HCA CFO: Medium-Term Network Goal is 20 Outpatient Sites Per Hospital
What does the ideal hospital network for the 2030s look like? To the leaders of HCA Healthcare Inc., it’ll be roughly 40% more expansive than today’s when it comes to outpatient facilities.
That’s the target CFO Mike Marks put forth at two recent conferences hosted by Wolfe Research and Stephens Inc. Speaking to attendees about the Nashville-based hospital giant’s capital spending, Marks said the company’s typical hospital—today, it operates 191 in 20 states and the United Kingdom (see the map below)—in the relatively recent past had roughly 10 outpatient facilities feeding into it. Today, that figure stands at about 14.
“Between now and […] the end of the decade, into the next decade, we will probably be at 20-to-1,” Marks said Nov. 20 at the Stephens gathering in HCA’s hometown. “So the reach of the company—and adding things like urgent care centers and freestanding emergency rooms and surgery centers and physician clinics to continue to deal with the growth that we see in our marketplaces—is good.”
HCA runs more than 2,500 ambulatory sites of care, which is up about 200 over the past two years. A sizable chunk of the company’s annual capital spending—which will be about $5 billion this year—goes to growing that number and Marks said teams across the country are identifying plenty of opportunities that will get HCA to that 20-to-1 ratio over time. Hitting that mark based on about 190 hospitals means building roughly 1,300 new sites over the next five years or so.
“The pipeline of project requests that we continue to get from our hospital operating teams is really good. So I think we have a good runway,” he said. “We have markets that are growing, which allows us to continue to invest and strengthen those networks.”
For Marks and other HCA executives, those outpatient networks in turn drive volume growth across HCA’s systems from California to New Hampshire, with Texas and Florida being the states where the company does the most business. Through the first nine months of this year, the company’s equivalent admissions rose 2.9 percent from 2024 to nearly 3.1 million.
HCA isn’t the only big publicly traded hospital company investing consistently in growth: Tenet Healthcare Corp. CEO Saum Sutaria recently told investors his team had boosted its 2025 capex range by $150 million to between $875 million and $975 million. Dallas-based Tenet, which runs about 50 hospitals as well as the larger United Surgical Partners International network, is focusing more of its spending on growing high-acuity services such as cardiac care and catheterization laboratories.
About the Author
Geert De Lombaerde
A native of Belgium, Geert De Lombaerde has more than two decades of business journalism experience and writes about markets and economic trends for Endeavor Business Media publications Healthcare Innovation, IndustryWeek, FleetOwner, Oil & Gas Journal and T&D World. With a degree in journalism from the University of Missouri, he began his reporting career at the Business Courier in Cincinnati and later was managing editor and editor of the Nashville Business Journal. Most recently, he oversaw the online and print products of the Nashville Post for more than a decade and reported primarily on Middle Tennessee’s finance sector as well as many of its publicly traded companies.