Core Insights - HCA Healthcare, Inc. reported second-quarter 2025 adjusted earnings per share (EPS) of $6.84, exceeding the Zacks Consensus Estimate by 10.5% and showing a year-over-year improvement of 24.4% [1][9] - Revenues reached $18.6 billion, reflecting a 6.4% year-over-year increase and surpassing the consensus mark by 0.7% [1][9] Financial Performance - The quarterly results were supported by increased patient volumes, higher same-facility revenue per equivalent admission, and a rise in emergency room visits [2] - Same-facility equivalent admissions grew by 1.7% year over year, while same-facility admissions increased by 1.8%, both below growth estimates of 3.8% and 4% respectively [3] - Same-facility revenue per equivalent admission rose by 4% year over year, exceeding the growth estimate of 3.2% [3] - Adjusted EBITDA improved by 8.4% year over year to $3.8 billion, beating the estimate of $3.6 billion [5] Cost and Expenses - Salaries and benefits, supplies, and other operating expenses totaled $14.78 billion, increasing by 6% year over year but lower than the estimate of $14.84 billion [4] - Same-facility inpatient surgeries decreased by 0.3% year over year, missing the growth estimate of 1.5%, while same-facility outpatient surgeries fell by 0.6% [4] Cash Flow and Capital Management - HCA generated $5.9 billion in cash from operations in the first half of 2025, a 32% increase from the prior-year period [8] - The company repurchased $2.5 billion in shares during the quarter and had a remaining capacity of $5.8 billion under its buyback authorization [10] Guidance and Outlook - HCA revised its 2025 revenue guidance to between $74 billion and $76 billion, up from the previous range of $72.8 billion to $75.8 billion, indicating a 6.2% rise from 2024 [11] - Adjusted EBITDA is now expected to be in the range of $14.7 billion to $15.3 billion, higher than the earlier forecast [12] - EPS is projected to be in the $25.5 to $27 range for 2025, an increase from the previous estimate [13]

Financial Data and Key Metrics Changes - The company reported a 24% increase in diluted earnings per share, adjusted to $6.84, reflecting strong financial results for the second quarter [6] - Revenue growth was 6.4%, driven by increased demand for services, improved payer mix, and stable patient acuity levels [6][13] - Adjusted EBITDA margin improved by 30 basis points compared to the prior year quarter, with adjusted EBITDA growing 8.4% year-over-year [13][14] Business Line Data and Key Metrics Changes - Equivalent admissions increased by 1.7% for the quarter and 2.3% year-to-date, with managed care equivalent admissions growing by 4% [12] - Medicare admissions grew by 3%, slightly below expectations, while Medicaid saw a slight decline and self-pay increased slightly [12][13] - The company experienced a $100 million increase in net benefit from Medicaid supplemental payment programs compared to the prior year quarter [14] Market Data and Key Metrics Changes - Approximately 60% of the company's Medicaid volumes and revenue are in non-expansion states, which mitigates the expected impact of recent federal policy changes [9] - The company anticipates some individuals will lose insurance coverage due to changes in federal policies, but believes its financial resiliency program will offset these effects [10][11] Company Strategy and Development Direction - The company aims to combine high-quality local health networks with national capabilities to reinforce its competitive position and respond to market dynamics [8] - A balanced capital allocation strategy is in place, with $1.2 billion in capital expenditures, $2.5 billion in share repurchases, and $171 million in dividends planned for 2025 [15][19] - The company is optimistic about future growth, with a diversified portfolio of markets and ongoing investments in outpatient facilities and inpatient capacity [20][57] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's ability to manage the impacts of federal policy changes and maintain a strong balance sheet [11] - The company has seen a recovery in facilities affected by Hurricane Saline and Milton, with better-than-expected performance in some markets [21] - Management noted that 14 out of 15 divisions grew their admissions, indicating strong underlying business performance despite some volume metrics being lower than expected [33][34] Other Important Information - The company is actively developing resiliency programs to mitigate potential adverse impacts from federal policy changes and is focused on operational improvements [40] - The company has approximately $5.5 billion in capital projects underway, which are expected to enhance its network and service capacity [57][108] Q&A Session Summary Question: Guidance update and impact of Tennessee DPP program - Management confirmed that the updated guidance reflects the approval of the Tennessee DPP program and better visibility on other programs [27][28] Question: Resiliency programs and potential headwinds - Management indicated that their financial resiliency program should offset adverse impacts from federal policy changes, with further details to be provided in the fourth quarter earnings call [39][40] Question: Commercial volume trends and consumer confidence - Management noted that managed care equivalent admissions are up 4% year-to-date, with health care exchanges performing better than expected [45][46] Question: Market share dynamics and local market performance - Management reported sustained market share gains, with a focus on improving network integrity and patient retention [56][57] Question: Changes in Medicare Advantage behavior and revenue cycle investments - Management stated that there have been no significant impacts from denial activities, reflecting improvements in revenue cycle management [67][68] Question: Update on commercial contracting and capital expenditures - Management confirmed that they are largely contracted for 2025 and about 80% contracted for 2026, with ongoing capital investments to enhance service capacity [106][108]

