Business Wire | Jul 20, 2021 07:30AM EDT

HCA Healthcare Reports Second Quarter 2021 Results; Raises 2021 Guidance

Jul. 20, 2021

NASHVILLE, Tenn.--(BUSINESS WIRE)--Jul. 20, 2021--HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the second quarter ended June 30, 2021.

Key second quarter metrics (all percentage changes compare 2Q 2021 to 2Q 2020 unless otherwise noted):

* Revenues totaled $14.435 billion * Net income attributable to HCA Healthcare, Inc. totaled $1.450 billion, or $4.36 per diluted share * Adjusted EBITDA totaled $3.219 billion * Cash flows from operating activities totaled $2.251 billion * Same facility admissions increased 17.5 percent and same facility equivalent admissions increased 26.8 percent

"With the effects of the pandemic moderating in the second quarter, we experienced a strong rebound in demand for healthcare services," said Sam Hazen, Chief Executive Officer of HCA Healthcare. "We continue to invest aggressively in our strategic agenda, which is building greater clinical capabilities to serve our communities while also developing more comprehensive enterprise resources to support caregivers and differentiate our local networks."

Revenues in the second quarter of 2021 increased to $14.435 billion, compared to $11.068 billion in the second quarter of 2020. Net income attributable to HCA Healthcare, Inc. totaled $1.450 billion, or $4.36 per diluted share, compared to $1.079 billion, or $3.16 per diluted share, in the second quarter of 2020. The second quarter of 2021 results include gains on sales of facilities of $8 million, or $0.02 per diluted share, and losses on retirement of debt of $12 million, or $0.03 per diluted share. The second quarter of 2020 results included losses on sales of facilities of $27 million, or $0.07 per diluted share. The Company recognized $822 million ($590 million net of tax), or $1.73 per diluted share, in government stimulus income during the second quarter of 2020 related to general distribution funds received from the provider relief fund established by the Coronavirus Aid, Relief, and Economic Security ("CARES") Act. During October 2020, the Company announced it would return, or repay early, its share of provider relief fund distributions of approximately $1.6 billion and approximately $4.4 billion in Medicare accelerated payments. In the third quarter of 2020, the Company reversed the $822 million of government stimulus income that it recognized during the second quarter of 2020.

For the second quarter of 2021, Adjusted EBITDA totaled $3.219 billion, compared to $2.666 billion in the second quarter of 2020, which included $822 million in government stimulus income. 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 17.5 percent and same facility equivalent admissions increased 26.8 percent in the second quarter of 2021, compared to the prior year period. Same facility emergency room visits increased 40.5 percent in the second quarter of 2021, compared to the prior year period. Same facility inpatient surgeries increased 15.0 percent while same facility outpatient surgeries increased 52.5 percent in the second quarter of 2021 compared to the same period of 2020. The second quarter of 2021 volume statistics show strong recoveries from the pandemic-related restrictions and policies that negatively affected patient volumes during the second quarter of 2020. Same facility revenue per equivalent admission increased 2.6 percent in the second quarter of 2021, compared to the second quarter of 2020.

Because of the decline in volumes in the second quarter of 2020 driven by the pandemic-related restrictions and policies, the Company believes a comparison of volume statistics to the comparable period in 2019 provides additional context to the improvement in operations during 2021. The following table provides a summary of statistical measures for the second quarter of 2021 compared to the same period in 2019 on a consolidated basis.

