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HCA Healthcare (NYSE: HCA) Q1 2026 results, dividend and buybacks

Filing Impact
(High)
Filing Sentiment
(Neutral)
Form Type
8-K

Rhea-AI Filing Summary

HCA Healthcare, Inc. reported first quarter 2026 results showing modest growth and solid cash generation. Revenues rose 4.3% to $19.109 billion, while net income attributable to HCA increased 0.6% to $1.620 billion. Diluted earnings per share climbed 10.9% to $7.15, helped by share repurchases.

Adjusted EBITDA grew 1.9% to $3.802 billion, and cash flows from operating activities increased 22.0% to $2.014 billion. Management noted weaker seasonal respiratory volumes and weather-related impacts, largely offset by certain Medicaid supplemental program recognition.

The company continued significant capital deployment, with $1.119 billion in capital expenditures and repurchase of 3.157 million shares for $1.571 billion. The board declared a quarterly dividend of $0.78 per share, payable June 30, 2026. HCA reaffirmed its full-year 2026 guidance, including projected revenues of $76.5–$80.0 billion and Adjusted EBITDA of $15.55–$16.45 billion.

Positive

  • None.

Negative

  • None.

Insights

HCA posts steady Q1 growth, strong cash flow, and reaffirms 2026 outlook.

HCA Healthcare delivered Q1 2026 revenue of $19.109 billion, up 4.3%, with net income attributable to HCA at $1.620 billion. EPS grew faster than profits, rising to $7.15 on a smaller share count. Adjusted EBITDA increased to $3.802 billion, though the margin eased to 19.9%.

Volumes were mixed: same facility admissions and equivalent admissions grew modestly, while inpatient and outpatient surgeries and emergency visits dipped slightly. Management cited a lack of typical seasonal respiratory volume and a winter storm, largely offset by certain Medicaid supplemental program recognition, highlighting reliance on policy-driven payments.

Cash generation remained strong with operating cash flow of $2.014 billion and substantial capital deployment: $1.119 billion of capital expenditures and $1.571 billion of share repurchases, plus a $0.78 per-share dividend. Reaffirmed 2026 guidance for revenues of $76.5–$80.0 billion and Adjusted EBITDA of $15.55–$16.45 billion signals unchanged expectations despite macro and policy risks detailed in the forward-looking statements.

Item 2.02 Results of Operations and Financial Condition Financial
Disclosure of earnings results, typically an earnings press release or preliminary financials.
Item 7.01 Regulation FD Disclosure Disclosure
Material non-public information disclosed under Regulation Fair Disclosure, often investor presentations or guidance.
Item 8.01 Other Events Other
Voluntary disclosure of events the company deems important to shareholders but not covered by other items.
Item 9.01 Financial Statements and Exhibits Exhibits
Financial statements, pro forma financial information, and exhibit attachments filed with this report.
Q1 2026 Revenue $19.109 billion Up 4.3% vs Q1 2025
Q1 2026 Net Income attributable to HCA $1.620 billion Up 0.6% vs Q1 2025
Q1 2026 Diluted EPS $7.15 per share Up 10.9% vs $6.45 in Q1 2025
Q1 2026 Adjusted EBITDA $3.802 billion Up 1.9% vs Q1 2025; margin 19.9%
Operating Cash Flow Q1 2026 $2.014 billion Cash flows from operating activities, up 22.0% YoY
Share Repurchases Q1 2026 $1.571 billion 3.157 million shares repurchased
Quarterly Dividend $0.78 per share Payable June 30, 2026 to holders of record June 16, 2026
2026 Revenue Guidance $76.5–$80.0 billion Full-year 2026 forecast range reaffirmed
2026 Adjusted EBITDA Guidance $15.55–$16.45 billion Full-year 2026 forecast range reaffirmed
Adjusted EBITDA financial
"Adjusted EBITDA increased 1.9 percent to $3.802 billion"
Adjusted EBITDA is a way companies measure how much money they make from their core operations, like running a business, by removing certain costs or income that aren’t part of regular business activities. It helps investors see how well a company is doing without distractions from unusual expenses or gains, making it easier to compare companies or track performance over time.
same facility admissions financial
"Same facility admissions increased 0.9 percent and same facility equivalent admissions"
diluted earnings per share, as adjusted financial
"Diluted earnings per share, as adjusted, and Adjusted EBITDA are non-GAAP financial measures"
noncontrolling interests financial
"Net income attributable to noncontrolling interests 237"
The portion of a subsidiary’s equity and profits that belongs to outside owners rather than the parent company; when a parent reports consolidated results it includes the whole subsidiary but shows the noncontrolling slice separately. Think of a company’s subsidiary as a pie where the parent owns most slices but some are held by other investors — noncontrolling interests tell you how much of the pie and its future earnings don’t belong to the parent, which affects how much profit and net assets are truly attributable to the parent’s shareholders.
non-GAAP financial measures financial
"Diluted earnings per share, as adjusted, and Adjusted EBITDA are non-GAAP financial measures"
Non-GAAP financial measures are numbers companies use to show their financial performance that exclude certain expenses or income. They help investors see how the company might perform without one-time costs or other unusual items, giving a different perspective from official reports. However, since they can be adjusted, they don’t always tell the full story and should be looked at alongside standard financial figures.
Forward-Looking Statements regulatory
"This press release contains forward-looking statements within the meaning of the federal securities laws"
Forward-looking statements are predictions or plans that companies share about what they expect to happen in the future, like estimating sales or profits. They matter because they help investors understand a company's outlook, but since they are based on guesses and assumptions, they can sometimes be wrong.
Revenue $19.109 billion +4.3% YoY
Net income attributable to HCA $1.620 billion +0.6% YoY
Diluted EPS $7.15 +10.9% YoY
Adjusted EBITDA $3.802 billion +1.9% YoY
Guidance

