Raises 2024 Guidance

NASHVILLE, Tenn.–(BUSINESS WIRE)–HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the second quarter ended June 30, 2024.


Key second quarter metrics (all percentage changes compare 2Q 2024 to 2Q 2023 unless otherwise noted):

  • Revenues totaled $17.492 billion
  • Net income attributable to HCA Healthcare, Inc. totaled $1.461 billion, or $5.53 per diluted share
  • Adjusted EBITDA totaled $3.550 billion
  • Cash flows from operating activities totaled $1.971 billion
  • Same facility admissions increased 5.8 percent while same facility equivalent admissions increased 5.2 percent

“The company’s results for the second quarter were positive and reflected strong demand for our services. Our teams continued to execute our strategic plan effectively and produce positive outcomes for our patients. I want to thank our HCA colleagues for their outstanding work and their continued pursuits to innovate and deliver on our mission,” said Sam Hazen, Chief Executive Officer of HCA Healthcare.

Revenues in the second quarter of 2024 totaled $17.492 billion, compared to $15.861 billion in the second quarter of 2023. Net income attributable to HCA Healthcare, Inc. totaled $1.461 billion, or $5.53 per diluted share, compared to $1.193 billion, or $4.29 per diluted share, in the second quarter of 2023. Results for the second quarter of 2024 include gains on sales of facilities of $12 million, or $0.03 per diluted share.

For the second quarter of 2024, Adjusted EBITDA totaled $3.550 billion, compared to $3.056 billion in the second quarter of 2023. 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 increased 5.8 percent while same facility equivalent admissions increased 5.2 percent in the second quarter of 2024, compared to the prior year period. Same facility emergency room visits increased 5.5 percent in the second quarter of 2024, compared to the prior year period. Same facility inpatient surgeries increased 2.6 percent, and same facility outpatient surgeries declined 2.1 percent in the second quarter of 2024, compared to the same period of 2023. Same facility revenue per equivalent admission increased 4.4 percent in the second quarter of 2024, compared to the second quarter of 2023.

Six Months Ended June 30, 2024

Revenues for the six months ended June 30, 2024 totaled $34.831 billion, compared to $31.452 billion in the same period of 2023. Net income attributable to HCA Healthcare, Inc. was $3.052 billion, or $11.47 per diluted share, compared to $2.556 billion, or $9.14 per diluted share, for the first six months of 2023. Results for the six months ended June 30, 2024 include gains on sales of facilities of $213 million, or $0.61 per diluted share. Results for the six months ended June 30, 2023 included losses on sales of facilities of $14 million, or $0.08 per diluted share.

Balance Sheet and Cash Flows from Operations

As of June 30, 2024, HCA Healthcare, Inc.’s balance sheet reflected cash and cash equivalents of $831 million, total debt of $40.880 billion, and total assets of $57.379 billion. During the second quarter of 2024, capital expenditures totaled $1.281 billion, excluding acquisitions. Cash flows provided by operating activities in the second quarter of 2024 totaled $1.971 billion, compared to $2.475 billion in the second quarter of 2023.

During the second quarter of 2024, the Company repurchased 4.217 million shares of its common stock at a cost of $1.367 billion. The Company had $4.228 billion remaining under its repurchase authorization as of June 30, 2024. As of June 30, 2024, the Company had $7.137 billion of availability under its credit facilities.

Dividend

HCA today announced that its Board of Directors declared a quarterly cash dividend of $0.66 per share on the Company’s common stock. The dividend will be paid on September 30, 2024 to stockholders of record at the close of business on September 16, 2024.

The declaration and payment of any future dividend will be subject to the discretion of the Board of Directors and will depend on a variety of factors, including the Company’s financial condition, results of operations, and contractual restrictions. Future dividends are expected to be funded by cash balances and future cash flows from operations.

2024 Revised Guidance

Today, the Company revised its 2024 estimated guidance ranges issued on January 30, 2024.

