HCA Inc.’s third-quarter earnings rose 24% as the hospital operator reported higher revenue per admission and severity of cases amid roughly flat same-facility volume and an increase in uninsured patients.

The largest U.S. for-profit hospital chain also unveiled plans to offer nearly $1.53 billion in junk bonds to help pay a dividend to its private-equity owners ahead of a planned initial public offering. The senior unsecured notes mature in 2021.

HCA was taken private in a 2006 leveraged buyout and filed IPO plans earlier this year, projecting the sale of up to an estimated $4.6 billion of stock.

Chairman and Chief Executive Richard Bracken said during a conference call that the company will assess the timing of the IPO “based on overall market conditions, sector performance and input from our underwriters.”

Hospital operators have been experiencing soft admissions linked to the economic downturn and lower newborn deliveries, as well as high numbers of uninsured and underinsured patients whose care is uncompensated. HCA’s same-hospital admissions were roughly flat in the third quarter, although the company fared better than some publicly traded peers in inpatient volume.

“Despite the ongoing challenges in our economy and a difficult employment environment, we are reporting a very solid performance for our third quarter,” Bracken said.

Meanwhile, Moody’s Investors Service changed its outlook on HCA to positive, in spite of the addition of debt.

“HCA has been able to offset industry pressures, such as increasing bad-debt expense and weak volumes, and realize solid earnings growth,” said Dean Diaz, Moody’s senior credit officer.

HCA’s significant scale and market presence should continue to help diversify risks, and further focus on cost containment should improve performance and help position the company to benefit from a broad economic recovery, Moody’s said.

In the third quarter, HCA’s profit rose to $243 million from $196 million. Revenue increased 1.5% to $7.6 billion.

On a same-facility basis, admissions and outpatient visits combined rose 0.7%, while admissions declined 0.6%; revenue per admission adjusted to include outpatient visits increased 0.8%. Inpatient and outpatient surgery cases both declined, while emergency room visits increased. HCA also reported that higher patient acuity, or severity and costliness of cases, helped to boost revenue.

The provision for doubtful accounts, reflecting patients unlikely to pay their hospital bills, combined with charity care and discounts for the uninsured increased to 26.4% of revenue from 24.9% a year earlier. Admissions of uninsured patients increased 3.9% on a same-hospital basis and comprised 7.4% of total admissions.

Cash flow from operations grew 21% year over year to $1.26 billion.

HCA, which operates 163 hospitals and 105 freestanding surgery centers in 20 states and in England, plans to distribute $2 billion to its owners in the fourth quarter using the company’s existing senior secured revolving credit facilities and the new debt.

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