NYSE$HCA

HCA Holdings Inc · Q4 2025 earnings

Q4 2025 earnings · · Before market open · Investor relations

Briefing

HCA Healthcare reported Q4 2025 revenue of $19.5B with net income of $1.88B and diluted EPS of $8.14.

Revenues increased 6.7% to $19.513 billion; net income rose 30.6% to $1.878 billion with diluted EPS of $8.14 (adjusted $8.01). Adjusted EBITDA grew 10.8% to $4.114 billion. Same-facility admissions rose 2.4%. Management issued 2026 guidance for revenue of $76.5–$80.0 billion, adjusted EBITDA of $15.55–$16.45 billion, and diluted EPS of $29.10–$31.50.

  • Q4 revenue $19.5B (+6.7% YoY); adjusted EBITDA $4.1B.
  • Diluted EPS $8.14 (+44.6% YoY).
  • 2026 revenue guide $76.5–$80.0B.
  • Same-facility admissions +2.4%.

Headline financials

Total Revenue

$19.5B

Previous: $18.3B+6.7%
EPS (adj)

$8.01

Previous: $6.22+28.8%
Admissions

576.8K

Previous: 559.2K+3.2%
Number of Hospitals

190

Previous: 190+0.0%
Licensed Beds at End of Period

50.4K

Previous: 50.0K+0.9%
Occupancy

72.0%

Previous: 71.7%+0.4%
Average Length of Stay (days)

4.696

Previous: 4.814-2.5%
Equivalent Admissions

1.0M

Previous: 1.0M+3.0%
Inpatient Surgery Cases

137.0K

Previous: 135.6K+1.0%
Outpatient Surgery Cases

264.4K

Previous: 263.8K+0.2%
Emergency Room Visits

2.5M

Previous: 2.5M+0.5%
Net Income

$1.88B

Previous: $1.44B+30.6%
Operating Income

$2.67B

Previous: $2.13B+25.3%

Revenue & EPS history

HCA · Revenue · Quarterly

$19.5B

Q4 2025+6.7%vs Q4 2024
Beat estimate in 9 of 15 quarters(60%)
ActualEstimate

Forward guidance

HCA guided 2026 revenue of $76.5–$80.0 billion, adjusted EBITDA of $15.55–$16.45 billion, and diluted EPS of $29.10–$31.50, with capex of $5.0–$5.5 billion excluding acquisitions.

Tailwinds

  • 2026 diluted EPS guide $29.10–$31.50.
  • Same-facility volume trends stable entering 2026.
  • Network expansion and clinical investments support growth.
  • Quarterly dividend $0.78 declared for March 2026.

Headwinds

  • Medicaid supplemental payment and EPTC expiration risks.
  • Labor and payer mix pressure on margins.
  • Deferred tax payments impacted Q4 operating cash flow.
  • Regulatory and reimbursement uncertainty in managed care.

Historical earnings impact

How earnings announcements have historically affected this stock's price.

Avg. return before/after earnings

Based on 20 quarterly earnings reports · overlaid with Q4 2025

Historical avgQ4 2025

-0.1%

Avg return

Earnings day

+0.8%

Avg return

5 days after

+2.9%

Avg return

30 days after

47%

31 / 66 earnings

Positive

+16.1%

Q2 2020

Best reaction

-21.9%

Q1 2022

Worst reaction

Earnings price reactions
QuarterReport dateReaction (Day 0)+5 days+30 days
Q1 2026-5.2%-8.3%-16.8%
Q4 2025+6.2%+3.4%+11.3%
Q3 2025+1.5%+6.4%+11.6%
Q2 2025+0.8%+3.1%+3.8%
Q1 2025-4.0%+1.1%+10.3%
Q4 2024-3.8%+0.7%-2.7%
Q3 2024-10.6%-9.5%-18.5%
Q2 2024+5.7%+9.0%+17.7%
Q1 2024-0.9%-1.5%+1.5%
Q4 2023+6.3%+7.9%+8.7%
Q3 2023-6.5%-6.5%+5.0%
Q2 2023-3.2%-2.9%-3.2%
Q1 2023+5.7%+2.7%+4.3%
Q4 2022-0.6%+2.6%-2.2%
Q3 2022+0.8%+4.3%+10.3%
Q2 2022+9.6%+12.9%+18.6%
Q1 2022-21.9%-21.2%-24.0%
Q4 2021-1.4%-1.1%+5.5%
Q3 2021-7.0%-5.6%-8.1%
Q2 2021+14.5%+14.2%+13.3%
Q1 2021+2.5%+0.7%+4.5%
Q4 2020+3.7%+5.9%+5.6%
Q3 2020-4.4%-9.3%+12.5%
Q2 2020+16.1%+14.6%+21.2%
Q1 2020-5.4%-2.4%-2.2%
Q4 2019+2.6%-2.0%-10.1%
Q3 2019+6.2%+5.3%+10.3%
Q2 2019-8.7%-13.0%-17.4%
Q1 2019-1.1%+0.2%-2.3%
Q4 2018+5.6%+6.1%+5.5%
Q3 2018+3.5%+4.2%+12.0%
Q2 2018+14.9%+14.7%+21.4%
Q1 2018+2.1%+1.9%+7.7%
Q4 2017+3.6%+2.1%+1.9%
Q3 2017+0.9%+0.3%+11.6%
Q2 2017-5.2%-6.6%-7.9%
Q1 2017-1.2%-0.4%-0.1%
Q4 2016+3.4%+5.7%+10.2%
Q3 2016-2.1%-4.5%-9.6%
Q2 2016-1.1%-3.8%-4.8%
Q1 2016-1.7%
Q4 2015+3.1%
Q3 2015-0.1%
Q2 2015-2.8%
Q1 2015-1.2%
Q4 2014-1.7%
Q3 2014-2.1%
Q2 2014+4.1%
Q1 2014-1.2%
Q4 2013-1.0%
Q3 2013-5.1%
Q2 2013+0.1%
Q1 2013+3.8%
Q4 2012-1.1%
Q3 2012+8.0%
Q2 2012+1.1%
Q1 2012-1.1%
Q4 2009+3.5%
Q4 2011+3.5%
Q3 2011+2.6%
Q3 2010+2.6%
Q2 2011-20.6%
Q2 2010-20.6%
Q1 2011-0.2%
Q1 2010-0.2%
Q4 2010-0.2%

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