A Business at a Glance
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HCA Healthcare, Inc.
HCA
$91.5B
Mkt Cap
$382.19
+1.51%
HCA Healthcare, Inc. (HCA) has a current P/E ratio of 13.5, compared to its historical median P/E of 13.7. The stock is currently considered Fair based on its historical valuation range.
HCA Healthcare, Inc. (HCA) has a 5-year average return on invested capital (ROIC) of 21.9%. This indicates strong capital allocation and a potential competitive advantage.
HCA Healthcare, Inc. (HCA) has a market capitalization of $85.0B. It is classified as a large-cap stock.
Yes, HCA Healthcare, Inc. (HCA) pays a dividend with a trailing twelve-month yield of 0.80%. The company also returns capital through share buybacks, with a buyback yield of 10.74%.
Based on historical P/E analysis, HCA Healthcare, Inc. (HCA) appears fair. The current P/E of 13.5 is 2% below its historical median of 13.7. The estimated fair value CAGR (P/E method) is 15.4%.
HCA Healthcare, Inc. (HCA) operates in the Services-General Medical & Surgical Hospitals, Nec industry, within the Healthcare sector.
HCA Healthcare, Inc. (HCA) reported annual revenue of $75.6 billion in its most recent fiscal year, based on SEC EDGAR filings.
HCA Healthcare is one of the leading U.S. health care services companies, operating 190 hospitals (179 general acute care, 7 behavioral, and 4 rehabilitation), 121 freestanding ambulatory surgery centers, and 31 freestanding endoscopy centers across 19 states and England. The company generates revenue from inpatient and outpatient services provided to patients covered by Medicare, Medicaid, managed care plans (including health insurance exchange plans), private insurers, and uninsured patients, with reimbursement rates varying significantly by payer type, service category, and geographic location. HCA's general acute care hospitals provide comprehensive medical and surgical services including emergency care, intensive care, and diagnostic services, while behavioral hospitals deliver mental health and substance abuse treatment; outpatient facilities including ASCs and urgent care centers extend the company's reach and support its strategy to develop integrated health care networks in select communities. The company operates through a decentralized model with local boards of trustees at each facility, supported by centralized corporate services including supply chain management, financial systems, clinical programs, and information technology, which generate economies of scale and operational leverage. HCA's competitive positioning rests on its scale, geographic diversification, clinical capabilities, and ability to attract and retain physicians and health care professionals, though the company faces headwinds from payer mix shifts driven by health insurance exchange dynamics, Medicaid redetermination, and supplemental payment program volatility.
【Exchange headwinds and resiliency focus】 Management expects continued volume growth in the 2%-3% range, supported by strong demand in its markets, but anticipates material headwinds from health insurance exchange coverage losses and supplemental payment program declines in 2026. The company is implementing a $400 million resiliency program targeting operational efficiencies and cost management to offset approximately half of the estimated $600 million–$900 million adverse impact from exchange-related payer mix deterioration. Management remains confident in its ability to navigate policy dynamics through disciplined capital deployment, continued investment in digital and AI capabilities, and expansion of outpatient access points and high-acuity service lines. The company expects margins to remain stable at slightly above 20% in 2026 despite cost pressures, particularly in physician compensation, and plans to continue investing in technology transformation and clinical systems to support long-term value creation.
