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HCA Healthcare
HCA Healthcare (HCA) investor relations material
HCA Healthcare Q4 2025 earnings summary
Complete event summary combining all related documents: earnings call transcript, report, and slide presentation.Q4 2025 earnings summary27 Jan, 2026
Executive summary
Achieved 19 consecutive quarters of volume growth, with strong demand and improved margins year-over-year and sequentially in Q4 2025.
Fourth quarter 2025 revenues rose 6.7% year-over-year to $19.513 billion, with net income up 30.6% to $1.878 billion and adjusted EBITDA up 10.8% to $4.114 billion.
Full-year 2025 revenues reached $75.600 billion, net income $6.784 billion, and adjusted EBITDA $15.566 billion, all showing strong year-over-year growth.
Record 47 million patient encounters in 2025, driven by network expansion and workforce investments.
Strategic focus on resiliency, cost management, and digital transformation to offset policy and reimbursement headwinds.
Financial highlights
Q4 2025 admissions up 2.4%, equivalent admissions up 2.5% year-over-year; ER visits up 0.5%.
Same-facility net revenue per equivalent admission increased 2.9% year-over-year.
Full-year 2025 consolidated adjusted EBITDA up 12.1%, with a 90 bps margin improvement.
Operating cash flow reached $12.6B for 2025, up 20% from 2024.
$2.6B in share repurchases in Q4 and $10B for the year; $679M in dividends paid in 2025.
Outlook and guidance
2026 revenue expected between $76.5B and $80B; adjusted EBITDA $15.55B–$16.45B.
Net income guidance: $6.495B–$7.035B; adjusted EPS: $29.10–$31.50.
Capital spending range increased to $5B–$5.5B for 2026.
Guidance assumes 2%–3% equivalent admissions growth, $600M–$900M adverse EBITDA impact from health insurance exchanges, partially offset by $400M in resiliency savings.
Anticipates $250M–$450M decline in supplemental payment net benefit; full-year margins expected slightly above 20%.
New $10B share repurchase program authorized; quarterly dividend increased from $0.72 to $0.78 per share.
What explains Q4 2025 adjusted EPS variance?
Assess 2025 share repurchases vs. cash flow
Reconcile Q4 same-facility admissions vs. surgeries
Supplemental payment decline drivers
Capital allocation priorities for 2026
AI's role in clinical and operational improvements
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Next HCA Healthcare earnings date
Q1 202624 Apr, 2026
HCA Healthcare
Next HCA Healthcare earnings date
Q1 202624 Apr, 2026
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Frequently asked questions
HCA Healthcare, Inc., provides health care services company in the United States. It operates through Hospital & Ambulatory Care segment. The company offers medical and surgical products and services; sleep medicine; imaging services; physical therapy and rehabilitation; diagnostic laboratory service; ambulatory surgery services; ambulatory urgent care centers, including urgent care centers; endoscopy centers, including colonoscopy centers; surgical hospitals, including cardiac surgery hospitals; outpatient rehabilitation clinics; and family planning centers.
It also provides primary, acute and ancillary care services in an arrangement with third parties that includes contract provisions for total management of the facilities. The company was founded in 1968 and is headquartered in Nashville, Tennessee
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