This story was originally published in the Asheville Watchdog
Mission Health’s corporate owner, HCA Healthcare, has seen its revenues increase by $3.8 billion in the first three quarters of 2025, the company reported.
The 7.2 percent increase over 2024, along with its third quarter performance, caused the hospital conglomerate to revise its 2025 revenue projections upward by as much as $1 billion.
“Our teams continue to execute our agenda at a high level,” HCA Chief Executive Officer Sam Hazen said in an earnings call in late October. “Across many operational measures, including quality and key stakeholder satisfaction, outcomes were better year over year.”
Hazen said the company had turned its revenue growth “into better margins with disciplined operations.”
HCA is one of the largest healthcare providers in the nation with 191 hospitals and hundreds of surgery centers and other facilities in 20 states and the United Kingdom.
The company purchased Mission Hospital in Asheville and five regional hospitals in western North Carolina in 2019 for $1.5 billion. Complaints soon followed, including that the company’s emphasis on profits came at the expense of patient care.
Last month, Mission Hospital was placed in immediate jeopardy of losing Medicare and Medicaid funding for the third time since 2019. The sanction, the most severe a hospital can face, followed inspections by state regulators after a trio of incidents, including the death of a cardiac patient after becoming disconnected from telemetry equipment for at least an hour.
HCA is facing a lawsuit by the North Carolina attorney general for failing to provide services as required under the purchase agreement. “HCA apparently cares more about its profits than its patients,” then-Attorney General and current Gov. Josh Stein said in announcing the suit in December 2023. The company maintains it is not in violation of the agreement.
HCA earnings documents do not disclose actions or performance of specific hospitals, and a company spokesperson did not respond to a request for comment about its stewardship of Mission.
“We operate in a highly regulated and litigious industry,” HCA reported in its third quarter filing with the U.S. Securities and Exchange Commission. “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.
“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 ‘$250 million hit’ from hurricanes
HCA Executive Vice President and Chief Financial Officer Michael Marks said on the earnings call that the company took a “$250 million hit” from 2024’s hurricanes, including Helene, on its operations in Florida, Georgia and North Carolina.
“We believe that we’ll recapture, call it $100 million of that, in 2025,” Marks said. “The real impact here now is just the continued and lingering effects of that storm [Helene], and mostly in our North Carolina market. While volumes have recovered in North Carolina, the payer mix has deteriorated, and we’re having to use a significant amount of premium labor to staff those facilities.”
Companywide, HCA reported net income, or profit, increased to $5.62 billion in the first nine months of the year, up from $4.97 billion in the same period in 2024.
In the quarter ending Sept. 30, revenues rose 9.6 percent. The company reported increases in admissions, inpatient and outpatient surgeries and emergency department visits. Uncompensated care, which includes uninsured and charity care, also went up.
HCA revised its 2025 revenue projections to $75 billion to $76.5 billion. As of July, projected revenue for the year was $74 billion to $76 billion.
The company continued expanding this year, purchasing two hospitals, one in New Hampshire and one in Florida. The total number of beds at HCA facilities increased to 50,577 in 2025, up from 49,890 last year.
The company was still weighing the impact of recent developments, including the passage of the “One Big Beautiful Bill Act” in July that it said is expected to “decrease access to health insurance” and cut Medicaid spending.
But Hazen said HCA is prepared. “We’ve had 18 – 18 – consecutive quarters of volume growth,” he said on the earnings call, “so that gives us a pretty confident foundation that we can continue to navigate through different dynamics within our markets.”
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