HCA Healthcare estimates ~$400M Q3 2026 pretax hit
An estimated $400 million pretax impact from uninsured volume accompanies HCA’s expectation for full-year results in the upper half of prior guidance.
Sentiment and the balance of points
Rhea-AI Sentiment reads the wording of the document, how positive or negative its language is on a 1 to 5 scale. The balance of points shown with the takes weighs what the document actually discloses, so the two can disagree, for example when a trial that missed its main goal is described in upbeat language.
Rhea-AI Filing Summary
HCA Healthcare, Inc. reported third-quarter 2026 revenue of $19.849 billion, up 3.6% year over year, while net income attributable to HCA declined 3.9% to $1.579 billion. Diluted EPS was $7.27, up 4.5%, and Adjusted EBITDA was $3.918 billion, up 1.2%. Operating cash flow was $4.461 billion, compared with $4.416 billion a year earlier. Same-facility equivalent admissions increased 3.0%, while same-facility inpatient and outpatient surgeries declined 1.4% and 3.7%, respectively.
HCA estimated that increased uninsured patient volume, primarily among patients who lost health-exchange coverage, had an unfavorable impact of approximately $400 million on third-quarter income before income taxes. The company now believes full-year operating results will be in the upper half of its previously issued 2026 guidance ranges, which include revenue of $77.0 billion to $79.5 billion and Adjusted EBITDA of $15.4 billion to $16.1 billion. During the quarter, HCA repurchased 7.230 million shares for $2.970 billion. Its board declared a quarterly dividend of $0.78 per share, payable December 29, 2026, to stockholders of record December 15, 2026.
How this balance works
Rhea-AI gives every point it takes from this document a weight. Minor counts 1, Moderate 3 and Major 9, so one Major point outweighs several Minor ones. The bar adds up the weights on each side, and when neither side holds more than 65% of the total the balance reads Mixed.
It reads the document as published, with the same rules for every company, and it does not look at what the market expected or at how the stock traded, so a point can be objectively good on a day the stock falls.
Rhea-AI Sentiment measures something else, the tone of the wording.
Positive
- None.
Negative
- Moderate pointUninsured-volume shift: approximately $400 million estimated third-quarter pretax income impact.
Filing Explained
As of
8-K Event Classification
Key Figures
Key Terms
Adjusted EBITDA financial
same facility equivalent admissions financial
payer mix financial
Medicaid Supplemental Payment Programs regulatory
Earnings Snapshot
HCA now believes full-year operating results will be in the upper half of its previously issued 2026 estimated guidance ranges.
FAQ
AI-generated questions and answers. How Rhea-AI works. Not financial advice.
What were HCA’s third-quarter 2026 revenue and net income?
How did uninsured patient volume affect HCA’s third-quarter results?
What is HCA’s full-year 2026 outlook?
When will HCA pay its quarterly dividend?
AI-generated analysis. How Rhea-AI works. Not financial advice.
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 8-K
CURRENT REPORT
Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934
Date of Report (Date of earliest event reported): |
(Exact name of Registrant as Specified in Its Charter)
(State or Other Jurisdiction |
(Commission File Number) |
(IRS Employer |
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(Address of Principal Executive Offices) |
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Registrant’s Telephone Number, Including Area Code: |
(Former Name or Former Address, if Changed Since Last Report)
Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:
Securities registered pursuant to Section 12(b) of the Act:
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Trading |
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Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Item 2.02. Results of Operations and Financial Condition.
On October 27, 2026, HCA Healthcare, Inc. (the “Company”) issued a press release announcing, among other matters, its results of operations for the third quarter ended September 30, 2026, the text of which is set forth as Exhibit 99.1.
Item 7.01. Regulation FD Disclosure.
On October 27, 2026, the Company issued a press release announcing, among other matters, its results of operations for the third quarter ended September 30, 2026, the text of which is set forth as Exhibit 99.1.
Item 8.01. Other Events.
On October 27, 2026, the Company announced that its Board of Directors had declared a quarterly cash dividend of $0.78 per share of the Company’s common stock. The dividend will be paid on December 29, 2026 to stockholders of record at the close of business on December 15, 2026.
Item 9.01. Financial Statements and Exhibits.
(d) Exhibits:
Exhibit 99.1 |
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Press Release, dated October 27, 2026 |
Exhibit 104 |
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Cover Page Interactive Data File (embedded within the Inline XBRL document) |
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
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HCA HEALTHCARE, INC. |
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Date: |
October 27, 2026 |
By: |
/s/ Michael A. Marks |
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Michael A. Marks |
Exhibit 99.1
FOR IMMEDIATE RELEASE
INVESTOR CONTACT: |
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MEDIA CONTACT: |
Frank Morgan |
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Harlow Sumerford |
615-344-2688 |
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615-344-1851 |
HCA Healthcare reports THIRD quarter 2026 results
Nashville, Tenn., October 27, 2026 – HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the third quarter ended September 30, 2026.
