HCA(US:HCA)2026-02-10 21:27Financial Performance - Net income for HCA Healthcare, Inc. in 2025 was $6.784 billion, or $28.33 per diluted share, up from $5.760 billion, or $22.00 per diluted share in 2024, reflecting a significant increase in profitability [329]. - Total revenues increased to $75.600 billion in 2025, a rise of 7.1% from $70.603 billion in 2024, driven by a 2.9% increase in equivalent admissions and a 4.0% increase in revenue per equivalent admission [330]. - Revenues increased by 7.1% to $75.600 billion for 2025 from $70.603 billion for 2024, driven by a 2.9% increase in equivalent admissions and a 4.0% increase in revenue per equivalent admission [387]. - Net income attributable to HCA Healthcare, Inc. was $6.784 billion in 2025, representing a 17.8% increase from $5.760 billion in 2024 [385]. Operational Metrics - Consolidated admissions rose by 2.7% in 2025, with inpatient surgical volumes increasing by 0.9%, while outpatient surgical volumes slightly declined by 0.2% [331]. - Consolidated admissions increased by 2.7% in 2025, with same facility admissions rising by 2.3% compared to 2024 [386]. - Same facility revenues increased by 6.6% for 2025 compared to 2024, attributed to a 2.4% increase in equivalent admissions and a 4.1% increase in revenue per equivalent admission [364]. - Emergency room visits increased by 1.6% on a consolidated basis in 2025, with a 1.8% increase on a same facility basis [386]. - The average length of stay for patients was 4.8 days in 2025, consistent with 2024 [382]. - The occupancy rate for hospital beds was 73% in 2025, unchanged from 2024 [382]. Cash Flow and Expenses - Cash flows from operating activities increased by $2.122 billion, reaching $12.636 billion in 2025, primarily due to a $1.319 billion increase in net income and positive changes in working capital [333]. - Cash provided by operating activities totaled $12.636 billion in 2025, a $2.122 billion increase from 2024, attributed to a $1.319 billion increase in net income [398]. - Cash used in investing activities was $4.988 billion in 2025, with planned capital expenditures expected to be between $5.0 billion and $5.5 billion in 2026 [399]. - Cash used in financing activities totaled $8.550 billion in 2025, including $10.067 billion for repurchases of common stock [402]. - Depreciation expense increased to $3.508 billion in 2025 from $3.294 billion in 2024, representing 4.6% of revenues [391]. - Other operating expenses remained stable at 21.0% of revenues for both 2025 and 2024, with inflation expected to continue impacting these expenses in 2026 [390]. Debt and Interest - Interest expense increased to $2.248 billion in 2025, up from $2.061 billion in 2024, primarily due to a higher average debt balance [332]. - The total long-term debt of HCA Healthcare, Inc. was estimated at $45.911 billion as of December 31, 2025, with $2.507 billion subject to variable interest rates and $43.985 billion at fixed rates [420][421]. - The average effective interest rate for long-term debt was 5.0% for both 2025 and 2024 [420]. - A hypothetical 1% increase in interest rates could lead to a potential annualized reduction in future pretax earnings of approximately $25 million [421]. - HCA Healthcare, Inc. targets a majority of its debt portfolio to be maintained at fixed rates to mitigate interest rate fluctuations [421]. Uncompensated Care and Challenges - The estimated cost of total uncompensated care rose by $239 million in 2025, with uninsured admissions increasing by 1.9% [332]. - Total uncompensated care costs were estimated at $47.966 billion for 2025, up from $43.231 billion in 2024, with an estimated cost of total uncompensated care at $4.605 billion for 2025 [350]. - Management expects continued challenges related to the collection of patient due accounts, influenced by economic conditions and changes in healthcare coverage [350]. Strategic Initiatives - HCA Healthcare plans to expand its presence in existing markets by developing comprehensive service lines and outpatient facilities, aiming for long-term growth [334]. - The company is investing in digital and artificial intelligence capabilities to enhance clinical quality and operational efficiency, focusing on secure, enterprise-grade solutions [341]. - HCA Healthcare aims to achieve industry-leading performance in clinical, operational, and satisfaction measures through various initiatives, including infection reduction and advanced health information technology [336]. - The company continues to pursue a disciplined development strategy, focusing on selectively developing and acquiring new hospitals and outpatient facilities to capitalize on growth opportunities [339]. Tax and Regulatory Matters - The effective income tax rate decreased to 23.2% in 2025 from 24.5% in 2024, influenced by adjustments related to an internal restructuring of certain affiliates [394]. - The IRS concluded its examination of the Company's 2022 and 2023 income tax returns, resolving all federal income tax matters for those years without material impact on results [423]. - HCA Healthcare, Inc. is currently under examination by the IRS for the 2019 income tax returns of certain affiliates [423]. Market Risks - The company does not consider market risk related to foreign currency translation to be material to its consolidated financial statements or liquidity [422]. - The company is exposed to market risk related to market illiquidity, which could impair investments in debt and equity securities [419]. - The company may face credit-related impairments on investment securities in future periods if issuers default on interest payments [419].