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To Shareholders of Record on March 2, to Shareholders President — Clinical Compliance Officer 2020

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To Shareholders of Record on March 2, to Shareholders President — Clinical Compliance Officer 2020 investor-report-folder PRINT.pdf 1 2/28/20 4:12 PM One Park Plaza Nashville, Tennessee 37203 www.hcahealthcare.com Directors Thomas F. Frist III Nancy-Ann DeParle Michael W. Michelson Chairman Partner Retired Member HCA Healthcare Consonance Capital KKR Management LLC Partners Managing Principal Wayne J. Riley, M.D., M.B.A. Frist Capital William R. Frist President of SUNY Samuel N. Hazen Principal Downstate Health Sciences Chief Executive Officer Frist Capital University Corporate Information HCA Healthcare Charles O. Holliday, Jr. John W. Rowe, M.D. Chairman (Not standing for re-election) Meg G. Crofton Transfer Agent and Registrar Professor Retired President, Parks Royal Dutch Shell plc EQ Shareowner Services Columbia University, and Resorts Operations P.O. Box 64874 Geoffrey G. Meyers Mailman School of Public The Walt Disney Company St. Paul, Minnesota 55164-0874 (Not standing for re-election) Health Retired Executive VP & CFO Toll free: 800-468-9716 Robert J. Dennis Former Chairman & CEO Executive Chairman Manor Care, Inc. Aetna Certified/Overnight Mail Genesco Inc. EQ Shareowner Services 1110 Centre Pointe Curve, Suite 101 Mendota Heights, Minnesota 55120 Independent Registered Public Accounting Firm C Ernst & Young LLP Nashville, Tennessee M Executive Officers 2019 Y Corporate Headquarters Samuel N. Hazen Charles J. Hall William B. Rutherford One Park Plaza Annual CM Chief Executive Officer President — National Group Executive Vice President Nashville, Tennessee 37203 and Director and Chief Financial Officer MY A. Bruce Moore, Jr. 615-344-9551 CY Jennifer L. Berres President — Service Line Joseph A. Sowell, III Senior Vice President and and Operations Integration Senior Vice President and Form 10-K CMY Chief Human Resource Chief Development Officer The Company has filed an annual report on Form 10-K for the year ended Sandra L. Morgan K Officer December 31, 2019 with the United States Securities and Exchange Commission Senior Vice President — Kathryn A. Torres (SEC). Shareholders may obtain a copy of this report, without charge, by writing: Phillip G. Billington Provider Relations Senior Vice President — Senior Vice President — Payer Contracting and Investor Relations, HCA Healthcare, Inc., One Park Plaza, Nashville, TN 37203 J. William B. Morrow Internal Audit Services Alignment or by visiting the Company’s website at www.hcahealthcare.com. Senior Vice President — Jeff E. Cohen Finance and Treasurer Robert A. Waterman Report Common Stock and Dividend Information Senior Vice President — Senior Vice President and The Common Stock of HCA Healthcare, Inc. is listed on the New York Stock Government Affairs P. Martin Paslick General Counsel Senior Vice President and Exchange (NYSE) under the symbol “HCA”. On March 9, 2020, the Company had Michael S. Cuffe, M.D. Chief Information Officer Kathleen M. Whalen approximately 400 shareholders of record. On January 27, 2020, the Company’s President — Physician Senior Vice President and Board of Directors declared a quarterly dividend of $0.43 per share on our Services Group Jonathan B. Perlin, M.D. Chief Ethics and common stock payable on March 31, 2020 to shareholders of record on March 2, to Shareholders President — Clinical Compliance Officer 2020. Future declarations of quarterly dividends and the establishment of future Jane D. Englebright Services Group and Chief record and payment dates are subject to the final determination of the Senior Vice President and Medical Officer Christopher F. Wyatt Company’s Board of Directors. Chief Nursing Officer Senior Vice President and Deborah M. Reiner Controller Jon M. Foster Senior Vice President — Annual Meeting of Shareholders President — American Marketing and The annual meeting of shareholders will be held on May 1, 2020, at 2:00 pm local Group Communications time at the HCA corporate offices located at One Park Plaza, Nashville, Tennessee 37203. Shareholders of record as of March 9, 2020 are invited to attend. 2019 A letter to our shareholders investor-brochure-concept v6_DC.indd 1 3/16/20 11:23 AM Dear shareholders, HCA Healthcare had another strong advancing strategic relationships with year in 2019 while we transitioned physicians, payers, and vendors to into our new roles of chairman and strengthen our networks and offer CEO. The company’s results, across better services. These characteristics, key performance metrics, reflect both we believe, will allow us to respond the steadfast commitment we have effectively to most industry dynamics to our mission and our disciplined and continue to grow and drive operational culture. Across our meaningful value for our patients and networks we took care of nearly 35 for our shareholders. million patients in 2019—a record level of patient volumes. In the midst of ongoing discussions Across our networks about the United States’ healthcare we took care of nearly industry, HCA Healthcare continues 35 million patients in to enhance its position across the communities we