Key third quarter metrics (all percentage changes compare 3Q 2026 to 3Q 2025 unless otherwise noted):
"I have often mentioned that HCA has strong staying power because of our scale, the important role we play in providing critical services to communities, and our disciplined culture. Despite the challenges brought about by federal policy changes this year, our colleagues have continued to provide high-quality care to patients, and we believe HCA Healthcare is positioned to end the year positively,” said Sam Hazen, Chief Executive Officer of HCA Healthcare.
Revenues in the third quarter of 2026 totaled $19.849 billion, compared to $19.161 billion in the third quarter of 2025. Net income attributable to HCA Healthcare, Inc. totaled $1.579 billion, or $7.27 per diluted share, compared to $1.643 billion, or $6.96 per diluted share, in the third quarter of 2025. Results for the third quarter of 2026 include gains on sales of facilities of $13 million, or $0.05 per diluted share, compared to losses on sales of facilities of $2 million in the third quarter of 2025.
For the third quarter of 2026, Adjusted EBITDA totaled $3.918 billion, compared to $3.870 billion in the third quarter of 2025. Diluted earnings per share, as adjusted, and Adjusted EBITDA are non-GAAP financial measures. A table providing supplemental information on these non-GAAP financial measures and reconciling GAAP measures of financial performance to them is included in this release.
Same facility admissions increased 2.7 percent and same facility equivalent admissions increased 3.0 percent in the third quarter of 2026, compared to the prior year period. Same facility emergency room visits increased 5.1 percent in the third quarter of 2026, compared to the prior year period. Same facility inpatient surgeries declined 1.4 percent, and same facility
1
outpatient surgeries declined 3.7 percent in the third quarter of 2026, compared to the same period of 2025. Same facility revenue per equivalent admission increased 0.6 percent in the third quarter of 2026, compared to the third quarter of 2025.
During the third quarter, the Company experienced a payer mix shift driven by an increase in uninsured volume, primarily due to patients who lost coverage on the health insurance exchanges. The Company estimates this payer mix shift had an unfavorable impact on income before income taxes of approximately $400 million during the third quarter.
Despite the unfavorable payer mix shift, the Company’s third quarter results reflected improvement in key areas of its business: growth accelerated in same facility equivalent admissions and insured revenue per equivalent admission (excluding Medicaid Supplemental Payment Programs); cost results improved; and the net benefit from Medicaid Supplemental Payment Programs modestly increased.
2026 Guidance
The Company now believes its full year operating results will be in the upper half of its 2026 estimated guidance ranges previously issued on July 14, 2026.
The Company’s guidance contains a number of assumptions, including, among others, the Company’s current expectations regarding volume growth coupled with an anticipated mostly stable operating environment, payer mix, service mix, the impact of current and future health care public policy developments, including the estimated impact on health insurance exchanges from administrative reforms and the expiration of the enhanced premium tax credits, anticipated results from resiliency initiatives, as well as general business or economic conditions, including inflation and the impact of trade policies, including tariffs, and excludes the impact of items such as, but not limited to, gains or losses on sales of facilities, losses on retirement of debt, legal claims costs and impairment of long-lived assets. In addition, the Company’s guidance excludes the impact of future approvals that could impact reimbursement under certain state Medicaid directed and supplemental payments.
Adjusted EBITDA is a non-GAAP financial measure. A table reconciling forecasted net income attributable to HCA Healthcare, Inc. to forecasted Adjusted EBITDA is included in this release.
The Company’s updated guidance is based on current plans and expectations and is subject to a number of known and unknown uncertainties and risks, including those set forth below in the Company’s “Forward-Looking Statements.”
Nine Months Ended September 30, 2026
Revenues for the nine months ended September 30, 2026 totaled $59.188 billion, compared to $56.087 billion in the prior year period. Net income attributable to HCA Healthcare, Inc. for the first nine months of 2026 was $4.898 billion, or $22.05 per diluted share, compared to $4.906 billion, or $20.23 per diluted share, for the first nine months of 2025. Results for the nine months ended September 30, 2026 include gains on sales of facilities of $22 million, or $0.08 per diluted share. Results for the nine months ended September 30, 2025 included losses on sales of facilities of $4 million, or $0.01 per diluted share.
2
Balance Sheet and Cash Flows from Operations
As of September 30, 2026, HCA Healthcare, Inc.’s balance sheet reflected cash and cash equivalents of $908 million, total debt of $50.493 billion, and total assets of $63.452 billion. During the third quarter of 2026, capital expenditures totaled $1.357 billion, excluding acquisitions. Cash flows provided by operating activities in the third quarter of 2026 totaled $4.461 billion, compared to $4.416 billion in the third quarter of 2025.
During the third quarter of 2026, the Company repurchased 7.230 million shares of its common stock at a cost of $2.970 billion. The Company had $4.240 billion remaining under its repurchase authorization as of September 30, 2026. As of September 30, 2026, the Company had $2.226 billion of availability under its credit facility (after giving effect to letters of credit and amounts reserved to backstop its commercial paper program).
Dividend
HCA today announced that its Board of Directors declared a quarterly cash dividend of $0.78 per share on the Company’s common stock. The dividend will be paid on December 29, 2026 to stockholders of record at the close of business on December 15, 2026.
