Stock Analysis on Net
Stock Analysis on Net

HCA Healthcare Inc. (NYSE:HCA)

This company has been moved to the archive! The financial data has not been updated since May 3, 2022.

Economic Value Added (EVA)

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EVA is registered trademark of Stern Stewart.

Economic value added or economic profit is the difference between revenues and costs,where costs include not only expenses, but also cost of capital.


Economic Profit

HCA Healthcare Inc., economic profit calculation

US$ in millions

Microsoft Excel
12 months ended: Dec 31, 2021 Dec 31, 2020 Dec 31, 2019 Dec 31, 2018 Dec 31, 2017
Net operating profit after taxes (NOPAT)1 9,050 5,607 5,941 5,865 4,332
Cost of capital2 17.82% 17.25% 16.22% 16.77% 14.32%
Invested capital3 36,837 34,570 33,534 29,729 27,635
 
Economic profit4 2,487 (356) 503 880 375

Based on: 10-K (reporting date: 2021-12-31), 10-K (reporting date: 2020-12-31), 10-K (reporting date: 2019-12-31), 10-K (reporting date: 2018-12-31), 10-K (reporting date: 2017-12-31).

1 NOPAT. See details »

2 Cost of capital. See details »

3 Invested capital. See details »

4 2021 Calculation
Economic profit = NOPAT – Cost of capital × Invested capital
= 9,05017.82% × 36,837 = 2,487


The analysis of economic value added reveals a period of significant volatility in value creation, concluding with a substantial increase in economic profit by the end of the 2021 fiscal year. While there was a consistent expansion of the asset base, the ability to generate returns exceeding the cost of capital varied considerably over the five-year period.

Net Operating Profit After Taxes (NOPAT)
A general upward trajectory is observed, with NOPAT increasing from 4,332 million US$ in 2017 to 9,050 million US$ in 2021. A marginal decline occurred in 2020, but this was followed by a sharp increase of approximately 61% in 2021, indicating a strong recovery and expansion in operational profitability.
Cost of Capital and Invested Capital
Invested capital demonstrated steady growth, rising from 27,635 million US$ in 2017 to 36,837 million US$ in 2021. Concurrently, the cost of capital exhibited an overall upward trend, increasing from 14.32% to 17.82%. This rising cost of capital effectively increased the financial hurdle required for the company to generate positive economic profit.
Economic Profit Trends
Economic profit experienced significant fluctuations, reaching a peak of 2,487 million US$ in 2021. A notable downturn occurred in 2020, when economic profit fell to -356 million US$, signifying that NOPAT was insufficient to cover the cost of the capital employed during that period. The subsequent shift from a negative value in 2020 to a record high in 2021 reflects a rapid improvement in capital efficiency and a surge in value creation for shareholders.

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Net Operating Profit after Taxes (NOPAT)

HCA Healthcare Inc., NOPAT calculation

US$ in millions

Microsoft Excel
12 months ended: Dec 31, 2021 Dec 31, 2020 Dec 31, 2019 Dec 31, 2018 Dec 31, 2017
Net income attributable to HCA Healthcare, Inc. 6,956 3,754 3,505 3,787 2,216
Deferred income tax expense (benefit)1 17 (109) 278 15 432
Increase (decrease) in equity equivalents2 17 (109) 278 15 432
Interest expense 1,566 1,584 1,824 1,755 1,690
Interest expense, operating lease liability3 94 98 98 94 90
Adjusted interest expense 1,660 1,682 1,922 1,849 1,780
Tax benefit of interest expense4 (349) (353) (404) (388) (623)
Adjusted interest expense, after taxes5 1,312 1,329 1,518 1,461 1,157
Net income (loss) attributable to noncontrolling interest 765 633 640 602 527
Net operating profit after taxes (NOPAT) 9,050 5,607 5,941 5,865 4,332

Based on: 10-K (reporting date: 2021-12-31), 10-K (reporting date: 2020-12-31), 10-K (reporting date: 2019-12-31), 10-K (reporting date: 2018-12-31), 10-K (reporting date: 2017-12-31).