For full-year 2026, HCA forecasts revenues of $76.5–$80.0 billion, net income attributable to HCA of $6.495–$7.035 billion, and Adjusted EBITDA of $15.55–$16.45 billion, with diluted EPS of $29.10–$31.50 on 223.5 million diluted shares.

false000086073000008607302026-04-242026-04-24

 

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): April 24, 2026

 

 

HCA Healthcare, Inc.

(Exact name of Registrant as Specified in Its Charter)

 

 

Delaware

001-11239

27-3865930

(State or Other Jurisdiction
of Incorporation)

(Commission File Number)

(IRS Employer
Identification No.)

 

 

 

 

 

One Park Plaza

 

Nashville, Tennessee

 

37203

(Address of Principal Executive Offices)

 

(Zip Code)

 

Registrant’s Telephone Number, Including Area Code: (615) 344-9551

 

Not Applicable

(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:

Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:


Title of each class

 

Trading
Symbol(s)

 


Name of each exchange on which registered

Common Stock, $0.01 par value per share

 

HCA

 

New York Stock Exchange

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 April 24, 2026, HCA Healthcare, Inc. (the “Company”) issued a press release announcing, among other matters, its results of operations for the first quarter ended March 31, 2026, the text of which is set forth as Exhibit 99.1.

Item 7.01. Regulation FD Disclosure.

On April 24, 2026, the Company issued a press release announcing, among other matters, its results of operations for the first quarter ended March 31, 2026, the text of which is set forth as Exhibit 99.1.

Item 8.01. Other Events.

On April 24, 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 June 30, 2026 to stockholders of record at the close of business on June 16, 2026.

Item 9.01. Financial Statements and Exhibits.

(d) Exhibits:

 

Exhibit 99.1

Press Release, dated April 24, 2026

Exhibit 104

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.

 

 

 

HCA HEALTHCARE, INC.

 

 

 

 

Date:

April 24, 2026

By:

/s/ Michael A. Marks

 

 

 

Michael A. Marks
Executive Vice President and Chief Financial Officer

 


Exhibit 99.1

img60930783_0.gif

FOR IMMEDIATE RELEASE

 

INVESTOR CONTACT:

 

MEDIA CONTACT:

Frank Morgan

 

Harlow Sumerford

615-344-2688

 

615-344-1851

 

HCA Healthcare reports FIRST quarter 2026 results

Nashville, Tenn., April 24, 2026 – HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the first quarter ended March 31, 2026.

