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Jack O'Brien and Melanie Blackman's picture
Jack O'Brien and Melanie Blackman

HCA's Net Income Reaches $1.4B in Q1 2021

Jack O'Brien and Melanie Blackman, April 22, 2021

The Nashville-based for-profit hospital operator's top line revenues exceeded $13.9 billion during the first quarter of 2021.

HCA Healthcare recorded a net income of $1.4 billion in Q1 2021, up from $581 million in Q1 2020, according to the company's latest earnings report released Thursday morning.

HCA saw cash flows used in operating activities total more than $1.9 billion during the quarter, compared to $1.3 billion in Q1 2020.

Related: HCA's Net Income Rises Nearly $400M in Q4 2020

The Nashville-based for-profit hospital operator's top line revenues also exceeded $13.9 billion during the first quarter of 2021.

Forward-looking, HCA projected revenues in the range of $54 billion to $55.5 billion in 2021 along with an adjusted EBITDA between $10.853 billion to $11.35 billion.

C-suite perspective:

"The first quarter is yet another period where the disciplined operating culture and strong execution by our teams were on display. I want to thank our 275,000 colleagues and 50,000 physicians for their tremendous work," Sam Hazen, CEO of HCA, said in a statement. "As we continue to resource and execute on our strategic agenda, we will remain true to our mission of improving lives and delivering on the responsibilities we have to our stakeholders."

During the first quarter, HCA repurchased over 8.4 million shares of its common stock for over $1.5 billion. At the end of Q1, HCA had over $7.2 billion remaining under the organization's repurchase authorization.

Related: HCA East Florida Healthcare Appoints New Hospital CEO

Despite the positive financial metrics, HCA continued to face admissions challenges related to the ongoing COVID-19 pandemic as same facility admissions and equivalent admissions fell 4.1% and 6.4%, respectively.

The company's same facility emergency room visits fell 18.4%, while same facility inpatient surgeries dropped 5.4%. Same facility outpatient surgeries grew 2.3%.

HCA declared a quarterly cash dividend of $0.48 per share on its common stock which will be paid on June 30.

The most significant move made by HCA during the quarter was the announced purchase of Brookdale's home health unit for $400 million.

Related: HCA Buying Majority of Brookdale Home Health Unit

For the quarter, HCA reported capital expenditures of $654 million, excluding acquisitions, while cash flows provided by operating activities totaled over $1.9 billion, compared to over $1.3 billion year over year.

At the end of Q1, HCA had cash and cash equivalents of over $1 billion, total debt of just over $31 billion, and total assets of just over $47.2 billion.

Related: Despite COVID, Many Wealthy Hospitals Had a Banner Year With Federal Bailout

For complete financial information, review HCA's filing with the Securities and Exchange Commission.

Anthem Continues to See Membership Growth, Operating Revenue Hits $32.1B

Jack O'Brien and Melanie Blackman, April 21, 2021

The Indianapolis-based insurer reported medical enrollment totaling 43.5 million members at the end of Q1, up 3.3% from the previous quarter.

Anthem Inc. reported an operating income of $32.1 billion for Q1 2021, boosted by continued growth in membership, according to the company's latest earnings report released Wednesday morning.

IngenioRX, the insurer's PBM, produced an operating revenue of $407 million during Q1, up 16.6% from $349 million year-over-year.

While the Commercial & Specialty business saw its quarterly operating revenues drop $152 million, Anthem's Government business saw revenues increase 16.3% year-over-year.

Related: Thanks to Medicaid, Medicare Growth, Anthem Operating Revenue Hits $31.5B

The Indianapolis-based insurer recorded an operating cash flow of $2.5 billion during Q1, due to "changes in working capital, membership growth in Government business, and higher net income, offset by the repeal of the health insurance tax in 2021."

For its outlook, Anthem projected a full-year operating revenue of $135.1 billion, medical membership in the range of 44.1 million to 44.7 million members, and an operating cash flow exceeding $5.7 billion.

Anthem released its earnings report less than a week after the company announced the launch of Hydrogen Health, LLC, a joint venture with K Health and Blackstone Growth.