1 Elimination of deferred tax expense. See details »

2 Addition of increase (decrease) in equity equivalents to net income attributable to HCA Healthcare, Inc..

3 2021 Calculation
Interest expense on capitalized operating leases = Operating lease liability × Discount rate
= 2,147 × 4.40% = 94

4 2021 Calculation
Tax benefit of interest expense = Adjusted interest expense × Statutory income tax rate
= 1,660 × 21.00% = 349

5 Addition of after taxes interest expense to net income attributable to HCA Healthcare, Inc..


Net Income Attributable to HCA Healthcare, Inc.
The net income shows a general upward trend over the analyzed period. Starting at 2,216 million US dollars in 2017, the figure increased significantly to 3,787 million in 2018, representing strong growth. There was a slight decline in 2019 to 3,505 million, followed by a moderate recovery in 2020 to 3,754 million. Notably, the net income surged markedly in 2021, reaching 6,956 million US dollars, indicating a substantial increase and a possible improvement in operational efficiency or market conditions.
Net Operating Profit After Taxes (NOPAT)
The NOPAT values also exhibit a consistent upward trajectory with minor fluctuations. Beginning at 4,332 million US dollars in 2017, it rose steadily to 5,865 million in 2018 and slightly higher to 5,941 million in 2019. A small decrease occurred in 2020, with NOPAT declining to 5,607 million. However, a significant increase is evident in 2021, with NOPAT rising sharply to 9,050 million US dollars. This substantial growth in 2021 may reflect enhanced operational performance or effective cost management, contributing to improved profitability after taxes.

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Cash Operating Taxes

HCA Healthcare Inc., cash operating taxes calculation

US$ in millions

Microsoft Excel
12 months ended: Dec 31, 2021 Dec 31, 2020 Dec 31, 2019 Dec 31, 2018 Dec 31, 2017
Provision for income taxes 2,112 1,043 1,099 946 1,638
Less: Deferred income tax expense (benefit) 17 (109) 278 15 432
Add: Tax savings from interest expense 349 353 404 388 623
Cash operating taxes 2,444 1,505 1,225 1,319 1,829

Based on: 10-K (reporting date: 2021-12-31), 10-K (reporting date: 2020-12-31), 10-K (reporting date: 2019-12-31), 10-K (reporting date: 2018-12-31), 10-K (reporting date: 2017-12-31).


Provision for Income Taxes
The provision for income taxes exhibited a fluctuating pattern over the five-year period. Initially, there was a decline from 1,638 million US dollars in 2017 to 946 million in 2018. This was followed by an increase in 2019 to 1,099 million. In 2020, the provision slightly decreased to 1,043 million, but surged significantly in 2021 to 2,112 million US dollars, representing the highest level in the observed timeframe.
Cash Operating Taxes
Cash operating taxes showed a general upward trend despite some variability. The amount decreased from 1,829 million US dollars in 2017 to 1,319 million in 2018, then marginally declined again to 1,225 million in 2019. However, there was a notable increase in 2020 to 1,505 million, followed by a substantial rise in 2021 to 2,444 million US dollars, reaching the peak value for the period under review.
Comparative Analysis
Both the provision for income taxes and cash operating taxes demonstrated significant increases in 2021, more than doubling their respective lows in 2018 and 2019. The divergence in trends between 2017 and 2018 indicates an initial reduction phase before a strong upward movement. The cash operating taxes consistently remained higher than the provision for income taxes each year, suggesting a potential difference in the timing or recognition of tax expenses compared to actual tax payments.

