Core Insights - HCA Healthcare reported $18.29 billion in revenue for Q4 2024, a year-over-year increase of 5.7% [1] - The EPS for the same period was $6.22, up from $5.90 a year ago, exceeding the consensus estimate of $5.97 by 4.19% [1] Financial Performance - Revenue surpassed the Zacks Consensus Estimate of $18.09 billion, resulting in a surprise of +1.07% [1] - HCA's shares returned +7.5% over the past month, outperforming the Zacks S&P 500 composite's +2.5% change [3] Key Metrics - Revenue per Equivalent Admission was $18,146, exceeding the five-analyst average estimate of $18,036.69 [4] - Equivalent Admissions reached 1.01 billion, surpassing the five-analyst average estimate of 997.59 million [4] - Admissions totaled 559.17 million, slightly below the average estimate of 561.41 million [4] - Equivalent Patient Days were 4.85 million, close to the average estimate of 4.89 million [4] - Average Length of Stay remained at 5 days, matching the two-analyst average estimate [4] - The number of hospitals increased to 190, above the two-analyst average estimate of 187 [4] - Inpatient Revenue per Admission was $19,737, exceeding the average estimate of $19,608.16 [4] - Licensed Beds at the end of the period were 49,985, slightly above the two-analyst average estimate of 49,819 [4] - Patient Days were recorded at 2,691.71, below the average estimate of 2,714.32 [4] - The number of freestanding outpatient surgery centers was 124, slightly below the average estimate of 125 [4]

Group 1: Earnings Performance - HCA Healthcare reported quarterly earnings of $6.22 per share, exceeding the Zacks Consensus Estimate of $5.97 per share, and up from $5.90 per share a year ago, representing an earnings surprise of 4.19% [1] - The company posted revenues of $18.29 billion for the quarter ended December 2024, surpassing the Zacks Consensus Estimate by 1.07%, compared to $17.3 billion in the same quarter last year [2] - Over the last four quarters, HCA has surpassed consensus EPS estimates four times and topped consensus revenue estimates three times [2] Group 2: Stock Performance and Outlook - HCA shares have increased approximately 8.4% since the beginning of the year, outperforming the S&P 500's gain of 4% [3] - The sustainability of the stock's price movement will depend on management's commentary during the earnings call and future earnings expectations [3][4] - The current consensus EPS estimate for the upcoming quarter is $5.82 on revenues of $18.22 billion, and for the current fiscal year, it is $24.77 on revenues of $74.54 billion [7] Group 3: Industry Context - The Medical - Hospital industry, to which HCA belongs, is currently ranked in the bottom 7% of over 250 Zacks industries, indicating potential challenges ahead [8] - Empirical research shows a strong correlation between near-term stock movements and trends in earnings estimate revisions, which can impact HCA's stock performance [5][6]