Financial Data and Key Metrics Changes - The company reported a 24% increase in diluted earnings per share, adjusted to $6.84, reflecting solid revenue growth of 6.4% driven by increased demand for services and improved payer mix [5][12] - Adjusted EBITDA margin improved by 30 basis points compared to the prior year quarter, with adjusted EBITDA growing 8.4% over the prior year quarter [12][13] - Cash flow from operations was $4.2 billion in the quarter, with capital allocation including $1.2 billion in capital expenditures and $2.5 billion in share repurchases [14][15] Business Line Data and Key Metrics Changes - Equivalent admissions increased by 1.7% for the quarter and 2.3% for the year, with managed care equivalent admissions growing by 4% year-to-date [11][12] - Medicare admissions grew by 3%, slightly below expectations, while Medicaid was down slightly and self-pay was up slightly [11][12] - The company experienced a 1% improvement in same facility contract labor costs as a percentage of total labor costs [13] Market Data and Key Metrics Changes - Approximately 60% of the company's Medicaid volumes and revenue are in non-expansion states, which lessens the expected impact from recent federal policy changes [7] - Health care exchanges grew by 15.8% year-to-date, while commercial managed care admissions were up just short of 1% [44] - The company noted that 14 out of 15 divisions grew their adjusted admissions, with specific procedure volumes such as cardiac procedures up 5% and obstetrics volumes up 3% [32] Company Strategy and Development Direction - The company aims to combine high-quality local health networks with national capabilities to reinforce its competitive position and respond effectively to market dynamics [6] - The company is focused on innovation through technology and increasing efficiencies while maintaining accountability for delivering results [6] - A balanced strategy for capital allocation is in place, with ongoing investments in outpatient facilities and inpatient capacity [58][108] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the future, citing a strong balance sheet and an experienced team, while acknowledging potential challenges from federal policy changes [10] - The company is developing resiliency programs to offset potential adverse impacts from the expiration of enhanced premium tax credits [39] - Management noted that the recovery in hurricane-affected facilities is progressing better than anticipated, although some markets are underperforming [19][79] Other Important Information - The company updated its full-year 2025 guidance, expecting revenues to range between $74 billion and $76 billion, with net income projected between $6.11 billion and $6.48 billion [17] - The approval of the Tennessee directed payment program is expected to contribute positively to the company's financial outlook [17][63] Q&A Session Summary Question: Guidance update and impact of the Tennessee DPP program - Management confirmed that the updated guidance reflects the approval of the Tennessee program and better visibility on other programs, with half of the guidance increase attributed to state supplemental payment programs [24][63] Question: Resiliency programs and potential headwinds - Management indicated that resiliency programs are being developed to offset potential adverse impacts from federal policy changes, with more details expected in the fourth quarter earnings call [39][40] Question: Commercial volume trends and consumer confidence - Management noted that managed care equivalent admissions are up 4% year-to-date, with health care exchanges performing better than expected, while consumer confidence remains difficult to assess [44][45] Question: Market share dynamics and local market performance - Management reported sustained market share gains, with a focus on improving network integrity and responding to competitive dynamics in underperforming markets [56][58] Question: Changes in Medicare Advantage behavior and revenue cycle investments - Management stated that there have been no significant impacts from denial activities, reflecting improvements in revenue cycle management [68]