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Invested Capital

HCA Healthcare Inc., invested capital calculation (financing approach)

US$ in millions

Microsoft Excel
Dec 31, 2021 Dec 31, 2020 Dec 31, 2019 Dec 31, 2018 Dec 31, 2017
Long-term debt due within one year 237 209 145 788 200
Long-term debt due after one year, less debt issuance costs and discounts 34,342 30,795 33,577 32,033 32,858
Operating lease liability1 2,147 2,052 1,849 1,708 1,725
Total reported debt & leases 36,726 33,056 35,571 34,529 34,783
Stockholders’ equity (deficit) attributable to HCA Healthcare, Inc. (933) 572 (2,808) (4,950) (6,806)
Net deferred tax (assets) liabilities2 (395) (385) (300) (478) (510)
Equity equivalents3 (395) (385) (300) (478) (510)
Accumulated other comprehensive (income) loss, net of tax4 404 502 460 381 278
Noncontrolling interests 2,422 2,320 2,243 2,032 1,811
Adjusted stockholders’ equity (deficit) attributable to HCA Healthcare, Inc. 1,498 3,009 (405) (3,015) (5,227)
Construction in progress5 (1,387) (1,495) (1,632) (1,785) (1,921)
Invested capital 36,837 34,570 33,534 29,729 27,635

Based on: 10-K (reporting date: 2021-12-31), 10-K (reporting date: 2020-12-31), 10-K (reporting date: 2019-12-31), 10-K (reporting date: 2018-12-31), 10-K (reporting date: 2017-12-31).

1 Addition of capitalized operating leases.

2 Elimination of deferred taxes from assets and liabilities. See details »

3 Addition of equity equivalents to stockholders’ equity (deficit) attributable to HCA Healthcare, Inc..

4 Removal of accumulated other comprehensive income.

5 Subtraction of construction in progress.


Total reported debt & leases

This liability metric showed a generally stable pattern throughout the observed periods, fluctuating slightly but remaining within the range of approximately US$33 billion to US$37 billion. Specifically, the value decreased from US$34.8 billion in 2017 to US$33.1 billion in 2020, followed by an increase to US$36.7 billion in 2021. This trend suggests a degree of active debt management, with a reduction during the 2018-2020 period and an increase in the most recent year.

Stockholders’ equity (deficit) attributable to HCA Healthcare, Inc.

The equity position exhibited a significant improvement from a negative value of US$6.8 billion in 2017 to nearly break-even at US$572 million in 2020, indicating a substantial repair of shareholders’ equity over this four-year span. However, in 2021, there was a reversal back to a negative equity balance of US$933 million, though this deficit was still less severe than the initial figures at the beginning of the period. This reflects volatility in retained earnings or other components influencing equity, as well as possible impacts of operational or non-operational factors on equity structure.

Invested capital

A steady and continuous increase in invested capital is evident across the five-year timeframe, rising from US$27.6 billion in 2017 to US$36.8 billion in 2021. This indicates ongoing investment activity and capital deployment in the business, suggesting expansion or renewal efforts. The upward trend is consistent year-over-year without any contractions or plateaus, signaling sustained capital growth.

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Cost of Capital

HCA Healthcare Inc., cost of capital calculations

Capital (fair value)1 Weights Cost of capital
Equity2 74,109 74,109 ÷ 114,797 = 0.65 0.65 × 25.61% = 16.53%
Long-term debt3 38,541 38,541 ÷ 114,797 = 0.34 0.34 × 4.60% × (1 – 21.00%) = 1.22%
Operating lease liability4 2,147 2,147 ÷ 114,797 = 0.02 0.02 × 4.40% × (1 – 21.00%) = 0.07%
Total: 114,797 1.00 17.82%

Based on: 10-K (reporting date: 2021-12-31).

1 US$ in millions

2 Equity. See details »

3 Long-term debt. See details »

4 Operating lease liability. See details »

Capital (fair value)1 Weights Cost of capital
Equity2 60,291 60,291 ÷ 98,157 = 0.61 0.61 × 25.61% = 15.73%
Long-term debt3 35,814 35,814 ÷ 98,157 = 0.36 0.36 × 5.00% × (1 – 21.00%) = 1.44%
Operating lease liability4 2,052 2,052 ÷ 98,157 = 0.02 0.02 × 4.80% × (1 – 21.00%) = 0.08%
Total: 98,157 1.00 17.25%

Based on: 10-K (reporting date: 2020-12-31).

