10-QPeriod: Q2 FY2026

HCA Healthcare, Inc. Quarterly Report for Q2 Ended Jun 30, 2026

Filed July 28, 2026For Securities:HCA

Summary

HCA Healthcare, Inc. (HCA) reported a solid second quarter for 2026, with revenues increasing by 8.7% to $20.23 billion, driven by a 6.0% rise in revenue per equivalent admission and a 2.6% increase in equivalent admissions. Net income attributable to HCA Healthcare, Inc. grew to $1.699 billion ($7.62 per diluted share) from $1.653 billion ($6.83 per diluted share) in the prior year quarter. This performance was bolstered by a significant $1.372 billion in incremental revenues from the Florida directed payment program, though this also included $829 million in associated operating expenses. Despite revenue growth, cash flow from operations declined year-over-year due to unfavorable working capital changes, particularly an increase in accounts receivable linked to state directed payment programs and higher income taxes paid. The company continued its share repurchase program and declared a quarterly dividend, indicating a commitment to returning capital to shareholders. However, rising uninsured admissions (up 23.3%) due to the expiration of Enhanced Premium Tax Credits (EPTCs) and other factors present a potential headwind. Management remains focused on cost control, with salaries and benefits as a percentage of revenue decreasing, though other operating expenses saw an increase, partly attributed to inflation.

Key Highlights

  • 1Revenues for Q2 2026 increased by 8.7% year-over-year to $20.23 billion, driven by higher revenue per equivalent admission and increased patient volumes.
  • 2Net income attributable to HCA Healthcare, Inc. rose to $1.699 billion ($7.62 per diluted share) in Q2 2026, up from $1.653 billion ($6.83 per diluted share) in Q2 2025.
  • 3The company recognized $1.372 billion in incremental revenues from the Florida directed payment program, which positively impacted top-line results.
  • 4Consolidated and same-facility uninsured admissions saw a significant increase of 23.3% and 23.4% respectively, primarily attributed to the expiration of Enhanced Premium Tax Credits (EPTCs) at the end of 2025.
  • 5Cash flow from operating activities declined by $1.875 billion in Q2 2026 compared to Q2 2025, largely due to unfavorable working capital changes and increased income tax payments.
  • 6Salaries and benefits as a percentage of revenue decreased to 41.0% in Q2 2026 from 43.7% in Q2 2025, indicating improved labor cost management relative to revenue.
  • 7The company repurchased approximately $4.75 million shares of common stock in Q2 2026 and declared a quarterly dividend of $0.78 per share.

Frequently Asked Questions

The primary driver of the revenue increase was a combination of a 6.0% increase in revenue per equivalent admission and a 2.6% increase in equivalent admissions. Additionally, HCA recognized $1.372 billion in incremental revenues from the Florida directed payment program.

The increase in uninsured admissions, up 23.3% year-over-year, is primarily attributed to the expiration of Enhanced Premium Tax Credits (EPTCs) at the end of 2025, administrative reforms impacting insurance purchased through Exchanges, and a decline in Medicaid conversions.

Cash flow from operating activities declined by $1.875 billion in the second quarter of 2026 compared to the prior year. This was mainly due to unfavorable working capital changes, including an increase in accounts receivable related to Medicaid programs, and higher income taxes paid stemming from a 2025 IRS deferral.

The Florida directed payment program resulted in incremental revenues of $1.372 billion and associated other operating expenses of $829 million for the period October 1, 2024, through June 30, 2026. This program significantly contributed to revenue growth but also increased operating expenses.