The declaration and payment of any future dividend will be subject to the discretion of the Board of Directors and will depend on a variety of factors, including the Company’s financial condition and results of operations. Future dividends are expected to be funded by cash balances and future cash flows from operations.
Earnings Conference Call
HCA Healthcare will host a conference call for investors at 9:00 a.m. Central Time today. All interested investors are invited to access a live audio broadcast of the call via webcast. The broadcast also will be available on a replay basis beginning this afternoon. The webcast can be accessed through the Company’s Investor Relations web page at
https://investor.hcahealthcare.com/events-and-presentations/default.aspx.
About the Company
As of September 30, 2026, HCA operated 189 hospitals and approximately 2,600 ambulatory sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics, in 19 states and the United Kingdom.
3
Forward-Looking Statements
This press release contains forward-looking statements within the meaning of the federal
securities laws, which involve risks and uncertainties. Forward-looking statements include the
Company’s financial guidance for the year ending December 31, 2026, as well as other
statements that do not relate solely to historical or current facts. Forward-looking statements can
be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,”
“anticipate,” “plan,” “initiative” or “continue.” These forward-looking statements are based on our
current plans and expectations and are subject to a number of known and unknown
uncertainties and risks, many of which are beyond our control, which could significantly affect
current plans and expectations and our future financial position and results of operations. These
factors include, but are not limited to, (1) changes in or related to general economic or business
conditions nationally and regionally in our markets, including inflation, and the impact of trade
policies, including changes in, or the imposition of, tariffs and/or trade barriers; changes in
revenues resulting from declining patient volumes; changes in payer mix (including increases in
uninsured and underinsured patients); potential increased expenses related to labor,
pharmaceuticals, supply chain or other expenditures; workforce disruptions; supply and
pharmaceutical shortages and disruptions (including as a result of tariffs or geopolitical
disruptions); and the impact of federal government shutdowns, holds on or cancellations of
congressionally authorized spending and interruptions in the distribution of governmental funds,
(2) the impact of current and future health care public policy developments and the
implementation of new, and possible changes to existing, federal, state or local laws and
regulations affecting health care spending or the health care industry, including the expiration at
the end of 2025 of enhanced premium tax credits (“EPTCs”) for eligible individuals purchasing
insurance coverage through federal and state-based health insurance exchanges, changes in
the structure and administration of, and funding for, federal and state agencies and programs,
effects of the 2025 Federal Budget Act (the “FBA”) and efforts to address health care
affordability, (3) the ability to achieve operating and financial targets, develop and execute resiliency plans to offset to the extent possible impacts from the FBA, the expiration of EPTCs and tariffs, attain expected levels of patient volumes and revenues and service mix, and control the costs of providing services, (4) the impact of our significant indebtedness and the ability to refinance such indebtedness on acceptable terms, (5) the effects related to the implementation of sequestration spending reductions required under the Budget Control Act of 2011, related legislation extending these reductions, and the potential for future deficit or other spending reduction legislation that may alter current spending reductions, which include cuts to Medicare payments, or impose additional spending reductions, (6) the impact of reductions or other changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs, Medicaid waiver programs and state directed payment arrangements, any of which may negatively impact reimbursements to health care providers and insurers and the size of the uninsured or underinsured population, (7) the results of our efforts to use technology and resilience initiatives, including artificial intelligence and machine learning, to drive efficiencies, better outcomes and an enhanced patient experience, (8) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (9) personnel-related capacity constraints, increases in wages and the ability to attract, utilize and retain qualified management and other personnel, including affiliated physicians, nurses and medical and technical support personnel, (10) the highly competitive nature of the health care business, (11) changes in service mix, revenue mix and service volumes, including potential declines in the population covered under third-party payer agreements, the ability to enter into and renew third-party payer provider agreements on acceptable terms and the impact of consumer-driven health plans and physician utilization
trends and practices, (12) the efforts of health insurers, health care providers, large employer
groups and others to contain health care costs, (13) the outcome of our continuing efforts to
4
monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (14)
the availability and terms of capital to fund the expansion of our business and improvements to
our existing facilities, (15) changes in accounting practices, (16) the emergence of and effects
related to pandemics, epidemics and outbreaks of infectious diseases or other public health
crises, (17) future divestitures which may result in charges and possible impairments of long
lived assets, (18) changes in business strategy or development plans, (19) delays in receiving or
failure to receive payments for services provided, (20) the outcome of pending and any future
tax audits, disputes and litigation associated with our tax positions, (21) the impact of known and
unknown government investigations, litigation and other claims that may be made against us,
(22) the impact of actual and potential cybersecurity incidents or security breaches involving us
or our vendors and other third parties, (23) our ongoing ability to demonstrate meaningful use of
certified electronic health record technology and the impact of interoperability requirements, (24)
the impact of natural disasters, such as hurricanes and floods, physical risks from changing global weather patterns or similar events beyond our control on our assets and activities and the communities we serve, (25) changes in U.S. federal, state, or foreign tax laws, interpretations of tax laws by taxing authorities, other standard setting bodies or judicial decisions, (26) changes to, and the timing and amount of future approvals (if any) of, state Medicaid directed and supplemental payments and (27) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2025 and our other filings with the Securities and Exchange Commission. Many of the factors that will determine our future results are beyond our ability to control or predict. In light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management’s views only as of the date hereof. We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise. All references to “Company,” “HCA” and “HCA Healthcare” as used throughout this release refer to HCA Healthcare, Inc. and its affiliates.
