HCA Healthcare, Inc. (NYSE:HCA) Q2 2023 Earnings Call Transcript

Operator: The next question comes from Andrew Mok with UBS.

Andrew Mok: I just wanted to follow up on the pricing discussion maybe from a different angle. Revenue per outpatient equivalent looks, like it was down about 1% in the quarter, which seems to be weighing on strong inpatient pricing up 6%. Can you help us understand the pricing and mix trends across your outpatient platform that are causing that unit revenue metric to blend down this year?

Bill Rutherford: Well, I’d say we’re pleased with the outpatient growth that we’re seeing. If you look at the overall outpatient growth that we have, it’s — our expectation was mid-single digits. We’re well north of that in the quarter and on a year-to-date basis. There’s always a little bit of a mix issue that occurs. Our emergency room volume was up, what, 3.7%, which were a lot of are outpatient. Our outpatient surgical growth was up 3.3% in the quarter. So I think those are really good stats. On the outpatient revenue, per unit. There’s always a blend between surgical, emergency room and diagnostic. But I would say, overall, we’re very pleased with the outpatient overall growth that we are seeing.

Sam Hazen: Yes. And Bill, just the second quarter overall outpatient revenue growth was actually up over the first quarter. So we are seeing some acceleration. There’s a lot of moving parts, as Bill just alluded to, to outpatient revenues between physician, clinics, urgent care, all the way up to outpatient cardiology procedures, which tend to be our highest reimbursed type of procedures. And so the mix of that can influence the outpatient. We tend to look at it in the aggregate. And for the most part, our aggregate revenue growth has been stronger in the second quarter than it was in the first quarter. And then within sort of the pricing elements, we continue to get the targeted price increases that we want in both our inpatient and our outpatient businesses. So it’s more, to Bill’s point, sort of the mix and the mixture of all of the different components in a way that has produced solid growth for us.

Operator: Next question comes from Calvin Sternick with JPMorgan.

Calvin Sternick: I wanted to ask about the commercial rate cycle. I think last quarter, you said you guys are about 2/3 of the way through 2024 and about 1/4 of the way through 2025. Can you give us an update on the progress and how those rate discussions are evolving?

Bill Rutherford: Yes. They’re evolving pretty consistent. As we just mentioned, we’re continuing to see rates in kind of the mid-single digit level. As far as contracted for ’24, I think we’re a little north of 70% for ’24 now. And I think our efforts continue. I think our relationships with our major payers continue to be strong and we’re pleased with the progress we’re making in that area.

Operator: And the next question comes from Scott Fidel with Stephens.

Scott Fidel: Interested just as against the backdrop where the managed care payers are seeing the higher medical cost trends this year, whether you’re seeing any changes in behaviors when interfacing with them from a prior authorization or utilization management-type perspective? Or are things pretty consistent there? And then just a quick follow-up, just on the slight raise in the CapEx. Is that just related to the general broad-based investments that Sam just talked about? Or are there any specific projects that you would cite around the update to the CapEx guide?

Bill Rutherford: Yes, let me try to take both of those. I think as we maybe mentioned in the past, as you think about authorization and medical necessity reviews, those activities have picked up again as — during the COVID period of time, those have eased a little bit. But we still see a lot of friction, if you will, as you go through that effort. We work with our payers to try to resolve those appropriately, make sure that we defend our positions where necessary. But there is a level of activity that both us and the payers have to devote to try to smooth through that process. But we tend to be able to work our way through it. On the CapEx, I think it’s simply reflective of the opportunities we see in the market to continue to deploy capital for growth. Fortunately, we continue to see really strong cash flow to be able to support that CapEx. And again, I think it’s reflective of the growth opportunities we see in the market.