HCA Healthcare (HCA) Q1 2025 earnings summary

Executive summary

• Revenues rose 5.7% year-over-year to $18.321 billion in Q1 2025, driven by higher admissions, improved payer mix, and revenue per admission.

• Net income attributable to HCA was $1.610 billion ($6.45 per diluted share), up from $1.591 billion ($5.93 per share) in Q1 2024.

• Strong financial and operational momentum continued, supported by investments in facilities and workforce, leading to higher patient satisfaction and reduced length of stay.

• Market share gains were observed across service categories, with robust growth in cardiac procedures and rehabilitation.

• Cash flows from operating activities declined to $1.651 billion from $2.469 billion, mainly due to working capital changes.

Financial highlights

• Adjusted diluted EPS rose over 20% year-over-year to $6.45 in Q1 2025.

• Revenue reached $18.321 billion, a 5.7% increase year-over-year.

• Adjusted EBITDA margin improved to 20.4%, with adjusted EBITDA at $3.733 billion.

• Cash flow from operations was $1.65 billion, impacted by timing-related working capital changes.

• Capital expenditures totaled $991 million, excluding acquisitions.

Outlook and guidance

• Full-year 2025 guidance reaffirmed: revenue $72.8–$75.8 billion, net income $5.85–$6.29 billion, adjusted EBITDA $14.3–$15.1 billion, and diluted EPS $24.05–$25.85.

• Capital expenditures expected at $5–$5.2 billion for 2025, with a step-up in spend anticipated in subsequent quarters.

• Management expects to finance capital expenditures with internally generated and borrowed funds.

• A significant portion of the $10 billion share repurchase authorization is expected to be completed in 2025, subject to market conditions.

• Guidance assumes stable operating environment and volume growth, excluding non-recurring items.