Rutherford, CFO
”We continue to see good trends on contract labor, which improved 21.7% from the prior year.” - William Rutherford, CFO
”Our exchange volume was up close to 50% in the first quarter…a large portion of those end up in either HICS or employer-sponsored coverage.” - William Rutherford, CFO