 

 

Previous 2024 Guidance Range

as of January 30, 2024

 

Revised 2024 Guidance Range

as of July 23, 2024

Revenues

$67.750 to $70.250 billion

 

$69.750 to $71.750 billion

Net Income Attributable to HCA Healthcare, Inc.

$5.200 to $5.600 billion

 

$5.675 to $5.975 billion

Adjusted EBITDA

$12.850 to $13.550 billion

 

$13.750 to $14.250 billion

EPS (diluted)

$19.70 to $21.20 per diluted share

 

$21.60 to $22.80 per diluted share

Capital expenditures for 2024, excluding acquisitions, are estimated to be in the range of $5.1 to $5.3 billion.

The Company’s revised 2024 guidance contains a number of assumptions, including, among others, the Company’s current expectations regarding patient volumes and payor mix as well as general economic conditions, including inflation, and excludes the impact of items such as, but not limited to, gains or losses on sales of facilities, losses on retirement of debt, legal claims costs and impairment of long-lived assets.

Adjusted EBITDA is a non-GAAP financial measure. A table reconciling forecasted net income attributable to HCA Healthcare, Inc. to forecasted Adjusted EBITDA is included in this release.

The Company’s guidance is based on current plans and expectations and is subject to a number of known and unknown uncertainties and risks, including those set forth below in the Company’s “Forward-Looking Statements.”

Earnings Conference Call

HCA Healthcare will host a conference call for investors at 9:00 a.m. Central 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 through the Company’s Investor Relations web page at https://investor.hcahealthcare.com/events-and-presentations/default.aspx.

About the Company

As of June 30, 2024, HCA operated 188 hospitals and approximately 2,400 ambulatory sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics, in 20 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 financial guidance for the year ending December 31, 2024, 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) changes in or related to general economic conditions nationally and regionally in our markets, including inflation and economic and business conditions (and the impact thereof on the economy, financial markets and banking industry); changes in revenues due to declining patient volumes; changes in payer mix (including increases in uninsured and underinsured patients); potential increased expenses related to labor, supply chain or other expenditures; workforce disruptions; supply shortages and disruptions (including as a result of geopolitical disruptions); and the impact of potential federal government shutdowns, (2) the impact of our significant indebtedness and the ability to refinance such indebtedness on acceptable terms, (3) the impact of current and future federal and state health reform initiatives and possible changes to other federal, state or local laws and regulations affecting the health care industry, including, but not limited to, proposals to expand coverage of federally-funded insurance programs as an alternative to private insurance or establish a single-payer system (such reforms often referred to as “Medicare for All”), (4) the effects related to the implementation of sequestration spending reductions required under the Budget Control Act of 2011, related legislation extending these reductions and those required under the Pay-As-You-Go Act of 2010 as a result of the federal budget deficit impact of the American Rescue Plan Act of 2021, 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, attain expected levels of patient volumes and revenues, and control the costs of providing services, (7) possible changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs, Medicaid waiver programs or state directed payments, that may impact reimbursements to health care providers and insurers and the size of the uninsured or underinsured population, (8) personnel-related capacity constraints, increases in wages and the ability to attract, utilize and retain qualified management and other personnel, including affiliated physicians, nurses and medical and technical support personnel, (9) the highly competitive nature of the health care business, (10) 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, (11) the efforts of health insurers, health care providers, large employer groups and others to contain health care costs, (12) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (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) the emergence of and effects related to pandemics, epidemics and outbreaks of infectious diseases or other public health crises, including but not limited to developments related to COVID-19, (16) future divestitures which may result in charges and possible impairments of long-lived assets, (17) changes in business strategy or development plans, (18) delays in receiving payments for services provided, (19) the outcome of pending and any future tax audits, disputes and litigation associated with our tax positions, (20) the impact of known and unknown government investigations, litigation and other claims that may be made against us, (21) the impact of actual and potential cybersecurity incidents or security breaches involving us or our vendors and other third parties, including the data security incident disclosed in July 2023, (22) our ongoing ability to demonstrate meaningful use of certified electronic health record technology and the impact of interoperability requirements, (23) the impact of natural disasters, such as hurricanes and floods, physical risks from climate change or similar events beyond our control, (24) changes in U.S. federal, state, or foreign tax laws including interpretive guidance that may be issued by taxing authorities or other standard setting bodies, (25) the results of our efforts to use technology and resilience initiatives, including artificial intelligence and machine learning, to drive efficiencies, better outcomes and an enhanced patient experience, (26) the impact of recent decisions of the U.S. Supreme Court regarding the actions of federal agencies, and (27) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2023 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,” “HCA” and “HCA Healthcare” as used throughout this release refer to HCA Healthcare, Inc. and its affiliates.

