HCA
#Hey, <UNK>, how long are you going to live here.
The Parallon first ---+ we do not see Parallon as a separate entity and actually reform Parallon.
We really wanted it to be a subsidiary within HCA that we could grow.
And we still have that objective and Parallon is growing.
I mentioned HPG earlier ---+ solid growth in HPG, and I think we will continue to see that as well.
With respect to your first question, around acquisition opportunities, we have the financial flexibility as you know, and access to capital, to do more significant acquisitions.
We are very disciplined in the sort of markets and facilities that we want to invest in.
If is just a matter of owning hospitals, we could do that, but, again, they would not fit our profile or would not fit the long term growth prospects and return prospects that we're looking for.
So we have been very disciplined and we will continue to be disciplined.
That being said, we pretty much at any point in time have a pipeline of meaningful opportunities.
As I said ---+
I was going to say, you've heard me say many times over recent years ---+
Of course, we do a lot of big market acquisitions, but as far as the big ones you're thinking to, things like Kansas City that happened in 2003 ---+ those opportunities are really hard to find and they are going to come up in the not-for-profit sector.
Typically we may engage in conversation, but many times these organizations decide ultimately not to sell.
So we'll continue to be active in looking for the right opportunity.
Again, we're not building any of those into our expectations here in the short term.
But then again, if we find the right one we are prepared to move on it and we've got the balance sheet capabilities to do it, and we will continue to be active in pursuing them.
Again, if the right market present themselves.
<UNK>, thank you very much.
Matt, thank you.
<UNK>, you want to get that.
Matt, thank you.
Historically, and pretty much consistent this year, about 30% of our bad debt is associated with the deductible and co-pay; and 70% coming from the uninsured population.
When I look at our deductible and co-pay and patient liability, really what we have seen throughout 2015, we have seen those average balances grow in that 10% to 11% level, while maybe historically they were growing in 7% to 8%.
So the average balances are growing a little bit.
Our collections are holding.
So our collections per account are holding with what are historical levels.
So it is slightly contributing to some increase in bad debts, but the majority of the bad debt is being driven by uninsured activity that we had.
All right, thanks, <UNK>.
Thanks, Matt.
First, put in perspective that our exchange volume is roughly 2% of the total Company volume.
So the exchange activity by itself is relatively small, going forward on that.
So as we look at the activity within the exchanges, we did mention in the third quarter we were seeing some previous exchange volume moved to uninsured.
It was 400 admissions for HCA in the third quarter.
It was roughly the same in the fourth.
That's on 460,000 admissions for the Company.
So there is some activity in that area, but for HCA it is immaterial for us, and it is contained within the overall aspect of our bad debt, which I've talked about previously.
<UNK>, thanks.
We have time for just a couple more quick ones.
With our increasing capital, <UNK> and I and a lot of our group [presence] spend time out in the field, within our hospitals.
And from that, we see opportunities ---+ opportunities to invest, as <UNK> said, to expand services or to deal with the capacity constraints that would otherwise exist.
And it is a conservative investment strategy versus an acquisition for the reason <UNK> just noted.
To back up to our performance, if you look back two years ago, our return on invested capital was still 14.1%, and that's incredible number to start with.
But based on 12 months ended December 2015, our return invested capital was 15.4%.
So if we're investing more capital in our existing markets, we are seeing our return grow.
And so again, we like the strategy; that's why we expanded it over three years to $7.7 billion, up about $0.5 billion.
And again, it gives us confidence with our guidance to see these opportunities in these fast-growing markets.
All right.
Thanks, <UNK>.
Two more questions.
All right.
Next.
<UNK>, do you want to take that one.
<UNK>, thank you.
Thank all of you and look forward to hearing from you.
Have a great day.