serve. Our 2019–a record level of unmatched scale helps us drive patient volumes. efficiencies; our enterprise capabilities and innovative solutions that come from best practices in our facilities allow us to learn from each other and improve clinical outcomes; and our strong cash flow creates capacity to invest in our people, technology, and facilities. Moreover, we are 1 investor-brochure-concept v6_DC.indd 1 3/16/20 11:23 AM Financial performance— disciplined operational culture There is no silver bullet in healthcare. Details make the difference—in delivering high-quality outcomes and in delivering sustained growth. That is why HCA Healthcare has strong management systems and a focused management team. These attributes allowed us to deliver solid financial results for 2019 that continued the momentum from a similarly strong performance in 2018. Revenues grew 10.0% year over year, to more than $51 billion in 2019. We converted this revenue growth into strong earnings. In addition, cash Revenues grew flows from operations were $7.6 billion. This 10.0% year over growth was driven by strong same-facilities year, to more volume increases across most service categories in both the inpatient and outpatient settings and than $51 billion broadly across our 44 markets. HCA Healthcare in 2019. has now grown its same-facilities inpatient admissions in 23 consecutive quarters. This remarkable consistency reflects positive market forces, a robust growth agenda, significant capital spending, and strong execution by our people. Additionally, our recent acquisitions in Asheville, NC, Savannah, GA, and Houston, Texas, contributed to this growth. These acquired facilities performed well against our expectations. 2 investor-brochure-concept v6_DC.indd 2 3/16/20 11:23 AM We continued to deploy capital in a continued to run at record high balanced and disciplined manner in levels. We are confident that our 2019. We spent $4.2 billion in capital capital spending and performance expenditures. Approximately one- will continue to add value. Our return half of this was for routine capital on invested capital was 16.7% for needs, and the balance was made up the year ending December 31, 2019. of investments needed to support Additionally, we spent $1.7 billion our growth agenda, improve our on the acquisitions of Mission competitive positioning, and add to our Health and other support entities. relevance in the communities we serve. We paid dividends of $550 Most of our growth capital million to our shareholders, and expenditures were for additional we repurchased approximately inpatient and emergency room $1 billion of our own stock. capacity, new outpatient facility development, and service line At year end, our leverage ratio finished enhancements, which included slightly below the low end of our long expanding surgical services capacity term range with our weighted average and adding more clinical technologies interest rate on our debt at 5.2%. for our physicians. HCA Healthcare HCA Healthcare is built to grow, but has approximately $4 billion of we will maintain a disciplined approach previously approved capital in the with any acquisition opportunity. pipeline, and we expect most of these projects will come online within the next 24 months. Fortunately, we continue to see investment opportunities in our existing markets that will help drive organic growth. The occupancy, or asset utilization, of our facilities 3 investor-brochure-concept v6_DC.indd 3 3/16/20 11:23 AM Growing demand for healthcare services We believe the factors that have allowed us to deliver consistent performance over the past few years will continue to present growth opportunities in the future. Overall, the fundamentals in our markets remain strong with growing demand for healthcare services. We operate in 43 domestic markets across 21 states and in the United Kingdom. No market represents more than 10% of the company’s revenues, which creates tremendous geographic diversification for us. Moreover, no service line represents more than 15% of our revenues, which also contributes to our diversification and resilience. We believe our unique portfolio creates a competitive advantage for us and reduces our enterprise risk. Throughout our domestic markets, which make up approximately 98% of the company’s We believe our revenues, we continued to see positive competitive economic indicators and population growth positioning across above national averages. Both of these trends are creating demand. Additionally, with the our markets is aging of the population plus the growing stronger than it number of people who struggle with chronic ever has been as a conditions, we expect more healthcare services will be needed in the future. Across result of sustained our markets, we believe overall demand for improvements in healthcare services will grow in the 1.5%-2.5% quality outcomes, range annually over the next few years. advancements in nursing performance, and increases in capital spending. 4 investor-brochure-concept v6_DC.indd 4 3/16/20 11:23 AM To capitalize on this increasing demand, we approach each market with a general operating model, which we slightly nuance and tailor to meet local market dynamics.
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