10-QPeriod: Q1 FY2026

HCA Healthcare, Inc. Quarterly Report for Q1 Ended Mar 31, 2026

Filed April 29, 2026For Securities:HCA

Summary

HCA Healthcare, Inc. (HCA) reported solid financial results for the first quarter of 2026, demonstrating revenue growth and improved profitability year-over-year. Revenues increased by 4.3% to $19.1 billion, driven by a modest rise in equivalent admissions and a stronger increase in revenue per equivalent admission. Net income attributable to HCA Healthcare, Inc. also saw an uptick to $1.62 billion, or $7.15 per diluted share, reflecting effective cost management and favorable share repurchases, which reduced the diluted share count. Despite positive top-line and bottom-line growth, investors should note the increasing proportion of uninsured admissions, up 15.6%, largely attributed to the expiration of Enhanced Premium Tax Credits (EPTCs) at the end of 2025. While overall patient volumes saw slight increases in admissions, surgical volumes (both inpatient and outpatient) and emergency department visits experienced declines. The company continues to manage significant debt and is investing heavily in capital expenditures, with planned expenditures between $5.0 billion and $5.5 billion for 2026.

Financial Highlights

45 data points
Beta

Revenue

$19.11B

Net Income

$1.62B

8.5% Net Margin

EPS (Diluted)

$7.15

Total Assets

$61.45B

Cash & Equivalents

$940.00M

Free Cash Flow

$895.00M

Financial Statements
Beta
Revenue$19.11B
Operating Expenses$16.82B
Interest Expense$584.00M
Net Income$1.62B
EPS (Basic)$7.25
EPS (Diluted)$7.15
Shares Outstanding (Basic)223.59M
Shares Outstanding (Diluted)226.65M

Key Highlights

  • 1Revenues grew 4.3% year-over-year to $19.1 billion in Q1 2026, driven by increases in equivalent admissions and revenue per equivalent admission.
  • 2Net income attributable to HCA Healthcare, Inc. rose to $1.62 billion, or $7.15 per diluted share, aided by share repurchases that reduced the diluted share count.
  • 3Uninsured admissions significantly increased by 15.6%, indicating potential headwinds from the expiration of Enhanced Premium Tax Credits (EPTCs).
  • 4Despite revenue growth, inpatient and outpatient surgical volumes declined, as did emergency department visits on a consolidated basis.
  • 5Cash flow from operations increased substantially by $363 million to $2.014 billion, primarily due to favorable working capital changes.
  • 6The company plans significant capital expenditures for 2026, estimated between $5.0 billion and $5.5 billion, and has substantial ongoing construction projects.
  • 7Salaries and benefits, as a percentage of revenue, slightly decreased, while other operating expenses increased, partly due to higher professional fees and technology investments.

Frequently Asked Questions

Revenue growth of 4.3% to $19.1 billion in Q1 2026 was primarily driven by a 1.1% increase in equivalent admissions and a 3.1% increase in revenue per equivalent admission on a consolidated basis. Same-facility metrics showed a similar trend with a 1.3% rise in equivalent admissions and a 3.1% increase in revenue per equivalent admission.

Consolidated and same-facility uninsured admissions increased by 15.6% and 15.5%, respectively. This is attributed to the expiration of Enhanced Premium Tax Credits (EPTCs) at the end of 2025, administrative reforms, and a decline in Medicaid conversions. This trend could pressure future revenue collection and profitability if it continues.

HCA maintains a substantial debt load, with total debt at $48.023 billion as of March 31, 2026. While interest expense increased to $584 million, the company is managing this through a combination of operations, available credit facilities, and planned access to debt markets. A majority of its debt is maintained at fixed rates to mitigate interest rate risk, although approximately $3.95 billion was subject to variable rates.

Key operational challenges include a decline in surgical volumes (both inpatient and outpatient) and a slight decrease in consolidated emergency department visits. The company also noted that seasonal respiratory activity was lower than typical and a winter storm impacted volumes in certain markets. The increase in uninsured admissions is a significant area to monitor for its potential financial impact.