5
HCA Healthcare, Inc.
Condensed Consolidated Comprehensive Income Statements
Third Quarter
Unaudited
(Dollars in millions, except per share amounts)
|
|
|
2026 |
|
|
|
2025 |
|
|
||||||||||
|
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|
Amount |
|
|
Ratio |
|
|
|
Amount |
|
|
Ratio |
|
|
||||
Revenues |
|
|
$ |
19,849 |
|
|
|
100.0 |
|
% |
|
$ |
19,161 |
|
|
|
100.0 |
|
% |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Salaries and benefits |
|
|
|
8,581 |
|
|
|
43.2 |
|
|
|
|
8,364 |
|
|
|
43.6 |
|
|
Supplies |
|
|
|
2,822 |
|
|
|
14.2 |
|
|
|
|
2,782 |
|
|
|
14.5 |
|
|
Other operating expenses |
|
|
|
4,548 |
|
|
|
23.0 |
|
|
|
|
4,161 |
|
|
|
21.8 |
|
|
Equity in earnings of affiliates |
|
|
|
(20 |
) |
|
|
(0.1 |
) |
|
|
|
(16 |
) |
|
|
(0.1 |
) |
|
Depreciation and amortization |
|
|
|
954 |
|
|
|
4.8 |
|
|
|
|
889 |
|
|
|
4.7 |
|
|
Interest expense |
|
|
|
607 |
|
|
|
3.1 |
|
|
|
|
561 |
|
|
|
2.9 |
|
|
Losses (gains) on sales of facilities |
|
|
|
(13 |
) |
|
|
(0.1 |
) |
|
|
|
2 |
|
|
|
— |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
|
17,479 |
|
|
|
88.1 |
|
|
|
|
16,743 |
|
|
|
87.4 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Income before income taxes |
|
|
|
2,370 |
|
|
|
11.9 |
|
|
|
|
2,418 |
|
|
|
12.6 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Provision for income taxes |
|
|
|
521 |
|
|
|
2.6 |
|
|
|
|
515 |
|
|
|
2.7 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Net income |
|
|
|
1,849 |
|
|
|
9.3 |
|
|
|
|
1,903 |
|
|
|
9.9 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Net income attributable to noncontrolling interests |
|
|
|
270 |
|
|
|
1.3 |
|
|
|
|
260 |
|
|
|
1.3 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Net income attributable to HCA Healthcare, Inc. |
|
|
$ |
1,579 |
|
|
|
8.0 |
|
|
|
$ |
1,643 |
|
|
|
8.6 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Diluted earnings per share |
|
|
$ |
7.27 |
|
|
|
|
|
|
$ |
6.96 |
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Shares used in computing diluted earnings per share (millions) |
|
|
|
217.212 |
|
|
|
|
|
|
|
236.181 |
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Comprehensive income attributable to HCA Healthcare, Inc. |
|
|
$ |
1,563 |
|
|
|
|
|
|
$ |
1,635 |
|
|
|
|
|
||
6
HCA Healthcare, Inc.
Condensed Consolidated Comprehensive Income Statements
For the Nine Months Ended September 30, 2026 and 2025
Unaudited
(Dollars in millions, except per share amounts)
|
|
|
2026 |
|
|
|
2025 |
|
|
||||||||||
|
|
|
Amount |
|
|
Ratio |
|
|
|
Amount |
|
|
Ratio |
|
|
||||
Revenues |
|
|
$ |
59,188 |
|
|
|
100.0 |
|
% |
|
$ |
56,087 |
|
|
|
100.0 |
|
% |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Salaries and benefits |
|
|
|
25,154 |
|
|
|
42.5 |
|
|
|
|
24,499 |
|
|
|
43.7 |
|
|
Supplies |
|
|
|
8,561 |
|
|
|
14.5 |
|
|
|
|
8,390 |
|
|
|
15.0 |
|
|
Other operating expenses |
|
|
|
13,771 |
|
|
|
23.3 |
|
|
|
|
11,799 |
|
|
|
21.0 |
|
|
Equity in earnings of affiliates |
|
|
|
(45 |
) |
|
|
(0.1 |
) |
|
|
|
(53 |
) |
|
|
(0.1 |
) |
|
Depreciation and amortization |
|
|
|
2,828 |
|
|
|
4.7 |
|
|
|
|
2,612 |
|
|
|
4.6 |
|
|
Interest expense |
|
|
|
1,790 |
|
|
|
3.0 |
|
|
|
|
1,676 |
|
|
|
3.0 |
|
|
Losses (gains) on sales of facilities |
|
|
|
(22 |
) |
|
|
— |
|
|
|
|
4 |
|
|
|
— |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
|
52,037 |
|
|
|
87.9 |
|
|
|
|
48,927 |
|
|
|
87.2 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Income before income taxes |
|
|
|
7,151 |
|
|
|
12.1 |
|
|
|
|
7,160 |
|
|
|
12.8 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Provision for income taxes |
|
|
|
1,515 |
|
|
|
2.6 |
|
|
|
|
1,541 |
|
|
|
2.8 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Net income |
|
|
|
5,636 |
|
|
|
9.5 |
|
|
|
|
5,619 |
|
|
|
10.0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Net income attributable to noncontrolling interests |
|
|
|
738 |
|
|
|
1.2 |
|
|
|
|
713 |
|
|
|
1.3 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Net income attributable to HCA Healthcare, Inc. |
|
|
$ |
4,898 |
|
|
|
8.3 |
|
|
|
$ |
4,906 |
|
|
|
8.7 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Diluted earnings per share |
|
|
$ |
22.05 |
|
|
|
|
|
|
$ |
20.23 |
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Shares used in computing diluted earnings per share (millions) |
|
|
|
222.197 |
|
|
|
|
|
|
|
242.459 |
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Comprehensive income attributable to HCA Healthcare, Inc. |
|
|
$ |
4,853 |
|
|
|
|
|
|
$ |
4,976 |
|
|
|
|
|
||
7
HCA Healthcare, Inc.
