HCAHCA Healthcare, Inc.

HCA Healthcare owns a hospital network — a rare case of care delivered commercially at national scale.

Revenue comes from insurers and government programmes. The key variables are patient volume, case complexity and payer mix: commercial insurance pays markedly more than a government programme for the same procedure, so a shift in patient composition moves profit more than patient numbers do.

Scale confers negotiating advantage: a network of hundreds of hospitals contracts with insurers on better terms than a standalone clinic and buys equipment and drugs more cheaply. Concentration in fast-growing southern states is a separate growth factor.

Risks: nursing and physician labour costs, the share of uncompensated care, and political decisions on government programmes and pricing. HCA pays a dividend and buys back stock very actively.