HCA Healthcare Corp. | STOCKHOLDER PROPOSAL REGARDING REPORT ON ACQUISITION STRATEGY at HCA Healthcare Corp.

Status
Filed
AGM date
Previous AGM date
Proposal number
8
Resolution details
Company ticker
HCA
Lead filer
Individual
Resolution ask
Report on or disclose
ESG theme
  • Social
ESG sub-theme
  • Public health
Type of vote
Shareholder proposal
Filer type
Shareholder
Company sector
Health Care
Company HQ country
United States
Resolved clause
HCA Healthcare, Inc. (“HCA”) shareholders request that its Board of Directors publish a report within one year of the
upcoming annual meeting (at reasonable expense and omitting proprietary and personally protected information) describing the healthcare
consequences of its acquisition strategy and the impact its hospital acquisitions within the last 10 years have had on impacted
communities. The report should include information related to (i) the number of physician departures post-acquisition; (ii) a comparison of
pre and post-acquisition patient satisfaction ratings; (iii) a comparison of the number of staff per occupied beds pre and post-acquisition;
and (iv) an overview of the impacted community’s perception of the acquisition.
Supporting statement
Studies illustrate that hospital acquisitions can have a significant impact on the patients served by such hospitals, especially in rural
areas with lower incomes and high poverty rates.1 HCA’s latest Form 10-K states that “a component of [HCA’s] business strategy is
acquiring hospitals and other health care businesses.” HCA has spent a significant amount of money acquiring hospitals in various states,
and shareholders are interested in understanding the healthcare consequences of such activities in the communities impacted by these
acquisitions.
HCA’s acquisition of Mission Health (“Mission”) in 2019 illustrates the potentially harmful impact such acquisitions can have on
impacted communities. After HCA acquired Mission, over 200 physicians2 left the hospital. In addition, almost immediately after the
Mission acquisition, HCA allegedly raised prices by 10%, started charging patients surprise fees3 and reduced the number of staff per
occupied bed from 6 full time equivalents pre-sale to 3.7 after the sale (average across North Carolina is 5.1).4 Patient satisfaction ratings
declined precipitously from 4’s and 5’s pre-sale to 1’s and 2’s in 2023, and there were significant staff reductions and/or departures in
services such as chaplaincy, pharmacy, rehabilitation, sterile processing, laboratory, and environmental services.5 Lastly, nursing
shortages at Mission coincided with an Immediate Jeopardy citation based on nine cases, including four deaths, and an Emergency
Medical Treatment and Labor Act violation in February 2024.6 Prior to HCA’s acquisition, Mission was the only health system designated as one of the nation’s Top 15 Health Systems in six of
seven years by IBM/Watson Health (2012-2015; 2017-2018). Since 2019, Mission has experienced a steep decline in the quality of care
and patient experience,7 regulatory censure, lawsuits from the North Carolina Attorney General and community opposition.8
There is robust evidence that hospital acquisitions can cause an array of problems, including higher prices, worse health outcomes,
shutdowns and reduced access.9
Understanding the impact of HCA’s acquisitions on healthcare outcomes is important for shareholders, and it is imperative that HCA
consider how its actions potentially contribute to the healthcare crisis impacting our society. For these reasons, I urge you to vote FOR this
proposal.

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