HCA Healthcare (HCA) Oppenheimer 36th Annual Healthcare MedTech & Services Conference summary

Business performance and growth outlook

• Achieved 2.4% admission growth and 90 basis point EBITDA margin improvement in 2025, with plans to maintain focus on strategic agenda in 2026.

• Investments target digital, AI, financial resiliency, and network optimization strategies.

• Capital projects focus on expanding inpatient capacity and outpatient sites, aiming for 20 outpatient sites per hospital and a 30% market share by decade's end.

• $7 billion in capital projects expected to come online within 24–36 months.

Market dynamics and payer mix

• Exchange admissions represented 8% of admissions and 10% of revenue in 2025; a 15–20% decline in exchange volume is expected in 2026, with some migration to employer-sponsored insurance and an uptick in uninsured volume.

• Medicare, Medicaid, and commercial (excluding exchanges) volumes are projected to grow 2–3% in 2026, with Medicaid rebounding after recent declines.

• State supplemental payments are expected to decline by $250–$450 million year-over-year, driven by program pauses and retro payments, but new approvals in Georgia and potential in Florida could provide upside.

• Medicaid cuts under OB3 are seen as manageable due to incremental benefits, phased implementation, and strong positioning in non-expansion states.

Pricing, acuity, and expense management

• Continued investment in high-acuity services has lifted hospital acuity and improved patient retention.

• 90% of commercial contracts for 2026 are finalized, with rate increases in the expected single-digit range.

• Supply expenses are stable, with over two-thirds of 2026 pricing locked in and most sourcing from North America, mitigating tariff and geopolitical risks.