Condensed Consolidated Balance Sheets
Unaudited
(Dollars in millions)
|
|
September 30, |
|
|
June 30, |
|
|
December 31, |
|
|||
|
|
2026 |
|
|
2026 |
|
|
2025 |
|
|||
ASSETS |
|
|
|
|
|
|
|
|
|
|||
Current assets: |
|
|
|
|
|
|
|
|
|
|||
Cash and cash equivalents |
|
$ |
908 |
|
|
$ |
1,013 |
|
|
$ |
1,040 |
|
Accounts receivable |
|
|
11,509 |
|
|
|
12,281 |
|
|
|
10,867 |
|
Inventories |
|
|
1,670 |
|
|
|
1,662 |
|
|
|
1,652 |
|
Other |
|
|
2,132 |
|
|
|
2,234 |
|
|
|
2,224 |
|
|
|
|
16,219 |
|
|
|
17,190 |
|
|
|
15,783 |
|
|
|
|
|
|
|
|
|
|
|
|||
Property and equipment, at cost |
|
|
69,632 |
|
|
|
68,409 |
|
|
|
66,275 |
|
Accumulated depreciation |
|
|
(37,364 |
) |
|
|
(36,593 |
) |
|
|
(35,134 |
) |
|
|
|
32,268 |
|
|
|
31,816 |
|
|
|
31,141 |
|
|
|
|
|
|
|
|
|
|
|
|||
Investments of insurance subsidiaries |
|
|
463 |
|
|
|
402 |
|
|
|
485 |
|
Investments in and advances to affiliates |
|
|
815 |
|
|
|
813 |
|
|
|
633 |
|
Goodwill and other intangible assets |
|
|
11,199 |
|
|
|
10,662 |
|
|
|
10,293 |
|
Right-of-use operating lease assets |
|
|
2,208 |
|
|
|
2,109 |
|
|
|
2,130 |
|
Other |
|
|
280 |
|
|
|
258 |
|
|
|
255 |
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
$ |
63,452 |
|
|
$ |
63,250 |
|
|
$ |
60,720 |
|
|
|
|
|
|
|
|
|
|
|
|||
LIABILITIES AND STOCKHOLDERS' DEFICIT |
|
|
|
|
|
|
|
|
|
|||
Current liabilities: |
|
|
|
|
|
|
|
|
|
|||
Accounts payable |
|
$ |
5,103 |
|
|
$ |
4,752 |
|
|
$ |
4,659 |
|
Accrued salaries |
|
|
2,373 |
|
|
|
2,199 |
|
|
|
2,525 |
|
Other accrued expenses |
|
|
4,210 |
|
|
|
4,097 |
|
|
|
4,277 |
|
Short-term borrowings and long-term debt due within |
|
|
8,093 |
|
|
|
6,264 |
|
|
|
4,889 |
|
|
|
|
19,779 |
|
|
|
17,312 |
|
|
|
16,350 |
|
|
|
|
|
|
|
|
|
|
|
|||
Long-term debt, less debt issuance costs and discounts |
|
|
42,400 |
|
|
|
43,454 |
|
|
|
41,603 |
|
Professional liability risks |
|
|
1,538 |
|
|
|
1,464 |
|
|
|
1,466 |
|
Right-of-use operating lease obligations |
|
|
1,933 |
|
|
|
1,834 |
|
|
|
1,853 |
|
Income taxes and other liabilities |
|
|
2,401 |
|
|
|
2,395 |
|
|
|
2,219 |
|
|
|
|
|
|
|
|
|
|
|
|||
Stockholders' deficit: |
|
|
|
|
|
|
|
|
|
|||
Stockholders' deficit attributable to HCA Healthcare, Inc. |
|
|
(8,077 |
) |
|
|
(6,642 |
) |
|
|
(6,027 |
) |
Noncontrolling interests |
|
|
3,478 |
|
|
|
3,433 |
|
|
|
3,256 |
|
|
|
|
(4,599 |
) |
|
|
(3,209 |
) |
|
|
(2,771 |
) |
|
|
$ |
63,452 |
|
|
$ |
63,250 |
|
|
$ |
60,720 |
|
8
HCA Healthcare, Inc.
