Where HCA, Tenet’s 2024 outlooks stand after Q3

Nashville, Tenn.-based HCA Healthcare and Dallas-based Tenet Healthcare gave updates on their 2024 outlooks with the releases of their third-quarter earnings reports. 

HCA reaffirmed its outlook, but officials now expect its 2024 results to fall on the lower end of that range due to the effects of Hurricane Helene and Hurricane Milton. 

The system raised its 2024 guidance in July, estimating revenues of $69.75 billion to $71.75 billion and an adjusted EBITDA of $13.75 billion to $14.25 billion for the year ending Dec. 31. 

HCA incurred additional expenses and loss of revenues estimated at $50 million in the third quarter associated with Hurricane Helene’s impact on certain facilities in Florida, Georgia and North Carolina, according to its Oct. 25 financial report. The system anticipates ongoing additional expenses and loss of revenue due to Helene’s impact on its North Carolina facilities, as well as from Hurricane Milton, which affected certain facilities in Florida during October. The financial effect of the hurricanes is estimated at $200 million to $300 million. Those estimates do not include any insurance recoveries HCA might receive.

Tenet tightened the range of its projected net operating revenues and boosted its projected adjusted EBITDA, according to its Oct. 29 financial report. Tenet now expects revenues between $20.6 billion and $20.8 billion. In July, the system estimated a range of $20.6 billion to $21 billion. Tenet now expects an adjusted EBITDA in the range of $3.9 billion to $4 billion. In July, the system estimated a range of $3.83 billion to $3.98 billion.

The system said its revised outlook reflects the sale of three South Carolina hospitals in July, six California hospitals in March and five Alabama hospitals in September. 

Tenet said in its financial report that third-quarter net operating revenues declined 3.4% from the same period in 2023, primarily due to the effect of hospital divestitures in the first quarter, partially offset by strong same-hospital admissions growth, favorable payer mix, and improved pricing yield.

The system’s adjusted EBITDA in the third quarter was $539 million compared to $484 million in the same quarter last year. Tenet said this reflected strong same-hospital admissions growth and revenue per adjusted admission, favorable payer mix and increased supplemental revenues in Michigan, partially offset by higher medical fees as well as the effect of hospital sales.