Hospital Corporation of America

Hospital Corporation of America (HCA)

Staff Analysis

Statement of Problem

HCA, after following a conservative financial policy since its establishment, has entered the new decade preparing to make some changes in order to realign their financial strategy and capital structure. Since establishment, HCA has often been used as a measure for the entire proprietary hospital industry. Is it now time for the market to realign their expectations for the industry as a whole? HCA has target goals which need to be met in order to accomplish milestones in the future. The problem arises as to which area holds priority to the company. HCA must decide how the key components of their financial strategy and policy should my approached in order to meet their future goals.

Background

HCA has set target goals in several areas and it is important to identify which goals hold priority: Debt Ratio, Growth Rate, ROE, and Bond Rating.

Debt Ratio:

Currently, HCA is approaching an all time high debt ratio of 70%, well above their established target ratio of 60%. The increase in debt ratio has attracted the attention of rating agencies who have clearly stated that in order for HCA to maintain their A bond rating HCA must return to their 60-40 capital structure. Now the question arises as to whether the A rating should be sought or should HCA move to a less conservative position. Some investors believe that a more aggressive use of leverage would present greater opportunities in the future. Others feel that with changes in Medicare/Medicaid reimbursement structure on the horizon, HCA should remain conservative. In order to decrease the debt ratio, HCA would have to 1) decrease the growth rate (inadvertently decreasing ROE) or 2) decrease debt/increase equity. The debt ratio is important for many reasons, but it should not be the basis of a company’s future. The market will ultimately decide the value based on numerous facts, not just the bond rating.

Growth Rate:

HCA would like to see the annual growth rate in the 25-30% range, although they have also set a minimum of 13%. This would signal aggressive action in the company and with this growth rate HCA would experience a dramatic increase in ROE as well as leverage. Why would HCA want to take on a debt ratio of 86% (See Case Exhibit 1)? Vice President Bill McInnes believes that in order for HCA to compete with other management companies in the industry they must continue acquisitions. An increasing growth rate does appeal to the investors, but is it necessary to take on this kind of risk when uncertainties lie in the future. More importantly, there is evidence that increasing growth