Condensed Consolidated Statements of Cash Flows
For the Nine Months Ended September 30, 2026 and 2025
Unaudited
(Dollars in millions)
|
|
2026 |
|
|
2025 |
|
||
Cash flows from operating activities: |
|
|
|
|
|
|
||
Net income |
|
$ |
5,636 |
|
|
$ |
5,619 |
|
Adjustments to reconcile net income to net cash provided by operating activities: |
|
|
|
|
|
|
||
Increase (decrease) in cash from operating assets and liabilities: |
|
|
|
|
|
|
||
Accounts receivable |
|
|
(635 |
) |
|
|
345 |
|
Inventories and other assets |
|
|
82 |
|
|
|
(125 |
) |
Accounts payable and accrued expenses |
|
|
330 |
|
|
|
29 |
|
Depreciation and amortization |
|
|
2,828 |
|
|
|
2,612 |
|
Income taxes |
|
|
98 |
|
|
|
1,314 |
|
Losses (gains) on sales of facilities |
|
|
(22 |
) |
|
|
4 |
|
Amortization of debt issuance costs and discounts |
|
|
34 |
|
|
|
32 |
|
Share-based compensation |
|
|
304 |
|
|
|
301 |
|
Other |
|
|
155 |
|
|
|
146 |
|
|
|
|
|
|
|
|
||
Net cash provided by operating activities |
|
|
8,810 |
|
|
|
10,277 |
|
|
|
|
|
|
|
|
||
Cash flows from investing activities: |
|
|
|
|
|
|
||
Purchase of property and equipment |
|
|
(3,707 |
) |
|
|
(3,455 |
) |
Acquisition of hospitals and health care entities |
|
|
(942 |
) |
|
|
(361 |
) |
Sales of hospitals and health care entities |
|
|
107 |
|
|
|
177 |
|
Change in investments |
|
|
(214 |
) |
|
|
(26 |
) |
Other |
|
|
1 |
|
|
|
(6 |
) |
|
|
|
|
|
|
|
||
Net cash used in investing activities |
|
|
(4,755 |
) |
|
|
(3,671 |
) |
|
|
|
|
|
|
|
||
Cash flows from financing activities: |
|
|
|
|
|
|
||
Issuances of long-term debt |
|
|
2,994 |
|
|
|
5,233 |
|
Net change in short-term borrowings and revolving credit facilities |
|
|
3,507 |
|
|
|
1,906 |
|
Repayment of long-term debt |
|
|
(2,713 |
) |
|
|
(5,834 |
) |
Distributions to noncontrolling interests |
|
|
(574 |
) |
|
|
(631 |
) |
Payment of debt issuance costs |
|
|
(17 |
) |
|
|
(57 |
) |
Payment of dividends |
|
|
(519 |
) |
|
|
(517 |
) |
Repurchase of common stock |
|
|
(6,605 |
) |
|
|
(7,509 |
) |
Other |
|
|
(256 |
) |
|
|
(142 |
) |
|
|
|
|
|
|
|
||
Net cash used in financing activities |
|
|
(4,183 |
) |
|
|
(7,551 |
) |
|
|
|
|
|
|
|
||
Effect of exchange rate changes on cash and cash equivalents |
|
|
(4 |
) |
|
|
9 |
|
|
|
|
|
|
|
|
||
Change in cash and cash equivalents |
|
|
(132 |
) |
|
|
(936 |
) |
Cash and cash equivalents at beginning of period |
|
|
1,040 |
|
|
|
1,933 |
|
|
|
|
|
|
|
|
||
Cash and cash equivalents at end of period |
|
$ |
908 |
|
|
$ |
997 |
|
|
|
|
|
|
|
|
||
Interest payments |
|
$ |
1,725 |
|
|
$ |
1,696 |
|
Income tax payments, net |
|
$ |
1,417 |
|
|
$ |
227 |
|
9
HCA Healthcare, Inc.