Core Insights - HCA Healthcare reported quarterly earnings of $6.84 per share, exceeding the Zacks Consensus Estimate of $6.19 per share, and up from $5.5 per share a year ago, representing an earnings surprise of +10.50% [1] - The company generated revenues of $18.61 billion for the quarter ended June 2025, surpassing the Zacks Consensus Estimate by 0.68% and increasing from $17.49 billion year-over-year [2] - HCA shares have appreciated approximately 13.8% year-to-date, outperforming the S&P 500's gain of 8.2% [3] Earnings Outlook - The current consensus EPS estimate for the upcoming quarter is $5.52 on revenues of $18.45 billion, while for the current fiscal year, the estimate is $25.30 on revenues of $74.62 billion [7] - The estimate revisions trend for HCA was mixed prior to the earnings release, resulting in a Zacks Rank 3 (Hold) for the stock, indicating expected performance in line with the market [6] Industry Context - The Medical - Hospital industry, to which HCA belongs, is currently ranked in the top 22% of over 250 Zacks industries, suggesting a favorable outlook compared to the bottom 50% [8] - Another competitor in the same industry, Universal Health Services, is expected to report quarterly earnings of $4.85 per share, reflecting a year-over-year increase of +12.5% [9]

Exhibit 99.1 FOR IMMEDIATE RELEASE INVESTOR CONTACT: MEDIA CONTACT: Frank Morgan Harlow Sumerford 615-344-2688 615-344-1851 HCA HEALTHCARE REPORTS SECOND QUARTER 2025 RESULTS RAISES 2025 GUIDANCE Nashville, Tenn., July 25, 2025 – HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the second quarter ended June 30, 2025. Key second quarter metrics (all percentage changes compare 2Q 2025 to 2Q 2024 unless otherwise noted): "We are pleased to report strong financial results for ...

Group 1 - HCA Healthcare is set to release its Q2 earnings results on July 25, with expected earnings of $6.32 per share, an increase from $5.5 per share in the same period last year [1] - The company is projected to report quarterly revenue of $18.5 billion, up from $17.49 billion a year earlier [1] - HCA Healthcare appointed John W. Chidsey, III as a new Independent Director on July 11 [1] Group 2 - HCA Healthcare shares fell by 3.3%, closing at $341.48 [2] - Analysts have provided various ratings and price targets for HCA stock, with Truist Securities maintaining a Buy rating and raising the price target from $390 to $415 [7] - B of A Securities downgraded the stock from Buy to Neutral while increasing the price target from $394 to $410 [7] - JP Morgan assumed a Neutral rating with a price target of $380 [7] - Keybanc initiated coverage with an Overweight rating and a price target of $475 [7]

Core Viewpoint - Analysts forecast HCA Healthcare will report quarterly earnings of $6.14 per share, reflecting an 11.6% year-over-year increase, with revenues expected to reach $18.46 billion, a 5.5% increase compared to the previous year [1]. Earnings Projections - The consensus EPS estimate has been revised downward by 0.3% over the past 30 days, indicating a collective reassessment by analysts [2]. - Changes in earnings projections are crucial for predicting investor reactions, as empirical studies show a strong correlation between earnings estimate trends and short-term stock price movements [3]. Revenue Estimates - Analysts estimate 'Revenues- Other' to be $1.02 billion, representing a year-over-year increase of 19.6% [4]. - 'Revenues- Medicare' is projected at $2.82 billion, a 7.6% increase from the previous year, while 'Revenues- Managed Medicare' is expected to be $3.00 billion, reflecting a 3.1% increase [5]. - 'Revenues- International (Managed Care & Insurers)' is anticipated to reach $432.32 million, indicating a 3.9% year-over-year change [5]. Key Metrics - 'Revenue per Equivalent Admission' is expected to be $18,084.34, up from $17,583.00 in the same quarter last year [6]. - Analysts predict 'Equivalent Admissions' to be 1.02 billion, compared to 994.84 million a year ago, and 'Admissions' at 573.97 million, up from 554.46 million [6]. - 'Patient Days' are forecasted to reach 2,786 days, an increase from 2,663 days in the same quarter last year [7]. - The estimated 'Inpatient Revenue per Admission' is $19,563.87, compared to $18,814.00 in the same quarter last year [8]. Market Performance - Over the past month, HCA shares have returned -3.7%, contrasting with the S&P 500 composite's +5.9% change [8].

