Hca Holdings Stock Earnings Reports

HCA reported Q1 2026 revenue up 4.3%, adjusted EBITDA up ~2%, and adjusted diluted EPS up ~11% year-over-year. Volume growth was muted by an unusually mild respiratory season (respiratory admissions down 42%, ER visits down 32%) and a January winter storm that affected several markets; management estimates those factors reduced adjusted EBITDA by about $180 million in the quarter. Offsetting this, state Medicaid supplemental payment net benefits were roughly $200 million higher year-over-year (Georgia grandfathered approval, Texas Atlas reinstatement, and Tennessee benefit), and management adjusted the full-year supplemental payment assumption to a decline of $50 million to $250 million versus prior year (not including any additional approvals). The exchanges remain a material, evolving headwind: HCA estimates a Q1 exchange-related adjusted EBITDA impact of ~$150 million and continues to expect a full-year impact in the range of $600 million to $900 million. Same-facility admissions rose ~0.9% (equivalent admissions +1.3%); outpatient surgeries declined 1.7%; ER visits +0.3%. Adjusted EBITDA margin was down ~50 bps; some operating expense increases were driven by supplemental payment program-related costs, professional fees and tech investments. Management reaffirmed full-year 2026 guidance, citing that the Q1 respiratory/ weather effects are temporal and that resiliency initiatives (targeting $400 million of savings), network expansion, capital projects and AI/digital programs are progressing. Cap allocation highlights: $1.1B of capex in Q1, $1.57B of share repurchases, $183M dividends paid, and cash flow from operations of $2.0B. Management is positive on the prospects for Florida’s DPP approval but notes CMS review is taking time. Overall tone: disciplined execution, confidence in hitting year guidance despite near-term volatility, and continued focus on resiliency, digital/AI rollout and network expansion.