| Metric | Target | Period |
|---|---|---|
| Revenue | $76.5 billion–$80 billion | FY2026 |
| Adjusted EBITDA | $15.55 billion–$16.45 billion | FY2026 |
| Net income attributable to HCA Healthcare | $6.5 billion–$7 billion | FY2026 |
| Diluted earnings per share | $29.10–$31.50 | FY2026 |
| Equivalent admissions growth | 2%–3% | FY2026 |
| Adverse impact on adjusted EBITDA from health insurance exchanges | $600 million–$900 million | FY2026 |
| Resiliency initiatives offset to exchange headwind | approximately $400 million | FY2026 |
| Decline in supplemental payment programs net benefit | $250 million–$450 million | FY2026 |
| Full year margins | slightly above 20% | FY2026 |
| Cash flow from operations | $12 billion–$13 billion |
Generated solely from the company's own reports listed below — not from third-party data. Hallucination risk is low. · Sources: 10-K, Q4 FY2025 Earnings Call, Q3 FY2025 Earnings Call, Q2 FY2025 Earnings Call, Q1 FY2025 Earnings Call
| Metric | TTM | FY2025 | FY2024 | FY2023 | FY2022 | FY2021 |
|---|---|---|---|---|---|---|
| Revenue | 76.4B | 75.6B | 70.6B | 65.0B | 60.2B | 58.8B |
| Net Income | 6.8B | 6.8B | 5.8B | 5.2B | 5.6B | 7.0B |
| EPS | $29.79 | $28.33 | $22.00 | $18.97 | $19.15 | $21.16 |
| Free Cash Flow | 7.9B | 7.7B | 5.6B | 4.7B | 4.1B | 5.4B |
| ROIC | 0.0% | 22.8% | 20.3% | 19.8% | 21.0% | 25.7% |
| Gross Margin | - | 21.4% | 20.3% | 20.1% | 22.6% | 24.8% |
| Debt/Equity | 0.00 | -7.71 | -17.22 | -22.32 | -13.76 | -40.98 |
| Dividends/Share | $3.06 | $2.88 | $2.64 | $2.40 | $2.24 | $1.92 |
| Operating Income | 0 | 11.1B | 9.7B | 8.8B | 9.1B | 10.6B |
| Operating Margin | 0.0% | 14.7% | 13.7% | 13.5% | 15.2% | 18.1% |
| ROE | 0.0% | -159.1% | -269.6% | -230.9% | -305.0% | - |
| Shares Outstanding | 223M | 239M | 262M | 276M | 295M | 329M |
| Metric | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Income Statement | |||||||||||||
| Revenue | 40.1B | 3.7B | 41.5B | 43.6B | 46.7B | 51.3B | 51.5B | 58.8B | 60.2B | 65.0B | 70.6B | 75.6B | 76.4B |
| Gross Margin | N/A | N/A | 21.3% | 19.6% | 54.1% | 19.5% | 19.7% | 24.8% | 22.6% | 20.1% | 20.3% | 21.4% | N/A |
| R&D | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| SG&A | 285M | 327M | 343M | 340M | 21.4B | 370M | 416M | 337M | 307M | 353M | 421M | 548M | 555M |
| EBIT | 4.7B | 5.1B | 6.0B | 5.5B | 6.5B | 6.4B | 6.4B | 10.6B | 9.1B | 8.8B | 9.7B | 11.1B | 0 |
| Op. Margin | 11.8% | N/A | 14.4% | 12.7% | 13.9% | 12.5% | 12.4% | 18.1% | 15.2% | 13.5% | 13.7% | 14.7% | 0.0% |
| Net Income | 1.9B | 2.1B | 2.9B | 2.2B | 3.8B | 3.5B | 3.8B | 7.0B | 5.6B | 5.2B | 5.8B | 6.8B | 6.8B |
| Net Margin | 4.7% | 57.7% | 7.0% | 5.1% | 8.1% | 6.8% | 7.3% | 11.8% | 9.4% | 8.1% | 8.2% | 9.0% | 8.9% |
