HCA Healthcare, Inc. (NYSE:HCA) Q4 2022 Earnings Call Transcript

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Operator: Our next question comes from Stephen Baxter with Wells Fargo.

Stephen Baxter: Hi, good morning. Just wanted to ask a follow-up on the 2023 guidance, I was hoping you could talk a little bit more specifically about your expectations on inpatient admissions. I guess, first, how are you thinking about where the COVID figure goes in 2023 compared to the 5.2% of admissions in 2022? Any implication being I’d love to hear how you’re thinking about non-COVID admission growth in 2023? Thank you.

Bill Rutherford: Yes. So I’ll start with that. So we expect a continued decline of COVID admission as you’ve mentioned, and I said in my prepared remarks, they represent about 5.2% of our total admissions. This year, we’re thinking next year, probably somewhere between 3% and 4% of our total admissions. We believe right now, our inpatient admission growth somewhere around that 2% number, and that’s embedded within the equivalent admission guidance that I gave between 2% to 3%. And again, we will continue to monitor that as we go through the year. We continue to believe that there is strong demand in our markets, and we’re positioned well to serve that demand. So inpatient volume, we’re thinking hovering around 2%, and then outpatient revenue probably continue to grow in that mid-single-digit level. And that helps us get to the 2% to 3% equivalent admissions that’s €“ that our guidance entails.

Operator: Our next question comes from Scott Fidel with Stephens.

Scott Fidel: Hi, thanks. Good morning. Interested if you can just recap for us what the non-COVID acuity and case mix trends were in 2022. And then what you’re building in for your assumptions for 2023? Thanks.

Bill Rutherford: Yes. So I don’t know if I have the case mix necessarily. We’ve seen relatively flat, as I recall, on the COVID case mix, right? Our non-COVID mix improved about 2% sequentially from the third quarter to the fourth quarter going forward. Our revenue per equivalent admission was roughly flat for the year-over-year comparisons.

Scott Fidel: And then, Bill, on the outlook for €˜23.

Bill Rutherford: For non-COVID?

Scott Fidel: Yes.

Bill Rutherford: Yes, that would be embedded in our revenue per equivalent admission of about 2%. And then when you factor out the loss of the revenue items, I think, as I mentioned earlier, that pushes us closer to 3%. And that would be just a combination of all factors of acuity as well as payer mix and pricing trends underneath the…

Sam Hazen: And Bill if I can add, I think it’s important for everybody to understand it. Strategically, we continue to invest in programs, as I mentioned in my prepared comments. A lot of those programs are farther up the acuity ladder, if you will. They are more significant programs. They are extensions of existing programs and as we get our footing, so to speak, with a mid-level program or an upper-mid level program, then we can move into a more acute level program. And that helps with our overall acuity statistic. So, that part of our strategy, we are doing that on top of the same fixed cost platform. So, our hospitals have the same fixed cost regardless of the acuity in many instances. And so if we can increase the acuity, we get operating leverage from that.

So, strategically, that’s a very important initiative of ours. The transfers and that we haven’t been able to take care of tends to be slightly more acute than our average in most instances. And here, again, that’s why it’s so important for us to get more employees across the organization to take care of these patients who need our services. But all of that’s embedded inside of a real strategic initiative that we have.

Operator: Our next question comes from Calvin Sternick with JPMorgan.

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