HCA Healthcare’s fourth quarter results were met with a significant positive response from the market, reflecting confidence in the company’s operational execution and margin improvements. Management credited the quarter’s performance to sustained volume growth across its networks, disciplined expense management, and continued investment in both inpatient and outpatient capacity. CEO Samuel Hazen emphasized that the company delivered its nineteenth consecutive quarter of volume growth and highlighted the benefits from network expansion and enhanced clinical capabilities, stating, “Our teams executed at a high level, we gained ground with our strategic agenda, and we stayed focused on the fundamentals.”
Is now the time to buy HCA? Find out in our full research report (it’s free for active Edge members).
HCA Healthcare (HCA) Q4 CY2025 Highlights:
- Revenue: $19.51 billion vs analyst estimates of $19.71 billion (6.7% year-on-year growth, 1% miss)
- EPS (GAAP): $8.14 vs analyst estimates of $7.46 (9.2% beat)
- Adjusted EBITDA: $4.11 billion vs analyst estimates of $4.03 billion (21.1% margin, 2% beat)
- EPS (GAAP) guidance for the upcoming financial year 2026 is $30.30 at the midpoint, beating analyst estimates by 1.9%
- EBITDA guidance for the upcoming financial year 2026 is $16 billion at the midpoint, above analyst estimates of $15.82 billion
- Operating Margin: 16.8%, up from 13.5% in the same quarter last year
- Same-Store Sales rose 2.4% year on year, in line with the same quarter last year
- Market Capitalization: $113.4 billion
While we enjoy listening to the management's commentary, our favorite part of earnings calls are the analyst questions. Those are unscripted and can often highlight topics that management teams would rather avoid or topics where the answer is complicated. Here is what has caught our attention.
Our Top 5 Analyst Questions From HCA Healthcare’s Q4 Earnings Call
- A.J. Rice (UBS) asked about assumptions for expense items like salaries, supplies, and professional fees in the 2026 outlook; CFO Mike Marks explained margins are expected to remain stable, with ongoing cost pressures for physicians but steady contract labor.
- Ann Hynes (Mizuho) questioned the resilience of cost-saving initiatives to offset ACA-related headwinds; Marks detailed the resiliency program’s focus on revenue integrity, cost efficiency, and digital transformation, expressing confidence in achieving targeted savings.
- Pito Chickering (Deutsche Bank) probed whether core growth guidance exceeded long-term trends after adjusting for headwinds; Marks confirmed guidance reflects strong underlying performance and momentum, excluding one-time factors.
- Whit Mayo (Leerink Partners) inquired about digital integration efforts with payers; Marks described progress in electronic data exchange and administrative simplification, which are improving revenue cycle and cash flow.
- Ryan Langston (TD Cowen) asked about the M&A pipeline and capital priorities, given policy and subsidy changes; CEO Hazen noted increased opportunities in outpatient acquisitions and significant capital investment planned for both organic and inorganic growth.
Catalysts in Upcoming Quarters
In the quarters ahead, the StockStory team will be watching (1) the pace and effectiveness of HCA’s resiliency and cost-saving programs in offsetting policy headwinds, (2) the impact of expiring premium tax credits and Medicaid payment changes on patient volumes and uncompensated care, and (3) continued expansion and integration of outpatient facilities. Progress in digital transformation and the ability to adapt to evolving reimbursement environments will also be key indicators of execution.
HCA Healthcare currently trades at $496.92, up from $472.38 just before the earnings. At this price, is it a buy or sell? See for yourself in our full research report (it’s free).
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