HCA Healthcare Inc. operates in 2 segments: National Group and American Group.
Segment Profit Margin
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | |
|---|---|---|---|---|---|
| National Group | 24.14% | 21.53% | 21.74% | 22.05% | 22.15% |
| American Group | 23.54% | 22.60% | 21.16% | 20.92% | 20.23% |
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).
Between 2017 and 2021, both reportable segments exhibited an overall increase in profit margins, with a significant peak occurring in the final year of the period. While the trajectories differed in the interim, both groups concluded the period at their highest recorded margin levels.
- National Group Profit Margin
- A gradual contraction is observed from 2017 to 2020, as margins declined from 22.15% to a low of 21.53%. This downward trend was reversed in 2021, which saw a sharp expansion to 24.14%, marking the highest margin for the segment within the analyzed timeframe.
- American Group Profit Margin
- A consistent upward trajectory is evident, with profit margins increasing every year from 20.23% in 2017 to 23.54% in 2021. This steady growth reflects a sustained improvement in margin performance over the five-year period.
- Comparative Segment Analysis
- The National Group maintained a higher profit margin than the American Group throughout the entire period. However, the margin gap narrowed from 1.92 percentage points in 2017 to 0.60 percentage points in 2021, driven by the American Group's uninterrupted growth compared to the National Group's mid-period decline.
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Segment Profit Margin: National Group
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | |
|---|---|---|---|---|---|
| Selected Financial Data (US$ in millions) | |||||
| Adjusted segment EBITDA | 7,200) | 5,532) | 5,634) | 4,980) | 4,600) |
| Revenues | 29,826) | 25,694) | 25,913) | 22,581) | 20,772) |
| Segment Profitability Ratio | |||||
| Segment profit margin1 | 24.14% | 21.53% | 21.74% | 22.05% | 22.15% |
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 2021 Calculation
Segment profit margin = 100 × Adjusted segment EBITDA ÷ Revenues
= 100 × 7,200 ÷ 29,826 = 24.14%
The National Group demonstrated a general trajectory of growth in both top-line revenue and operational earnings between 2017 and 2021, characterized by steady expansion, a brief period of stagnation, and a significant recovery in the final year.
- Revenue Growth Trends
- Revenues increased from US$ 20,772 million in 2017 to US$ 29,826 million in 2021. This growth was consistent through 2019, peaking at US$ 25,913 million before experiencing a slight contraction in 2020. A substantial surge occurred in 2021, representing the largest single-year increase in the period analyzed.
- Adjusted Segment EBITDA Performance
- Adjusted segment EBITDA mirrored the revenue trend, rising from US$ 4,600 million in 2017 to US$ 7,200 million in 2021. While growth was steady until 2019, there was a moderate decline in 2020 to US$ 5,532 million. The period concluded with a sharp increase in 2021, indicating a strong recovery in operational earnings.
- Segment Profit Margin Analysis
- The segment profit margin exhibited a period of gradual compression from 2017 to 2020, declining from 22.15% to a low of 21.53%. This downward trend suggests that operating costs grew slightly faster than revenues during this window. This pattern reversed abruptly in 2021, with the margin expanding to 24.14%, the highest level in the five-year period, signifying enhanced operational efficiency or a shift toward more profitable revenue streams.
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Segment Profit Margin: American Group
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | |
|---|---|---|---|---|---|
| Selected Financial Data (US$ in millions) | |||||
| Adjusted segment EBITDA | 6,156) | 5,333) | 4,904) | 4,593) | 4,231) |
| Revenues | 26,152) | 23,593) | 23,173) | 21,959) | 20,912) |
| Segment Profitability Ratio | |||||
| Segment profit margin1 | 23.54% | 22.60% | 21.16% | 20.92% | 20.23% |
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 2021 Calculation
Segment profit margin = 100 × Adjusted segment EBITDA ÷ Revenues
= 100 × 6,156 ÷ 26,152 = 23.54%
The American Group segment exhibited a consistent upward trajectory in financial performance from 2017 through 2021, characterized by simultaneous growth in total revenues and operational efficiency.
- Revenue Growth
- Revenues increased steadily each year, rising from 20,912 million USD in 2017 to 26,152 million USD in 2021. This represents a sustained expansion of the segment's top-line performance over the five-year period.