Key first quarter metrics (all percentage changes compare 1Q 2026 to 1Q 2025 unless otherwise noted):

Revenues increased 4.3 percent to $19.109 billion
Net income attributable to HCA Healthcare, Inc. increased 0.6 percent to $1.620 billion
Diluted earnings per share and diluted earnings per share, as adjusted, increased 10.9 percent to $7.15 per diluted share
Adjusted EBITDA increased 1.9 percent to $3.802 billion
Cash flows from operating activities increased 22.0 percent to $2.014 billion
Same facility admissions increased 0.9 percent and same facility equivalent admissions increased 1.3 percent

"The start of the year presented a dynamic environment for HCA Healthcare. I want to recognize our colleagues for continuing to demonstrate a remarkable ability to adapt to changing conditions and deliver for our patients, communities, and stakeholders,” said Sam Hazen, Chief Executive Officer of HCA Healthcare.

Revenues in the first quarter of 2026 totaled $19.109 billion, compared to $18.321 billion in the first quarter of 2025. Net income attributable to HCA Healthcare, Inc. totaled $1.620 billion, or $7.15 per diluted share, compared to $1.610 billion, or $6.45 per diluted share, in the first quarter of 2025.

For the first quarter of 2026, Adjusted EBITDA totaled $3.802 billion, compared to $3.733 billion in the first 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 0.9 percent and same facility equivalent admissions increased 1.3 percent in the first quarter of 2026, compared to the prior year period. Same facility emergency room visits increased 0.3 percent in the first quarter of 2026, compared to the prior year period. Same facility inpatient surgeries declined 0.3 percent, and same facility outpatient surgeries declined 1.7 percent in the first quarter of 2026, compared to the same period of 2025. Same facility revenue per equivalent admission increased 3.1 percent in the first quarter of 2026, compared to the first quarter of 2025.

1


 

During the first quarter of 2026, the Company did not experience a typical seasonal volume increase, primarily due to respiratory activity. Respiratory-related admissions were down 42 percent, and respiratory-related emergency room visits were down 32 percent, compared to the first quarter of 2025. In addition, a winter storm in January negatively impacted first quarter volumes in certain of our markets.

These unfavorable volume impacts were mostly offset by the recognition of certain Medicaid supplemental programs that were not included in the Company's initial 2026 guidance.

Balance Sheet and Cash Flows from Operations

As of March 31, 2026, HCA Healthcare, Inc.’s balance sheet reflected cash and cash equivalents of $940 million, total debt of $48.023 billion, and total assets of $61.450 billion. During the first quarter of 2026, capital expenditures totaled $1.119 billion, excluding acquisitions. Cash flows provided by operating activities in the first quarter of 2026 totaled $2.014 billion, compared to $1.651 billion in the first quarter of 2025.

During the first quarter of 2026, the Company repurchased 3.157 million shares of its common stock at a cost of $1.571 billion. The Company had $9.179 billion remaining under its repurchase authorization as of March 31, 2026. As of March 31, 2026, the Company had $4.336 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 June 30, 2026 to stockholders of record at the close of business on June 16, 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.

2026 Guidance

Today, the Company is reaffirming its 2026 estimated guidance ranges previously issued on January 27, 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, 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.

2

 


 

The Company’s guidance is based on current plans and expectations and are subject to a number of known and unknown uncertainties and risks, including those set forth below in the Company’s “Forward-Looking Statements.”

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 March 31, 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.

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 marketplaces, 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 impact of our significant indebtedness and the ability to refinance such indebtedness on acceptable terms, (4) 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, (5) the ability to achieve operating and financial

3

 


 

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 control the costs of providing services, (6) possible 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 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, including Hurricanes Milton and Helene, 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.

4

 


 

HCA Healthcare, Inc.