Second Quarter 2021 2019 % Change

Reported: Admissions 532,041 518,253 2.7%

Equivalent Admissions 916,212 903,419 1.4%

Patient Days 2,629,950 2,530,548 3.9%

Equivalent Patient Days 4,535,678 4,412,348 2.8%

Inpatient Surgery Cases 136,460 140,473 -2.9%

Outpatient Surgery Cases 262,107 253,441 3.4%

Emergency Room Visits 2,128,428 2,253,337 -5.5%

Six Months Ended June 30, 2021

Revenues for the six months ended June 30, 2021 totaled $28.412 billion, compared to $23.929 billion in the same period of 2020. Net income attributable to HCA Healthcare, Inc. was $2.873 billion, or $8.50 per diluted share, compared to $1.660 billion, or $4.84 per diluted share, for the first six months of 2020. Results for the six months ended June 30, 2021 included gains on sales of facilities of $10 million, or $0.02 per diluted share, and losses on retirement of debt of $12 million, or $0.03 per diluted share. Results for the six months ended June 30, 2020 included government stimulus income of $822 million ($590 million net of tax), or $1.72 per diluted share, losses on sales of facilities of $20 million, or $0.06 per diluted share, and losses on retirement of debt of $295 million, or $0.66 per diluted share.

Balance Sheet and Cash Flows from Operations

As of June 30, 2021, HCA Healthcare, Inc.'s balance sheet reflected cash and cash equivalents of $1.120 billion, total debt of $32.572 billion, and total assets of $48.164 billion. During the second quarter of 2021, capital expenditures totaled $842 million, excluding acquisitions. Cash flows provided by operating activities in the second quarter totaled $2.251 billion, compared to $8.723 billion in the second quarter of 2020. The $8.723 billion of cash flow from operations for the second quarter of 2020 included the $822 million of government stimulus income and $4.999 billion of contract liabilities-deferred revenues, which were reversed during the third and fourth quarters of 2020.

During the second quarter of 2021, the Company repurchased 11.261 million shares of its common stock at a cost of $2.287 billion. The Company had $4.987 billion remaining under its repurchase authorization as of June 30, 2021. As of June 30, 2021, the Company had $5.620 billion of availability under its credit facilities.

Dividend

HCA today announced that its Board of Directors declared a quarterly cash dividend of $0.48 per share on the Company's common stock. The dividend will be paid on September 30, 2021 to stockholders of record at the close of business on September 16, 2021.

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 and results of operations and contractual restrictions. Future dividends are expected to be funded by cash balances and future cash flows from operations.

2021 Revised Guidance

The 2021 guidance ranges for the year have been revised from our first quarter release and are as follows:

