Originally reported by Asheville Watchdog
HCA Healthcare, the corporate entity behind Mission Health, has experienced a $3.8 billion rise in revenues during the first nine months of 2025, according to the company’s latest financial report. This 7.2% increase over the previous year has prompted a revision of their annual revenue expectations, adding up to $1 billion more than initially estimated.
In a late October earnings call, CEO Sam Hazen remarked, “Our teams continue to execute our agenda at a high level. Across many operational measures, including quality and key stakeholder satisfaction, outcomes were better year over year.” He credited the organization’s revenue growth to “better margins with disciplined operations.”
HCA Healthcare stands as a leading healthcare provider, managing 191 hospitals and numerous surgical centers across 20 states and the UK. The company acquired Mission Hospital in Asheville, along with five other hospitals in western North Carolina, for $1.5 billion in 2019. However, post-acquisition, there have been complaints that financial priorities overshadow patient care.
Recently, Mission Hospital faced the possibility of losing Medicare and Medicaid funding for the third time since its acquisition due to severe regulatory sanctions following patient care incidents, one involving a cardiac patient death linked to telemetry equipment disconnection.
Moreover, the North Carolina Attorney General has filed a lawsuit against HCA, citing failure to meet service obligations as per their purchase agreement. “HCA apparently cares more about its profits than its patients,” said then-Attorney General and now Governor Josh Stein in announcing the suit in December 2023. HCA disputes these claims.
HCA’s financial disclosures do not provide details on individual hospital performance, and company representatives have not commented on their management of Mission Health. In their quarterly filing with the U.S. Securities and Exchange Commission, HCA noted, “We operate in a highly regulated and litigious industry. Certain of our individual facilities have received, and from time to time other facilities may receive, government inquiries from, and may be subject to investigation by, federal and state agencies.”
HCA added, “Depending on whether the underlying conduct in these or future inquiries or investigations could be considered systemic, their resolution could have a material, adverse effect on our results of operations, financial position, or liquidity.”
A ‘Financial Impact’ from Natural Disasters
Executive Vice President and CFO Michael Marks disclosed during the earnings call that HCA’s operations in Florida, Georgia, and North Carolina suffered a “financial impact” of $250 million due to hurricanes in 2024, including Hurricane Helene. Despite this setback, Marks expressed confidence in recouping about $100 million in 2025.
The storms’ effects linger, particularly in North Carolina, where volume recovery is challenged by a deteriorated payer mix and reliance on premium labor for staffing. In the first nine months of 2025, HCA’s net income rose to $5.62 billion, up from $4.97 billion in the same period the previous year, with a 9.6% increase in third-quarter revenue.
Admissions, surgeries, and emergency visits all saw increases, as did uncompensated care. HCA’s revised revenue forecast for 2025 now stands between $75 billion and $76.5 billion, up from an earlier estimate of $74 billion to $76 billion.
This year, HCA expanded by acquiring two more hospitals in New Hampshire and Florida, raising their total bed count to 50,577 from last year’s 49,890. Despite recent legislative changes, such as the “One Big Beautiful Bill Act,” which may reduce health insurance access and Medicaid spending, Hazen expressed confidence in HCA’s readiness to face such challenges. “We’ve had 18 — 18 — consecutive quarters of volume growth,” he stated.
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