Enthusiasm for hospital stocks tempered by HCA earnings

Hospital operator HCA Holdings, Inc., of Nashville, Tennessee, did not see a major effect from the rollout of the Affordable Care Act (ACA) individual mandate in its first quarter financials and missed revenue expectations by $70 million.

However, investors still seem to see much that they like in the hospital sector. It had been up overall since the administration announced higher than expected ACA insurance exchange enrollment number and then went up even further as LifePoint Hospitals — a primarily rural community hospital operator — this week announced first quarter financials with better than expected numbers driven in part by newly insured patients.

HCA has a different mix of patients, of course, and operates in different states from LifePoint. Most of HCA’s hospitals are in states that did not expand Medicaid, and in those states, the number of uninsured patients HCA saw went up 5.9 percent and its number of Medicaid admissions declined 1.3 percent.

However, the company is encouraged. About 13 percent of HCA’s capacity — as measured by number of hospital beds — is in California, Colorado, Kentucky and Nevada. These states expanded Medicaid, and as a result, HCA saw a 29 percent decline in uninsured admissions in those states and a 22.3 percent increase in Medicaid admissions.

“We saw encouraging signs from healthcare reform during the quarter and found them to be consistent with our early expectations … but as expected healthcare reform had minimal impact on the company's first quarter results,” said HCA President and CEO Milton Johnson on the earnings call with investors.

Only 1,700 admissions were patients with an ACA exchange health insurance in the first quarter of 2014, which is less than half of one percent of HCA’s total of 440,000 admissions for the company in the first quarter.

Overall, HCA’s revenues increased 4.6 percent to $8.832 billion. Net income attributable to HCA Holdings, Inc. totaled $347 million, or $0.76 per diluted share. Adjusted EBITDA increased 4.8 percent to $1.644 billion.