| Non-Recurring | 29M | -5.0M | 23M | 8.0M | 428M | 18M | -7.0M | 1.6B | 1.3B | -5.0M | 14M | 37M | 37M |
| Returns on Capital | |||||||||||||
| ROIC | 15.9% | 16.0% | 18.7% | 14.2% | 19.3% | 17.1% | 17.2% | 25.7% | 21.0% | 19.8% | 20.3% | 22.8% | 0.0% |
| ROE | -23.2% | -27.5% | -38.8% | -31.4% | -76.5% | -90.4% | -335.8% | N/A | -305.0% | -230.9% | -269.6% | -159.1% | 0.0% |
| ROA | 6.3% | 6.7% | 8.7% | 6.3% | 9.7% | 8.3% | 8.1% | 14.2% | 10.9% | 9.6% | 10.0% | 11.3% | 11.1% |
| Cash Flow | |||||||||||||
| Op. Cash Flow | 4.4B | 4.7B | 5.7B | 5.4B | 6.8B | 7.6B | 9.2B | 9.0B | 8.5B | 9.4B | 10.5B | 12.6B | 13.0B |
| Free Cash Flow | 2.3B | 2.4B | 2.9B | 2.4B | 3.2B | 3.4B | 6.4B | 5.4B | 4.1B | 4.7B | 5.6B | 7.7B | 7.9B |
| Owner Earnings | 2.5B | 2.6B | 3.4B | 3.0B | 4.2B | 4.7B | 6.1B | 5.7B | 5.2B | 6.1B | 6.8B | 8.7B | 9.0B |
| CapEx | 2.2B | 2.4B | 2.8B | 3.0B | 3.6B | 4.2B | 2.8B | 3.6B | 4.4B | 4.7B | 4.9B | 4.9B | 5.1B |
| Maint. CapEx | 1.8B | 1.9B | 2.0B | 2.1B | 2.3B | 2.6B | 2.7B | 2.9B | 3.0B | 3.1B | 3.3B | 3.5B | 3.6B |
| Growth CapEx | 356M | 471M | 794M | 884M | 1.3B | 1.6B | 114M | 724M | 1.4B | 1.7B | 1.6B | 1.4B | 1.5B |
| D&A | 1.8B | 1.9B | 2.0B | 2.1B | 2.3B | 2.6B | 2.7B | 2.9B | 3.0B | 3.1B | 3.3B | 3.5B | 3.6B |
| CapEx/OCF | 48.9% | 50.2% | 48.8% | 55.6% | 52.8% | 54.7% | 30.7% | 39.9% | 51.6% | 50.3% | 46.4% | 39.1% | 39.0% |
| Capital Allocation | |||||||||||||
| Dividends Paid | 7.0M | 0 | 0 | 0 | 487M | 550M | 153M | 624M | 653M | 661M | 690M | 679M | 682M |
| Dividend Yield | 0.0% | N/A | N/A | N/A | 1.3% | 1.3% | 0.4% | 0.9% | 1.0% | 0.9% | 0.8% | 0.7% | 0.8% |
| Share Buybacks | 1.8B | 2.4B | 2.8B | 2.1B | 1.5B | 1.0B | 441M | 8.2B | 7.0B | 3.8B | 6.0B | 10.1B | 9.1B |
| Buyback Yield | 5.6% | 8.9% | 10.2% | 6.7% | 3.7% | 2.1% | 0.8% | 10.1% | 10.3% | 5.2% | 7.7% | 8.8% | 10.7% |
| Stock-Based Comp | 163M | 239M | 251M | 270M | 268M | 347M | 362M | 440M | 341M | 262M | 360M | 401M | 389M |
| Debt Repayment | 5.2B | 4.9B | 4.5B | 753M | 1.7B | 5.3B | 3.4B | 3.9B | 2.8B | 909M | 2.4B | 7.4B | 7.4B |
| Balance Sheet | |||||||||||||
| Net Debt | 28.8B | 29.7B | 30.7B | 32.3B | 32.6B | 34.8B | 29.1B | 36.2B | 36.7B | 38.2B | 40.5B | 45.0B | 46.7B |
| Cash & Equiv. | 566M | 741M | 646M | 732M | 502M | 621M | 1.8B | 1.5B | 908M | 935M | 1.9B | 1.0B | 1.3B |
| Long-Term Debt | 29.1B | 30.3B | 31.2B | 32.9B | 32.0B | 33.6B | 30.8B | 34.3B | 37.7B | 37.2B | 38.3B | 41.6B | 39.5B |
| Debt/Equity | -3.73 | -4.01 | -4.30 | -4.86 | -6.79 | -12.67 | 54.20 | -40.98 | -13.76 | -22.32 | -17.22 | -7.71 | 0.00 |
| Interest Coverage | 2.7 | 3.0 | 3.5 | 3.3 | 3.7 | 3.5 | 4.0 | 6.8 | 5.2 | 4.5 | 4.7 | 4.9 | 4.9 |
