Even without the help of COVID-19 relief grants, HCA Healthcare's profit grew more than 9% in the third quarter year-over-year.
Nashville-based HCA's net income of $668 million in the quarter ended Sept. 30 compares with $612 million in the prior-year period, the company announced Monday. HCA's $13.3 billion in revenue was in line with the preview it released earlier this month. Revenue was almost 5% higher than the $12.7 billion HCA recorded in the same quarter last year.
HCA's results include a reversal of $822 million in CARES Act grants the company recognized in the second quarter.
The company said it is returning all $1.6 billion in grants it received under the program. That announcement was made when HHS guidance capped profit at 2019 levels in order to keep the grant money. Last week, the agency walked back that rule and said providers could account for the grants based on revenue. Even so, an HCA spokesperson wrote in an email the company still plans to give back the money.
HCA's adjusted earnings before interest, taxes, depreciation and amortization, a non-GAAP measure, was about $2.1 billion in the quarter, down from $2.3 billion in the prior-year period.
Same-facility admissions declined 3.8% year-over-year, and same-facility equivalent admissions fell 9%. Same-facility inpatient surgeries declined 6.8% in the quarter year-over-year.
Bill Rutherford, HCA's chief financial officer, explained on a Monday morning earnings call that COVID-19 surges in July and August prompted HCA to voluntarily suspend elective procedures in more than 100 hospitals during that time.
Same-facility emergency department visits were down 20.3% in the third quarter compared with the prior-year period. Within that, low-acuity visits—categories at levels one to three—declined 29%, while high-acuity visits declined 14%.
One metric that's been high for hospitals during the pandemic is revenue per admission. HCA's same-facility net revenue per adjusted admission was up 14.8% in the third quarter year-over-year.
Rutherford said that's due to three factors: First, lots of COVID patients, who are sicker and are hospitalized longer than the average patient. The company treated almost 40,000 COVID patients across its hospitals in the quarter, about 8% of total admissions. Second, patients without COVID tended to be sicker and were treated in higher-acuity areas like neurology and oncology, Rutherford said. Finally, the share of commercially insured patients was higher in the quarter as patients with Medicare continue to shy away from hospitals.
Sam Hazen, HCA's CEO, said on the earnings call that over the past two quarters, COVID patients have represented about 6% of the company's admissions, and he predicts up to 5% of HCA's admissions in 2021 will be related to the coronavirus.
"We believe we will continue to treat COVID-19 patients throughout 2021," he said.