HCA Healthcare Expands AI Initiatives Across Clinical, Operational, and Administrative Areas

HCA Healthcare is expanding the use of artificial intelligence across its hospital network, according to Executive Vice President and Chief Financial Officer Michael Marks. Speaking at the 2025 UBS Global Healthcare Conference, Marks outlined the company’s progress in deploying AI tools for clinical, operational, and administrative functions within its 191 hospitals.

Marks said clinical applications of AI are advancing more slowly due to patient safety risks. Nonetheless, HCA is running multiple projects designed to improve clinical quality and patient safety. Among them is a collaboration with Google aimed at enhancing approximately 400,000 weekly nurse shift handoffs across the health system. 

The initiative uses AI to compile and summarize patient and operational records to assist nurses during patient transfers. The program is currently active in eight hospitals, with expansion expected next year.

Another clinical project under development involves an AI algorithm created with GE Healthcare to analyze portions of fetal heart monitoring strips for the labor and delivery service line. Marks said the algorithm has been submitted to the U.S. Food and Drug Administration for review and approval.

Operationally, HCA has implemented an AI-based staffing and scheduling system for nurses in nearly 100 hospitals. Marks described the rollout as ongoing and noted that it has presented challenges related to implementation. He said the company has learned that introducing new AI systems requires as much focus on adoption and management as on technical development.

The administrative domain, which includes IT, supply chain, human resources, revenue cycle, and physician practice management, has shown the quickest measurable benefits, according to Marks. He said the high volume of transactions and standardized data structures across these departments create numerous opportunities to integrate AI for efficiency gains. Marks said digital transformation will remain a key strategic initiative for the foreseeable future.

The company’s broader financial outlook was also addressed during the conference. HCA recently raised its 2025 guidance following a third-quarter performance that exceeded analyst expectations. The company reported a 9.6% increase in revenue and a 29% rise in net income attributable to shareholders, with same-facility admissions up 2.1% year over year.

Looking to 2026, Marks projected overall volume growth between 2% and 3%, depending on whether enhanced Affordable Care Act premiums are extended or expire. He said HCA is actively advocating for an extension but has also been preparing for either scenario through digital and operational planning efforts.

Marks also discussed policy-related developments that could influence the company’s financial performance. These include the federal government’s $50 billion Rural Hospital Transformation Program, which could provide moderate benefits to the 15% of HCA hospitals classified as rural, and supplemental Medicaid payments awaiting approval in several states. He noted that Kansas and Texas have already received approvals, while Florida, Georgia, and Virginia are pending.

“These are helpful things that I think will, if we can get them approved by [the Centers for Medicare & Medicaid Services], help us navigate both the [ACA marketplace subsidy] environment should those expire, and then, over the longer-term view, help us navigate the reform to Medicaid,” Marks said.

Marks declined to quantify the potential benefit from the pending Medicaid applications, though UBS Managing Director A.J. Rice said his group’s projection suggested “in aggregate about $700 million of potential EBITDA tailwind.”