HCA aims to hit labor, growth goals with 'winning plays' in 2023, CEO says

HCA Healthcare's agenda in 2023 will focus on overcoming labor and capacity challenges, countering inflationary pressures and accelerating growth through "winning plays," CEO Sam Hazen said during the company's fourth-quarter earnings call on Jan. 27.

The 182-hospital, for-profit system, which posted $5.64 billion in net income for 2022, is prioritizing capital investments at outpatient facilities, clinical equipment for physicians and expanding its service lines. 

Long term, Nashville, Tenn.-based HCA is making investments in four key areas: advancing clinical systems and digital capabilities; transforming care models with innovative solutions; strengthening workforce development programs; and investing capital in its networks to expand offerings.

"These efforts are pressuring our results some in the current year, but we believe they are necessary in creating a platform for ultimately optimizing our networks so they can deliver even better patient care in the future," Mr. Hazen said during the earnings call. 

The return of pre-pandemic seasonality demand norms, a slight decrease in labor costs and payer mix and acuity levels remaining at "favorable levels" helped drive growth in the fourth quarter, according to Mr. Hazen.

However, 2022 was a tail of two halves, he said, "with the first half being more about winding down from the previous two years of intense COVID activity and responding to the resulting challenges. The second half was more about normalization, which included strong demand and an improving labor market."

In terms of its people agenda, HCA said it is pleased with improvements in some key metrics, but admitted its nurse turnover rate is still higher than it wants.

However, turnover numbers for registered nurses fell 26 percent in the fourth quarter compared to the previous four quarters' average. Hiring increased 6 percent year over year in 2022. HCA also opened its seventh Galen College of Nursing school this year.

HCA has experienced stable labor costs per hour with utilization of contract labor declining, but continues to battle some capacity challenges. 

"It remains a top organizational priority," Mr. Hazen said. "Even with the progress, we continued this quarter to experience capacity constraints, creating situations where we were unable to deliver services in certain situations."

As 2023 progresses, Mr. Hazen said the strong demand for healthcare services presents an opportunity for HCA in an otherwise challenging macro environment and believes the system is "well-positioned culturally, competitively and financially to capitalize."

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