SUPPORTING STATEMENT: In June 2022, the White House released a report examining the state of maternal health across the country. The report, based on examination of trends in pregnancy and childbirth complications, concluded that the nation faces “a maternal health crisis”:



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The United States ranks last among developed countries in maternal health care.



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A Blue Cross Blue Shield study of current trends related to serious complications during labor and delivery (known as “maternal morbidity”) showed rates increased for all women between the years 2018-2020.



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Black mothers are twice as likely to experience SMM as white mothers. Black mothers are also more than twice as likely to die in childbirth than white mothers.



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A study based on New York City hospital data found wide disparities in maternal morbidity between races. Women who experience a SMM event are far more likely to be readmitted to a hospital during the postpartum period than women who do not experience one.

HCA is one of the nation’s largest providers of healthcare services with 182 hospitals and approximately 2,300 ambulatory sites of care that include freestanding ERs, urgent care centers, and physician clinics, serving 20 states. More than 218,000 babies are delivered annually at network hospitals in 20 US states. HCA operates more than 100 hospitals in three states-Tennessee, Texas, and Florida-each one facing major challenges with women’s health and inequities in pregnancy-related outcomes.1

Increasingly, state Medicaid programs are experimenting with value-based care arrangements to incentivize efficient care with respect to pregnancy and postpartum care. These include “pay for performance” and bundled payments which would financially penalize hospitals with poor maternal morbidity outcomes.

The HCA 2023 Annual Impact Report highlights eleven HCA hospitals included on the influential Leapfrog Group’s list of Best Hospitals for Maternity Care. Investors applaud this achievement. We believe that by building on successful hospital and physician best-practices and programs like those in operation at the eleven hospitals saluted by Leapfrog, and by regularly reporting to shareholders about HCA’s progress in reducing maternal morbidities and eliminating racially and ethnically disparate pregnancy-related outcomes, our company can best serve its investors’ long-term goals.

Filed by John White.