2021 Guidance Range

Revenues $57.0 to $58.0 billion

Adjusted EBITDA $12.10 to $12.50 billion

EPS (diluted) $16.30 to $17.10 per diluted share

Capital Expenditures Approximately $3.7 billion

The Company's 2021 guidance contains a number of assumptions, including, among others, the Company's current expectations regarding the impact of the COVID-19 pandemic and related government legislation, 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 Daylight 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, 2021, HCA operated 187 hospitals and approximately 2,000 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, 2021, 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) developments related to COVID-19, including, without limitation, the length and severity of the pandemic and the spread of virus strains with new epidemiological characteristics; the volume of canceled or rescheduled procedures and the volume of COVID-19 patients cared for across our health systems; measures we are taking to respond to the COVID-19 pandemic; the impact and terms of government and administrative regulation and stimulus (including the Families First Coronavirus Response Act, the Coronavirus Aid, Relief and Economic Security ("CARES") Act, the Paycheck Protection Program and Health Care Enhancement Act, the Consolidated Appropriations Act, 2021, the American Rescue Plan Act of 2021 and other enacted and potential future legislation); changes in revenues due to declining patient volumes, changes in payer mix and deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients); potential increased expenses related to labor, supply chain or other expenditures; workforce disruptions; supply shortages and disruptions; and the timing, availability and adoption of effective medical treatments and vaccines, (2) the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable terms, as well as risks associated with disruptions in the financial markets and the business of financial institutions as the result of the COVID-19 pandemic which could impact us from a financial perspective, (3) the impact of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the "Affordable Care Act"), including the effects of changes or court challenges to the Affordable Care Act or additional changes to its implementation, the possible enactment of additional federal or state health care reforms and possible changes to other federal, state or local laws or regulations affecting the health care industry, including 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"), and also including any such laws or governmental regulations which are adopted in response to the COVID-19 pandemic, (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 ("PAYGO Act") 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, and attain expected levels of patient volumes and control the costs of providing services, (7) possible changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs or Medicaid waiver programs, that may impact reimbursements to health care providers and insurers and the size of the uninsured or underinsured population, (8) the highly competitive nature of the health care business, (9) 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, (10) the efforts of health insurers, health care providers, large employer groups and others to contain health care costs, (11) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (12) increases in wages and the ability to attract and retain qualified management and personnel, including affiliated physicians, nurses and medical and technical support personnel, (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) changes in general economic conditions nationally and regionally in our markets, including economic and business conditions (and the impact thereof on the economy, financial markets and banking industry) resulting from the COVID-19 pandemic, (16) the emergence of and effects related to other pandemics, epidemics and infectious diseases, (17) future divestitures which may result in charges and possible impairments of long-lived assets, (18) changes in business strategy or development plans, (19) delays in receiving payments for services provided, (20) the outcome of pending and any future tax audits, disputes and litigation associated with our tax positions, (21) potential adverse impact of known and unknown government investigations, litigation and other claims that may be made against us, (22) the impact of potential cybersecurity incidents or security breaches, (23) our ongoing ability to demonstrate meaningful use of certified electronic health record ("EHR") technology and the impact of interoperability requirements, (24) the impact of natural disasters, such as hurricanes and floods, or similar events beyond our control, (25) changes in the U.S. federal, state, or foreign tax laws including interpretive guidance that may be issued by taxing authorities or other standard setting bodies, and (26) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2020 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" and "HCA Healthcare" as used throughout this release refer to HCA Healthcare, Inc. and its affiliates.

HCA Healthcare, Inc.Condensed Consolidated Comprehensive Income StatementsSecond Quarter(Dollars in millions, except per share amounts) ($ millions, except per share amounts) 2021 2020

Amount Ratio Amount Ratio Revenues $14,435 100.0 % $11,068 100.0 %

Salaries and benefits 6,385 44.2 5,330 48.2

Supplies 2,380 16.5 1,748 15.8

Other operating expenses 2,473 17.2 2,147 19.3

Government stimulus income - - (822) (7.4)

Equity in earnings of affiliates (22) (0.2) (1) -

Depreciation and amortization 712 4.9 691 6.3

Interest expense 386 2.7 388 3.5

Losses (gains) on sales of facilities (8) (0.1) 27 0.2

Losses on retirement of debt 12 0.1 - -

12,318 85.3 9,508 85.9

Income before income taxes 2,117 14.7 1,560 14.1

Provision for income taxes 453 3.2 344 3.1

Net income 1,664 11.5 1,216 11.0

Net income attributable to noncontrolling 214 1.5 137 1.2interests Net income attributable to HCA Healthcare, $1,450 10.0 $1,079 9.8Inc. Diluted earnings per share $4.36 $3.16

Shares used in computing diluted earnings 332.613 341.599 per share (millions) Comprehensive income attributable to HCA $1,466 $1,088 Healthcare, Inc.Condensed Consolidated Comprehensive Income StatementsFor the Six Months Ended June 30, 2021 and 2020(Dollars in millions, except per share amounts)2021

2020

AmountRatioAmountRatioRevenues$28,412

100.0

%

$23,929

100.0

%

Salaries and benefits12,686

44.6

11,448

47.8

Supplies4,604

16.2

3,871

16.2

Other operating expenses4,894

17.3

4,574

19.1

Government stimulus income-

-

(822)

(3.4)

Equity in earnings of affiliates(43)

(0.2)

(8)

-

Depreciation and amortization1,409

5.0

1,365

5.7

Interest expense770

2.7

816

3.4

Losses (gains) on sales of facilities(10)