Core Insights - HCA Healthcare, Inc. is expected to report second-quarter 2025 results on July 25, with earnings estimated at $6.14 per share and revenues at $18.46 billion [1] - The earnings estimate reflects an 11.6% increase year-over-year, while revenue is projected to grow by 5.5% [2] - For the full year 2025, revenue is estimated at $74.6 billion, indicating a 5.7% year-over-year rise, and EPS is projected at $25.26, a 15% increase [3] Earnings Performance - HCA has a history of exceeding earnings estimates, achieving this in the last four quarters with an average surprise of 7.1% [3] - However, current indicators suggest uncertainty regarding an earnings beat for the upcoming quarter, with an Earnings ESP of -8.77% and a Zacks Rank of 3 [4] Operational Metrics - The consensus estimate for equivalent admissions indicates a 2.9% year-over-year growth, with revenue per equivalent admission also expected to rise by 2.9% [5] - Equivalent patient days are projected to grow by 4.3% year-over-year, and occupancy is expected to increase to 73.1% from 71.9% a year ago [5] Cost and Surgery Trends - Total operating expenses are anticipated to rise by 6.5% year-over-year, driven by higher salaries, benefits, and supply costs, with supply costs expected to increase by 5.3% [8] - A decline of 2.2% in outpatient surgery cases is projected, along with a 1.4% decrease in the average length of stay [9]

Industry Overview - The Zacks Medical-Hospital industry includes for-profit hospital companies providing various healthcare services, such as acute care, rehabilitation, and psychiatric services [3] - Revenue generation is influenced by inpatient occupancy levels, medical services ordered by physicians, and outpatient procedure volumes [3] - Payments for services come from government programs like Medicare and Medicaid, managed care plans, private insurers, and directly from patients [3] Key Trends - Rising patient demand is noted, particularly with an increase in elective procedures, while the 65+ population is projected to grow from 17.3% in 2022 to 22.8% by 2050 [4] - Health spending is expected to reach $5.3 trillion by 2025, but there is a shift from inpatient to outpatient and home-based services, leading to underused hospital beds [4] - Labor shortages, higher wages, and supply chain disruptions are squeezing hospital margins, prompting providers to adopt automation and refine staffing models [5] - Hospitals are investing in AI, automation, and real-time analytics to improve care delivery and operational efficiency [6] Consolidation and M&A Activity - Consolidation through mergers and acquisitions is a key strategy for hospitals to scale operations and increase market share in a fragmented market [2] - Post-pandemic, M&A activity has rebounded as hospitals seek efficiency and financial resilience, driven by economic recovery and regulatory clarity [7] Financial Performance and Outlook - The Zacks Medical-Hospital industry currently holds a Zacks Industry Rank of 181, placing it in the bottom 26% of nearly 250 Zacks industries, indicating challenging near-term prospects [8] - Aggregate earnings estimates for the industry have decreased by 0.2% since February-end, reflecting a negative outlook for earnings growth [9] - The industry has gained 4.2% over the past year, underperforming the S&P 500's 13.1% but outperforming the broader Medical sector's decline of 17.6% [11] Current Valuation - The industry trades at a trailing 12-month EV/EBITDA ratio of 7.84X, compared to the S&P 500's 17.79X and the sector's 9.72X [14] - Over the past five years, the industry's EV/EBITDA ratio has ranged from a high of 9.55X to a low of 6.45X, with a median of 8.03X [14] Notable Companies - **HCA Healthcare**: Positioned to benefit from rising patient volumes, with a projected 15% year-over-year EPS growth for 2025 and a 5.7% revenue increase [18] - **Tenet Healthcare Corporation**: Strong revenue growth driven by its Ambulatory Care and Hospital segments, with projected revenue of $20.9 billion for 2025 [22] - **Universal Health Services**: Growth supported by rising patient days and network expansion, with projected EPS growth of 17% for 2025 [26] - **Community Health Systems**: Benefiting from higher occupancy rates and a growing telehealth focus, with projected EPS growth of 69.9% for 2025 [31]

Group 1 - Bank of America downgraded Centene's rating from "Neutral" to "Underperform" with a target price cut from $52 to $30 due to concerns over the impact of the recently signed "Big Beautiful Law" by President Trump [1] - The downgrade is attributed to expected slow growth in the Medicaid market and the potential expiration of exchange subsidies this year, which poses dual pressures on Centene [1] - Analyst Joanna Gajuk indicated that significant changes in risk pools are expected to lead to more downside than upside in exchange pricing risks by 2026, with adverse effects on Medicaid enrollment starting to manifest from 2027 [1] Group 2 - HCA Healthcare's rating was downgraded from "Buy" to "Neutral," with a slight target price adjustment from $410 to $394, as funding cuts from the ACA and Medicaid are anticipated to create headwinds [1] - The decline in insured individuals may result in slower growth in hospital visits and increased bad debt, although HCA is expected to be less affected than peers due to its scale advantages [2] - The law significantly raises the likelihood of the expiration of enhanced exchange subsidies, which is expected to create additional resistance in 2026 [2]