- Adjusted Segment EBITDA Performance
- Operational earnings demonstrated a more aggressive growth rate than total revenues. Adjusted segment EBITDA rose from 4,231 million USD in 2017 to 6,156 million USD in 2021. The most significant year-over-year increase occurred between 2020 and 2021, with an absolute growth of 823 million USD.
- Segment Profit Margin Expansion
- The segment profit margin improved monotonically throughout the observed period. Starting at 20.23% in 2017, the margin expanded to 23.54% by 2021. This continuous increase indicates that the segment successfully scaled its operations while improving cost management, resulting in higher profitability per unit of revenue.
The observed data indicates a positive correlation between revenue expansion and margin improvement, suggesting that the American Group segment benefited from strong operational leverage during this period.
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Segment Return on Assets (Segment ROA)
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | |
|---|---|---|---|---|---|
| National Group | 33.95% | 29.25% | 30.80% | 33.56% | 35.12% |
| American Group | 28.73% | 25.69% | 23.80% | 24.02% | 23.33% |
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).
The segment return on assets (ROA) for the analyzed period reveals divergent performance trajectories between the National Group and the American Group, although both segments concluded the period with an upward trend in 2021.
- National Group Performance
- A period of consistent contraction is observed from 2017 to 2020, during which the return on assets declined from 35.12% to 29.25%. This downward trend was reversed in 2021, with a significant recovery to 33.95%, indicating a restoration of asset efficiency toward historical levels.
- American Group Performance
- The American Group exhibited a general upward trajectory in its return on assets. Starting at 23.33% in 2017, the ratio reached 28.73% by 2021. Despite a marginal decrease in 2019 to 23.80%, the subsequent growth in 2020 and 2021 demonstrates a steady improvement in the segment's ability to generate earnings from its asset base.
- Comparative Segment Trends
- The National Group consistently maintained a higher return on assets than the American Group throughout the five-year duration. However, the performance gap between the two segments narrowed considerably; the differential decreased from 11.79 percentage points in 2017 to 5.22 percentage points in 2021.
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Segment ROA: National Group
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | |
|---|---|---|---|---|---|
| Selected Financial Data (US$ in millions) | |||||
| Adjusted segment EBITDA | 7,200) | 5,532) | 5,634) | 4,980) | 4,600) |
| Assets | 21,205) | 18,913) | 18,290) | 14,839) | 13,097) |
| Segment Profitability Ratio | |||||
| Segment ROA1 | 33.95% | 29.25% | 30.80% | 33.56% | 35.12% |
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 2021 Calculation
Segment ROA = 100 × Adjusted segment EBITDA ÷ Assets
= 100 × 7,200 ÷ 21,205 = 33.95%
The National Group exhibited a period of significant asset expansion and fluctuating profitability between 2017 and 2021. While total assets grew consistently throughout the period, the Return on Assets (ROA) experienced a multi-year decline before recovering sharply in the final year.
- Adjusted Segment EBITDA Trends
- Operating performance showed a general upward trajectory, increasing from US$ 4,600 million in 2017 to US$ 7,200 million in 2021. Growth was steady through 2019, followed by a marginal contraction in 2020, where EBITDA decreased by approximately 1.8% to US$ 5,532 million. A substantial recovery occurred in 2021, with a year-over-year increase of approximately 30.1%.
- Asset Base Expansion
- The asset base grew aggressively and without interruption over the five-year horizon. Assets rose from US$ 13,097 million in 2017 to US$ 21,205 million in 2021, representing a total increase of approximately 61.9%. The most rapid expansion occurred between 2018 and 2019, with a growth rate of 23.3%.
- Segment ROA Analysis
- The Segment ROA followed a U-shaped pattern, starting at 35.12% in 2017 and declining steadily to a low of 29.25% in 2020. This downward trend was driven by the fact that asset growth consistently outpaced EBITDA growth during this window. However, in 2021, the ROA rebounded to 33.95%, as the surge in Adjusted Segment EBITDA significantly exceeded the rate of asset accumulation.
The data indicates that the National Group successfully scaled its operations, though the efficiency of asset utilization temporarily diminished as the segment invested heavily in its infrastructure. The strong performance in 2021 suggests a successful synchronization of increased capacity with higher earnings generation.
