HCA Healthcare (HCA) Q1 2026 earnings summary

Executive summary

• Revenues grew 4.3% year-over-year to $19.109 billion in Q1 2026, with adjusted EBITDA up 1.9% and adjusted EPS up 10.9%.

• Net income attributable to shareholders was $1.62 billion ($7.15 per diluted share), up 0.6% from Q1 2025.

• Respiratory-related admissions and ER visits declined sharply due to a mild season and winter storms, but Medicaid supplemental program recognition and higher-than-expected state payments offset much of the impact.

• Cash flows from operating activities increased 22% to $2.014 billion, driven by positive working capital changes.

• Resiliency initiatives and digital transformation, including AI, are progressing and supporting cost control.

Financial highlights

• Admissions increased 0.9% and equivalent admissions rose 1.3% year-over-year.

• Inpatient surgeries fell 0.3%, outpatient surgeries declined 1.7%, and ER visits rose 0.3%.

• Salaries and benefits were 43.3% of revenues, supplies 14.9%, and other operating expenses 21.9%.

• Adjusted EBITDA margin was 19.9%, down from 20.4% a year ago; net income margin was 8.5%.

• Cash flow from operations was $2.014 billion, up 22% year-over-year.

Outlook and guidance

• Full-year 2026 guidance reaffirmed: revenues expected at $76.5–$80 billion, net income $6.495–$7.035 billion, and adjusted EBITDA $15.55–$16.45 billion.

• Volume growth expected at 2%-3% for the remainder of the year.

• Supplemental payment program net benefit guidance updated to a decline of $50M-$250M versus prior year.

• Exchange-related adjusted EBITDA impact expected to be $600M-$900M for the year.

• Resiliency program targeted to deliver $400M in cost savings for 2026.