HCA Healthcare Inc

Latest Results (30.08.2026):

HCA Healthcare, Inc. reported results for the second quarter of 2026: revenues rose to $20.230 billion (up 8.7%), net income attributable to HCA Healthcare, Inc. was $1.699 billion (up 2.8%), and diluted EPS was $7.62 (up 11.6%). Adjusted EBITDA was $4.027 billion (up 4.6%). The quarter was affected by an unfavorable payer‑mix shift (about $400 million pre‑tax) tied to increased uninsured volume from health insurance exchange changes, offset in part by roughly $400 million of incremental net benefit from Medicaid supplemental payment programs (primarily Florida). Cash from operations fell to $2.335 billion in Q2 2026 versus $4.210 billion a year ago, and the company updated 2026 guidance lowering net income and EPS ranges while narrowing revenue and Adjusted EBITDA guidance.

Revenues and Profitability

Q2 2026 revenues: $20.230B (+8.7% vs Q2 2025). Net income attributable to HCA Healthcare, Inc.: $1.699B (+2.8%). Diluted EPS: $7.62 (+11.6%); adjusted diluted EPS: $7.59 (+11.0%). Adjusted EBITDA: $4.027B (+4.6%) with an Adjusted EBITDA margin of 19.9%.

Payer Mix, Medicaid & Florida Program

The company estimates an unfavorable payer‑mix impact of ~ $400M on income before taxes in Q2 (including a $75M adjustment from Q1). Offsetting this, HCA recognized ~ $400M incremental net benefit from Medicaid supplemental payments, largely tied to a Florida directed payment program; incremental Florida revenues recorded in the quarter totaled $1.372B with related other operating expenses of $829M (about $980M revenue and $557M expense related to periods prior to 2026).

Volumes and Service Mix

Same facility admissions rose 2.5% and same facility equivalent admissions rose 2.7% year‑over‑year. ER visits up ~3.6%. Surgical volumes declined: same facility inpatient surgeries -2.3% and outpatient surgeries -3.4%. Revenue per equivalent admission increased ~6.4% (same facility).

Cash Flow, Balance Sheet & Capital

Cash flows from operating activities were $2.335B in Q2 2026 (vs. $4.210B in Q2 2025). Cash and cash equivalents at June 30, 2026: $1.013B. Total debt: $49.718B. Capital expenditures in Q2: $1.231B (ex‑acquisitions).

Shareholder Returns

Q2 repurchases: 4.752M shares for $2.064B; $7.210B remaining under repurchase authorization as of June 30, 2026. Board declared quarterly cash dividend of $0.78 per share payable Sept 30, 2026 (record Sept 16, 2026).

2026 Guidance Update and Key Assumptions

Revised 2026 guidance (as of July 14, 2026): revenues $77.0B–$79.5B; net income attributable $6.3B–$6.7B; Adjusted EBITDA $15.4B–$16.1B; diluted EPS $28.70–$30.50. Management widened its estimate of the negative impact from health insurance exchanges to ($1.0B)–($1.2B) and now expects a $300M–$500M net benefit from Medicaid supplemental payment programs for 2026.

Other operational notes

Q2 included modest gains on sales of facilities ($10M pre‑tax, ~$0.03 per diluted share). Six‑month results: revenues $39.339B and net income attributable $3.319B. HCA operated 190 hospitals and ~2,600 ambulatory sites as of June 30, 2026.