-

20

0.1

Losses on retirement of debt12

-

295

1.2

24,322

85.6

21,559

90.1

Income before income taxes4,090

14.4

2,370

9.9

Provision for income taxes846

3.0

456

1.9

Net income3,244

11.4

1,914

8.0

Net income attributable to noncontrolling interests371

1.3

254

1.1

Net income attributable to HCA Healthcare, Inc.$2,873

10.1

$1,660

6.9

Diluted earnings per share$8.50

$4.84

Shares used in computing diluted earnings per share (millions)337.940

342.848

Comprehensive income attributable to HCA Healthcare, Inc.$2,900

$1,558

Condensed Consolidated Comprehensive Income StatementsFor the Six Months Ended June 30, 2021 and 2020(Dollars in millions, except per share amounts) 2021 2020

Amount Ratio Amount Ratio Revenues $28,412 100.0 % $23,929 100.0 %

Salaries and benefits 12,686 44.6 11,448 47.8

Supplies 4,604 16.2 3,871 16.2

Other operating expenses 4,894 17.3 4,574 19.1

Government stimulus income - - (822) (3.4)

Equity in earnings of affiliates (43) (0.2) (8) -

Depreciation and amortization 1,409 5.0 1,365 5.7

Interest expense 770 2.7 816 3.4

Losses (gains) on sales of facilities (10) - 20 0.1

Losses on retirement of debt 12 - 295 1.2

24,322 85.6 21,559 90.1

Income before income taxes 4,090 14.4 2,370 9.9

Provision for income taxes 846 3.0 456 1.9

Net income 3,244 11.4 1,914 8.0

Net income attributable to noncontrolling 371 1.3 254 1.1interests Net income attributable to HCA Healthcare, Inc. $2,873 10.1 $1,660 6.9

Diluted earnings per share $8.50 $4.84

Shares used in computing diluted earnings per 337.940 342.848share (millions) Comprehensive income attributable to HCA $2,900 $1,558Healthcare, Inc.HCA Healthcare, Inc.Condensed Consolidated Balance Sheets(Dollars in millions)June 30,March 31,December 31,2021

2021

2020

ASSETSCurrent assets:Cash and cash equivalents$1,120

$1,030

$1,793

Accounts receivable7,636

7,424

7,051

Inventories2,027

2,068

2,025

Other1,692

1,514

1,464

12,475

12,036

12,333

Property and equipment, at cost50,698

49,877

49,317

Accumulated depreciation(27,227)

(26,689)

(26,118)

23,471

23,188

23,199

Investments of insurance subsidiaries410

393

388

Investments in and advances to affiliates382

427

422

Goodwill and other intangible assets8,680

8,575

8,578

Right-of-use operating lease assets2,118

2,083

2,024

Other628

575

546

$48,164

$47,277

$47,490

LIABILITIES AND STOCKHOLDERS' EQUITYCurrent liabilities:Accounts payable$3,531

$3,524

$3,535

Accrued salaries1,896

1,767

1,720

Other accrued expenses2,935

3,117

3,240

Long-term debt due within one year253

234

209

8,615

8,642

8,704

Long-term debt, less debt issuance costs and discounts of $255, $229 and $23632,319

30,838

30,795

Professional liability risks1,585

1,553

1,486

Right-of-use operating lease obligations1,767

1,730

1,673

Income taxes and other liabilities2,088

2,032

1,940

Stockholders' equity:Stockholders' (deficit) equity attributable to HCA Healthcare, Inc.(593)

247

572

Noncontrolling interests2,383

2,235

2,320

1,790

2,482

2,892

$48,164

$47,277

$47,490

HCA Healthcare, Inc.Condensed Consolidated Balance Sheets(Dollars in millions) June 30, March December 31, 31, 2021 2021 2020

ASSETS Current assets: Cash and cash equivalents $1,120 $1,030 $1,793

Accounts receivable 7,636 7,424 7,051

Inventories 2,027 2,068 2,025

Other 1,692 1,514 1,464

12,475 12,036 12,333

Property and equipment, at cost 50,698 49,877 49,317

Accumulated depreciation (27,227) (26,689) (26,118)

