How AI Is Already Playing A Role At The Country’s Largest For-Profit Hospital Chain

The country’s largest for-profit hospital system, HCA Healthcare, is moving quickly to integrate artificial intelligence across its clinical, operational and administrative functions.

Speaking at the 2025 UBS Global Healthcare Conference, HCA Executive Vice President and CFO Michael Marks outlined the system’s progress.

“While the organization is still in the early innings, it is focused on investments that generate clear clinical or financial value,” said Mark.

Clinical AI: Slow but Significant Progress

Marks said clinical applications remain the most complex due to patient-safety risks, which lengthens rollout timelines. Even so, HCA has several major initiatives underway.

One of the most prominent is a partnership with Google aimed at improving the nearly 400,000 weekly nursing shift handoffs across the system. AI is being used to summarize medical and operational information so incoming nurses can receive faster, more consistent patient reports—an area he called “one of the riskier points of care.” The tool is currently live in eight hospitals, with broader deployment expected next year.

HCA is also working with GE Healthcare on an algorithm that analyzes portions of fetal heart monitoring strips. That tool is now under review by the FDA.

Operational AI: Potential with Challenges

On the operations front, nearly 100 hospitals have adopted an AI-driven scheduling and staffing platform for nurses. Marks said the initiative has strong potential but has underscored the difficulty of changing day-to-day behaviors in clinical settings. Effective implementation and change management, he said, are proving to be just as important as the technology itself.

Administrative AI: Fastest Return on Investment

HCA is seeing the quickest payoff in administrative areas such as IT, supply chain, HR, revenue cycle, and physician practice management. High transaction volumes and standardized data make these processes well-suited to automation, Marks said, adding that AI is streamlining workflows and boosting efficiency. Overall, Marks said he is “really encouraged” and expects digital transformation to remain a core strategic priority for HCA.

HCA Still Hoping for Last-Minute ACA Subsidy Extension

HCA recently raised its 2025 guidance after beating expectations in the third quarter, with revenue up 9.6% and net income up 29% year over year. Marks reiterated comments from the company’s earnings call, noting that projected 2026 volume growth of 2%–3% will depend largely on whether enhanced ACA marketplace subsidies are extended.

He voiced optimism that bipartisan awareness of the issue could lead to a deal but also emphasized that HCA has spent the past year preparing for either outcome through resiliency planning and digital transformation.

Marks also discussed other policy considerations:

• Rural Hospital Transformation Program: About 15% of HCA hospitals qualify, representing what Marks described as a modest potential benefit.
• Supplemental Medicaid Payments: Federal decisions on pending applications from Florida, Georgia, and Virginia—along with approvals already granted for Kansas and Texas—remain “material” for HCA. These payments could help offset challenges if ACA subsidies lapse and support long-term Medicaid reforms under the recent “One Big Beautiful Bill.”

While Marks did not provide a financial estimate, UBS Managing Director A.J. Rice suggested the combined potential impact could be about $700 million in EBITDA tailwind.

Source: Fierce Healthcare