HCA Healthcare, Inc.
Condensed Consolidated Comprehensive Income Statements
Second Quarter
Unaudited
(Dollars in millions, except per share amounts)
 
 
 

2024

 

2023

Amount

Ratio

Amount

Ratio

 
Revenues

$

17,492

 

100.0

 

%

$

15,861

 

100.0

%

 
Salaries and benefits

 

7,685

 

43.9

 

 

7,277

 

45.9

Supplies

 

2,634

 

15.1

 

 

2,478

 

15.6

Other operating expenses

 

3,623

 

20.7

 

 

3,043

 

19.2

Equity in losses of affiliates

 

 

 

 

7

 

Depreciation and amortization

 

819

 

4.7

 

 

763

 

4.8

Interest expense

 

506

 

2.9

 

 

485

 

3.1

Gains on sales of facilities

 

(12

)

(0.1

)

 

(1

)

 

 

15,255

 

87.2

 

 

14,052

 

88.6

 
Income before income taxes

 

2,237

 

12.8

 

 

1,809

 

11.4

 
Provision for income taxes

 

550

 

3.2

 

 

397

 

2.5

 
Net income

 

1,687

 

9.6

 

 

1,412

 

8.9

 
Net income attributable to noncontrolling interests

 

226

 

1.2

 

 

219

 

1.4

 
Net income attributable to HCA Healthcare, Inc.

$

1,461

 

8.4

 

$

1,193

 

7.5

 
Diluted earnings per share

$

5.53

 

$

4.29

 

 
Shares used in computing diluted earnings per share (millions)

 

264.071

 

 

278.198

 

 
Comprehensive income attributable to HCA Healthcare, Inc.

$

1,461

 

$

1,207

 

HCA Healthcare, Inc.
Condensed Consolidated Comprehensive Income Statements
For the Six Months Ended June 30, 2024 and 2023
Unaudited
(Dollars in millions, except per share amounts)
 
 
 

2024

2023

Amount

Ratio

Amount

Ratio

 
Revenues

$

34,831

 

100.0

 

%

$

31,452

100.0

%

 
Salaries and benefits

 

15,392

 

44.2

 

 

14,361

45.7

Supplies

 

5,305

 

15.2

 

 

4,901

15.6

Other operating expenses

 

7,229

 

20.8

 

 

5,937

18.8

Equity in losses of affiliates

 

2

 

 

 

25

0.1

Depreciation and amortization

 

1,614

 

4.6

 

 

1,519

4.8

Interest expense

 

1,018

 

2.9

 

 

964

3.1

Losses (gains) on sales of facilities

 

(213

)

(0.6

)

 

14

 

 

30,347

 

87.1

 

 

27,721

88.1

 
Income before income taxes

 

4,484

 

12.9

 

 

3,731

11.9

 
Provision for income taxes

 

995

 

2.9

 

 

776

2.5

 
Net income

 

3,489

 

10.0

 

 

2,955

9.4

 
Net income attributable to noncontrolling interests

 

437

 

1.2

 

 

399

1.3

 
Net income attributable to HCA Healthcare, Inc.

$

3,052

 

8.8

 

$

2,556

8.1

 
Diluted earnings per share

$

11.47

 

$

9.14

 
Shares used in computing diluted earnings per share (millions)

 

266.044

 

 

279.573

 
Comprehensive income attributable to HCA Healthcare, Inc.

