Sam Hazen: Excuse me. So Ann, it’s Sam. We, pre pandemic, were somewhere around 13% or 14% €“ excuse me, 14% for nursing turnover. We’re on a run rate now 18%, 18.5%. That’s down from mid-20s. We think the industry average is somewhere in the mid to upper 20s right now from what we’ve seen external benchmarks and so forth. So we’re really encouraged by the progress our teams have made. And again, over the last 6 months of the year, we were starting to see improving trends. We believe we have the right initiatives in place to carry some momentum in that area into 2023. The market, as I mentioned, is a bit tenuous still, but we’re encouraged by the investments we’ve made in our recruiting, the investments we’ve made in retention and leadership training and just the €“ I’ll call it, the hand-to-hand combat that exists in making sure that our employees have the resources on their units that are necessary for them to deliver great care to their patients and for them to be successful in whatever their role is in the company.
And we think we’re making progress on pretty much all of those fronts.
Bill Rutherford: And Ann, on the emergency room, I’ve brought it to more than emergency from just hospital-based physician we have talked about in the past. We are seeing some increased pressures for subsidies around our interest room and anesthesiologists and the like. We have a number of initiatives to try to counter those. But yes, we are expecting some upward pressure in those areas that we factored into our guidance. If it rolls through, as I mentioned in the previous question, in our other operating expenses, then we could potentially see higher single-digit year-over-year growth in those categories, probably at a little bit of pace above our revenue. But we think we’ve made appropriate consideration for those trends inside of our guidance.
Ann Hynes: Alright. Thanks.
Bill Rutherford: Yes.
Operator: Our next question comes from Brian Tanquilut with Jefferies.
Brian Tanquilut: Hey, good morning, guys. I guess, Sam, follow-up to Ann’s question and to Bill’s answer of that. I saw that you exercise the call option and the Envision JV last week. So just curious how you’re thinking about operationalizing that and what would change for HCA as you bring those physicians back in-house? And maybe just thoughts on the P&L and balance sheet impact of that as well? Thanks.
Sam Hazen: So we’ve had a wonderful relationship with Envision over the years, and it continues to be strong across different facilities in our company. A number of years ago, we had made an investment in a co-venture with them that we felt was an opportunity for us to integrate that physician service, mainly in the ER and hospitalist medicine and a few other subspecialty categories within our hospitals as more clinically aligned and so forth. And what we see is an opportunity to further that. And so we are moving to acquire a larger percentage of that co-venture, and we think it will give us a little better visibility in how to achieve better clinical integration to improve quality. We think we can use that platform to improve efficiency within our emergency rooms primarily and even on our med surge floors where our hospitalists work.
It will support graduate medical education in some innovative ways, we believe. And then, finally, we think it offers up an opportunity for us to advance our connections to our strategic outreach partners in ways that maybe we don’t necessarily accomplish in the structure we have today. So we are pushing through the final stages of that transaction. I think it’s scheduled to close sometime in the spring. We will take the rest of the year to fully assimilate it, so to speak. And then as we get into 2024, we anticipate being able to execute more effectively on these categories.