| Equity | -7.9B | -7.6B | -7.3B | -6.8B | -5.0B | -2.8B | 572M | -933M | -2.8B | -1.8B | -2.5B | -6.0B | -6.3B |
| Total Assets | 31.0B | 32.7B | 33.8B | 36.6B | 39.2B | 45.1B | 47.5B | 50.7B | 52.4B | 56.2B | 59.5B | 60.7B | 61.5B |
| Total Liabilities | 37.5B | 38.8B | 39.4B | 41.6B | 42.1B | 45.6B | 44.6B | 49.3B | 52.5B | 55.2B | 59.0B | 63.5B | -990M |
| Intangibles | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Retained Earnings | -7.6B | -7.3B | -7.0B | -6.5B | -4.6B | -2.4B | 777M | -532M | -2.3B | -1.4B | -2.1B | -5.7B | -6.0B |
| Working Capital | 3.5B | 3.7B | 3.3B | 3.8B | 2.6B | 3.4B | 3.6B | 4.0B | 3.7B | 2.3B | 1.2B | -567M | -3.2B |
| Current Assets | 8.9B | 9.2B | 9.1B | 10.0B | 10.2B | 11.2B | 12.3B | 13.5B | 13.6B | 14.9B | 16.4B | 15.8B | 16.1B |
| Current Liabilities | 5.5B | 5.5B | 5.8B | 6.2B | 7.6B | 7.8B | 8.7B | 9.6B | 9.9B | 12.7B | 15.2B | 16.4B | 19.3B |
| Per Share Data | |||||||||||||
| EPS | 4.16 | 4.99 | 7.30 | 5.95 | 10.66 | 10.07 | 10.93 | 21.16 | 19.15 | 18.97 | 22.00 | 28.33 | 29.79 |
| Owner EPS | 5.47 | 6.07 | 8.68 | 8.12 | 11.86 | 13.39 | 17.90 | 17.24 | 17.69 | 22.05 | 26.13 | 36.38 | 40.52 |
| Book Value | -17.51 | -17.81 | -18.44 | -18.27 | -13.93 | -8.07 | 1.67 | -2.84 | -9.39 | -6.42 | -9.54 | -25.17 | -28.32 |
| Cash Flow/Share | 9.87 | 11.10 | 14.28 | 14.57 | 19.03 | 21.84 | 26.88 | 27.25 | 28.92 | 34.13 | 40.16 | 52.77 | 46.68 |
| Dividends/Share | 0.02 | N/A | N/A | 0.00 | 1.40 | 1.60 | 0.43 | 1.92 | 2.24 | 2.40 | 2.64 | 2.88 | 3.06 |
| Shares Out. | 450.7M | 426.7M | 395.9M | 372.4M | 355.3M | 348.1M | 343.5M | 328.7M | 294.7M | 276.3M | 261.8M | 239.5M | 222.5M |
| Valuation | |||||||||||||
| P/E Ratio | 16.7 | 12.7 | 9.4 | 13.8 | 10.8 | 14.1 | 14.4 | 11.7 | 12.0 | 14.0 | 13.6 | 16.8 | 12.8 |
| P/FCF | 13.8 | 11.4 | 9.4 | 12.7 | 12.8 | 14.4 | 8.4 | 15.1 | 16.5 | 15.7 | 13.9 | 14.9 | 10.7 |
| EV/EBIT | 12.7 | 11.1 | 9.6 | 11.2 | 11.3 | 12.8 | 13.0 | 10.8 | 11.5 | 13.0 | 12.8 | 14.8 | N/A |
| Price/Book | N/A | N/A | N/A | N/A | N/A | N/A | 94.3 | N/A | N/A | N/A | N/A | N/A | N/A |
| Price/Sales | 0.6 | 0.7 | 0.6 | 0.7 | 0.8 | 0.8 | 0.8 | 1.2 | 1.1 | 1.1 | 1.2 | 1.2 | 1.1 |
| FCF Yield | 7.2% | 8.7% | 10.7% | 7.9% | 7.8% | 7.0% | 11.9% | 6.6% | 6.1% | 6.4% | 7.2% | 6.7% | 9.3% |
| Market Cap | 31.3B | 27.0B | 27.1B | 30.6B | 40.9B | 49.5B | 53.9B | 81.5B | 68.0B | 73.6B | 78.6B | 114.3B | 85.0B |
| Avg. Price | 55.40 | 72.21 | 69.76 | 76.28 | 106.71 | 123.79 | 119.99 | 208.25 | 215.83 | 257.52 | 333.00 | 381.47 | 382.19 |
| Year-End Price | 69.55 | 63.25 | 68.38 | 82.09 | 115.24 | 142.15 | 157.06 | 248.03 | 230.71 | 266.39 | 300.27 | 477.13 | 382.19 |
HCA Healthcare, Inc. passes 5 of 9 quality checks, suggesting mixed fundamentals.
