HCA will continue to pursue capital projects, mergers and acquisitions in 2023.

HCA Healthcare prioritizes capital expenditures even as difficult economic conditions weigh on its bottom line.

The Nashville, Tennessee-based commercial system estimates 2023 capital expenditures of $4.3 billion, excluding acquisitions, down from nearly $4.4 billion in 2022. Spending was higher than expected last year due to real estate and information. investment in technology, chief financial officer Bill Rutherford said during Friday’s earnings call.

CEO Sam Hazen told investors that HCA will continue to invest in clinical equipment and service line expansion, and will continue to acquire outpatient services. It also plans to channel the capital into infrastructure projects such as expanding the campus and setting up separate emergency departments.

HCA isn’t as optimistic about hospital facilities, Hazen says, as acquisition opportunities are few. Last October, LCMC Health agreed to buy three HCA hospitals in Louisiana for $150 million.

Sistema reported a net income of $2.65 billion in the fourth quarter, up 32% from last year. Operating expenses, excluding any applicable asset changes, rose 3.2% to $12.33 billion, including a 0.8% payroll increase. Revenue rose 2.9% to $15.5 billion.

The fourth quarter results include a profit of $1.33 billion from the sale of properties.

For the full year, net income fell 11.5% to $6.83 billion. Revenue rose 2.5% to $60.23 billion. Operating expenses rose 4.3% to $48.21 billion.

“As we move into 2023 and beyond, we believe that strong demand for healthcare services presents an opportunity for HCA Healthcare in a challenging macro environment. We believe that the company has a good cultural, competitive and financial opportunity to generate profits,” Hazen said. on call.

High labor costs remain a major concern for the healthcare industry. Rutherford said contract work accounted for approximately 8% of HCA’s wages and payroll costs in the fourth quarter. However, those costs are down about 16% year-on-year this quarter. He expects contract labor costs to continue to decline during this year.

Hazen said HCA is working to hire more nurses as full-time employees, bringing in new graduates through academic partnerships and bringing in former traveling nurses.

The company announced that the board of directors has authorized share buybacks of up to $4.5 billion this year, including approximately $1.5 billion that has already been approved. Shares were trading at $248 each when markets opened on Friday, compared to the HCA’s current 52-week high of $275.16 per share.