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North America Equity Research December 2025 Healthcare Services 2026 Outlook: It's Different This Time: Potential for Margin Improvement and Policy Clarity Create a Positive Backdrop Conference Call Details Tuesday, December 17 @ 10:00am ET / 15:00 UK Dial-in Info: Please contact us or your JPM salesperson for details Replay Info: Available approximately 2-3 hours after the call ends Healthcare Services Lisa C. Gill AC (212) 622-6466 lisa.c.gill@jpmorgan.com Bloomberg JPMA GILL J.P. Morgan Securities LLC Ma ...

Summary of the 2026 Hospital Outlook Survey Industry Overview - The survey focuses on the US healthcare industry, specifically the hospital sector, and provides insights into capital expenditures, utilization trends, and the impact of macroeconomic factors on hospital operations [1][2]. Key Insights Utilization Trends - **Utilization Growth Expectations**: 52% of hospital executives anticipate utilization growth in 2026 to be above 2025 levels, a decrease from 55% in the previous year [7][19]. - **Outpatient vs. Inpatient**: 56% expect outpatient utilization growth to exceed 2025 levels, while 41% expect inpatient utilization growth to increase, up from 34% last year [11][19]. - **Elective Procedures**: 54% expect elective procedures to grow above or in line with 2025 levels, down from 64% last year [16][19]. Capital Expenditures (CapEx) - **CapEx Growth**: Hospital capital spending is projected to increase by 4.1% in 2026, consistent with the 4.0% growth reported in 2025 [7][45]. - **Investment Priorities**: Hospitals are likely to increase spending on bedside patient monitoring, bedside pumps, and operating room (OR) suite equipment [16][45]. - **Impact of OBBBA**: The One Big Beautiful Bill Act (OBBBA) may lead to conservative spending due to anticipated reimbursement pressures [49][46]. Robotics and Technology - **Robotic Systems**: 96% of hospitals currently utilize surgical robotic systems, with Intuitive Surgical maintaining a leading position in soft-tissue robotics [90][91]. - **Orthopedic Robotics Demand**: 49% of respondents expect to purchase orthopedic robotic systems, with Stryker's MAKO being the most favored option [7][8]. - **IT Investments**: Hospitals are prioritizing IT investments, particularly in AI (66% expect to increase spending) and cybersecurity (65%) [80][81]. Value-Based Care (VBC) - **Revenue Tied to VBC**: The average revenue tied to VBC arrangements is approximately 19%, down from 22% last year, although interest in establishing VBC partnerships has increased [34][35]. Challenges and Concerns - **Reimbursement Pressure**: 34% of executives cite reimbursement pressure as the biggest challenge for hospitals in the coming year, an increase from 25% last year [58][59]. - **Labor Costs**: Labor cost inflation remains a significant concern, with 18% of respondents identifying it as a major challenge [58][59]. Future Outlook - **Purchasing Intentions**: Despite economic uncertainties, over 70% of hospitals plan to consider purchasing new equipment across various categories in the next two years [62][64]. - **Investment in ASCs**: 57% of respondents expect to increase investments in Ambulatory Surgery Centers (ASCs) over the next year, reflecting a shift towards outpatient care [18][19]. Additional Insights - **AI Utilization**: Hospitals are increasingly leveraging AI for tasks such as medical record analysis (56%) and clinical imaging analysis (52%), with larger hospitals showing a higher propensity to adopt these technologies [81][88]. - **Market Dynamics**: The survey indicates a stable payor mix for 2026, with commercial insurers and Medicare making up approximately 70% of the mix [12][27]. This comprehensive survey provides a detailed outlook on the hospital sector, highlighting trends in utilization, capital spending, and the evolving landscape of healthcare technology and reimbursement challenges.

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Key Takeaways THC has surged 71.8% YTD, outpacing peers as analysts maintain a positive outlook for further upside.THC raised 2025 revenue and EBITDA guidance after a strong quarter and continued outpatient expansion.THC's ambulatory network, AI investments and portfolio shifts support growth amid valuation concerns.Tenet Healthcare Corporation (THC) has been one of the standout performers in the healthcare space this year, delivering an impressive 71.8% year-to-date gain. That advance not only tops the bro ...

