Universal Health Services (UHS) Q4 2025 earnings summary

Executive summary

• Q4 2025 revenue grew 9.1% and adjusted EBITDA net of NCI rose 10% year-over-year; adjusted EPS up 20%.

• Full-year 2025 revenue increased 9.7%, adjusted EBITDA net of NCI up 15%, and adjusted EPS up 31%.

• Net income attributable to shareholders rose to $445.9M ($7.06/share) in Q4 2025 and $1.489B ($23.10/share) for the year.

• Growth agenda advanced with new inpatient capacity, expansion of outpatient services, and accelerated technology adoption including AI.

• Strong expense management, sequential volume improvements, and significant share repurchases highlighted performance.

Financial highlights

• Q4 2025 net income per diluted share was $7.06; adjusted net income per diluted share was $5.88.

• Q4 2025 EBITDA net of NCI was $785.1M (17.5% margin); full-year EBITDA net of NCI was $2.725B (15.7% margin).

• Cash from operations was $1.864B for 2025, down from $2.067B in 2024, impacted by receivables and Medicaid payment timing.

• $1.015B spent on capital expenditures in 2025; $899M used for share repurchases.

• Acute care same-facility net revenues increased 6.9% year-over-year; behavioral health same-facility net revenues rose 7.2%.

Outlook and guidance

• 2026 revenue expected at $18.417B–$18.789B (6–8% growth); adjusted EBITDA net of NCI at $2.641B–$2.789B (2–8% growth).

• Adjusted net income per diluted share projected at $22.64–$24.52 (4–13% growth).

• Same-facility volume growth of 2–3% expected for both segments in 2026, with Q1 likely below range due to winter storms.

• Capital expenditures for 2026 forecasted at $950M–$1.1B.

• Guidance includes $75M pre-tax headwind from health insurance exchange reductions and $35M from new California staffing regulations.