[HCA Healthcare Fourth Quarter 2024 Earnings Release](index=1&type=section&id=HCA%20Healthcare%20Fourth%20Quarter%202024%20Earnings%20Release) [Financial and Operating Highlights](index=1&type=section&id=Financial%20and%20Operating%20Highlights) HCA Healthcare achieved strong 2024 financial performance with increased revenues and net income, despite Q4 impacts [Fourth Quarter 2024 Performance](index=1&type=section&id=Fourth%20Quarter%202024%20Performance) Q4 2024 revenues grew to **$18,285 million**, but net income decreased to **$1,438 million** due to special items and hurricane impacts Q4 2024 Key Financial Metrics vs. Q4 2023 (in millions) | Metric | Q4 2024 | Q4 2023 | | :--- | :--- | :--- | | Revenues | $18,285 | $17,303 | | Net Income Attributable to HCA | $1,438 | $1,607 | | Diluted EPS | $5.63 | $5.93 | | Adjusted EBITDA | $3,712 | $3,618 | - Q4 2024 results include losses on sales of facilities of **$195 million**, or **$0.59 per diluted share**, primarily from a pending sale in California[2](index=2&type=chunk) Q4 2024 Same Facility Operating Metrics (YoY Change) | Metric | % Change YoY | | :--- | :--- | | Admissions | +3.0% | | Equivalent Admissions | +3.1% | | Emergency Room Visits | +2.4% | | Inpatient Surgeries | +2.8% | | Outpatient Surgeries | -1.3% | | Revenue per Equivalent Admission | +2.9% | [Full Year 2024 Performance](index=2&type=section&id=Full%20Year%202024%20Performance) Full year 2024 revenues grew 8.7% to **$70,603 million**, with net income at **$5,760 million** and Adjusted EBITDA at **$13,882 million** Full Year 2024 Key Financial Metrics vs. Full Year 2023 (in millions) | Metric | FY 2024 | FY 2023 | | :--- | :--- | :--- | | Revenues | $70,603 | $64,968 | | Net Income Attributable to HCA | $5,760 | $5,242 | | Diluted EPS | $22.00 | $18.97 | | Adjusted EBITDA | $13,882 | $12,726 | [Financial Position and Shareholder Returns](index=2&type=section&id=Financial%20Position%20and%20Shareholder%20Returns) HCA maintained a strong balance sheet with **$59.513 billion** in assets, demonstrating commitment to shareholder returns through significant stock repurchases Balance Sheet Summary (as of Dec 31, 2024, in billions) | Item | Amount | | :--- | :--- | | Cash and cash equivalents | $1.933 billion | | Total Assets | $59.513 billion | | Total Debt | $43.031 billion | - The Board of Directors authorized a new share repurchase program for up to **$10 billion** of the company's outstanding common stock[9](index=9&type=chunk) - A quarterly cash dividend of **$0.72 per share** was declared, payable on March 31, 2025[10](index=10&type=chunk) - In Q4 2024, the company repurchased **4.739 million shares** for **$1.700 billion**, with **$764 million** remaining under the previous authorization[8](index=8&type=chunk) [Special Items and Future Outlook](index=3&type=section&id=Special%20Items%20and%20Future%20Outlook) Hurricanes Helene and Milton impacted Q4 2024 by **$200 million**, with HCA's 2025 guidance projecting revenues between **$72.80 billion** and **$75.80 billion** - Hurricanes Helene and Milton caused an estimated **$200 million** in lost revenues and additional expenses in Q4 2024, impacting diluted EPS by approximately **$0.60**[12](index=12&type=chunk) - The total impact of the hurricanes for the full year 2024 was estimated at **$250 million**, or **$0.73 per diluted share**[13](index=13&type=chunk) 2025 Full Year Guidance | Metric | 2025 Guidance Range | | :--- | :--- | | Revenues | $72.80 - $75.80 billion | | Net Income Attributable to HCA | $5.85 - $6.29 billion | | Adjusted EBITDA | $14.30 - $15.10 billion | | EPS (diluted) | $24.05 - $25.85 | | Capital Expenditures | $5.0 - $5.2 billion | [Corporate Information and Disclosures](index=4&type=section&id=Corporate%20Information%20and%20Disclosures) HCA operates 190 hospitals and 2,400 ambulatory sites, with its 2025 annual stockholders' meeting on April 24, and forward-looking statements subject to risks - As of December 31, 2024, HCA operated **190 hospitals** and approximately **2,400 ambulatory sites** of care across 20 states and the United Kingdom[19](index=19&type=chunk) - The 2025 annual stockholders' meeting is scheduled to be held virtually on **April 24, 2025**[17](index=17&type=chunk) - The press release contains forward-looking statements based on current plans and expectations, which are subject to significant risks and uncertainties detailed in the document and SEC filings[20](index=20&type=chunk)[21](index=21&type=chunk) [Consolidated Financial Statements](index=6&type=section&id=Consolidated%20Financial%20Statements) HCA's consolidated financial statements for Q4 and full-year 2024 show revenue growth, increased assets and liabilities, and strong operating cash flow [Condensed Consolidated Comprehensive Income Statements](index=6&type=section&id=Condensed%20Consolidated%20Comprehensive%20Income%20Statements) Q4 2024 revenues were **$18,285 million** with **$1,438 million** net income; full year 2024 revenues