Operating Statistics
|
|
Third Quarter |
|
|
For the Nine Months |
|
||||||||||
|
|
2026 |
|
|
2025 |
|
|
2026 |
|
|
2025 |
|
||||
Operations: |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Number of Hospitals |
|
|
189 |
|
|
|
191 |
|
|
|
189 |
|
|
|
191 |
|
Number of Freestanding Outpatient |
|
|
117 |
|
|
|
123 |
|
|
|
117 |
|
|
|
123 |
|
Licensed Beds at End of Period |
|
|
50,424 |
|
|
|
50,577 |
|
|
|
50,424 |
|
|
|
50,577 |
|
Weighted Average Beds in Service |
|
|
42,866 |
|
|
|
42,896 |
|
|
|
42,873 |
|
|
|
42,872 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Reported: |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Admissions |
|
|
592,179 |
|
|
|
577,804 |
|
|
|
1,751,999 |
|
|
|
1,720,226 |
|
% Change |
|
|
2.5 |
% |
|
|
|
|
|
1.8 |
% |
|
|
|
||
Equivalent Admissions |
|
|
1,068,119 |
|
|
|
1,038,799 |
|
|
|
3,136,078 |
|
|
|
3,068,883 |
|
% Change |
|
|
2.8 |
% |
|
|
|
|
|
2.2 |
% |
|
|
|
||
Revenue per Equivalent Admission |
|
$ |
18,583 |
|
|
$ |
18,446 |
|
|
$ |
18,873 |
|
|
$ |
18,276 |
|
% Change |
|
|
0.7 |
% |
|
|
|
|
|
3.3 |
% |
|
|
|
||
Inpatient Revenue per Admission |
|
$ |
20,059 |
|
|
$ |
19,908 |
|
|
$ |
20,953 |
|
|
$ |
19,638 |
|
% Change |
|
|
0.8 |
% |
|
|
|
|
|
6.7 |
% |
|
|
|
||
Patient Days |
|
|
2,734,440 |
|
|
|
2,692,513 |
|
|
|
8,199,970 |
|
|
|
8,204,413 |
|
% Change |
|
|
1.6 |
% |
|
|
|
|
|
-0.1 |
% |
|
|
|
||
Equivalent Patient Days |
|
|
4,932,906 |
|
|
|
4,842,027 |
|
|
|
14,677,946 |
|
|
|
14,636,673 |
|
% Change |
|
|
1.9 |
% |
|
|
|
|
|
0.3 |
% |
|
|
|
||
Inpatient Surgery Cases |
|
|
136,795 |
|
|
|
138,563 |
|
|
|
403,098 |
|
|
|
408,444 |
|
% Change |
|
|
-1.3 |
% |
|
|
|
|
|
-1.3 |
% |
|
|
|
||
Outpatient Surgery Cases |
|
|
242,819 |
|
|
|
253,426 |
|
|
|
729,827 |
|
|
|
758,411 |
|
% Change |
|
|
-4.2 |
% |
|
|
|
|
|
-3.8 |
% |
|
|
|
||
Emergency Room Visits |
|
|
2,607,642 |
|
|
|
2,477,474 |
|
|
|
7,642,872 |
|
|
|
7,435,953 |
|
% Change |
|
|
5.3 |
% |
|
|
|
|
|
2.8 |
% |
|
|
|
||
Outpatient Revenues as a |
|
|
38.4 |
% |
|
|
38.3 |
% |
|
|
36.2 |
% |
|
|
38.0 |
% |
Average Length of Stay (days) |
|
|
4.618 |
|
|
|
4.660 |
|
|
|
4.680 |
|
|
|
4.769 |
|
Occupancy** |
|
|
73.2 |
% |
|
|
71.7 |
% |
|
|
73.8 |
% |
|
|
73.5 |
% |
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Same Facility: |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Admissions |
|
|
588,020 |
|
|
|
572,337 |
|
|
|
1,739,663 |
|
|
|
1,704,947 |
|
% Change |
|
|
2.7 |
% |
|
|
|
|
|
2.0 |
% |
|
|
|
||
Equivalent Admissions |
|
|
1,056,672 |
|
|
|
1,026,200 |
|
|
|
3,105,298 |
|
|
|
3,034,806 |
|
% Change |
|
|
3.0 |
% |
|
|
|
|
|
2.3 |
% |
|
|
|
||
Revenue per Equivalent Admission |
|
$ |
18,614 |
|
|
$ |
18,508 |
|
|
$ |
18,906 |
|
|
$ |
18,289 |
|
% Change |
|
|
0.6 |
% |
|
|
|
|
|
3.4 |
% |
|
|
|
||
Inpatient Revenue per Admission |
|
$ |
20,095 |
|
|
$ |
19,984 |
|
|
$ |
20,993 |
|
|
$ |
19,641 |
|
% Change |
|
|
0.6 |
% |
|
|
|
|
|
6.9 |
% |
|
|
|
||
Inpatient Surgery Cases |
|
|
135,620 |
|
|
|
137,554 |
|
|
|
400,766 |
|
|
|
406,019 |
|
% Change |
|
|
-1.4 |
% |
|
|
|
|
|
-1.3 |
% |
|
|
|
||
Outpatient Surgery Cases |
|
|
237,263 |
|
|
|
246,452 |
|
|
|
714,535 |
|
|
|
735,387 |
|
% Change |
|
|
-3.7 |
% |
|
|
|
|
|
-2.8 |
% |
|
|
|
||
Emergency Room Visits |
|
|
2,585,811 |
|
|
|
2,459,510 |
|
|
|
7,587,606 |
|
|
|
7,367,118 |
|
% Change |
|
|
5.1 |
% |
|
|
|
|
|
3.0 |
% |
|
|
|
||
* Excludes freestanding endoscopy centers (30 centers at September 30, 2026 and 29 centers at September 30, 2025).
