Among the first hospital companies to become international, HCA opens a London office and hires health care exec Ron Marston to establish HCA International. This organization would go on to become an independent entity in 1989 and be named HCCA Management Company. Marston remains CEO today.

Shortly after opening the London office, HCA launches an initiative to expand its reach into Australia, investing $45 million for hospital acquisition and building. By year’s end, HCA operates 10 facilities in Australia.

Today, the Frists are opening hospitals across China, through the China Healthcare Corp. (CHC). Though not officially affiliated with HCA, the company is operated by Dr. Thomas Frist Jr.’s son-in-law, Charles Elcan.