HCA has solid Q3, downplays benefits from ACA

HCA, the country's largest hospital chain by revenue, reported a 41.9% increase in net income in the third quarter on higher revenue, prompting it to raise earnings projections for the full year.

The Nashville-based company treated more patients year-over-year, but downplayed the impact of healthcare reform on the numbers. Instead, executives pointed to the improving economy and job growth in a number of HCA markets, which led to volume increases in service lines such as outpatient surgery and obstetrics.

In total, HCA recorded $518 million in net income on revenue of $9.2 billion in the third quarter compared with net income of $365 million on revenue of $8.5 billion during the same period last year.

Same-hospital admissions increased 2.8%, or 4.1% when adjusted for outpatient activity.

Executives on an earnings call also pointed to the company's efforts on the expense side. Although the chain reported higher supply and compensation costs, those expenses represented a smaller percentage of revenue than they did in the third quarter of 2013.

Two one-time items affected the company's results. HCA said it booked $94 million in Medicare revenues as part of a settlement agreement with the CMS over claims that had been denied by Recovery Audit Contractor entities. The company agreed to drop its appeal of the denied claims in exchange for a partial payment, totaling about 68% of the denied amount.

At the same time, HCA lost $68 million in Medicaid revenues in Texas. The CMS is withholding its portion of Medicaid payments while it investigates whether some local government/hospital affiliations are inconsistent with the Texas Medicaid Waiver Program.

CEO Milton Johnson attributed about one-third of HCA's earnings before interest, taxes, depreciation and amortization to healthcare reform, and the rest to its core operations. Medicaid admissions increased 9.7% year-over-year, or 12.6% when adjusted for outpatient activity. It was the highest year-over-year increase the chain has seen in the past three quarters.

About 7,800 admissions came from people with exchange plans. And the number of uninsured patients in its emergency departments fell to 20.5% of its total ER volume, down from 24.2% in the year-ago period.

HCA now projects healthcare reform will increase EBITDA by 4%, up from the 2% to 3% it forecast earlier this year. It raised its full-year revenue projections to $36.5 billion to $37 billion range, with earnings per share of $4.40 to $4.60. Its previous guidance forecast revenue in the $36 billion to $36.5 billion and earnings per share to $4.00 to $4.25.

Separately, HCA said it had signed an agreement to acquire CareNow, which has 24 urgent care centers in the Dallas-Fort Worth area. Terms of the agreement were not disclosed.

HCA has 11 hospitals and 50 ambulatory-care sites in the Dallas-Fort Worth region.

Follow Beth Kutscher on Twitter: @MHbkutscher