reached **$70,603 million** with **$5,760 million** net income Q4 2024 vs Q4 2023 Income Statement Highlights (in millions) | Account | Q4 2024 | Q4 2023 | | :--- | :--- | :--- | | Revenues | $18,285 | $17,303 | | Salaries and benefits | $7,917 | $7,570 | | Other operating expenses | $3,873 | $3,559 | | Income before income taxes | $2,133 | $2,345 | | Net Income Attributable to HCA | $1,438 | $1,607 | Full Year 2024 vs 2023 Income Statement Highlights (in millions) | Account | FY 2024 | FY 2023 | | :--- | :--- | :--- | | Revenues | $70,603 | $64,968 | | Salaries and benefits | $31,170 | $29,487 | | Other operating expenses | $14,819 | $12,875 | | Income before income taxes | $8,523 | $7,706 | | Net Income Attributable to HCA | $5,760 | $5,242 | [Condensed Consolidated Balance Sheets](index=8&type=section&id=Condensed%20Consolidated%20Balance%20Sheets) As of December 31, 2024, HCA's total assets increased to **$59,513 million**, with cash and property growth, and a rise in total liabilities Balance Sheet Comparison (in millions) | Account | Dec 31, 2024 | Dec 31, 2023 | | :--- | :--- | :--- | | Cash and cash equivalents | $1,933 | $935 | | Total Current Assets | $16,414 | $14,927 | | Property and equipment, net | $29,414 | $27,715 | | Total Assets | $59,513 | $56,211 | | Long-term debt | $38,333 | $37,169 | | Total Liabilities | $58,958 (a) | $55,151 (a) | | Total Stockholders' Equity | $555 | $1,060 | (a) Calculated as Total Assets - Total Stockholders' Equity [Condensed Consolidated Statements of Cash Flows](index=9&type=section&id=Condensed%20Consolidated%20Statements%20of%20Cash%20Flows) Net cash from operating activities for 2024 was **$10,514 million**, funding significant investing and financing activities, including **$6,042 million** in stock repurchases Cash Flow Summary for Full Year (in millions) | Activity | FY 2024 | FY 2023 | | :--- | :--- | :--- | | Net cash provided by operating activities | $10,514 | $9,431 | | Net cash used in investing activities | ($4,933) | ($5,317) | | Net cash used in financing activities | ($4,582) | ($4,094) | | Change in cash and cash equivalents | $998 | $27 | - Key uses of cash in financing activities for 2024 included **$6.042 billion** for stock repurchases and **$690 million** for dividend payments[26](index=26&type=chunk) [Operating Statistics](index=10&type=section&id=Operating%20Statistics) HCA expanded to 190 hospitals in 2024, with full-year same-facility admissions and equivalent admissions showing positive growth Full Year 2024 Same Facility Key Metrics (% Change YoY) | Metric | % Change YoY | | :--- | :--- | | Admissions | +4.9% | | Equivalent Admissions | +4.5% | | Revenue per Equivalent Admission | +3.2% | | Inpatient Surgery Cases | +2.2% | | Outpatient Surgery Cases | -1.6% | | Emergency Room Visits | +4.9% | Q4 2024 Same Facility Key Metrics (% Change YoY) | Metric | % Change YoY | | :--- | :--- | | Admissions | +3.0% | | Equivalent Admissions | +3.1% | | Revenue per Equivalent Admission | +2.9% | | Inpatient Surgery Cases | +2.8% | | Outpatient Surgery Cases | -1.3% | | Emergency Room Visits | +2.4% | [Supplemental Non-GAAP Disclosures](index=11&type=section&id=Supplemental%20Non-GAAP%20Disclosures) HCA uses non-GAAP Adjusted EBITDA for performance assessment, reporting **$13,882 million** for FY 2024 and forecasting **$14,300 million** to **$15,100 million** for 2025 [Reconciliation of Adjusted EBITDA](index=11&type=section&id=Reconciliation%20of%20Adjusted%20EBITDA) Q4 2024 Adjusted EBITDA was **$3,712 million** (20.3% margin), with full-year 2024 reaching **$13,882 million** (19.7% margin) Adjusted EBITDA Performance (in millions) | Period | Adjusted EBITDA | Adjusted EBITDA Margin | | :--- | :--- | :--- | | Q4 2024 | $3,712 | 20.3% | | Q4 2023 | $3,618 | 20.9% | | FY 2024 | $13,882 | 19.7% | | FY 2023 | $12,726 | 19.6% | - Management uses Adjusted EBITDA as a primary measure to assess the operating performance of its healthcare facilities[31](index=31&type=chunk)[32](index=32&type=chunk) [2025 Operating Results Forecast (Non-GAAP)](index=12&type=section&id=2025%20Operating%20Results%20Forecast%20%28Non-GAAP%29) The 2025 forecast projects Net Income Attributable to HCA between **$5,850 million** and **$6,290 million**, with Adjusted EBITDA ranging from **$14,300 million** to **$15,100 million** 2025 Forecast Reconciliation: Net Income to Adjusted EBITDA (in millions) | Metric | Low Range | High Range | | :--- | :--- | :--- | | Net income attributable to HCA | $5,850 | $6,290 | | Depreciation and amortization | $3,495 | $3,565 | | Interest expense | $2,230 | $2,320 | | Provision for income taxes | $1,800 | $1,950 | | Net income attributable to noncontrolling interests | $925 | $975 | | **Adjusted EBITDA** | **$14,300** | **$15,100** | - The company does not forecast certain items like gains/losses on sales of facilities, legal costs, or impairments due to the inability to predict them with sufficient accuracy[38](index=38&type=chunk)