23,471 23,188 23,199

Investments of insurance subsidiaries 410 393 388

Investments in and advances to affiliates 382 427 422

Goodwill and other intangible assets 8,680 8,575 8,578

Right-of-use operating lease assets 2,118 2,083 2,024

Other 628 575 546

$48,164 $47,277 $47,490

LIABILITIES AND STOCKHOLDERS' EQUITY Current liabilities: Accounts payable $3,531 $3,524 $3,535

Accrued salaries 1,896 1,767 1,720

Other accrued expenses 2,935 3,117 3,240

Long-term debt due within one year 253 234 209

8,615 8,642 8,704

Long-term debt, less debt issuance costs and 32,319 30,838 30,795discounts of $255, $229 and $236Professional liability risks 1,585 1,553 1,486

Right-of-use operating lease obligations 1,767 1,730 1,673

Income taxes and other liabilities 2,088 2,032 1,940

Stockholders' equity: Stockholders' (deficit) equity attributable to (593) 247 572HCA Healthcare, Inc.Noncontrolling interests 2,383 2,235 2,320

1,790 2,482 2,892

$48,164 $47,277 $47,490

HCA Healthcare, Inc.Condensed Consolidated Statements of Cash FlowsFor the Six Months Ended June 30, 2021 and 2020(Dollars in millions)2021

2020

Cash flows from operating activities:Net income$3,244

$1,914

Adjustments to reconcile net income to net cash provided by operating activities:Increase (decrease) in cash from operating assets and liabilities:Accounts receivable(567)

1,215

Inventories and other assets(213)

(57)

Accounts payable and accrued expenses49

(336)

Contract liabilities - deferred revenues-

4,999

Depreciation and amortization1,409

1,365

Income taxes2

472

Losses (gains) on sales of facilities(10)

20

Losses on retirement of debt12

295

Amortization of debt issuance costs and discounts14

14

Share-based compensation226

148

Other73

49

Net cash provided by operating activities4,239

10,098

Cash flows from investing activities:Purchase of property and equipment(1,496)

(1,598)

Acquisition of hospitals and health care entities(98)

(346)

Sales of hospitals and health care entities30

39

Change in investments(12)

(11)

Other7

(37)

Net cash used in investing activities(1,569)

(1,953)

Cash flows from financing activities:Issuances of long-term debt4,337

2,700

Net change in revolving credit facilities800

(2,480)

Repayment of long-term debt(3,731)

(3,364)

Distributions to noncontrolling interests(357)

(199)

Payment of debt issuance costs(32)

(35)

Payment of dividends(325)

(153)

Repurchase of common stock(3,814)

(441)

Other(224)

(144)

Net cash used in financing activities(3,346)

(4,116)

Effect of exchange rate changes on cash and cash equivalents3

(12)

Change in cash and cash equivalents(673)

4,017

Cash and cash equivalents at beginning of period1,793

621

Cash and cash equivalents at end of period$1,120

$4,638

Interest payments$755

$854

Income tax payments (refunds), net$844

$(16)

HCA Healthcare, Inc.Condensed Consolidated Statements of Cash FlowsFor the Six Months Ended June 30, 2021 and 2020(Dollars in millions) 2021 2020

Cash flows from operating activities:Net income $3,244 $1,914

Adjustments to reconcile net income to net cash provided byoperating activities:Increase (decrease) in cash from operating assets andliabilities:Accounts receivable (567) 1,215

Inventories and other assets (213) (57)

Accounts payable and accrued expenses 49 (336)

Contract liabilities - deferred revenues - 4,999

Depreciation and amortization 1,409 1,365

Income taxes 2 472

Losses (gains) on sales of facilities (10) 20

Losses on retirement of debt 12 295

Amortization of debt issuance costs and discounts 14 14

Share-based compensation 226 148

Other 73 49

Net cash provided by operating activities 4,239 10,098

Cash flows from investing activities:Purchase of property and equipment (1,496) (1,598)

Acquisition of hospitals and health care entities (98) (346)