Condensed Consolidated Comprehensive Income Statements

First Quarter

Unaudited

(Dollars in millions, except per share amounts)

 

 

 

 

 

 

2026

 

 

 

2025

 

 

 

 

 

Amount

 

 

Ratio

 

 

 

Amount

 

 

Ratio

 

 

Revenues

 

$

19,109

 

 

 

100.0

 

%

 

$

18,321

 

 

 

100.0

 

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

 

8,283

 

 

 

43.3

 

 

 

 

7,997

 

 

 

43.6

 

 

Supplies

 

 

 

2,853

 

 

 

14.9

 

 

 

 

2,764

 

 

 

15.1

 

 

Other operating expenses

 

 

 

4,180

 

 

 

21.9

 

 

 

 

3,845

 

 

 

21.0

 

 

Equity in earnings of affiliates

 

 

 

(9

)

 

 

 

 

 

 

(18

)

 

 

(0.1

)

 

Depreciation and amortization

 

 

 

930

 

 

 

4.8

 

 

 

 

860

 

 

 

4.7

 

 

Interest expense

 

 

584

 

 

 

3.1

 

 

 

 

547

 

 

 

3.0

 

 

Losses (gains) on sales of facilities

 

 

1

 

 

 

 

 

 

 

(1

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16,822

 

 

 

88.0

 

 

 

 

15,994

 

 

 

87.3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Income before income taxes

 

 

 

2,287

 

 

 

12.0

 

 

 

 

2,327

 

 

 

12.7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Provision for income taxes

 

 

 

430

 

 

 

2.3

 

 

 

 

502

 

 

 

2.7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income

 

 

 

1,857

 

 

 

9.7

 

 

 

 

1,825

 

 

 

10.0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income attributable to noncontrolling interests

 

 

 

237

 

 

 

1.2

 

 

 

 

215

 

 

 

1.2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income attributable to HCA Healthcare, Inc.

 

 

$

1,620

 

 

 

8.5

 

 

 

$

1,610

 

 

 

8.8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Diluted earnings per share

 

$

7.15

 

 

 

 

 

 

$

6.45

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shares used in computing diluted earnings per share (millions)

 

 

226.652

 

 

 

 

 

 

 

249.440

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Comprehensive income attributable to HCA Healthcare, Inc.

 

$

1,598

 

 

 

 

 

 

$

1,640

 

 

 

 

 

 

 

 

 

5

 


 

HCA Healthcare, Inc.

Condensed Consolidated Balance Sheets

Unaudited

(Dollars in millions)

 

 

 

March 31,

 

 

December 31,

 

 

 

2026

 

 

2025

 

ASSETS

 

 

 

 

 

 

Current assets:

 

 

 

 

 

 

Cash and cash equivalents

$

940

 

 

$

1,040

 

Accounts receivable

 

11,324

 

 

 

10,867

 

Inventories

 

1,681

 

 

 

1,652

 

Other

 

2,107

 

 

 

2,224

 

 

16,052

 

 

 

15,783

 

 

 

 

 

 

 

Property and equipment, at cost

 

67,365

 

 

 

66,275

 

Accumulated depreciation

 

(35,893

)

 

 

(35,134

)

 

 

31,472

 

 

 

31,141

 

 

 

 

 

 

 

Investments of insurance subsidiaries

 

387

 

 

 

485

 

Investments in and advances to affiliates

 

615

 

 

 

633

 

Goodwill and other intangible assets

 

10,504

 

 

 

10,293

 

Right-of-use operating lease assets

 

2,094

 

 

 

2,130

 

Other

 

326

 

 

 

255

 

 

 

 

 

 

 

 

 

$

61,450

 

 

$

60,720

 

 

 

 

 

 

 

LIABILITIES AND STOCKHOLDERS' (DEFICIT) EQUITY

 

 

 

 

 

 

Current liabilities:

 

 

 

 

 

 

Accounts payable

$

4,806

 

 

$

4,659

 

Accrued salaries

 

2,022

 

 

 

2,525

 

Other accrued expenses

 

3,898

 

 

 

4,277

 

Short-term borrowings and long-term debt due within
   one year

 

8,532

 

 

 

4,889

 

 

 

19,258

 

 

 

16,350

 

 

 

 

 

 

 

 

Long-term debt, less debt issuance costs and discounts
   of $433 and $436

 

39,491

 

 

 

41,603

 

Professional liability risks

 

1,509

 

 

 

1,466

 

Right-of-use operating lease obligations

 

1,822

 

 

 

1,853

 

Income taxes and other liabilities

 

2,348

 

 

 

2,219

 

 

 

 

 

 

 

 

Stockholders' (deficit) equity:

 

 

 

 

 

 

Stockholders' deficit attributable to HCA Healthcare, Inc.

