VITALS
Coping strategies How three big names from Nashville’s health care ecosystem tackled the COVID crisis BY KARA HARTNETT
s our cover story illustrates, companies responded to the shock of COVID-19 with a wide range of strategies. Those whose shares are traded on stock exchanges have had to do so in much more public ways. Here are overviews of how three publicly traded companies from different parts of Middle Tennessee’s wide health care landscape responded to the shock of COVID-19 — starting with the biggest fish in the sea.
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HCA Healthcare The pandemic struck HCA Healthcare at one of the most profitable times in the company’s history. And while that provided a solid financial base for the Nashville-based hospital giant as it prepped for an unprecedented global pandemic, executives say they may now have to reimagine their growth strategies. “We were outperforming our internal expectations and off to what we believed was going to be a great 2020 — and that was after a really strong 2019,” HCA CEO Sam Hazen told attendees of an RBC Capital Markets conference in May. “We turned the calendar with a lot of momentum.” By the end of March, that momentum was gone with lucrative elective procedures suspended and many hospitals preparing for a wave of patients some feared would test their limits. HCA executives lined up $2 billion in financing and — a week later — started cutting salaries across its workforce to preserve
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cash as revenues fell. Though no employees were fully furloughed, a number of departments saw across-the-board pay cuts and clinicians whose procedures were suspended or canceled were either reassigned or paid only 70 percent of their salary. In addition, contract workers were cut from payrolls and overtime pay was limited. Those moves helped lead to several run-ins with nurses unions, members of which complained about shortages of protective gear and said HCA was seeking to delay scheduled pay raises or threatened layoffs. Executives adopted a similar strategy for corporate employees in early April, ordering a 10 percent cut in salaries in order to retain every job while shielding providers from salary cuts through the brunt of the pandemic. At the same time, HCA was partnering with Google to develop a COVID-19 data repository to help communities and researchers
understand how the virus was spreading and affecting hospitals across the country. HCA’s 185-facility network — which already tracks more than 35 million patient encounters annually — and 4,000 other hospitals across the country now submit data to the platform daily, updating metrics such as bed utilization, ventilator supply and syndromic trends. HCA was one of few hospital operators that could say it wasn’t facing potential supply shortages in April, although executives did put in place conservation protocols to help build up stores. When the American Hospital Association developed a public-private partnership to address the severe lack of ventilators on the federal level, Hazen was able to take part in a White House briefing to say HCA could contribute 1,000 of its ventilators without putting any of its hospitals at a disadvantage. To date, HCA has received nearly $1 billion in federal coronavirus aid — the largest pay-
