What drove HCA's operating expenses surge in 2023?

HCA's operating expenses surged in 2023 primarily due to an increase in staffing costs, which were influenced by several factors: 1. **Staffing Costs**: The most significant contributor to the operating expense surge was the rise in salaries and benefits, which increased by 9.5% year-on-year to $7.56 billion. This rise was primarily driven by higher physician expenses, which are a critical component of staffing costs. 2. **Valesco Joint Venture**: The performance of HCA's joint venture with Envision Healthcare, Valesco, also impacted overall expenses. Although the specifics of the impact were not clearly detailed, the joint venture's challenges contributed to the overall increase in operating expenses. In summary, HCA's operating expenses surged in 2023 due to increased staffing costs, particularly in physician salaries and benefits, and the challenges faced by its joint venture, Valesco.