Tuesday 29 May 2018 by FIIG Research Company updates

New USD investment grade DirectBond from HCA

HCA is a world class private healthcare operator, the largest for-profit hospital operator in the US by revenue


HCA Inc. (HCA) headquartered in Nashville, Tennessee, is the largest for-profit hospital operator in the US (by revenues) and a leading comprehensive, integrated provider of health care and related services.

HCA currently operates 179 hospitals with 47,000 and 120 freestanding surgery centres. Almost 50 per cent of its hospitals are located in Texas and Florida, but HCA operates across 20 US states and in the United Kingdom.

It is expected that HCA will generate net revenue of approximately USD45bn over the next 12 months.

We have recently added the HCA 5.25% April 2025 first lien notes to the DirectBond list. These are rated BBB-/Ba1/BB+ by S&P/Moody’s/Fitch.

Issuer Type Structure Maturity date  Rate  Payment frequency Yield to worst* Minimum investment amount 
HCA Inc. Fixed 1st Lien 15 April 2025  5.25% Semi annually on 15 April and 15 October each year 4.90%pa  USD10,000 
*Yield to worst accurate as of 29 May 2018, subject to change

Note this bond has a call provision; please see the Factsheet for more details.

HCA is made up of locally managed facilities, including psychiatric facilities, a rehabilitation hospital, as well as ambulatory surgery centres and cancer treatment and outpatient rehab centres. HCA has been an active consolidator in the industry, acquiring General Health Services, Columbia Healthcare, Hospital Affiliates, and Healthcare Corp, among others. In rationalising its offering of services and market focus, HCA has sold or spun-off hospital groups such as LifePoint, Triad, and HealthTrust.

HCA aims to increase its presence in key markets through organic expansion, strategic acquisitions and joint ventures, leveraging its scale and infrastructure, and further developing its physician and employee relationships.    

HCA history

The company listed on the New York Stock Exchange in 1969 then grew substantially over the next two decades. In 1994, its merger with Columbia Healthcare was the largest HCA has ever been with more than 350 hospitals and 145 ambulatory surgery centres.

In 2006, the company became privately held again following a USD33.6bn acquisition by Kohlberg Kravis Roberts and Bain Capital, together with Merrill Lynch and the founding Frist family. At the time of its announcement, the HCA buyout was the first of several to set new records for the largest, eclipsing the 1989 buyout of RJR Nabisco.

In November 2010, HCA reorganised its company structure to which HCA Holdings, Inc. became the parent company of HCA. The former became a guarantor but did not assume the debt of HCA’s outstanding secured notes and is not subject to the covenants contained in the indentures governing such secured notes.

In March 2011, HCA sold 126.2 million shares raising about USD3.79bn to become the largest private equity backed IPO in US history.

To learn more, please see the HCA April 2025 Factsheet

Also, see the HCA website, Investor Relations page for more information