Sales of hospitals and health care entities 30 39

Change in investments (12) (11)

Other 7 (37)

Net cash used in investing activities (1,569) (1,953)

Cash flows from financing activities:Issuances of long-term debt 4,337 2,700

Net change in revolving credit facilities 800 (2,480)

Repayment of long-term debt (3,731) (3,364)

Distributions to noncontrolling interests (357) (199)

Payment of debt issuance costs (32) (35)

Payment of dividends (325) (153)

Repurchase of common stock (3,814) (441)

Other (224) (144)

Net cash used in financing activities (3,346) (4,116)

Effect of exchange rate changes on cash and cash equivalents 3 (12)

Change in cash and cash equivalents (673) 4,017

Cash and cash equivalents at beginning of period 1,793 621

Cash and cash equivalents at end of period $1,120 $4,638

Interest payments $755 $854

Income tax payments (refunds), net $844 $(16)

HCA Healthcare, Inc.Operating StatisticsFor the Six MonthsSecond QuarterEnded June 30,2021

2020

2021

2020

Operations:Number of Hospitals187

186

187

186

Number of Freestanding Outpatient Surgery Centers*122

122

122

122

Licensed Beds at End of Period49,693

49,403

49,693

49,403

Weighted Average Beds in Service42,464

42,309

42,413

42,243

Reported:Admissions532,041

452,992

1,038,421

981,236

% Change17.5%

5.8%

Equivalent Admissions916,212

723,136

1,748,701

1,612,171

% Change26.7%

8.5%

Revenue per Equivalent Admission$ 15,756

$ 15,305

$ 16,248

$ 14,843

% Change2.9%

9.5%

Inpatient Revenue per Admission$ 16,144

$ 15,757

$ 16,606

$ 15,152

% Change2.5%

9.6%

Patient Days2,629,950

2,260,816

5,300,991

4,883,655

% Change .16.3%

8.5%

Equivalent Patient Days4,535,678

3,609,607

8,926,869

8,023,845

% Change25.7%

11.3%

Inpatient Surgery Cases136,460

118,591

264,050

253,736

% Change15.1%

4.1%

Outpatient Surgery Cases262,107

170,911

493,335

397,230

% Change53.4%

24.2%

Emergency Room Visits2,128,428

1,516,116

3,970,206

3,780,823

% Change40.4%

5.0%

Outpatient Revenues as aPercentage of Patient Revenues38.2%

31.8%

37.0%

34.8%

Average Length of Stay (days)4.943

4.991

5.105

4.977

Occupancy (weighted average beds in service)68.1%

58.7%

69.1%

63.5%

Same Facility:Admissions530,067

450,964

1,035,404

978,388

% Change17.5%

5.8%

Equivalent Admissions911,715

718,837

1,741,550

1,605,535

% Change26.8%

8.5%

Revenue per Equivalent Admission$ 15,683

$ 15,290

$ 16,193

$ 14,786

% Change2.6%

9.5%

Inpatient Revenue per Admission$ 16,168

$ 15,786

$ 16,626

$ 15,172

% Change2.4%

9.6%

Inpatient Surgery Cases136,027

118,293

263,608

253,011

% Change15.0%

4.2%

Outpatient Surgery Cases259,263

170,025

489,233

394,747

% Change52.5%

23.9%

Emergency Room Visits2,115,901

1,506,441

3,952,401

3,758,123

% Change40.5%

5.2%

* Excludes freestanding endoscopy centers (21 centers at both June 30, 2021 and June 30, 2020).HCA Healthcare, Inc.Operating Statistics For the Six Months Second Quarter Ended June 30, 2021 2020 2021 2020

Operations: Number of Hospitals 187 186 187 186

Number of Freestanding Outpatient 122 122 122 122Surgery Centers*Licensed Beds at End of Period 49,693 49,403 49,693 49,403

