Why Is HCA (HCA) Up 10% Since Last Earnings Report?

It has been about a month since the last earnings report for HCA Healthcare (HCA). Shares have added about 10% in that time frame, outperforming the S&P 500.

But investors have to be wondering, will the recent positive trend continue leading up to its next earnings release, or is HCA due for a pullback? Well, first let's take a quick look at the most recent earnings report in order to get a better handle on the recent catalysts for HCA Healthcare, Inc. before we dive into how investors and analysts have reacted as of late.

HCA Healthcare Q4 Earnings Beat Estimates on Strong Patient Volumes

HCA Healthcare reported fourth-quarter 2025 adjusted earnings per share (EPS) of $8.01, which outpaced the Zacks Consensus Estimate by 8.8%. The bottom line advanced 28.8% year over year.

Revenues rose 6.7% year over year to $19.5 billion. However, the top line lagged the consensus mark by 0.6%.

The quarterly results benefited on the back of strong same-facility admissions and equivalent admissions. Modest gains in emergency room visits and a rise in revenue per equivalent admission also supported performance. However, the upside was partly offset by elevated operating expenses.

HCA’s Q4 Details

Same-facility equivalent admissions grew 2.5% year over year in the fourth quarter, matching our growth estimate. Meanwhile, same-facility admissions advanced 2.4%, matching our growth estimate.

Same-facility revenue per equivalent admission rose 2.9% year over year but came lower than our growth estimate of 4.2%.

Same-facility inpatient surgeries remained unchanged year over year, while same-facility outpatient surgeries dipped 0.5%. Additionally, same-facility emergency room visits inched up 0.5% year over year in the quarter under review.

Salaries and benefits, supplies and other operating expenses increased 5.8% year over year to $15.4 billion. However, the metric came lower than our estimate of $15.6 billion.

Adjusted EBITDA of $4.1 billion advanced 10.8% year over year, which surpassed our estimate of $3.9 billion.

HCA Healthcare operated 190 hospitals and roughly 2,500 ambulatory sites of care across 19 states and the United Kingdom as of Dec. 31, 2025.

HCA’s Financial Update (as of Dec. 31, 2025)

HCA Healthcare exited the fourth quarter with cash and cash equivalents of $1 billion, which dropped 46.2% from the 2024-end level. It had a leftover capacity of approximately $5.8 billion under its credit facilities at the fourth-quarter end.

Total assets of $60.7 billion increased 2% from the figure at 2024-end.

Long-term debt, excluding debt issuance costs and discounts, was $41.6 billion, up 8.5% from the figure as of Dec. 31, 2024. Short-term borrowings and long-term debt due within one year totaled $4.9 billion.

Capital expenditures were $1.5 billion minus acquisitions during the quarter under review.

HCA’s Cash Flow

HCA Healthcare generated $12.6 billion in cash from operations in 2025, which improved 20.2% from the prior-year comparable period.

HCA Healthcare’s Capital Deployment Update

HCA bought back shares worth $2.6 billion in the fourth quarter. It had a leftover capacity of $750 million under its buyback authorization as of Dec. 31, 2025. Management sanctioned an additional share buyback program of $10 billion.

The board of directors approved an 8.3% hike in the quarterly cash dividend. The increased dividend, amounting to 78 cents per share, will be paid on March 31, 2026, to its shareholders of record as of March 17.

2025 Results for HCA

HCA Healthcare’s revenues grew 7.1% year over year to $75.6 billion. Full-year EPS of $28.21 climbed 28.5% year over year. Adjusted EBITDA improved 12.1% year over year to $15.6 billion.

HCA Issues 2026 Guidance

Annual revenues are anticipated to be between $76.5 billion and $80 billion, the midpoint of which indicates a 3.5% rise from the 2025 reported figure.

Management forecasts adjusted EBITDA to be in the range of $15.55-$16.45 billion, the midpoint of which suggests 2.8% growth from the 2025 figure.

Net income attributable to HCA Healthcare is presently expected to be between $6.495 billion and $7.035 billion.

EPS is forecasted to be in the $29.10-$31.50 band, the midpoint of which implies a 7% rise from the 2025 figure.

Capital expenditures, excluding acquisitions, are expected between $5 billion and $5.5 billion.

How Have Estimates Been Moving Since Then?

It turns out, estimates revision have trended upward during the past month.

VGM Scores

At this time, HCA has a great Growth Score of A, a grade with the same score on the momentum front. Following the exact same course, the stock was allocated a grade of A on the value side, putting it in the top quintile for this investment strategy.

Overall, the stock has an aggregate VGM Score of A. If you aren't focused on one strategy, this score is the one you should be interested in.

Outlook

Estimates have been broadly trending upward for the stock, and the magnitude of these revisions looks promising. Notably, HCA has a Zacks Rank #3 (Hold). We expect an in-line return from the stock in the next few months.

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HCA Healthcare, Inc. (HCA): Free Stock Analysis Report

This article originally published on Zacks Investment Research (zacks.com).

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