HCA Healthcare Reports Prelim Q2 Sales Of ~$20.230B, Up From $18.605B YoY; Lowers FY2026 GAAP EPS From $29.10-$31.50 To $28.70-$30.50

HCA Healthcare, Inc. (NYSE: HCA ) today announced preliminary financial and operating results for the second quarter ended June 30, 2026.

The preliminary financial and operating results are subject to finalization of the Company's quarterly financial and accounting procedures.

HCA anticipates revenues in the second quarter of 2026 to approximate $20.230 billion, compared to $18.605 billion in the second quarter of 2025.

Net income attributable to HCA Healthcare, Inc. is expected to approximate $1.699 billion, or $7.62 per diluted share, compared to $1.653 billion, or $6.83 per diluted share, in the second quarter of 2025.

Results for the second quarter of 2026 include anticipated gains on sales of facilities of $10 million, or $0.03 per diluted share.

Results for the second quarter of 2025 included losses on sales of facilities of $3 million, or $0.01 per diluted share.

For the second quarter of 2026, Adjusted EBITDA is expected to approximate $4.027 billion, compared to $3.849 billion in the second quarter of 2025.

Adjusted EBITDA is a non-GAAP financial measure.

A table providing supplemental information on Adjusted EBITDA and reconciling net income attributable to HCA Healthcare, Inc. to Adjusted EBITDA is included in this release.

Same facility admissions increased 2.5 percent and same facility equivalent admissions increased 2.7 percent in the second quarter of 2026 compared to the prior year period.

Same facility emergency room visits increased 3.6 percent in the second quarter of 2026 compared to the prior year period.

Same facility inpatient surgeries declined 2.3 percent, and same facility outpatient surgeries declined 3.4 percent in the second quarter of 2026 compared to the same period of 2025. "Our colleagues continue to manage well through the positive and negative factors that have impacted our business in the first half of the year, and I want to thank them for their great work.

As we look to the balance of the year, we have adjusted our guidance to reflect these factors.

Moreover, we remain confident in our ability to navigate through this dynamic environment, maintain our focus and investments on improving patient care, and execute on our strategic plan to digitize and grow our healthcare networks," said Sam Hazen, Chief Executive Officer of HCA Healthcare.

Second Quarter Commentary During the second quarter, the Company experienced a payer mix shift driven by an increase in uninsured volume, primarily due to patients who lost coverage on the health insurance exchanges.

The Company estimates this payer mix shift had an unfavorable impact on income before income taxes of approximately $400 million during the second quarter.

This amount includes an increase of approximately $75 million related to the Company’s previous estimate of the first quarter health insurance exchange impact.

In addition, to a lesser degree the Company experienced a service mix shift primarily related to a decline in surgical volume.

The Company also experienced positive factors including growth in admissions, equivalent admissions and ER visits, increased benefit from Medicaid Supplemental Payment Programs and improved expense trends.

During the second quarter, the Company recognized approximately $400 million of incremental net benefit from Medicaid Supplemental Payment Programs, primarily related to the state of Florida for the time period October 1, 2024 through June 30, 2026, to reflect the impact of the state directed payment program approved during the quarter by the Centers for Medicare and Medicaid Services.

The Company will provide additional commentary on its second quarter earnings call.

2026 Updated Guidance and Key Assumptions Based on results through the first half of the year, the Company has revised its 2026 guidance as follows: Previous 2026 Guidance Ranges, as of January 27, 2026 Revised 2026 Guidance Ranges, as of July 14, 2026 Revenues $76.500 to $80.000 billion $77.000 to $79.500 billion Net Income Attributable to HCA Healthcare, Inc. $6.495 to $7.035 billion $6.300 to $6.700 billion Adjusted EBITDA $15.550 to $16.450 billion $15.400 to $16.100 billion EPS (diluted) $29.10 to $31.50 per diluted share $28.70 to $30.50 per diluted share The Company revised its 2026 key assumptions related to the unfavorable impact on income before income taxes from payer mix shifts due to the health insurance exchanges, as well as the incremental net benefit from Medicaid Supplemental Payment Programs, as follows: Previous 2026 Estimates, as of April 24, 2026 Revised 2026 Estimates, as of July 14, 2026 Health Insurance Exchanges ($600) to ($900) million ($1.000) to ($1.200) billion Medicaid Supplemental Payment Programs ($50) to ($250) million $300 to $500 million The Company's 2026 estimate for capital expenditures of $5.0 billion to $5.5 billion, excluding acquisitions, remains unchanged.

The Company’s guidance contains a number of assumptions, including, among others, the Company’s current expectations regarding volume growth coupled with an anticipated mostly stable operating environment, payer mix, service mix, the impact of current and future health care public policy developments, including the estimated impact on health insurance exchanges from administrative reforms and the expiration of the enhanced premium tax credits, anticipated results from resiliency initiatives, as well as general business or economic conditions, including inflation and the impact of trade policies, including tariffs, and excludes the impact of items such as, but not limited to, gains or losses on sales of facilities, losses on retirement of debt, legal claims costs and impairment of long-lived assets.

In addition, the Company’s guidance excludes the impact of future approvals that could impact reimbursement under certain state Medicaid directed and supplemental payments.