Weighted Average Beds in Service 42,464 42,309 42,413 42,243

Reported: Admissions 532,041 452,992 1,038,421 981,236

% Change 17.5% 5.8%

Equivalent Admissions 916,212 723,136 1,748,701 1,612,171

% Change 26.7% 8.5%

Revenue per Equivalent Admission $ 15,756 $ 15,305 $ 16,248 $ 14,843

% Change 2.9% 9.5%

Inpatient Revenue per Admission $ 16,144 $ 15,757 $ 16,606 $ 15,152

% Change 2.5% 9.6%

Patient Days 2,629,950 2,260,816 5,300,991 4,883,655

% Change . 16.3% 8.5%

Equivalent Patient Days 4,535,678 3,609,607 8,926,869 8,023,845

% Change 25.7% 11.3%

Inpatient Surgery Cases 136,460 118,591 264,050 253,736

% Change 15.1% 4.1%

Outpatient Surgery Cases 262,107 170,911 493,335 397,230

% Change 53.4% 24.2%

Emergency Room Visits 2,128,428 1,516,116 3,970,206 3,780,823

% Change 40.4% 5.0%

Outpatient Revenues as a Percentage of Patient Revenues 38.2% 31.8% 37.0% 34.8%

Average Length of Stay (days) 4.943 4.991 5.105 4.977

Occupancy (weighted average beds 68.1% 58.7% 69.1% 63.5%in service) Same Facility: Admissions 530,067 450,964 1,035,404 978,388

% Change 17.5% 5.8%

Equivalent Admissions 911,715 718,837 1,741,550 1,605,535

% Change 26.8% 8.5%

Revenue per Equivalent Admission $ 15,683 $ 15,290 $ 16,193 $ 14,786

% Change 2.6% 9.5%

Inpatient Revenue per Admission $ 16,168 $ 15,786 $ 16,626 $ 15,172

% Change 2.4% 9.6%

Inpatient Surgery Cases 136,027 118,293 263,608 253,011

% Change 15.0% 4.2%

Outpatient Surgery Cases 259,263 170,025 489,233 394,747

% Change 52.5% 23.9%

Emergency Room Visits 2,115,901 1,506,441 3,952,401 3,758,123

% Change 40.5% 5.2%

* Excludes freestanding endoscopy centers (21 centers at both June 30, 2021 andJune 30, 2020).HCA Healthcare, Inc.Supplemental Non-GAAP DisclosuresOperating Results Summary(Dollars in millions, except per share amounts)For the Six MonthsSecond QuarterEnded June 30,2021

2020

2021

2020

Revenues$14,435

$11,068

$28,412

$23,929

Net income attributable to HCA Healthcare, Inc.$1,450

$1,079

$2,873

$1,660

Losses (gains) on sales of facilities (net of tax)(6)

24

(7)

19

Losses on retirement of debt (net of tax)9

-

9

227

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on salesof facilities and losses on retirement of debt (a)1,453

1,103

2,875

1,906

Depreciation and amortization712

691

1,409

1,365

Interest expense386

388

770

816

Provision for income taxes454

347

846

525

Net income attributable to noncontrolling interests214

137

371

254

Adjusted EBITDA (a)$3,219

$2,666

$6,271

$4,866

Adjusted EBITDA margin (a)22.3%

24.1%

22.1%

20.3%

Diluted earnings per share:Net income attributable to HCA Healthcare, Inc.$4.36

$3.16

$8.50

$4.84

Losses (gains) on sales of facilities(0.02)

0.07

(0.02)

0.06

Losses on retirement of debt0.03

-

0.03

0.66

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on salesof facilities and losses on retirement of debt (a)$4.37

$3.23

$8.51

$5.56

Shares used in computing diluted earnings per share (millions)332.613

341.599

337.940

342.848

(a)

(a)Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA should not be considered as measures of financial performance under generally accepted accounting principles ("GAAP"). We believe net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, 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., excluding losses (gains) on sales of facilities and losses on retirement of debt, 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., excluding losses (gains) on sales of facilities and losses on retirement of debt, 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 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., excluding losses (gains) on sales of facilities and losses on retirement of debt, 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., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are not measurements determined in accordance with GAAP and are susceptible to varying calculations, net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies. HCA Healthcare, Inc. Supplemental Non-GAAP Disclosures Operating Results Summary (Dollars in millions, except per share amounts) For the Six Months Second Quarter Ended June 30, 2021 2020 2021 2020

