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* Q4 EPS 92 cents ex legal costs tops view 82 cents
* Admissions to hospitals owned at least a year up 4.3 pct
* Emergency room visits jump 12.7 percent
* Sees impact of health reform phasing in over several years
* Shares climb almost 4 percent before turning lower
By Susan Kelly
Feb 5 (Reuters) - HCA Holdings Inc, the largest U.S. for-profit hospital operator, on Tuesday reported lower quarterly net earnings due to costs to settle legal claims, but revenues were boosted as more patients sought treatment during a severe flu season.
An early and unusually intense flu season has pushed up business for hospitals, pharmacies and their suppliers, but is putting a dent in insurers' profits. Health insurer Humana Inc on Monday reported higher costs for flu-related hospital visits, calling it the worst flu season in a decade.
HCA reported fourth-quarter earnings excluding special items that exceeded expectations on surprisingly strong patient volume, with emergency room visits jumping 12.7 percent in part due to people seeking treatment for the flu.
But HCA gave a forecast for 2013 that was below Wall Street views, news that overshadowed the fourth-quarter results and caused the company's shares to reverse early gains of almost 4 percent.
The shares had rallied 24 percent since the start of the year on anticipation that hospitals would soon see an influx of patients under health reform.
"The stock really is a reform trade right now more than anything else," said Jefferies & Co analyst Brian Tanquilut.
HCA Chief Executive Richard Bracken, on a conference call with analysts, said the expected ramp-up in patients enrolling in health insurance programs under the reform legislation could take three to four years.
How many people ultimately obtain health coverage will depend on variables such as which states expand their Medicaid programs for the poor, how many employers drop private coverage for employees, and what reimbursement levels will be for providers of insurance-exchange products.
HCA said it expects 2013 earnings, excluding items, in a range of $3.00 to $3.30 per share, on revenue of $33.5 billion to $34.5 billion.
Analysts on average were expecting full-year earnings of $3.46 per share, on revenue of $37.52 billion, according to Thomson Reuters I/B/E/S.
Fourth-quarter net income fell to $314 million, or 68 cents per share, from $1.94 billion, or $4.25 a share, a year earlier, when results included one-time gains from facilities sales and an investment.
Excluding legal expenses in the latest quarter, Nashville, Tennessee-based HCA reported earnings of 92 cents per share.
Analysts, on average, expected 82 cents per share, according to Thomson Reuters I/B/E/S.
Adjusted earnings before interest, taxes, depreciation and amortization fell 2 percent to $1.61 billion.
Revenue increased 8.5 percent to $8.43 billion in the quarter.
Admissions to hospitals operated at least one year rose 4.3 percent. Admissions to facilities operated for at least a year, combined with outpatient volumes, increased 5 percent.
Shares of were down less than 1 percent at $37.44.