Nashville, Tenn.-based HCA Healthcare CEO Sam Hazen was paid 420 times more than the health system’s median employee in 2025, according to a March 13 proxy statement filed with the Securities and Exchange Commission.
Mr. Hazen’s total compensation was $26,456,606 in 2025. The total compensation of HCA’s median compensated employee was $62,955. The ratio of these amounts was 420:1.
As of Dec. 31, HCA had 316,971 active employees who received compensation in 2025. Pay was annualized for permanent employees not employed for a full year in 2025.
HCA said in the filing that the pay ratio is a “reasonable estimate calculated in a manner consistent with SEC rules” based on its payroll and employment records.
The SEC requires public companies to disclose how CEO pay compares to the median employee’s overall compensation each year.
In 2024, HCA’s CEO-to-worker pay ratio was 391:1. Mr. Hazen’s total compensation was $23,799,137 and the median compensated employee’s earnings were $60,820.
In 2023, HCA’s CEO-to-worker pay ratio was 356:1. Mr. Hazen’s total compensation was $21,315,984 and the median compensated employee’s earnings were $59,816.
After Mr. Hazen, the highest earners at HCA in 2025 were COO Jon Foster and chief legal and administrative officer Michael McAlevey. Their total compensation was $10,992,786 and $5,710,335.
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