Revenues $14,435 $11,068 $28,412 $23,929

Net income attributable to HCA $1,450 $1,079 $2,873 $1,660 Healthcare, Inc. Losses (gains) on sales of (6) 24 (7) 19 facilities (net of tax) Losses on retirement of debt (net 9 - 9 227 of tax) Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on 1,453 1,103 2,875 1,906 retirement of debt (a) Depreciation and amortization 712 691 1,409 1,365

Interest expense 386 388 770 816

Provision for income taxes 454 347 846 525

Net income attributable to 214 137 371 254 noncontrolling interests Adjusted EBITDA (a) $3,219 $2,666 $6,271 $4,866

Adjusted EBITDA margin (a) 22.3% 24.1% 22.1% 20.3%

Diluted earnings per share: Net income attributable to HCA $4.36 $3.16 $8.50 $4.84 Healthcare, Inc. Losses (gains) on sales of (0.02) 0.07 (0.02) 0.06 facilities Losses on retirement of debt 0.03 - 0.03 0.66

Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on $4.37 $3.23 $8.51 $5.56 retirement of debt (a) Shares used in computing diluted 332.613 341.599 337.940 342.848 earnings per share (millions) (a)Net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA should not be considered as measures of financial performance under generally accepted accounting principles ("GAAP"). We believe net income attributable to HCA Healthcare, Inc., excluding losses(a) (gains) on sales of facilities and losses on retirement of debt, 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., excluding losses (gains) on sales of facilities and losses on retirement of debt, 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., excluding losses (gains) on sales of facilities and losses on retirement of debt, 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 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., excluding losses (gains) on sales of facilities and losses on retirement of debt, 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., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA are not measurements determined in accordance with GAAP and are susceptible to varying calculations, net income attributable to HCA Healthcare, Inc., excluding losses (gains) on sales of facilities and losses on retirement of debt, and Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.HCA Healthcare, Inc.Supplemental Non-GAAP Disclosures2021 Operating Results Forecast(Dollars in millions, except per share amounts)For the Year EndingDecember 31, 2021LowHighRevenues$57,000

$58,000

Net income attributable to HCA Healthcare, Inc. (a)$5,350

$5,615

Depreciation and amortization2,840

2,860

Interest expense1,560

1,580

Provision for income taxes1,625

1,695

Net income attributable to noncontrolling interests725

750

Adjusted EBITDA (a) (b)$12,100

$12,500

Diluted earnings per share:Net income attributable to HCA Healthcare, Inc.$16.30

$17.10

Shares used in computing diluted earnings per share (millions)329.000

329.000

The Company's forecasted guidance range is based on current plans and expectations and is subject to a number of known and unknown uncertainties and risks. (a)The Company does not forecast the impact of items such as, but not limited to, losses (gains) on sales of facilities, losses on retirement of debt, legal claim costs (benefits) and impairments of long-lived assets because the Company does not believe that it can forecast these items with sufficient accuracy.(b)

Adjusted EBITDA should not be considered a measure of financial performance under generally accepted accounting principles ("GAAP"). We believe Adjusted EBITDA is an important measure that supplements 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 Adjusted EBITDA as a primary measure 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.) 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.Adjusted EBITDA is not a measure of financial performance under GAAP and should not be considered as an alternative 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 Adjusted EBITDA is not a measurement determined in accordance with GAAP and is susceptible to varying calculations, Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies. View source version on businesswire.com: https://www.businesswire.com/news/home/20210720005191/en/

CONTACT: INVESTOR CONTACT: Mark Kimbrough 615-344-2688

CONTACT: MEDIA CONTACT: Harlow Sumerford 615-344-1851