HCA Healthcare Q4 EPS Surges 28.8% to $8.01; Revenue Rises 6.7% to $19.5B
HCA Healthcare delivered adjusted Q4 EPS of $8.01, up 28.8% year over year and beating estimates by 8.8%, driven by strong margins and volume growth. Revenue rose 6.7% to $19.5 billion, narrowly missing consensus, while adjusted EBITDA grew 10.8% to $4.1 billion.
1. Strong Earnings Performance
HCA Healthcare reported adjusted Q4 EPS of $8.01, a 28.8% increase from the prior year, surpassing consensus by 8.8%. The beat reflected disciplined expense management and favorable payer mix.
2. Revenue and Volume Trends
Revenues grew 6.7% year over year to $19.5 billion, slightly below consensus by 0.6%. Same-facility equivalent admissions rose 2.5%, with inpatient and emergency room visits up 2.4% and 0.5%, respectively, offsetting a 0.5% dip in outpatient surgeries.
3. Margin Expansion and EBITDA
Adjusted EBITDA reached $4.1 billion, up 10.8% from a year ago and ahead of expectations by $200 million. Improvement was driven by higher revenue per admission and continued cost controls in SG&A and supply chain.
4. Network Scale and Outlook
As of Dec. 31, 2025, HCA operated 190 hospitals and approximately 2,500 ambulatory sites across 19 states and the U.K. Management highlighted capacity investments and digital initiatives to support future volume growth and margin expansion.