1 US$ in millions

2 Equity. See details »

3 Long-term debt. See details »

4 Operating lease liability. See details »

Capital (fair value)1 Weights Cost of capital
Equity2 50,124 50,124 ÷ 88,999 = 0.56 0.56 × 25.61% = 14.42%
Long-term debt3 37,026 37,026 ÷ 88,999 = 0.42 0.42 × 5.20% × (1 – 21.00%) = 1.71%
Operating lease liability4 1,849 1,849 ÷ 88,999 = 0.02 0.02 × 5.30% × (1 – 21.00%) = 0.09%
Total: 88,999 1.00 16.22%

Based on: 10-K (reporting date: 2019-12-31).

1 US$ in millions

2 Equity. See details »

3 Long-term debt. See details »

4 Operating lease liability. See details »

Capital (fair value)1 Weights Cost of capital
Equity2 48,621 48,621 ÷ 83,216 = 0.58 0.58 × 25.61% = 14.96%
Long-term debt3 32,887 32,887 ÷ 83,216 = 0.40 0.40 × 5.50% × (1 – 21.00%) = 1.72%
Operating lease liability4 1,708 1,708 ÷ 83,216 = 0.02 0.02 × 5.50% × (1 – 21.00%) = 0.09%
Total: 83,216 1.00 16.77%

Based on: 10-K (reporting date: 2018-12-31).

1 US$ in millions

2 Equity. See details »

3 Long-term debt. See details »

4 Operating lease liability. See details »

Capital (fair value)1 Weights Cost of capital
Equity2 35,284 35,284 ÷ 71,698 = 0.49 0.49 × 25.61% = 12.60%
Long-term debt3 34,689 34,689 ÷ 71,698 = 0.48 0.48 × 5.20% × (1 – 35.00%) = 1.64%
Operating lease liability4 1,725 1,725 ÷ 71,698 = 0.02 0.02 × 5.20% × (1 – 35.00%) = 0.08%
Total: 71,698 1.00 14.32%

Based on: 10-K (reporting date: 2017-12-31).

1 US$ in millions

2 Equity. See details »

3 Long-term debt. See details »

4 Operating lease liability. See details »



Economic Spread Ratio

HCA Healthcare Inc., economic spread ratio calculation, comparison to benchmarks

Microsoft Excel
Dec 31, 2021 Dec 31, 2020 Dec 31, 2019 Dec 31, 2018 Dec 31, 2017
Selected Financial Data (US$ in millions)
Economic profit1 2,487 (356) 503 880 375
Invested capital2 36,837 34,570 33,534 29,729 27,635
Performance Ratio
Economic spread ratio3 6.75% -1.03% 1.50% 2.96% 1.36%
Benchmarks
Economic Spread Ratio, Competitors4
Abbott Laboratories -1.98%
Elevance Health Inc. 1.46%
Intuitive Surgical Inc. 12.27%
Medtronic PLC -6.73%
UnitedHealth Group Inc. 3.91%

Based on: 10-K (reporting date: 2021-12-31), 10-K (reporting date: 2020-12-31), 10-K (reporting date: 2019-12-31), 10-K (reporting date: 2018-12-31), 10-K (reporting date: 2017-12-31).

1 Economic profit. See details »

2 Invested capital. See details »

3 2021 Calculation
Economic spread ratio = 100 × Economic profit ÷ Invested capital
= 100 × 2,487 ÷ 36,837 = 6.75%

4 Click competitor name to see calculations.


The financial performance from 2017 to 2021 reflects a period of sustained capital expansion coupled with volatile value creation. While the capital base grew consistently, the ability to generate returns exceeding the cost of capital experienced significant fluctuations, culminating in a substantial recovery in the final year of the period.