Earnings and Financial Performance - HCA Healthcare is expected to report quarterly earnings of $6 14 per share for Q4 2025, up from $5 90 per share in the same period last year [1] - The company projects revenue of $18 23 billion for the recent quarter, compared to $17 3 billion a year earlier [1] Stock Performance and Analyst Ratings - HCA Healthcare shares gained 1 8% to close at $325 36 on Thursday [3] - Truist Securities analyst David Macdonald maintained a Buy rating but cut the price target from $430 to $390 [5] - Raymond James analyst John Ransom downgraded the stock from Outperform to Market Perform [5] - Keybanc analyst Matthew Gillmor maintained an Overweight rating but cut the price target from $475 to $420 [5] - Oppenheimer analyst Michael Wiederhorn maintained an Outperform rating and raised the price target from $390 to $400 [5] - Deutsche Bank analyst Pito Chickering maintained a Buy rating and raised the price target from $359 to $375 [5] Leadership Changes - HCA Healthcare named Wendy Warren as Senior Vice President and Chief Ethics and Compliance Officer on Dec 20, 2024 [2]

HCA Healthcare, Inc. (HCA) is scheduled to report fourth-quarter 2024 results on Jan. 24, before the opening bell. The Zacks Consensus Estimate for fourth-quarter earnings per share of $5.99 indicates a 1.5% increase from the prior-year figure of $5.90.Stay up-to-date with all quarterly releases: See Zacks Earnings Calendar.The earnings estimate has witnessed downward revisions over the past 60 days. The consensus estimate for fourth-quarter revenues of $18.1 billion indicates 4.6% growth from the year-ago ...

Analysts on Wall Street project that HCA Healthcare (HCA) will announce quarterly earnings of $5.99 per share in its forthcoming report, representing an increase of 1.5% year over year. Revenues are projected to reach $18.09 billion, increasing 4.6% from the same quarter last year.The consensus EPS estimate for the quarter has remained unchanged over the last 30 days. This represents how the covering analysts, as a whole, have reassessed their initial estimates during this timeframe.Prior to a company's ear ...

