HCA Q3 Earnings Beat Estimates on Rising Inpatient Surgery Cases

Core Insights - HCA Healthcare, Inc. reported third-quarter 2025 adjusted earnings per share (EPS) of $6.96, exceeding the Zacks Consensus Estimate by 23.2% and reflecting a 42% year-over-year improvement [1][10] - Revenues reached $19.2 billion, marking a 9.6% year-over-year increase and surpassing the consensus mark by 3.6% [1][10] Financial Performance - The strong quarterly results were driven by increased patient volumes, higher same-facility revenue per equivalent admission, and a rise in both inpatient and outpatient surgeries, along with more emergency room visits [2] - Same-facility equivalent admissions grew by 2.4% year over year, while same-facility admissions increased by 2.1%, falling short of the growth estimates of 3% [3] - Same-facility revenue per equivalent admission rose by 6.6% year over year, exceeding the growth estimate of 3.1% [3] - Adjusted EBITDA improved by 18.5% year over year to $3.9 billion, surpassing the estimate of $3.4 billion [4] Operational Metrics - Same-facility inpatient surgeries increased by 1.4% year over year, and same-facility outpatient surgeries grew by 1.1% [4] - Emergency room visits saw a slight increase of 1.3% year over year [4] - Total operating expenses, including salaries, benefits, and supplies, amounted to $15.3 billion, rising 7.5% year over year, which was higher than the estimate of $15.1 billion [4] Financial Position - As of September 30, 2025, HCA Healthcare had cash and cash equivalents of $997 million, a decrease of 48.4% from the end of 2024 [6] - Total assets stood at $59.7 billion, reflecting a 0.4% increase from the end of 2024 [6] - Long-term debt was reported at $38.4 billion, up 0.2% from December 31, 2024 [7] Cash Flow and Capital Deployment - HCA generated $10.3 billion in cash from operations in the first nine months of 2025, a 29.2% increase from the prior-year period [8] - The company repurchased shares worth $2.5 billion in the third quarter, with a remaining buyback capacity of $3.3 billion [11] Guidance Update - HCA raised its 2025 revenue guidance to between $75 billion and $76.5 billion, up from the previous range of $74 billion to $76 billion, indicating a 7.3% rise from 2024 [12] - Adjusted EBITDA is now forecasted to be between $15.25 billion and $15.65 billion, higher than the earlier estimate of $14.7 billion to $15.3 billion [13] - EPS is projected to be in the range of $27 to $28 for 2025, an increase from the previous forecast of $25.50 to $27.00, suggesting a 25% rise from 2024 [14]