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Segment ROA: American Group
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | |
|---|---|---|---|---|---|
| Selected Financial Data (US$ in millions) | |||||
| Adjusted segment EBITDA | 6,156) | 5,333) | 4,904) | 4,593) | 4,231) |
| Assets | 21,428) | 20,760) | 20,608) | 19,122) | 18,136) |
| Segment Profitability Ratio | |||||
| Segment ROA1 | 28.73% | 25.69% | 23.80% | 24.02% | 23.33% |
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 2021 Calculation
Segment ROA = 100 × Adjusted segment EBITDA ÷ Assets
= 100 × 6,156 ÷ 21,428 = 28.73%
The American Group demonstrates a consistent upward trajectory in both operational profitability and asset utilization between 2017 and 2021. This period is characterized by steady growth in Adjusted segment EBITDA and a corresponding expansion of the asset base, resulting in a general improvement in the Segment Return on Assets (ROA).
- Adjusted Segment EBITDA Trends
- Adjusted segment EBITDA exhibited uninterrupted annual growth throughout the analyzed period, rising from US$ 4,231 million in 2017 to US$ 6,156 million in 2021. This represents a significant cumulative increase, indicating a robust and consistent expansion of operational earnings over the five-year span.
- Asset Base Expansion
- Total assets within the segment grew steadily from US$ 18,136 million in 2017 to US$ 21,428 million by the end of 2021. The expansion was most pronounced between 2018 and 2019, while the growth rate slowed slightly in 2020 before continuing its upward trend in 2021.
- Segment ROA Analysis
- The Segment ROA increased from 23.33% in 2017 to 28.73% in 2021. Despite a slight contraction to 23.80% in 2019, the ratio accelerated sharply in 2020 and 2021. This trend indicates that EBITDA growth outpaced the growth of the asset base in the latter part of the period, reflecting enhanced efficiency in asset utilization and an improved capacity to generate earnings from the segment's invested capital.
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Segment Asset Turnover
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | |
|---|---|---|---|---|---|
| National Group | 1.41 | 1.36 | 1.42 | 1.52 | 1.59 |
| American Group | 1.22 | 1.14 | 1.12 | 1.15 | 1.15 |
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).
The asset turnover ratios for the National Group and American Group reveal distinct trajectories in operational efficiency over the five-year period ending December 31, 2021. While both segments demonstrated a recovery in 2021, the National Group consistently maintained a higher capacity to generate revenue from its asset base compared to the American Group.
- National Group Asset Turnover
- A sustained downward trend was observed from 2017 through 2020, with the ratio declining from 1.59 to 1.36. This suggests a period of diminishing asset efficiency or an increase in the asset base that outpaced revenue growth. This trend reversed in 2021, with the ratio recovering to 1.41.
- American Group Asset Turnover
- The American Group displayed relative stability between 2017 and 2020, with ratios fluctuating minimally between 1.12 and 1.15. A notable upward shift occurred in 2021, where the ratio reached 1.22, the highest level recorded for this segment during the analyzed period.
- Comparative Segment Performance
- The National Group operated with a consistently higher turnover ratio than the American Group across all five years. However, the efficiency gap between the two segments narrowed over time, decreasing from a difference of 0.44 in 2017 to 0.19 in 2021, primarily due to the National Group's mid-period decline and the American Group's subsequent improvement.
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Segment Asset Turnover: National Group
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | |
|---|---|---|---|---|---|
| Selected Financial Data (US$ in millions) | |||||
| Revenues | 29,826) | 25,694) | 25,913) | 22,581) | 20,772) |
| Assets | 21,205) | 18,913) | 18,290) | 14,839) | 13,097) |
| Segment Activity Ratio | |||||
| Segment asset turnover1 | 1.41 | 1.36 | 1.42 | 1.52 | 1.59 |
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 2021 Calculation
Segment asset turnover = Revenues ÷ Assets
= 29,826 ÷ 21,205 = 1.41
The National Group demonstrated a consistent expansion of its operational scale from 2017 through 2021, characterized by steady growth in both total revenues and the asset base. However, the efficiency with which assets were utilized to generate revenue experienced a period of decline before showing signs of recovery in the final year.