Related: Anthem Teams up with K Health and Blackstone Growth for Digital-First Health Tech JV

Anthem also projected its full-year GAAP net income will be greater than $25.10 per share, excluding approximately $1.05 per share of net unfavorable items. Its investment income is expected to be $820 million.

C-suite perspective:

"Our results in the first quarter reflect strong execution and a continued focus on supporting our communities through the pandemic," Gail Boudreaux, CEO of Anthem, said in a statement. "We expect the positive momentum in the first quarter to persist through the balance of the year, driven by our commitment to delivering affordable healthcare and innovative solutions for those we serve."

One of the most notable moves made by Anthem came at the end of Q1, when the company announced its intention to buy myNEXUS, which manages home health benefits for payors.

Related: Anthem to Buy myNEXUS

Arielle Trzcinski, principal analyst at Forrester, said in an email to HealthLeaders that the myNEXUS acquisition is a "necessary addition to the portfolio to meet the evolving needs of members and to be able to compete with legacy insurers and disruptors alike."

"This acquisition is needed to continue to compete with other large insurers such as Humana who have long partnered with and invested in companies like Heal and Dispatch who meet consumers in their homes to address immediate care needs, along with the looming threat of Amazon Care as an attractive alternative for employers to offer convenient care options for their employees," Trzcinski said. "Health insurers must be member-centric, which means they must meet the member where they are and bring care to them – not make them go to the care. Doing so will drive appropriate utilizations and improve outcomes."  

During Q1, the company repurchased 1.4 million shares of common stock for $447 million, at a weighted average price of $316.06.

On Tuesday, Anthem's audit committee declared a Q2 2021 dividend of $1.13 per share, annualized to $4.52 per share, which will be payable on June 25.

Related: Anthem to Provide All Employees With $50 Incentive to be Fully Vaccinated Against COVID-19

For complete financial information, review Anthem's filing with the Securities and Exchange Commission.

Editor's note: This story has been updated to include commentary from Arielle Trzcinski, principal analyst at Forrester.

Dr. Fauci: 'We Can Do Better Without Locking Down'

Jack O'Brien and Melanie Blackman, August 5, 2020

The head of the National Institute of Allergy and Infectious Diseases said he believes the country will not have to go into another economic shutdown.

Dr. Anthony Fauci said the U.S. can improve its response effort to the coronavirus disease 2019 (COVID-19) pandemic without another round of widespread economic shutdowns.

While speaking at an online event jointly hosted by the Harvard T.H. Chan School of Public Health and the New England Journal of Medicine Wednesday afternoon, Fauci told Dr. Sanjay Gupta of CNN that he doesn't believe the country will need to go into another economic shutdown to stem the spread of COVID-19.

"We can do better without locking down," Fauci said. 

He added that the U.S. has struggled with an ongoing surge of COVID-19 cases due to human behaviors that contribute to the spread of the virus.

"As long as you have any member of society, any demographic group, who's not seriously trying to get to the end game of suppressing this, it will continue to smolder and smolder and smolder, and that will be the reason why, in a non-unified way, we've plateaued at an unacceptable level," Fauci said.

Related: Don't Fall for This Video: Hydroxychloroquine Is Not a COVID-19 Cure

The shutdowns that took place across the country this spring had a significantly negative impact on the national economy and specifically impacted the business model for hospitals and health systems.

The widespread cancellation of elective surgeries temporarily eliminated a reliable revenue generator for provider organizations. 

In late June, a Definitive Healthcare study found that 40% of acute care organizations are at risk of closure, two-thirds of which are organizations with less than 100 beds, due to financial challenges stemming from the outbreak.

Related: Fauci Unfazed as Scientists Rely on Unproven Methods to Create COVID Vaccines

On the topic of the ongoing race to develop and test an effective and safe COVID-19 vaccine, Fauci said he is "cautiously optimistic" that pharmaceutical companies will manufacture one by the start of 2021.

He also spoke about the growing recognition of racial health disparities in healthcare, noting that African Americans and other minority groups have a "much greater incidence and prevalence of the underlying conditions that lead to a severe outcome." 

Related: Dr. Fauci Sides With President Trump on Reopening Schools After Telling Teachers They'll be 'Part of the Experiment'

Editor's note: This story was updated on August 6, 2020.

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