$

3,044

 

$

2,590

 
HCA Healthcare, Inc.
Condensed Consolidated Balance Sheets
Unaudited
(Dollars in millions)
 
 

June 30,

March 31,

December 31,

 

2024

 

 

2024

 

 

2023

 

Current assets:
Cash and cash equivalents

$

831

 

$

1,284

 

$

935

 

Accounts receivable

 

10,239

 

 

10,044

 

 

9,958

 

Inventories

 

1,800

 

 

1,903

 

 

2,021

 

Other

 

2,303

 

 

2,051

 

 

2,013

 

 

15,173

 

 

15,282

 

 

14,927

 

 
Property and equipment, at cost

 

60,625

 

 

59,440

 

 

58,548

 

Accumulated depreciation

 

(31,986

)

 

(31,344

)

 

(30,833

)

 

28,639

 

 

28,096

 

 

27,715

 

 
Investments of insurance subsidiaries

 

483

 

 

471

 

 

477

 

Investments in and advances to affiliates

 

702

 

 

736

 

 

756

 

Goodwill and other intangible assets

 

9,963

 

 

9,967

 

 

9,945

 

Right-of-use operating lease assets

 

2,179

 

 

2,211

 

 

2,207

 

Other

 

240

 

 

199

 

 

184

 

 

$

57,379

 

$

56,962

 

$

56,211

 

 
 
 
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable

$

4,029

 

$

4,735

 

$

4,233

 

Accrued salaries

 

1,993

 

 

1,759

 

 

2,127

 

Other accrued expenses

 

3,705

 

 

3,619

 

 

3,871

 

Long-term debt due within one year

 

4,574

 

 

3,028

 

 

2,424

 

 

14,301

 

 

13,141

 

 

12,655

 

 
Long-term debt, less debt issuance costs and discounts of $371, $381 and $333

 

36,306

 

 

37,163

 

 

37,169

 

Professional liability risks

 

1,573

 

 

1,571

 

 

1,557

 

Right-of-use operating lease obligations

 

1,894

 

 

1,912

 

 

1,903

 

Income taxes and other liabilities

 

1,966

 

 

1,905

 

 

1,867

 

 
Stockholders’ equity:
Stockholders’ deficit attributable to HCA Healthcare, Inc.

 

(1,600

)

 

(1,615

)

 

(1,774

)

Noncontrolling interests

 

2,939

 

 

2,885

 

 

2,834

 

 

1,339

 

 

1,270

 

 

1,060

 

$

57,379

 

$

56,962

 

$

56,211

 

HCA Healthcare, Inc.
Condensed Consolidated Statements of Cash Flows
For the Six Months Ended June 30, 2024 and 2023
Unaudited
(Dollars in millions)
 
 
 

 

2024

 

 

2023

 

 
Cash flows from operating activities:
Net income

$

3,489

 

$

2,955

 

Adjustments to reconcile net income to net cash provided by operating activities:
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable

 

(285

)

 

306

 

Inventories and other assets

 

(68

)

 

(301

)

Accounts payable and accrued expenses

 

(459

)

 

(505

)

Depreciation and amortization

 

1,614

 

 

1,519

 

Income taxes

 

(4

)

 

3

 

Losses (gains) on sales of facilities

 

(213

)

 

14

 

Amortization of debt issuance costs and discounts

 

17

 

 

17

 

Share-based compensation

 

199

 

 

133

 

Other

 

150

 

 

137

 

 
Net cash provided by operating activities

 

4,440

 

 

4,278

 

 
 
Cash flows from investing activities:
Purchase of property and equipment

 

(2,399

)

 

(2,438

)

Acquisition of hospitals and health care entities

 

(131

)

 

(124

)

Sales of hospitals and health care entities

 

311

 

 

172

 

Change in investments

 

(14

)

 

(16

)

Other

 

(2

)

 

(2

)

 
Net cash used in investing activities

 

(2,235

)

 

(2,408

)