Core Viewpoint - Tenet Healthcare reported strong Q3 2025 earnings, with adjusted EPS of $3.70, exceeding estimates by 11.1% and showing a year-over-year increase of 26.3% [2][3]. Financial Performance - Net operating revenues for Q3 2025 reached $5.3 billion, a 3.2% increase year over year, surpassing consensus estimates by 1% [2][3]. - Adjusted net income rose to $328 million, reflecting a 16.3% year-over-year growth [4]. - Adjusted EBITDA improved by 12.4% year over year to $1.1 billion, exceeding estimates [4]. - Total operating costs increased by 8.9% year over year to $4.5 billion, primarily due to higher supplies expenses [5]. Segment Performance - **Hospital Operations and Services**: - Net operating revenues were $4 billion, up 0.7% year over year, driven by improved same-hospital admissions and a favorable payer mix [6]. - Adjusted EBITDA for this segment climbed 12.6% year over year to $607 million [7]. - **Ambulatory Care**: - Net operating revenues increased by 11.9% year over year to $1.3 billion, supported by facility buyouts and service line expansions [8]. - Adjusted EBITDA reached $492 million, a 12.1% year-over-year increase [9]. Financial Position - As of September 30, 2025, Tenet had cash and cash equivalents of $3 billion, a decline of 1.5% from the end of 2024 [10]. - Total assets increased to $29.4 billion from $28.9 billion at the end of 2024 [10]. - Long-term debt slightly increased to $13.1 billion, while total shareholders' equity decreased by 3.8% to $4 billion [11]. Share Repurchase and Outlook - In Q3 2025, Tenet repurchased shares worth $93 million, with an authorization of approximately $1.7 billion remaining [12]. - The company raised its 2025 revenue outlook to $21.15-$21.35 billion, indicating a 2.8% growth from 2024 [13]. - Adjusted EBITDA is now expected to be between $4.47 billion and $4.57 billion, reflecting a 13% growth from 2024 [15]. Industry Context - Tenet is part of the Zacks Medical - Hospital industry, where Universal Health Services reported a 13.4% year-over-year revenue increase in its latest quarter [22]. - Universal Health Services has a Zacks Rank 1 (Strong Buy), contrasting with Tenet's Zacks Rank 3 (Hold) [20][23].

Core Insights - Major health insurers' shares declined due to a Senate deal that ended a 40-day U.S. government shutdown but did not extend Affordable Care Act (ACA) subsidies, creating uncertainty for millions relying on these subsidies for health coverage [1][3] - The ongoing debate over ACA subsidies is politically charged, with a narrow window for lawmakers to act before the open enrollment period for 2026 coverage ends on January 15 [5] Group 1: Market Reaction - Health insurance stocks fell as investors assessed the implications of the political stalemate on the sector [1] - Key companies affected include Cigna Group, Centene Corp, CVS Health Inc, Elevance Health, Humana Inc, Molina Healthcare Inc, UnitedHealth Group Inc, HCA Healthcare, and Tenet Healthcare Corporation [2] Group 2: Legislative Context - A procedural vote passed 60-40, allowing for short-term funding through January 30, while delaying the ACA subsidy issue until December [3] - The temporary spending bill prevents federal agencies from terminating employees until January 30, which is seen as a victory for federal worker unions [4] Group 3: Potential Impact on Consumers - Without congressional action, approximately 24 million enrollees could face significant premium increases for their 2026 plans, with estimates suggesting monthly premiums for ACA plans could more than double if pandemic-era assistance is not extended [3]

Group 1 - Tenet Healthcare Corporation announced a private placement offering totaling $1.5 billion in senior secured first lien notes due November 15, 2032, with an interest rate of 5.500% per annum [1] - The company will also issue $0.75 billion in senior notes due November 15, 2033, which will bear an interest rate of 6.000% [1]

Group 1 - The core viewpoint of the article is that Tenet Healthcare (THC) has raised its 2025 EBITDA guidance to $4.57 billion, driven by strong same-store growth and operational efficiency [1] Group 2 - Tenet Healthcare's stock price saw a slight increase in early trading on Wednesday [1] - The upward revision of EBITDA guidance reflects the company's positive performance metrics [1]

Group 1 - Tenet reported $5.3 billion in net operating revenues for Q3, exceeding Wall Street expectations and showing a 3.2% increase year-over-year [3] - The health system's earnings were driven by same-store revenue growth, operational efficiency initiatives, and a focus on high-acuity service lines for complex patients [3] - The acute hospital portfolio generated $4 billion in net revenue, aided by a $38 million increase from Medicaid supplemental payments from previous years [4] Group 2 - Tenet's ambulatory business, United Surgical Partners International (USPI), achieved $1.3 billion in revenue, with surgical volumes rising 2.1% year-over-year [4][6] - The company anticipates continued demand for high-acuity services, prompting an increase in its capital expenditure budget by $150 million, totaling between $875 million and $975 million [5][6] - Tenet raised its full-year revenue forecast for 2025 to between $21.2 billion and $21.4 billion, marking the second consecutive quarter of upward revisions due to strong performance [6]