- Revenue Trajectory
- Revenues grew from 20,772 million US dollars in 2017 to 29,826 million US dollars in 2021. This growth trend remained positive for most of the period, with a marginal contraction observed in 2020 followed by a significant acceleration in 2021.
- Asset Base Expansion
- The asset base expanded consistently throughout the five-year period, increasing from 13,097 million US dollars in 2017 to 21,205 million US dollars in 2021. The steady year-over-year increase indicates continuous capital investment within the segment.
- Segment Asset Turnover Performance
- The asset turnover ratio followed a downward trend between 2017 and 2020, falling from 1.59 to 1.36. This decline reflects a period where asset growth exceeded revenue growth, reducing the relative productivity of the asset base. A recovery was noted in 2021, as the ratio rose to 1.41, coinciding with the sharp increase in revenues that outpaced the growth of assets for that specific year.
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Segment Asset Turnover: American Group
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | |
|---|---|---|---|---|---|
| Selected Financial Data (US$ in millions) | |||||
| Revenues | 26,152) | 23,593) | 23,173) | 21,959) | 20,912) |
| Assets | 21,428) | 20,760) | 20,608) | 19,122) | 18,136) |
| Segment Activity Ratio | |||||
| Segment asset turnover1 | 1.22 | 1.14 | 1.12 | 1.15 | 1.15 |
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 2021 Calculation
Segment asset turnover = Revenues ÷ Assets
= 26,152 ÷ 21,428 = 1.22
The American Group demonstrated a consistent trajectory of growth in revenues and assets between 2017 and 2021, characterized by an overall improvement in asset utilization efficiency toward the end of the period.
- Revenue Growth Trends
- Revenues increased monotonically over the five-year period, rising from US$ 20,912 million in 2017 to US$ 26,152 million in 2021. The most significant expansion occurred in 2021, where revenue grew by approximately 10.8% compared to the previous year, following a period of more moderate growth in 2020.
- Asset Base Expansion
- The asset base grew from US$ 18,136 million in 2017 to US$ 21,428 million in 2021. Asset expansion was most pronounced between 2018 and 2019; however, growth decelerated significantly in 2020, increasing by only 0.7% during that fiscal year.
- Segment Asset Turnover Performance
- The segment asset turnover ratio remained relatively stable from 2017 through 2020, fluctuating within a narrow range between 1.12 and 1.15. A notable increase was observed in 2021, with the ratio rising to 1.22. This peak indicates a higher level of efficiency in generating revenue relative to the assets employed during the final year of the analysis.
The combination of accelerated revenue growth and moderated asset expansion in 2021 resulted in the highest asset turnover ratio of the analyzed period, reflecting optimized operational productivity and improved asset efficiency.
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Revenues
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | |
|---|---|---|---|---|---|
| National Group | 29,826) | 25,694) | 25,913) | 22,581) | 20,772) |
| American Group | 26,152) | 23,593) | 23,173) | 21,959) | 20,912) |
| Corporate and other | 2,774) | 2,246) | 2,250) | 2,137) | 1,930) |
| Total | 58,752) | 51,533) | 51,336) | 46,677) | 43,614) |
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).
Total revenues exhibited a consistent upward trajectory between 2017 and 2021, increasing from $43,614 million to $58,752 million. While growth was robust through 2019, a period of relative stagnation occurred in 2020, where revenues grew by less than 1%. A significant acceleration followed in 2021, resulting in a year-over-year increase of approximately 14%.
- National Group Performance
- This segment emerged as the primary driver of revenue expansion. After starting at $20,772 million in 2017, revenues grew aggressively to $25,913 million by 2019. Despite a slight contraction in 2020 to $25,694 million, the segment experienced a sharp rebound in 2021, reaching $29,826 million.
- American Group Performance
- The American Group demonstrated a more linear and stable growth pattern. Revenues rose steadily from $20,912 million in 2017 to $26,152 million in 2021. Unlike the National Group, this segment maintained positive growth through 2020, indicating a different revenue resilience profile during that period.
- Corporate and Other Segment
- Revenue from corporate and other activities remained a small fraction of total earnings but grew consistently from $1,930 million in 2017 to $2,774 million in 2021, reflecting a gradual increase in auxiliary income streams.
