HCA Healthcare Inc. (NYSE:HCA), one of the nation’s largest hospital operators, released mixed fourth-quarter 2025 financial results on Tuesday.
HCA reported total revenues of $19.513 billion, representing a 6.7% year-over-year increase, missing the consensus estimate of $19.67 billion.
The hospital chain operator reported adjusted earnings of $8.01, up from $6.22 a year ago, surpassing the consensus of $7.43.
Net income for the quarter reached $1.878 billion, or $8.14 per share, compared to $1.438 billion, or $5.63/share, a year ago.
Results for the fourth quarter of 2025 included gains on sales of facilities of $41 million, or $0.13 per diluted share, primarily related to the sale of a hospital facility in Indiana.
Performance Metrics
In the fourth quarter of 2025, same-facility admissions increased by 2.4%, and same-facility equivalent admissions increased by 2.5%.
Same facility emergency room visits increased 0.5%, and same facility inpatient surgeries were flat, and same facility outpatient surgeries decreased 0.5% in the fourth quarter.
For the fourth quarter of 2025, Adjusted EBITDA totaled $4.114 billion, compared to $3.712 billion a year ago.
Cash flows from operating activities totaled $2.359 billion, compared to $2.559 billion in the fourth quarter of 2024.
“We finished 2025 with strong performance consistent with previous quarters. Our investments in network expansion, workforce development, and advancing clinical capabilities further strengthened the HCA Healthcare system,” said Sam Hazen, CEO of HCA Healthcare.
Stock Buyback And Outlook
HCA Healthcare on Tuesday authorized an additional share repurchase program for up to $10 billion. It is worth noting that HCA Healthcare’s current market cap is approximately $103 billion, making the stock buyback worth approximately 10% of the listed stock.
HCA Healthcare forecasts fiscal 2026 earnings of $29.10-$31.50 per share compared to the consensus of $29.54.
The company sees 2026 sales of $76.5 billion-$80 billion compared to the consensus of $79.08 billion.
The hospital operator expects 2026 adjusted EBITDA between $15.55 billion and $16.45 billion and net income of $6.495 billion-$7.035 billion.
On the company conference call, the company executive said they expect a $600 million to $900 million adverse impact related to health insurance exchanges. The executive added that they expect a $250 million to $450 million decline in net benefit from supplemental payments in 2026.
HCA Price Action: HCA Healthcare shares were up 11.29% at $525.69 at the time of publication on Tuesday. The stock is trading at a new 52-week high, according to Benzinga Pro data.
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