HCA Healthcare reported fourth-quarter adjusted earnings per share of $8.01, up 28.8% from $6.22 a year earlier, beating consensus estimates by more than 7%. Revenue increased 6.7% year-over-year to $19.51 billion, supported by a 2.5% rise in equivalent admissions and a 2.9% increase in revenue per equivalent admission. Adjusted EBITDA climbed 10.8% to $4.11 billion, lifting the margin to 21.1% from 20.3% a year ago. Same-facility admissions grew 2.4%, underscoring sustained patient demand across HCA’s network of 186 hospitals and 2,300 healthcare sites.

Over the past 12 months, HCA shares have gained more than 40%, driven in part by an aggressive $10 billion stock repurchase program announced in the fourth quarter. The company has used buybacks to reduce its share count by over 5% year-to-date, boosting free cash flow yield to approximately 6%. Operating margin expansion—up 80 basis points year-over-year—has provided the financial flexibility to support capital allocation priorities, including incremental investments in outpatient facilities and digital health platforms.

For fiscal 2026, HCA projects adjusted earnings between $29.10 and $31.50 per share, well above the $27.70 Wall Street consensus, and anticipates revenue of $76.5 billion to $80.0 billion versus consensus of $75.7 billion. Management expects cost inflation to moderate and volume growth to accelerate modestly. However, the company cautions that margin benefits may be nearing a peak and highlights potential headwinds from forthcoming Medicaid reimbursement changes and Affordable Care Act policy revisions. At a valuation near 16 times forward earnings, analysts warn that any margin compression could weigh on the stock’s upside potential.