HCA Healthcare Inc., a leading hospital network operator, announced its financial results for the fourth quarter of 2025 on Tuesday. The company reported total revenues of $19.513 billion, marking a 6.7% increase compared to the same quarter in the previous year. However, this figure fell short of the consensus analyst estimate of $19.67 billion, indicating a slight miss on the revenue front.
Despite the revenue miss, HCA Healthcare's adjusted earnings per share demonstrated marked improvement. The company posted adjusted earnings of $8.01 per share, significantly higher than $6.22 recorded in the prior fiscal year’s Q4, and surpassing the consensus estimate of $7.43. This earnings performance highlights effective operational management contributing to profitability growth amidst varying market conditions.
Looking ahead to fiscal 2026, HCA Healthcare projected adjusted earnings per share in the range of $29.10 to $31.50, which marginally diverges from the consensus forecast of $29.54. Meanwhile, revenue guidance for the year is positioned between $76.5 billion and $80 billion, modestly flanking the consensus estimate of $79.08 billion. This forecast suggests management’s confidence in sustaining growth while also prudently navigating anticipated market factors.
Equity research firm Cantor Fitzgerald weighed in on these results and outlook, underscoring the favorable outlook for continued core growth in HCA Healthcare’s operations. Analyst Sarah James reiterated her Overweight rating on the stock and elevated the price target from $525 to $588. James emphasized that the structural underpinnings within HCA’s provider model continue to present an appealing investment opportunity.
The company’s recent performance also dispelled some concerns relating to subsidy risks from the enhanced Advanced Premium Tax Credit (eAPTC). HCA’s initial estimate of exposure to eAPTC-related subsidies came in well below bearish market apprehensions, complementing the encouraging core growth trajectory.
For fiscal 2026, HCA anticipates adjusted EBITDA between $15.55 billion and $16.45 billion. Cantor Fitzgerald noted this outlook comfortably exceeds more pessimistic or 'Bear Case' market expectations that projected flat year-over-year growth. The projections are underpinned by confidence in the company’s operational stability and structural positioning.
The stability of HCA’s balance sheet remains a notable strength, characterized by Cantor Fitzgerald as “best-in-class.” Management’s approach to capital allocation is demonstrated through a planned $10 billion share repurchase program, signaling robust confidence in the company's long-term value creation. Additionally, HCA's management team sees an improved pipeline of outpatient acquisition opportunities, marking a brighter landscape compared to previous years.
In contrast, analysts at BofA Securities expressed prudence regarding the hospital sector more broadly, highlighting ongoing headwinds such as moderating fundamental conditions and a challenging environment due to restrictive policy and reimbursement frameworks. They noted that peers such as Universal Health Services Inc. and Ardent Health Inc. might face greater operational pressures, while positioning HCA Healthcare as comparatively resilient in mitigating these issues.
Market reaction to HCA’s fiscal updates has been negative, with the company’s shares trading down 3.99% at $485.59 as of Wednesday’s session according to Benzinga Pro data. This decline reflects investor caution despite the company’s solid core financials and forward guidance.
Overall, HCA Healthcare’s fourth-quarter results and fiscal 2026 outlook illustrate a company poised for sustained growth. While revenue slightly dipped below expectations, strong earnings performance, a healthy balance sheet, and strategic capital deployment underpin a positive longer-term perspective amidst a complex hospital sector environment.