Stock Markets January 27, 2026

HCA Healthcare Sees 2026 Profit Outlook Above Street Estimates as Patient Demand Remains Firm

Robust utilization of government-backed insurance and a stronger-than-expected quarterly profit underpin guidance; revenue missed consensus while surgeries showed mixed trends

By Nina Shah
HCA Healthcare Sees 2026 Profit Outlook Above Street Estimates as Patient Demand Remains Firm

HCA Healthcare projected 2026 adjusted profit above analysts' consensus after reporting quarterly results that topped per-share expectations amid solid demand for medical services. The operator highlighted higher utilization of government insurance, a mixed surgical volume performance, and authorized a sizable share buyback.

Key Points

  • HCA projected 2026 adjusted earnings per share in a $29.10 to $31.50 range, with the midpoint above analysts' average estimate of $29.46 per share.
  • Fourth-quarter adjusted EPS of $8.01 beat the analyst consensus of $7.46, while total revenue of $19.51 billion missed the $19.68 billion expectation.
  • Same-facility revenue per equivalent admission rose 2.9%; inpatient surgeries were flat and outpatient surgeries fell 0.5%. The company authorized up to $10 billion in share repurchases.

HCA Healthcare on Tuesday provided 2026 profit guidance that sits above Wall Street forecasts following a quarterly report in which adjusted earnings per share beat analyst estimates on the back of persistent demand for medical services.

The Nashville, Tennessee-based hospital operator said rising utilization of government-run Medicare plans has supported patient volumes, particularly when older beneficiaries undergo surgical procedures. The company and market commentary also pointed to the expiration this year of COVID-era subsidies under individual Affordable Care Act plans - a dynamic the company said is expected to influence patient behavior. Specifically, HCA expects patients to take advantage of remaining affordable insurance coverage for elective procedures, preventive visits and diagnostic testing while that coverage remains accessible.

HCA noted that treating patients covered by government-backed programs delivers more predictable reimbursement compared with care for uninsured individuals, which often results in uncompensated services and elevated bad debt for hospital systems.

In premarket trading, shares of HCA climbed nearly 5% on the day of the release.

Operational and financial details for the quarter ended December 31 included a 2.9% rise in revenue per equivalent admission at same facilities - a measure that combines inpatient and outpatient admissions. Within that mix, same-facility inpatient surgery volumes held steady, while same-facility outpatient surgeries declined by 0.5%.

For the fourth quarter, total revenue was $19.51 billion, below the $19.68 billion that analysts had expected. On an adjusted basis, HCA reported earnings of $8.01 per share, beating the consensus estimate of $7.46 per share.

Looking ahead, the company set a 2026 profit-per-share outlook in a range of $29.10 to $31.50. The midpoint of that range sits above the analysts' average estimate of $29.46 per share, based on data compiled by LSEG.

HCA also approved a stock repurchase program authorizing up to $10 billion of its outstanding common shares.

The release also included a reference to third-party analytical services that evaluate stocks using automated models. Those services were described as applying large numbers of financial metrics to identify potential investment ideas and noted prior winners that had produced significant gains.


Methodology note: The article reports company statements, quarterly figures and forward guidance as provided by HCA and as presented using LSEG-compiled analyst estimates.

Risks

  • Revenue shortfall risk: Fourth-quarter total revenue of $19.51 billion fell short of the $19.68 billion analysts expected, indicating potential top-line pressure in the near term - this impacts healthcare and hospital sector revenue forecasts.
  • Volume and mix uncertainty: While revenue per equivalent admission rose, outpatient surgery declines (-0.5%) and flat inpatient surgery volumes suggest variability in service mix that could affect margins and utilization metrics - this affects hospital operations and payer mix analysis.
  • Payer mix and uncompensated care exposure: HCA benefits from higher utilization of government-backed insurance, but changes in insurance affordability and the transition of subsidies could shift patient behavior and reimbursement patterns, influencing bad debt and funding for hospitals.

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