 

(6,303

)

 

 

(6,027

)

Noncontrolling interests

 

3,325

 

 

 

3,256

 

 

(2,978

)

 

 

(2,771

)

 

 

$

61,450

 

 

$

60,720

 

 

6

 


 

HCA Healthcare, Inc.

Condensed Consolidated Statements of Cash Flows

First Quarter

Unaudited

(Dollars in millions)

 

 

 

2026

 

 

2025

 

Cash flows from operating activities:

 

 

 

 

 

 

Net income

 

$

1,857

 

 

$

1,825

 

Adjustments to reconcile net income to net cash provided by operating activities:

 

 

 

 

 

 

Increase (decrease) in cash from operating assets and liabilities:

 

 

 

 

 

 

Accounts receivable

 

 

(463

)

 

 

(327

)

Inventories and other assets

 

 

80

 

 

 

(360

)

Accounts payable and accrued expenses

 

 

(990

)

 

 

(1,000

)

Depreciation and amortization

 

 

930

 

 

 

860

 

Income taxes

 

 

435

 

 

 

492

 

Losses (gains) on sales of facilities

 

 

1

 

 

 

(1

)

Amortization of debt issuance costs and discounts

 

 

11

 

 

 

11

 

Share-based compensation

 

 

86

 

 

 

98

 

Other

 

 

67

 

 

 

53

 

 

 

 

 

 

 

 

Net cash provided by operating activities

 

 

2,014

 

 

 

1,651

 

 

 

 

 

 

 

 

Cash flows from investing activities:

 

 

 

 

 

 

Purchase of property and equipment

 

 

(1,119

)

 

 

(991

)

Acquisition of hospitals and health care entities

 

 

(265

)

 

 

(227

)

Sales of hospitals and health care entities

 

 

3

 

 

 

161

 

Change in investments

 

 

103

 

 

 

28

 

Other

 

 

(4

)

 

 

(3

)

 

 

 

 

 

 

 

Net cash used in investing activities

 

 

(1,282

)

 

 

(1,032

)

 

 

 

 

 

 

 

Cash flows from financing activities:

 

 

 

 

 

 

Issuances of long-term debt

 

 

-

 

 

 

5,233

 

Net change in short-term borrowings and revolving credit facilities

 

 

1,435

 

 

 

220

 

Repayment of long-term debt

 

 

(58

)

 

 

(3,895

)

Distributions to noncontrolling interests

 

 

(191

)

 

 

(220

)

Payment of debt issuance costs

 

 

-

 

 

 

(57

)

Payment of dividends

 

 

(183

)

 

 

(180

)

Repurchase of common stock

 

 

(1,571

)

 

 

(2,506

)

Other

 

 

(262

)

 

 

(90

)

 

 

 

 

 

 

 

Net cash used in financing activities

 

 

(830

)

 

 

(1,495

)

 

 

 

 

 

 

 

Effect of exchange rate changes on cash and cash equivalents

 

 

(2

)

 

 

3

 

 

 

 

 

 

 

 

Change in cash and cash equivalents

 

 

(100

)

 

 

(873

)

Cash and cash equivalents at beginning of period

 

 

1,040

 

 

 

1,933

 

 

 

 

 

 

 

 

Cash and cash equivalents at end of period

 

$

940

 

 

$

1,060

 

 

 

 

 

 

 

 

Interest payments

 

$

569

 

 

$

539

 

Income tax (refunds) payments, net

 

$

(5

)

 

$

10

 

 

7

 


 

HCA Healthcare, Inc.