 
 
Cash flows from financing activities:
Issuances of long-term debt

 

4,483

 

 

3,218

 

Net change in revolving credit facilities

 

(1,030

)

 

(1,840

)

Repayment of long-term debt

 

(2,269

)

 

(608

)

Distributions to noncontrolling interests

 

(338

)

 

(342

)

Payment of debt issuance costs

 

(40

)

 

(30

)

Payment of dividends

 

(356

)

 

(339

)

Repurchase of common stock

 

(2,547

)

 

(1,761

)

Other

 

(212

)

 

(221

)

 
Net cash used in financing activities

 

(2,309

)

 

(1,923

)

 
Effect of exchange rate changes on cash and cash equivalents

 

 

 

7

 

 
Change in cash and cash equivalents

 

(104

)

 

(46

)

Cash and cash equivalents at beginning of period

 

935

 

 

908

 

 
 
Cash and cash equivalents at end of period

$

831

 

$

862

 

 
 
Interest payments

$

943

 

$

925

 

Income tax payments, net

$

999

 

$

773

 

HCA Healthcare, Inc.

Operating Statistics

 
 
For the Six Months
Second Quarter Ended June 30,

 

2024

 

 

2023

 

 

2024

 

 

2023

 

 
Operations:
Number of Hospitals

 

188

 

 

182

 

 

188

 

 

182

 

Number of Freestanding Outpatient Surgery Centers* .

 

123

 

 

126

 

 

123

 

 

126

 

Licensed Beds at End of Period

 

49,844

 

 

49,063

 

 

49,844

 

 

49,063

 

Weighted Average Beds in Service

 

42,624

 

 

41,802

 

 

42,594

 

 

41,743

 

 
Reported:
Admissions

 

554,456

 

 

522,996

 

 

1,115,325

 

 

1,048,231

 

% Change

 

6.0

%

 

6.4

%

Equivalent Admissions

 

994,835

 

 

938,834

 

 

1,976,356

 

 

1,855,369

 

% Change

 

6.0

%

 

6.5

%

Revenue per Equivalent Admission

$

17,583

 

$

16,894

 

$

17,624

 

$

16,952

 

% Change

 

4.1

%

 

4.0

%

Inpatient Revenue per Admission

$

18,814

 

$

17,689

 

$

18,869

 

$

17,759

 

% Change

 

6.4

%

 

6.3

%

 
Patient Days

 

2,662,550

 

 

2,558,563

 

 

5,444,146

 

 

5,196,466

 

% Change

 

4.1

%

 

4.8

%

Equivalent Patient Days

 

4,779,234

 

 

4,594,604

 

 

9,647,027

 

 

9,197,745

 

% Change

 

4.0

%

 

4.9

%

 
Inpatient Surgery Cases

 

135,860

 

 

132,447

 

 

269,258

 

 

262,907

 

% Change

 

2.6

%

 

2.4

%

Outpatient Surgery Cases

 

258,967

 

 

263,601

 

 

511,802

 

 

519,572

 

% Change

 

-1.8

%

 

-1.5

%

 
Emergency Room Visits

 

2,414,960

 

 

2,294,205

 

 

4,843,874

 

 

4,546,874

 

% Change

 

5.3

%

 

6.5

%

 
Outpatient Revenues as a
Percentage of Patient Revenues

 

38.2

%

 

39.8

%

 

37.6

%

 

38.7

%

 
Average Length of Stay (days)

 

4.802

 

 

4.892

 

 

4.881

 

 

4.957

 

 
Occupancy**

 

71.9

%

 

71.1

%

 

73.6

%

 

72.6

%

 
Same Facility:
Admissions

 

550,610

 

 

520,520

 

 

1,106,303

 

 

1,043,978

 

% Change

 

5.8

%

 

6.0

%

Equivalent Admissions

 

975,130

 

 

926,526

 

 

1,936,030

 

 

1,839,489

 

% Change

 

5.2

%

 

5.2

%

Revenue per Equivalent Admission

$

17,503

 

