HCA Healthcare (HCA) Q4 2023 earnings summary

Executive summary

• Q4 revenue was $17.303B and Adjusted EBITDA was $3.618B; net income was $1.607B, or $5.93 per diluted share.

• FY2023 revenue totaled $64.968B, Adjusted EBITDA $12.726B, and net income $5.242B, or $18.97 per diluted share.

• Strong demand across markets and service lines, alongside improved cost trends, supported Q4 performance.

Financial highlights

• Q4 revenue was $17.303B vs. $15.497B YoY; net income was $1.607B vs. $2.081B, and diluted EPS was $5.93 vs. $7.28.

• Q4 Adjusted EBITDA was $3.618B vs. $3.179B; excluding facility-sale gains and debt-retirement losses, adjusted diluted EPS was $5.90 vs. $4.64.

• FY2023 revenue was $64.968B vs. $60.233B; net income was $5.242B vs. $5.643B, and diluted EPS was $18.97 vs. $19.15.

• FY2023 Adjusted EBITDA was $12.726B vs. $12.067B; adjusted diluted EPS, excluding facility-sale and debt-retirement items, was $19.01 vs. $16.89.

• Q4 operating cash flow was $2.674B vs. $2.527B YoY.

Outlook and guidance

• 2024 guidance: revenue $67.75B–$70.25B; net income $5.20B–$5.60B; Adjusted EBITDA $12.85B–$13.55B; diluted EPS $19.70–$21.20.

• 2024 capital expenditures, excluding acquisitions, are forecast at $5.1B–$5.3B.

• Guidance assumes expectations for patient volumes, payor mix, and economic conditions including inflation; it excludes facility-sale, debt-retirement, legal-claim, and impairment items.