Operating Statistics

 

 

First Quarter

 

 

 

 

2026

 

 

2025

 

 

Operations:

 

 

 

 

 

 

 

Number of Hospitals

 

189

 

 

 

192

 

 

Number of Freestanding Outpatient
   Surgery Centers*

 

119

 

 

 

125

 

 

Licensed Beds at End of Period

 

50,459

 

 

 

50,571

 

 

Weighted Average Beds in Service

 

42,848

 

 

 

42,862

 

 

 

 

 

 

 

 

 

 

Reported:

 

 

 

 

 

 

 

Admissions

 

580,258

 

 

 

576,361

 

 

% Change

 

0.7

%

 

 

 

 

Equivalent Admissions

 

1,023,575

 

 

 

1,012,090

 

 

% Change

 

1.1

%

 

 

 

 

Revenue per Equivalent Admission

$

18,669

 

 

$

18,102

 

 

% Change

 

3.1

%

 

 

 

 

Inpatient Revenue per Admission

$

20,297

 

 

$

19,349

 

 

% Change

 

4.9

%

 

 

 

 

Patient Days

 

2,774,607

 

 

 

2,836,616

 

 

% Change

 

-2.2

%

 

 

 

 

Equivalent Patient Days

 

4,894,407

 

 

 

4,981,098

 

 

% Change

 

-1.7

%

 

 

 

 

Inpatient Surgery Cases

 

133,262

 

 

 

133,759

 

 

% Change

 

-0.4

%

 

 

 

Outpatient Surgery Cases

 

240,061

 

 

 

246,620

 

 

% Change

 

-2.7

%

 

 

 

 

Emergency Room Visits

 

2,509,083

 

 

 

2,518,716

 

 

% Change

 

-0.4

%

 

 

 

 

Outpatient Revenues as a
   Percentage of Patient Revenues

 

36.6

%

 

 

37.3

%

 

Average Length of Stay (days)

 

4.782

 

 

 

4.922

 

 

Occupancy**

 

75.5

%

 

 

76.9

%

 

 

 

 

 

 

 

 

 

Same Facility:

 

 

 

 

 

 

 

Admissions

 

576,766

 

 

 

571,712

 

% Change

 

0.9

%

 

 

 

Equivalent Admissions

 

1,015,685

 

 

 

1,002,211

 

% Change

 

1.3

%

 

 

 

Revenue per Equivalent Admission

$

18,692

 

 

$

18,125

 

% Change

 

3.1

%

 

 

 

Inpatient Revenue per Admission

$

20,327

 

 

$

19,366

 

% Change

 

5.0

%

 

 

 

Inpatient Surgery Cases

 

132,568

 

 

 

132,980

 

% Change

 

-0.3

%

 

 

 

Outpatient Surgery Cases

 

236,326

 

 

 

240,386

 

% Change

 

-1.7

%

 

 

 

Emergency Room Visits

 

2,493,971

 

 

 

2,486,264

 

% Change

 

0.3

%

 

 

 

 

* Excludes freestanding endoscopy centers (30 centers at March 31, 2026 and 26 centers at March 31, 2025).

** Reflects the rate of occupancy (patient days and observations) based on weighted average beds in service.

8

 


 

HCA Healthcare, Inc.

Supplemental Non-GAAP Disclosures

Operating Results Summary

(Dollars in millions, except per share amounts)

 

 

First Quarter

 

 

 

 

2026

 

 

2025

 

 

Revenues

$

19,109

 

 

$

18,321

 

 

 

 

 

 

 

 

 

Net income attributable to HCA Healthcare, Inc.

$

1,620

 

 

$

1,610

 

Losses (gains) on sales of facilities (net of tax)

 

1

 

 

 

(1

)

Net income attributable to HCA Healthcare, Inc.,
   as adjusted (a)

 

1,621

 

 

 

1,609

 

Depreciation and amortization

 

930

 

 

 

860

 

Interest expense

 

584

 

 

 

547

 

Provision for income taxes

 

430

 

 

 

502

 

Net income attributable to noncontrolling interests

 

237

 

 

 

215

 

 

 

 

 

 

 

 

 

Adjusted EBITDA (a)

$

3,802

 

 

$

3,733

 

 

 

 

 

 

 

 

 

Adjusted EBITDA margin (a)

 

19.9

%

 

 

20.4

%

 

 

 

 

 

 

 

 

Diluted earnings per share:

 

 

 

 

 

 

 

Net income attributable to HCA Healthcare, Inc.

