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November 15, 2016 11:00 PM

HCA hub architect Sam Hazen adds president's title to COO role

Dave Barkholz
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    Sam Hazen, the top operating executive at 170-hospital HCA Holdings, has added the title of president to his position as chief operating officer, HCA announced Wednesday.

    Hazen, who has served 33 years at HCA in increasingly important management roles, became COO in January 2015.

    “With his intense focus and deep knowledge of HCA's markets, I am confident in Sam's ability to continue to lead the execution of our robust operations agenda,” HCA CEO Milton Johnson, 59, said in a statement. ​Johnson is the last person to hold the title of president at HCA, but the role has been unfilled since he became chairman and CEO in 2014.

    Hazen, 56, is a key architect of a market hub strategy that has positioned Nashville-based HCA as the nation's healthiest investor-owned hospital chain.

    While rivals such as Community Health Systems and Tenet Healthcare Corp. have experienced operating losses and a swoon in their stock prices, HCA has posted quarter after quarter of gains in admissions and surgeries.

    In the third quarter, the chain posted net income of $618 million, or $1.59 per share, compared with net income of $449 million, or $1.05, in the year-earlier quarter.

    HCA saw same-facility hospital admissions grow 1%, emergency room visits increase 3% and inpatient surgeries edge up 1%.

    Revenue in the third quarter grew about 4% to $10.27 billion from $9.86 billion in the year-earlier quarter.

    Under Johnson and Hazen, HCA has pursued few big acquisitions, instead using $2.7 billion of its capital in 2016 to build out its hub hospital markets with surgery centers, urgent-care facilities, free-standing emergency departments and physician clinics.

    The idea is to capture as much of the patient revenue in its 14 major markets as possible.

    Hazen told analysts in the third quarter that HCA has first- or second-place market share in the vast majority of those markets, with 10 of the 14 markets seeing admission gains in the third quarter.

    HCA's cash flow and disciplined acquisition strategy also leave the chain with a debt-to-EBITDA ratio of about 3.7 times, one of the lowest in the industry. CHS is about 6.5 times by comparison.

    HCA's stable financial results combined with an aggressive stock repurchase program also has kept the company's stock price from falling nearly as hard as much of provider segment.

    HCA announced Tuesday a new $2 billion stock repurchase authorization that allows the company to buy back stock to buoy the price. It is just completing a $3 billion authorization that has been drawn down to $40 million through stock repurchases over several quarters.

    While HCA's price is down 22% from a high of $95.24 in July 2015, to $73.99 Tuesday, CHS has seen its stock price fall 90% from the same time period to $5.43 Tuesday and Tenet's is off 72%.

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