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HCA Holdings, Inc. (HCA)
Presents at 38th Annual Deutsche Bank Health Care Conference
May 30, 2013 9:20 am ET
R. Milton Johnson - President, Chief Financial Officer, Principal Accounting Officer and Director
Victor L. Campbell - Senior Vice President
Darren Lehrich - Deutsche Bank AG, Research Division
Darren Lehrich - Deutsche Bank AG, Research Division
Previous Statements by HCA
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As some of you know, we're going to be doing this session as a fireside chat, so no formal presentation, but we certainly welcome your questions as I move through a discussion and please feel free to raise your hand at any point in time. We'll get the mic to you and get your question in.
So I'm hoping to cover a lot of ground here. And first, I think we'll focus a little bit on operations. I want to shift some questions about the Affordable Care Act and hope to get the capital structure as well. So Milt, just to really start the conversation, I wanted to focus a bit on volumes. Like everybody else, HCA had a bit of a rough first quarter. But overall, I think your volumes have been quite good on not just an absolute basis, but relatively speaking, very good. Can you just help frame for us what's going on nationally with hospital utilization, why you think HCA stacks up a bit differently from some of the national trends we've been seeing?
R. Milton Johnson
Sure, Darren. First of all, we have -- we've had a very good run relative to volume overall. Before the first quarter result, we had 20 -- I think it was 21 consecutive quarters where we saw positive adjusted admission volume growth. And although the first quarter, I think, was maybe adjusted for the calendar when you think about leap year and where New Year's day fell on a week -- a day last year and the timing of Easter, when you normalize for the calendar, we certainly would have reported, I think, close to 2% of volume growth in the first quarter. But when you look at the national view, when you look at HCA markets, we look at our market share. Unfortunately, our market share is somewhat dated. So today, we have mostly third quarter data, we have some fourth quarter data. But looking at the latest data we have across all of HCA's markets across the country, we're seeing demand flat to slightly up. So flat to maybe a half a point up. But when you look at HCA's performance within those markets, we have gained about 58 basis points of market share across the markets. We have gained market share in about -- we tracked 37 different markets and we have gained market share in 29 of the 37. And we've gained market share in most of our service lines. So we're certainly very pleased with that result from -- on the volume front. Now how have we been able to accomplish that? Well, there's not one single factor, I believe, that we can point to, but there's numerous factors. First of all, just the fact that our overall volume performance has been very consistent, it has to do, first, with the markets we're in. We're in outstanding markets. As you know, our markets are primarily in the Southeast or in the southern part of the country through the southwest to the western part of the country. In most of our markets, we're seeing net, we're seeing population growth and that's creating some demand -- better demand in our markets in the country overall. And then in addition to that, when you think about HCA size and scale and our ability to take best practices that we learn from one market and transfer that across all of our markets or most of our markets, that really helps us to achieve our results as well. We've developed all sorts of contact centers, transfer centers, improving our touch to the consumer as well directly to the patient. Our investment in physician practices and integrating our physicians in markets with our other access points, developing additional access points, especially freestanding EDs as -- and so all these things together, I believe, contribute to the success that we've been seeing on the volume front. Then you overlay our capital spend strategy on top of all that to make sure that where we see an opportunity to expand either service line we have or site services. And also, when we look at our market, we feel like that this market, we've got the right amount of service offerings in a market and how can expand that market and we think about going out with rural outreach to try to capture more of the market share that's coming into our urban market from the rural markets and how can we capture more share there. So we've been focused on that agenda. And then, again, putting our capital spend in place to make sure that we're not restrained -- we do not have any restraint on our volume relative the capacity. So all that together, over the last several years, has really enabled us to achieve a volume result.