HCA Holdings 2012 Annual Report Download - page 66

HCA HOLDINGS, INC.
MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATIONS
Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The selected financial data and the accompanying consolidated financial statements present certain
information with respect to the financial position, results of operations and cash flows of HCA Holdings, Inc.
which should be read in conjunction with the following discussion and analysis. The terms “HCA,” “Company,”
“we,” “our,” or “us,” as used herein, refer HCA Inc. and our affiliates prior to the Corporate Reorganization and
to HCA Holdings, Inc. and our affiliates after the Corporate Reorganization unless otherwise stated or indicated
by context. The term “affiliates” means direct and indirect subsidiaries of HCA Holdings, Inc. and partnerships
and joint ventures in which such subsidiaries are partners.
Forward-Looking Statements
This annual report on Form 10-K includes certain disclosures which contain “forward-looking statements.”
Forward-looking statements include statements regarding estimated EHR incentive income and related EHR
operating expenses, expected capital expenditures and expected net claim payments and all other statements that
do not relate solely to historical or current facts, and can be identified by the use of words like “may,” “believe,”
“will,” “expect,” “project,” “estimate,” “anticipate,” “plan,” “initiative” or “continue.” These forward-looking
statements are based on our current plans and expectations and are subject to a number of known and unknown
uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and
expectations and our future financial position and results of operations. These factors include, but are not limited
to, (1) the impact of our substantial indebtedness and the ability to refinance such indebtedness on acceptable
terms, (2) the effects related to the enactment and implementation of the Patient Protection and Affordable Care
Act, as amended by the Health Care and Education Reconciliation Act (collectively, the “Health Reform Law”),
the possible enactment of additional federal or state health care reforms and possible changes to the Health
Reform Law and other federal, state or local laws or regulations affecting the health care industry, (3) the effects
related to the enactment and implementation of the Budget Control Act of 2011 (the “BCA”) and the outcome of
negotiations and legislation related to BCA-mandated spending reductions, which include cuts to Medicare
payments, (4) increases in the amount and risk of collectibility of uninsured accounts and deductibles and
copayment amounts for insured accounts, (5) the ability to achieve operating and financial targets, and attain
expected levels of patient volumes and control the costs of providing services, (6) possible changes in the
Medicare, Medicaid and other state programs, including Medicaid upper payment limit (“UPL”) programs or
Waiver Programs, that may impact reimbursements to health care providers and insurers, (7) the highly
competitive nature of the health care business, (8) changes in service mix, revenue mix and surgical volumes,
including potential declines in the population covered under managed care agreements, the ability to enter into
and renew managed care provider agreements on acceptable terms and the impact of consumer driven health
plans and physician utilization trends and practices, (9) the efforts of insurers, health care providers and others to
contain health care costs, (10) the outcome of our continuing efforts to monitor, maintain and comply with
appropriate laws, regulations, policies and procedures, (11) increases in wages and the ability to attract and retain
qualified management and personnel, including affiliated physicians, nurses and medical and technical support
personnel, (12) the availability and terms of capital to fund the expansion of our business and improvements to
our existing facilities, (13) changes in accounting practices, (14) changes in general economic conditions
nationally and regionally in our markets, (15) future divestitures which may result in charges and possible
impairments of long-lived assets, (16) changes in business strategy or development plans, (17) delays in
receiving payments for services provided, (18) the outcome of pending and any future tax audits, appeals and
litigation associated with our tax positions, (19) potential adverse impact of known and unknown government
investigations, litigation and other claims that may be made against us, (20) our ongoing ability to demonstrate
meaningful use of certified electronic health record technology and recognize income for the related Medicare or
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