HCA Healthcare Inc.

ticker: HCA step: 01 generated: 2026-05-12 source: quick-research

HCA Healthcare, Inc. (HCA) — Business Overview

Business Description

HCA Healthcare is the largest for-profit healthcare provider in the United States — operates 190 hospitals + ~2,500 ambulatory sites of care (surgery centers, freestanding ERs, urgent care, physician clinics) in 19 states + United Kingdom. Captures ~5% of total US hospital admissions. Hub-and-spoke operating model links acute-care hospitals with outpatient centers to capture patients across the entire care continuum.

Revenue Model

~$75.6B FY2025 revenue from hospital-based services + outpatient services (now 42% of patient revenue). Payer mix FY2025: Managed Care + Private Insurance ~48%, Medicare ~32%, Medicaid ~10%, Self-Pay + International ~10%. Revenue per admission rises with patient acuity (case mix). Scale + payer-negotiation leverage = best-in-class economics among hospital systems.

Products & Services

• 190 Acute Care Hospitals — Cardiac, oncology, neurosciences, orthopedic, emergency, women's services
• ~125 Freestanding Outpatient Surgery Centers — Lower-cost surgical settings
• Freestanding ERs + Urgent Care Centers — Capture entry-point patient acquisition
• Physician Clinics — Primary + specialist physician network
• Sarah Cannon Cancer Network — Multi-state oncology platform
• HealthONE — Major Denver-area health system
• MD Now Urgent Care — Florida urgent care platform
• HCA International — UK operations (London Bridge Hospital, etc.)

Customer Base & Go-to-Market

~38M patient encounters annually. Concentrated in growth markets: Texas, Florida (largest), Tennessee, Virginia, Nevada, Colorado, Indiana. Geographic concentration in high-growth Sun Belt states + UK. Diversified payer mix protects from single-payer concentration risk.

Competitive Position

#1 US for-profit hospital operator by revenue + size. Competes with Tenet Healthcare (THC), Universal Health Services (UHS), Community Health Systems (CYH), HCA Florida vs nonprofits AdventHealth, Baptist, Memorial. Differentiation: scale + hub-and-spoke + data analytics + capital investment in growth corridors + acuity mix shift.

Key Facts

• Founded: 1968
• Headquarters: Nashville, TN
• Employees: ~280,000 (caregivers + physicians + staff)
• Exchange: NYSE (HCA)
• Sector / Industry: Healthcare / Healthcare Facilities (Hospitals)
• Market Cap: ~$110-120B
• CEO: Sam Hazen (since 2019)

ticker: HCA step: 04 generated: 2026-05-12 source: quick-research

HCA Healthcare, Inc. (HCA) — Financial Snapshot

Income Statement Summary

FY25: Same-facility admissions +2.4% in Q4; full-year inpatient + outpatient surgery + ER visits all positive. Adj EBITDA +12%; EBITDA margin 20.6% (record high). EPS +29% (driven by share buybacks compounding effect).

Cash Flow & Balance Sheet (FY2024)

Key Ratios (approximate)

• P/E: ~16x | EV/EBITDA: ~9-10x | FCF Yield: ~5.5%
• Revenue Growth (TTM): ~7% | Op Margin: ~15%
• Dividend Yield: ~1.0% | Modest dividend; capital return primarily via buybacks
• Aggressive buybacks: ~$8-10B annually = ~7-8% share count reduction

Growth Profile

Long-term: 5-7% revenue growth (admissions + price/acuity) + 100bps margin expansion + 10-12% adj EBITDA growth + 12-15% EPS growth (with aggressive buybacks). $5.2B capex plan adds 600-700 beds annually + ORs + ASCs. Hub-and-spoke + AI/analytics = $400M resiliency program savings.

Forward Estimates

• FY 2026: Revenue ~$80B; adj EBITDA $16-17B; adj EPS $29.10-31.50 (raised guidance)
• ACA + Medicaid headwind: $600-900M EBITDA hit (manageable)
• FY 2027: Adj EPS ~$33-36 with full-year 2026 buybacks compounding
• $10B buyback authorization (Jan 2026) for 2026-27 execution