- Revenue Composition Shift
- A shift in the internal revenue mix is observed. In 2017, the American Group was the largest contributor to total revenue. However, by 2019, the National Group surpassed the American Group in scale, a lead that widened further by the end of 2021.
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Adjusted segment EBITDA
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | |
|---|---|---|---|---|---|
| National Group | 7,200) | 5,532) | 5,634) | 4,980) | 4,600) |
| American Group | 6,156) | 5,333) | 4,904) | 4,593) | 4,231) |
| Corporate and other | (712) | (828) | (681) | (624) | (598) |
| Total | 12,644) | 10,037) | 9,857) | 8,949) | 8,233) |
Based on: 10-K (reporting date: 2021-12-31), 10-K (reporting date: 2020-12-31), 10-K (reporting date: 2019-12-31), 10-K (reporting date: 2018-12-31), 10-K (reporting date: 2017-12-31).
Total Adjusted Segment EBITDA exhibited a consistent upward trajectory between 2017 and 2021, increasing from US$ 8,233 million to US$ 12,644 million. This overall growth reflects a steady expansion of operating profitability, with a notable acceleration in performance occurring in the final year of the period.
- National Group Performance
- The National Group demonstrated strong growth, rising from US$ 4,600 million in 2017 to US$ 7,200 million in 2021. A marginal decline was observed in 2020, where EBITDA dipped to US$ 5,532 million from US$ 5,634 million in 2019. However, this was followed by a significant surge in 2021, representing the largest single-year increase for any segment in the provided period.
- American Group Performance
- The American Group showed a stable and linear growth pattern, increasing every year without exception. EBITDA rose from US$ 4,231 million in 2017 to US$ 6,156 million in 2021. Unlike the National Group, the American Group maintained positive momentum throughout 2020, suggesting a more consistent growth profile across the observed timeframe.
- Corporate and Other Expenses
- The Corporate and other segment consistently operated at a loss, acting as a drag on total EBITDA. These losses expanded from US$ 598 million in 2017 to a peak of US$ 828 million in 2020. A partial recovery was observed in 2021, as the loss narrowed to US$ 712 million.
The convergence of strong growth in both the National and American Groups, combined with a reduction in corporate losses in 2021, resulted in a substantial leap in total Adjusted Segment EBITDA for the final year. The combined contribution of the two primary operating groups effectively offset the corporate overhead, driving a cumulative increase in profitability of approximately 53.6% over the five-year period.
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Assets
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | |
|---|---|---|---|---|---|
| National Group | 21,205) | 18,913) | 18,290) | 14,839) | 13,097) |
| American Group | 21,428) | 20,760) | 20,608) | 19,122) | 18,136) |
| Corporate and other | 8,109) | 7,817) | 6,160) | 5,246) | 5,360) |
| Total | 50,742) | 47,490) | 45,058) | 39,207) | 36,593) |
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).
Total assets exhibited a consistent upward trajectory over the five-year period, increasing from 36,593 million US dollars in 2017 to 50,742 million US dollars by 2021. This represents an overall expansion of approximately 38.6%.
- National Group Asset Expansion
- The National Group demonstrated the most aggressive growth among the reportable segments. Assets grew from 13,097 million US dollars in 2017 to 21,205 million US dollars in 2021, marking a significant increase of approximately 61.9%. A notable acceleration occurred between 2018 and 2019, during which assets increased by approximately 23% within a single fiscal year.
- American Group Asset Stability
- The American Group showed a steady but more moderate growth pattern. Starting at 18,136 million US dollars in 2017, assets rose to 21,428 million US dollars by 2021. While this segment remained a primary driver of the asset base, its growth rate was considerably lower than that of the National Group.
- Corporate and Other Trends
- Corporate and other assets remained relatively stable between 2017 and 2018 but experienced a marked increase starting in 2019. Assets rose from 5,360 million US dollars in 2017 to 8,109 million US dollars in 2021, with the most substantial growth occurring between 2019 and 2020.
- Comparative Segment Distribution
- A shift in asset composition is observable over the period. In 2017, the American Group held a substantial lead over the National Group in terms of total assets. By 2021, this gap narrowed significantly, as both segments reached similar valuation levels near 21 billion US dollars, indicating a shift in the proportional weight of the National Group within the overall portfolio.
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