Image by Pexels from PixabayNashville, Tennessee-based HCA Healthcare (NYSE: HCA) is stepping up its focus on outpatient growth, CFO Michael Marks told investors during a Sept. 4 presentation.
While leaders from HCA, which operates the large ambulatory surgery center (ASC) chain Surgery Ventures, have made similar remarks in the past, Marks’ fresh remarks underscore the growing importance of outpatient strategy among the nation’s major health care operators.
“We’re pretty active on the outpatient side with M&A,” Marks said. “They tend to be lower-dollar transactions, just because of the size and scale. But we’ve acquired a number of urgent care systems, a number of freestanding emergency room businesses, imaging centers and the like. So we’re active in terms of network development using M&A both inpatient and outpatient.”
Those acquisitions are a part of HCA’s capital allocation approach as the company continues to try to grow in its 43 core markets while broadening its non-acute footprint, he said.
HCA operates 124 freestanding ASCs as of June 30, and the company’s overall outpatient footprint now includes more than 2,500 sites of care.
The rest of the Sept. 4 conversation centered on patient volumes, payer mix and policy. HCA’s volumes grew 2.3% in the first half of 2025, short of the company’s original 3% to 4% guidance, Marks said. Medicaid redeterminations, weaker-than-expected self-pay growth and slightly softer Medicare volumes were the main drags.
On costs, stabilization in the labor environment is encouraging, Marks said. Contract labor fell to 4.3% of staffing, nearly back to pre-pandemic levels, while hospital and clinical staff retention also returned to pre-pandemic norms.
Physician professional fees remain elevated, particularly in anesthesia and radiology, though Marks said HCA is making progress on those fronts.
“We’re seeing that now more in anesthesia and radiology and a little bit less in ER and hospitals, which is good, but we’ve still got to work through that,” Marks said.
Policy was another focus on the investor call.
“We were encouraged, just in the last few days, that Texas [state-level Medicaid supplemental payments] got approved, and that’s encouraging,” Marks said. “It’s a good sign that CMS is reviewing these applications and seems to be in pretty normal order under the grandfathering rule.”
Other state applications are also under review, with Florida representing the largest opportunity, he added.
