Specialist
Former Regional Director, Business Development at HCA Healthcare Inc
Agenda
- For-profit hospital sector overview
- Competitive positioning of HCA Healthcare (NYSE: HCA)
- Growth opportunities and potential for future M&A 4. 2020 outlook
Questions
1.
Could you share any key trends and themes you are monitoring in the for-profit hospitals market?
2.
How has HCA Healthcare’s story evolved over the last couple of years?
3.
You described HCA’s development of more diverse access points of care – is this its core reaction to the industry-wide stagnation and declining inpatient admissions and surgeries? Do you think the additional access points via freestanding ER [emergency room] and urgent care build-outs can offset all the inpatient declines?
4.
How are the lower-cost sites of care impacting HCA’s operations and how does that compare to the inpatient setting?
5.
Is there room for HCA to carve out more market share in the ASC [ambulatory surgery centre] segment? How would you describe the competitive landscape for ASCs?
6.
How would you rate HCA’s preparation to deal with the macro shifts in healthcare and maximise its revenue capture opportunity compared to competitors?
7.
How would you expect potential balance billing legislation to impact HCA, given its patient payer mix?
8.
How do you expect the reimbursement landscape to develop, and how would you imagine the industry and HCA to respond?
9.
During your tenure, had HCA developed any partnerships or functionality in telemedicine?
10.
Are there adjacent services or business lines that HCA could potentially enter to bolster its offerings?
11.
Do you expect any increase on self-pay admissions for HCA? If so, how might that affect the company and how could it be managed?
12.
How would you characterise the potential for increased Medicare Advantage enrolment? Could it be a potential headwind for HCA?
13.
During your tenure, was HCA on the networks of all major insurers in your region?
14.
Why do you think HCA’s geographical spread is so special compared to peers such as Quorum or Community Health? How many areas in the US fit demographics that have worked favourably for HCA so far?
15.
How might the new hospital pricing transparency requirements change HCA’s reporting, if at all?
16.
How long do you think HCA can sustain its 5-6% same-store revenue growth rate?
17.
The company’s strong M&A efforts in recent years have had a hit on margins. Do you think it can expand margin from 2019’s 19.2%? Would you expect HCA to be as acquisitive in 2020 as historically? Are there still opportunities to acquire smaller regional health systems?
18.
How would you rate the M&A and integration process at HCA? How much did HCA typically improve operations at acquired hospitals and clinics, and how did it approach those improvements?
19.
What characterises an attractive potential acquisition target that would fit into the HCA strategy?
20.
What is driving HCA’s consistent strength, despite the volume declines in inpatient surgeries? Is it quality of care and access to care? Is there potential for a slowdown in the 2% YoY inpatient surgery growth for HCA?
21.
How do you view HCA’s management team and strategy?
22.
Did you have any experience with staffing companies such as Envision or TeamHealth, and what is HCA’s relationship with them? Have they been frequently used, or has HCA made a strong point to keep physicians on staff and in-house?
23.
Where would you expect the company to focus its spending? Is it the technological build-out, or further acquisition for inorganic growth?
24.
Do you foresee any encroachment from other large for-profit hospital groups into certain HCA geographies?
25.
Do you have anything further to highlight on HCA and its outlook?
26.
What is your outlook for HCA in 5-10 years?