$

16,766

 

$

17,534

 

$

16,876

 

% Change

 

4.4

%

 

3.9

%

Inpatient Revenue per Admission

$

18,845

 

$

17,718

 

$

18,904

 

$

17,755

 

% Change

 

6.4

%

 

6.5

%

 
Inpatient Surgery Cases

 

135,129

 

 

131,656

 

 

267,294

 

 

261,584

 

% Change

 

2.6

%

 

2.2

%

Outpatient Surgery Cases

 

254,371

 

 

259,733

 

 

502,037

 

 

512,575

 

% Change

 

-2.1

%

 

-2.1

%

 
Emergency Room Visits

 

2,400,248

 

 

2,275,021

 

 

4,800,438

 

 

4,513,084

 

% Change

 

5.5

%

 

6.4

%

 
 
* Excludes freestanding endoscopy centers (23 centers at June 30, 2024 and 22 centers at June 30, 2023).
** Reflects the rate of occupancy (patient days and observations) based on weighted average beds in service.
HCA Healthcare, Inc.
Supplemental Non-GAAP Disclosures
Operating Results Summary
(Dollars in millions, except per share amounts)
 
 
For Six Months
Second Quarter Ended June 30,

 

2024

 

 

2023

 

 

2024

 

 

2023

 

 
Revenues

$

17,492

 

$

15,861

 

$

34,831

 

$

31,452

 

 
Net income attributable to HCA Healthcare, Inc.

$

1,461

 

$

1,193

 

$

3,052

 

$

2,556

 

Losses (gains) on sales of facilities (net of tax)

 

(9

)

 

 

 

(163

)

 

22

 

Net income attributable to HCA Healthcare, Inc., as adjusted (a)

 

1,452

 

 

1,193

 

 

2,889

 

 

2,578

 

Depreciation and amortization

 

819

 

 

763

 

 

1,614

 

 

1,519

 

Interest expense

 

506

 

 

485

 

 

1,018

 

 

964

 

Provision for income taxes

 

547

 

 

396

 

 

945

 

 

768

 

Net income attributable to noncontrolling interests

 

226

 

 

219

 

 

437

 

 

399

 

 
Adjusted EBITDA (a)

$

3,550

 

$

3,056

 

$

6,903

 

$

6,228

 

 
Adjusted EBITDA margin (a)

 

20.3

%

 

19.3

%

 

19.8

%

 

19.8

%

 
Diluted earnings per share:
Net income attributable to HCA Healthcare, Inc.

$

5.53

 

$

4.29

 

$

11.47

 

$

9.14

 

Losses (gains) on sales of facilities

 

(0.03

)

 

 

 

(0.61

)

 

0.08

 

Net income attributable to HCA Healthcare, Inc., as adjusted (a)

$

5.50

 

$

4.29

 

$

10.86

 

$

9.22

 

 
Shares used in computing diluted earnings per share (millions)

 

264.071

 

 

278.198

 

 

266.044

 

 

279.573

 

 
 
 
(a) Net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA should not be considered as measures of financial performance under generally accepted accounting principles (“GAAP”). These non-GAAP financial measures are adjusted to exclude losses (gains) on sales of facilities and losses on retirement of debt. We believe net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA are important measures that supplement discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA as the primary measures to review and assess operating performance of its health care facilities and their management teams.
 
Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and GAAP net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry. It is reasonable to expect that adjustments, including losses (gains) on sales of facilities and losses on retirement of debt will occur in future periods, but the amounts recognized can vary significantly from period to period, do not directly relate to the ongoing operations of our health care facilities and complicate period comparisons of our results of operations and operations comparisons with other health care companies.
 
Net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA are not measures of financial performance under GAAP, and should not be considered as alternatives to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA are not measurements determined in accordance with GAAP and are susceptible to varying calculations, net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.

Contacts

INVESTOR CONTACT:
Frank Morgan

615-344-2688

MEDIA CONTACT:
Harlow Sumerford

615-344-1851

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