Company Performance - Shares of HCA Healthcare have experienced significant volatility this year, initially rallying due to encouraging margin developments but later giving back most of those gains due to weaker quarterly results influenced by hurricanes and concerns about spending cuts [2] Market Sentiment - The stock's performance reflects market sensitivity to external factors such as natural disasters and potential spending reductions, highlighting the importance of monitoring macroeconomic and company-specific developments [2] Analyst Perspective - The analyst has over fifteen years of experience in making contrarian bets based on macro views and stock-specific turnaround stories, aiming for outsized returns with a favorable risk/reward profile [2]

Valuation and Market Position - HCA Healthcare is currently trading at a forward 12-month P/E of 12.28X, higher than the industry average of 11.91X and peers like Universal Health Services (10.24X) and Tenet Healthcare (11.45X) [1] - The company's stock has risen 12.1% year-to-date, outperforming the industry average of 10.4% but lagging behind peers and the S&P 500 [12] - The premium valuation reflects market confidence in HCA's prospects, but a detailed analysis is needed to determine if it is justified by fundamentals and growth potential [8] Financial Performance and Shareholder Returns - HCA repurchased $3.8 billion worth of shares in 2023 and $4.3 billion in the first nine months of 2024, with $525 million paid in dividends during the same period [3] - The company generated $5.9 billion in free cash flow over the trailing 12 months, a 25.5% year-over-year increase, following 13.6% growth in the prior year [9] - HCA ended Q3 2024 with $2.9 billion in cash and cash equivalents, but long-term debt rose to $38.3 billion, resulting in a debt-to-capital ratio of 97.99%, significantly higher than the industry average of 85.33% [17] Operational Performance and Growth Drivers - Same-facility equivalent admissions grew 4.5% year-over-year in Q3, while revenue per equivalent admission increased 2.5% [10] - The resumption of deferred elective procedures has driven higher patient volumes and occupancy levels, prompting investments in clinical systems, digital capabilities, and care models [4] - HCA beat earnings estimates in each of the past four quarters with an average surprise of more than 9% [5] Earnings and Revenue Outlook - The Zacks Consensus Estimate for 2024 earnings is $21.90 per share, indicating 15.2% year-over-year growth, with a further 13.1% increase expected in 2025 [11] - Revenue estimates for 2024 and 2025 suggest year-over-year growth of 8.4% and 5.9%, respectively [11] Industry Challenges and Tailwinds - The hospital industry, including HCA, faces headwinds such as potential reductions in government spending, policy changes, decreased hospital funding, and the expiration of insurance subsidies [22] - Despite these challenges, HCA's strong cash generation, rising admissions, and growing demand for services position it well to navigate uncertainties [23] Stock Performance and Investor Considerations - HCA's stock has faced a decline since the end of Q3, mirroring a broader dip among hospital operators due to industry challenges [6] - Current shareholders are advised to stay invested, while new investors should wait for a better entry point and monitor the company's debt burden and rising expenses [15]

HCA Healthcare TodayHCAHCA Healthcare$309.60 -4.33 (-1.38%) 52-Week Range$263.22▼$417.14Dividend Yield0.85%P/E Ratio13.90Price Target$387.13Add to WatchlistThe plight of medical providers collecting timely reimbursements from health insurers is a struggle that has been getting tougher by the year. Health insurance claim denials have come under scrutiny in light of recent events. Sentiment has turned sour on the medical sector stocks of insurance carriers and healthcare facilities and operators. Adding to t ...

For Immediate ReleaseChicago, IL – November 12, 2024 – Today, Zacks Equity Research like HCA Healthcare, Inc. (HCA) , Tenet Healthcare Corp. (THC) , Universal Health Services, Inc. (UHS) , Acadia Healthcare Company, Inc. (ACHC) and Community Health Systems, Inc. (CYH) .Industry: HospitalLink: https://www.zacks.com/commentary/2368306/5-hospital-stocks-set-to-thrive-amid-robust-industry-trendsThe Zacks Medical-Hospital industry is benefiting from several positive trends, including growing admissions, resumpti ...