HCA Healthcare patients are owing the health system more and struggling to pay for their medical bills amid economic headwinds, executive vice president and CFO Mike Marks said at the Sept. 15 Jefferies Healthcare Services and Technology Conference in Nashville.
“What we’re seeing this year is that our patients are owing a little bit more from benefit design, on employee-sponsored insurance, even a little bit on Medicare Advantage and then certainly on the exchanges,” he said. “There’s a bit of movement from silver to bronze and they’re owing more.”
Mr. Marks said that, at the same time, Nashville, Tenn.-based HCA has seen a slowdown in its ability to collect out-of-pocket amounts that patients owe. He pointed to increased economic strain, including energy costs, insurance premiums and inflation, which have shaped broader patient financial behaviors in 2026.
He also identified consumer sentiment as a potential third factor behind elective surgery volumes softening. He described this as an early, unconfirmed sign on top of bigger drivers connected to ACA exchange coverage losses and a Medicare inpatient-only list phaseout.
“It’s part of what we think consumer sentiment is having an effect on us,” he said. “Now we’re navigating that. I wouldn’t call that a really significant impact, but it’s not nothing.”
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