Gabby

Gabby asked for color on HCA Healthcare's payer mix performance compared to internal expectations, specifically regarding Medicaid's positive impact in 2025 and whether that trend is expected to persist.

Answer

CFO Mike Marks explained that the 2.5% growth in exchange volumes in Q4 was a smidge down sequentially, reflecting the timing of Medicaid redetermination processes in the prior year. He noted that Medicaid's 2.2% growth over prior year now appears to be returning to a normal growth rate, consistent with overall volume growth. He added that HCA did not see a pull-forward of demand from exchange enrollees anticipating premium increases, and overall, HCA was pleased with the payer mix and volume growth, with Medicare up 3.5% and total equivalent admissions up 2.5%.

Gabby, on behalf of Sarah James, inquired about HCA's payer mix, specifically how it played out compared to internal expectations, noting Medicaid's positive impact for the first time in 2025, and whether this trend is expected to persist.

Answer

CFO Mike Marks noted 2.5% growth in exchange volumes, which was a slight sequential decline from Q3 to Q4 2025, reflecting the timing of Medicaid redetermination. He stated that Medicaid growth of 2.2% year-over-year appears to be returning to a normal rate. Marks indicated that HCA did not observe a pull-forward of demand due to anticipated premium increases and expressed overall satisfaction with the payer mix and total volume growth, with Medicare up 3.5% and total equivalent admissions up 2.5%.