HCA Healthcare is sharply lower after reporting first-quarter 2026 results that investors viewed as a profitability disappointment. While the company posted higher revenue and year-over-year EPS growth, the market reaction centered on margins and operating performance, with adjusted EBITDA growth lagging expectations.

HCA reported Q1 2026 revenue of $19.109 billion, up 4.3% from the prior year, and net income attributable to HCA of $1.620 billion, translating to $7.15 per diluted share. Adjusted EBITDA rose 1.9% to $3.802 billion, and the company highlighted same-facility admissions up 0.9% and equivalent admissions up 1.3%, but weaker surgical volumes weighed on the mix (same-facility inpatient surgeries down 0.3% and outpatient surgeries down 1.7%).

Management said the company did not see its typical seasonal volume increase in Q1, primarily due to a major drop in respiratory activity: respiratory-related admissions fell 42% and respiratory-related emergency-room visits fell 32% versus Q1 2025. HCA also cited a January winter storm that negatively affected volumes in certain markets, a combination that can pressure staffing leverage, throughput, and near-term margin expectations even when revenue holds up.

HCA reaffirmed its previously issued 2026 guidance ranges, which may temper longer-term concerns but didn’t prevent a near-term derating as investors recalibrated expectations for volume-driven profitability. Key follow-through items now include whether volumes normalize in Q2, whether payer mix and labor costs stabilize as respiratory trends revert, and whether weather-related disruptions remain a recurring swing factor across HCA’s footprint.