HCA's business model evolution: 4 takeaways

Since Nashville, Tenn.-based HCA Healthcare launched 50 years ago, its business model has seen numerous changes in response to the evolving healthcare market, resulting in five decades of highs and lows, according to Nashville Public Radio.

Here are four takeaways about HCA's business strategy since its inception in 1968:

1. HCA Chairman and CEO R. Milton Johnson, who plans to leave his post by the end of the year, said in the beginning, the company did not have a strategy when buying hospitals and health systems.

"It was almost like a mentality of dots on a map, you couldn't be choosy, really, what kind of hospitals you purchased. There were a lot of rural hospitals," Mr. Johnson said during a recent conference appearance, according to the report.

2. Most of the hospitals HCA initially acquired were county-owned or faith-based institutions and were typically struggling to stay afloat. At its height, the hospital chain owned 360 hospitals nationwide, the report states.

3. However, HCA was the subject of allegations of Medicare fraud and was investigated by federal regulators during the 1990s. In December 2000, the hospital system pleaded guilty to charges of criminal conduct and entered into an $840 million settlement with the federal government. During that time, the company ousted its CEO and brought in co-founder Tommy Frist Jr., MD, to return and lead the organization.

4. Today, the health system is much pickier about the hospitals it acquires, downsizing its portfolio to 178 hospitals and selling off most of its rural facilities, the report states.

"Today, what I think is tremendously unique and powerful about HCA is this incredible portfolio of markets that we have," HCA COO Sam Hazen told Nashville Public Radio.

To access the full report, click here.

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