$

7.15

 

 

$

6.45

 

Losses (gains) on sales of facilities

 

-

 

 

 

-

 

Net income attributable to HCA Healthcare, Inc.,
   as adjusted (a)

$

7.15

 

 

$

6.45

 

 

 

 

 

 

 

Shares used in computing diluted earnings per
   share (millions)

 

226.652

 

 

 

249.440

 

 

(a)
Net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA should not be considered as measures of financial performance under generally accepted accounting principles ("GAAP"). These non-GAAP financial measures are adjusted to exclude losses (gains) on sales of facilities and losses on retirement of debt. We believe net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA are important measures that supplement discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA as the primary measures to review and assess operating performance of its health care facilities and their management teams.

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.

9

 


 

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

 

$

76,500

 

 

$

80,000

 

 

 

 

 

 

 

 

Net income attributable to HCA Healthcare, Inc. (a)

 

$

6,495

 

 

$

7,035

 

Depreciation and amortization

 

 

3,705

 

 

 

3,775

 

Interest expense

 

 

2,330

 

 

 

2,420

 

Provision for income taxes

 

 

2,010

 

 

 

2,160

 

Net income attributable to noncontrolling interests

 

 

1,010

 

 

 

1,060

 

 

 

 

 

 

 

 

Adjusted EBITDA (a) (b)

 

$

15,550

 

 

$

16,450

 

 

 

 

 

 

 

 

Diluted earnings per share:

 

 

 

 

 

 

Net income attributable to HCA Healthcare, Inc.

 

$

29.10

 

 

$

31.50

 

 

 

 

 

 

 

 

Shares used in computing diluted earnings per share (millions)

 

 

223.500

 

 

 

223.500

 

 

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.

 

(a)
The Company does not forecast the impact of items such as, but not limited to, losses (gains) on sales of facilities, losses on retirement of debt, legal claim costs (benefits) and impairments of long-lived assets because the Company does not believe that it can forecast these items with sufficient accuracy.

(b)
Adjusted EBITDA should not be considered a measure of financial performance under generally accepted accounting principles ("GAAP"). We believe Adjusted EBITDA is an important measure that supplements discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon Adjusted EBITDA as a primary measure to review and assess operating performance of its health care facilities and their management teams.

Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our healthcare 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.

 

10

 


FAQ

How did HCA (HCA) perform financially in Q1 2026?

HCA reported solid Q1 2026 results, with revenue of $19.109 billion, up 4.3% year over year, and net income attributable to HCA of $1.620 billion. Adjusted EBITDA reached $3.802 billion, reflecting 1.9% growth as the company navigated mixed volumes and reimbursement dynamics.

What were HCA (HCA) earnings per share for Q1 2026?

HCA’s diluted earnings per share for Q1 2026 were $7.15, up 10.9% from $6.45 a year earlier. The increase reflects modest growth in net income and the impact of share repurchases, with diluted shares declining from 249.440 million to 226.652 million over the period.

What dividend did HCA (HCA) declare in this filing?

HCA’s board declared a quarterly cash dividend of $0.78 per share on its common stock. The dividend is payable on June 30, 2026 to stockholders of record at the close of business on June 16, 2026, funded from cash balances and operating cash flows.

Did HCA (HCA) reaffirm its 2026 financial guidance?

Yes. HCA reaffirmed its 2026 guidance, projecting revenues of $76.5–$80.0 billion and net income attributable to HCA of $6.495–$7.035 billion. It expects Adjusted EBITDA of $15.55–$16.45 billion and diluted EPS of $29.10–$31.50, based on 223.5 million diluted shares.

How strong were HCA (HCA) cash flows and capital returns in Q1 2026?

HCA generated robust operating cash flow of $2.014 billion in Q1 2026, up 22.0% year over year. It invested $1.119 billion in capital expenditures and repurchased 3.157 million shares for $1.571 billion, while also paying $183 million in dividends to shareholders.

What is HCA’s (HCA) leverage and liquidity position as of March 31, 2026?

As of March 31, 2026, HCA reported $940 million in cash and cash equivalents, $48.023 billion in total debt, and $61.450 billion in total assets. The company also had $4.336 billion of availability under its credit facility, providing meaningful liquidity for operations and capital deployment.

Filing Exhibits & Attachments

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