** Reflects the rate of occupancy (patient days and observations) based on weighted average beds in service.
10
HCA Healthcare, Inc.
Supplemental Non-GAAP Disclosures
Operating Results Summary
(Dollars in millions, except per share amounts)
|
|
Third Quarter |
|
|
For the Nine Months |
|
||||||||||
|
|
2026 |
|
|
2025 |
|
|
2026 |
|
|
2025 |
|
||||
Revenues |
|
$ |
19,849 |
|
|
$ |
19,161 |
|
|
$ |
59,188 |
|
|
$ |
56,087 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Net income attributable to HCA Healthcare, Inc. |
|
$ |
1,579 |
|
|
$ |
1,643 |
|
|
$ |
4,898 |
|
|
$ |
4,906 |
|
Losses (gains) on sales of facilities (net of tax) |
|
|
(10 |
) |
|
|
1 |
|
|
|
(17 |
) |
|
|
3 |
|
Net income attributable to HCA Healthcare, Inc., |
|
|
1,569 |
|
|
|
1,644 |
|
|
|
4,881 |
|
|
|
4,909 |
|
Depreciation and amortization |
|
|
954 |
|
|
|
889 |
|
|
|
2,828 |
|
|
|
2,612 |
|
Interest expense |
|
|
607 |
|
|
|
561 |
|
|
|
1,790 |
|
|
|
1,676 |
|
Provision for income taxes |
|
|
518 |
|
|
|
516 |
|
|
|
1,510 |
|
|
|
1,542 |
|
Net income attributable to noncontrolling interests |
|
|
270 |
|
|
|
260 |
|
|
|
738 |
|
|
|
713 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Adjusted EBITDA (a) |
|
$ |
3,918 |
|
|
$ |
3,870 |
|
|
$ |
11,747 |
|
|
$ |
11,452 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Adjusted EBITDA margin (a) |
|
|
19.7 |
% |
|
|
20.2 |
% |
|
|
19.8 |
% |
|
|
20.4 |
% |
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Diluted earnings per share: |
|
|
|
|
|
|
|
|
|
|
|
|
||||
Net income attributable to HCA Healthcare, Inc. |
|
$ |
7.27 |
|
|
$ |
6.96 |
|
|
$ |
22.05 |
|
|
$ |
20.23 |
|
Losses (gains) on sales of facilities |
|
|
(0.05 |
) |
|
|
- |
|
|
|
(0.08 |
) |
|
|
0.01 |
|
Net income attributable to HCA Healthcare, Inc., |
|
$ |
7.22 |
|
|
$ |
6.96 |
|
|
$ |
21.97 |
|
|
$ |
20.24 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Shares used in computing diluted earnings per |
|
|
217.212 |
|
|
|
236.181 |
|
|
|
222.197 |
|
|
|
242.459 |
|
Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and GAAP net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry. It is reasonable to expect that adjustments, including losses (gains) on sales of facilities and losses on retirement of debt will occur in future periods, but the amounts recognized can vary significantly from period to period, do not directly relate to the ongoing operations of our health care facilities and complicate period comparisons of our results of operations and operations comparisons with other health care companies.
Net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA are not measures of financial performance under GAAP, and should not be considered as alternatives to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA are not measurements determined in accordance with GAAP and are susceptible to varying calculations, net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.
11
HCA Healthcare, Inc.
Supplemental Non-GAAP Disclosures
2026 Operating Results Forecast
(Dollars in millions, except per share amounts)
|
|
For the Year Ending |
|
|||||
|
|
December 31, 2026 |
|
|||||
|
|
Low |
|
|
High |
|
||
Revenues |
|
$ |
77,000 |
|
|
$ |
79,500 |
|
|
|
|
|
|
|
|
||
Net income attributable to HCA Healthcare, Inc. (a) |
|
$ |
6,300 |
|
|
$ |
6,700 |
|
Depreciation and amortization |
|
|
3,745 |
|
|
|
3,795 |
|
Interest expense |
|
|
2,410 |
|
|
|
2,470 |
|
Provision for income taxes |
|
|
1,975 |
|
|
|
2,125 |
|
Net income attributable to noncontrolling interests |
|
|
970 |
|
|
|
1,010 |
|
|
|
|
|
|
|
|
||
Adjusted EBITDA (a) (b) |
|
$ |
15,400 |
|
|
$ |
16,100 |
|
|
|
|
|
|
|
|
||
Diluted earnings per share: |
|
|
|
|
|
|
||
Net income attributable to HCA Healthcare, Inc. |
|
$ |
28.70 |
|
|
$ |
30.50 |
|
|
|
|
|
|
|
|
||
Shares used in computing diluted earnings per share (millions) |
|
|
219.500 |
|
|
|
219.500 |
|
The Company's forecasted guidance is based on current plans and expectations and is subject to a number of known and unknown uncertainties and risks.
Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA is utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry.
Adjusted EBITDA is not a measure of financial performance under GAAP and should not be considered as an alternative to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because Adjusted EBITDA is not a measurement determined in accordance with GAAP and is susceptible to varying calculations, Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.
12