Invested Capital Trends
Invested capital demonstrated a steady and uninterrupted upward trajectory, increasing from 27,635 million USD in 2017 to 36,837 million USD by 2021. This indicates a consistent increase in the total assets deployed to generate earnings throughout the five-year window.
Economic Profit Volatility
Economic profit exhibited high variability. An initial rise from 375 million USD in 2017 to 880 million USD in 2018 was followed by a decline to 503 million USD in 2019. The most significant downturn occurred in 2020, where economic profit turned negative at -356 million USD. This trend reversed sharply in 2021, with profit surging to a peak of 2,487 million USD.
Economic Spread Ratio Analysis
The economic spread ratio, which measures the difference between the return on invested capital and the cost of capital, mirrored the volatility of economic profit. The ratio fluctuated from 1.36% in 2017 to a peak of 2.96% in 2018, before declining to -1.03% in 2020. This negative spread in 2020 indicates that the returns generated were insufficient to cover the cost of the capital employed. The period concluded with a significant expansion of the spread to 6.75% in 2021, suggesting a marked improvement in capital efficiency and value creation.

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Economic Profit Margin

HCA Healthcare Inc., economic profit margin calculation, comparison to benchmarks

Microsoft Excel
Dec 31, 2021 Dec 31, 2020 Dec 31, 2019 Dec 31, 2018 Dec 31, 2017
Selected Financial Data (US$ in millions)
Economic profit1 2,487 (356) 503 880 375
Revenues 58,752 51,533 51,336 46,677 43,614
Performance Ratio
Economic profit margin2 4.23% -0.69% 0.98% 1.88% 0.86%
Benchmarks
Economic Profit Margin, Competitors3
Abbott Laboratories -2.85%
Elevance Health Inc. 0.68%
Intuitive Surgical Inc. 9.66%
Medtronic PLC -16.16%
UnitedHealth Group Inc. 1.92%

Based on: 10-K (reporting date: 2021-12-31), 10-K (reporting date: 2020-12-31), 10-K (reporting date: 2019-12-31), 10-K (reporting date: 2018-12-31), 10-K (reporting date: 2017-12-31).

1 Economic profit. See details »

2 2021 Calculation
Economic profit margin = 100 × Economic profit ÷ Revenues
= 100 × 2,487 ÷ 58,752 = 4.23%

3 Click competitor name to see calculations.


The financial performance between 2017 and 2021 is characterized by consistent revenue expansion contrasted with significant volatility in economic profit and the corresponding economic profit margin.

Revenue Trajectory
Revenues demonstrated a continuous upward trend, increasing from 43,614 million US dollars in 2017 to 58,752 million US dollars by 2021. This steady growth indicates a consistent increase in the scale of operations over the five-year period.
Economic Profit Fluctuations
Economic profit exhibited substantial instability. An initial increase from 375 million US dollars in 2017 to 880 million US dollars in 2018 was followed by a decline to 503 million US dollars in 2019. A significant downturn occurred in 2020, where economic profit fell to -356 million US dollars, representing a failure to cover the cost of capital. This was followed by a sharp recovery in 2021, with economic profit reaching a period high of 2,487 million US dollars.
Economic Profit Margin Analysis
The economic profit margin mirrored the volatility of the absolute economic profit figures. The margin rose to 1.88% in 2018 before contracting to 0.98% in 2019. The transition to a negative margin of -0.69% in 2020 highlights a period of value destruction. However, the margin expanded dramatically to 4.23% in 2021, indicating a substantial improvement in the ability to generate economic value relative to total revenues.

The divergence between the linear growth of revenues and the non-linear movement of the economic profit margin suggests that value creation was heavily impacted by factors other than top-line growth, particularly during the 2020 fiscal year, before achieving a high level of efficiency in 2021.

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