# HCA Healthcare **HCA Healthcare** is the largest hospital system in the United States by net patient revenue and by number of beds — the dominant operator of the [[For-Profit Hospital]] model and the anchor of the [[Healthcare Industry Ecosystem]]. ## Scale As of late 2025, HCA operated roughly **190 hospitals** plus approximately 2,500 ambulatory sites of care across the U.S. and the U.K. It reported about **$71 billion in revenue for 2024**, making it not just the largest for-profit chain but the largest health system in the country by most financial metrics. It is publicly traded (NYSE: HCA) and answerable to shareholders. ## History Founded in **1968** in Nashville by physician Thomas Frist Sr., his son Thomas Frist Jr., and businessman Jack Massey, HCA pioneered the investor-owned hospital model. (Thomas Frist Jr. is the father of former Senate Majority Leader Bill Frist.) The company went through multiple leveraged transactions over the decades, including a **2006 leveraged buyout** — at the time one of the largest in history — by a consortium including [[Bain Capital]], KKR, and Merrill Lynch, before returning to the public markets in 2011. That LBO history makes HCA a useful illustration of how [[Private Equity]]-style financial engineering operated inside the hospital sector well before the current PE-rollup wave. ## Why It Matters Here HCA is the reference point against which the rest of the for-profit field is measured. Its scale gives it enormous leverage over commercial insurer reimbursement rates and regional markets, and its profitability is the proof-of-concept that drives [[Hospital Consolidation]]. Critics point to its service-line economics — emphasis on profitable procedures, scrutiny over staffing and emergency-room practices — as the for-profit template. See [[Healthcare Industry Ecosystem]] for the full ownership map.