HCA Healthcare, Inc. trades at 13.5x trailing earnings, compared to its 15-year median P/E of 13.7x, suggesting it is currently Fair relative to its historical range. On a free-cash-flow basis, the stock trades at 11.1x vs a median of 14.2x. The company's 5-year average ROIC is 21.9% with a gross margin of 21.8%. Total shareholder yield (dividends + buybacks) is 11.5%. At current prices, the estimated annualized return to fair value is +13.6%.
HCA Healthcare, Inc. (HCA) has a net profit margin of 9.0%. This is a modest margin.
HCA Healthcare, Inc. (HCA) generated $7.7 billion in free cash flow in its most recent fiscal year. Positive free cash flow supports dividends, buybacks, and debt reduction.
HCA Healthcare, Inc. (HCA) reported earnings per share (EPS) of $28.33 in its most recent fiscal year.
HCA Healthcare, Inc. (HCA) has a return on equity (ROE) of -159.1%. A negative ROE may indicate losses or negative equity.
HCA Healthcare, Inc. (HCA) has a 5-year average gross margin of 21.8%. This lower margin is typical of capital-intensive or commodity businesses.
The Ledger Terminal provides 17 years of financial data for HCA Healthcare, Inc. (HCA), sourced directly from SEC EDGAR filings. This includes income statements, balance sheets, cash flow statements, and key financial ratios.
HCA Healthcare, Inc. (HCA) has a book value per share of $-25.17, based on its most recent annual SEC filing.
Based on recent SEC filings and earnings disclosures, Management expects continued volume growth in the 2%-3% range, supported by strong demand in its markets, but anticipates material headwinds from health insurance exchange coverage losses and supplemental payment program declines in 2026. The company is implementing a $400 million resiliency program targeting operational efficiencies and cost management to offset approximately half of the estimated $600 million–$900 million adverse impact from exchange-related payer mix deterioration. Management remains confident in its ability to navigate policy dynamics through disciplined capital deployment, continued investment in digital and AI capabilities, and expansion of outpatient access points and high-acuity service lines. The company expects margins to remain stable at slightly above 20% in 2026 despite cost pressures, particularly in physician compensation, and plans to continue investing in technology transformation and clinical systems to support long-term value creation.
Based on recent SEC filings and earnings calls, HCA Healthcare, Inc. (HCA) has provided the following forward guidance: Revenue: $76.5 billion–$80 billion (FY2026); Adjusted EBITDA: $15.55 billion–$16.45 billion (FY2026); Net income attributable to HCA Healthcare: $6.5 billion–$7 billion (FY2026); Diluted earnings per share: $29.10–$31.50 (FY2026); Equivalent admissions growth: 2%–3% (FY2026), plus 5 additional metrics.
| FY2026 |
Revenue (FY2026): “We expect revenues to range between $76.5 billion and $80 billion.”
Adjusted EBITDA (FY2026): “We expect Adjusted EBITDA to range between $15.55 billion and $16.45 billion.”
Net income attributable to HCA Healthcare (FY2026): “We expect net income attributable to HCA Healthcare to range between $6.5 billion and $7 billion.”
Diluted earnings per share (FY2026): “We expect diluted earnings per share to range between $29.10 and $31.50.”
Equivalent admissions growth (FY2026): “growth in equivalent admissions between 2% and 3%.”
Adverse impact on adjusted EBITDA from health insurance exchanges (FY2026): “An adverse impact on adjusted EBITDA between $600 million and $900 million related to the health insurance exchanges.”
Resiliency initiatives offset to exchange headwind (FY2026): “We expect an offset to this exchange headwind of approximately $400 million through resiliency initiatives designed to generate efficiencies throughout the organization.”
Decline in supplemental payment programs net benefit (FY2026): “We anticipate decline in supplemental payment programs net benefit between $250 million and $450 million.”