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  "documentTitle": "McKinsey Forecasting HCA Healthcare EBITDA Growth",
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  "notes": "The chart shows quarterly percent change in man-hours/AA from prior year. The callout box synthesizes the volatility into a flat forward-looking projection.",
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      "text": "No clear historical trend. 40% of costs are fixed; productivity logically should grow with volume. However, in the last 4 years productivity has declined an average of 0.9% annually despite volume growth of 1.8%.",
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      "text": "Source: Henry internal data, team analysis",
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      "text": "Average change during period: 0.9 and -0.4",
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      "kind": "title",
      "text": "HISTORICAL PERFORMANCE AND CONTINUED REGULATORY BURDEN POINT TO FLAT PRODUCTIVITY GOING FORWARD",
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