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HCA Healthcare, Inc. HCA

NYSEHealthcare servicesFinancials to Jun 30, 2026 · Updated Oct 9, 2026

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HCA financials
Moat score
78
ROIC
22.7%
P/E
14.1
EV/EBIT
12.0
FCF yield
6.2%
Dividend yield
0.7%
Market cap
$96.3B

Moat ranks

Score rankTied #165 of 396
Durabilitymedium
Market structureOligopoly
Pricing powermoderate

Balance sheet

6/30/26
$BDec 31Jun 30
Cash1.01.0
Securities0.00.0
Restricted cash0.60.5
Debt45.749.7
Net cash-44.7-48.7
Equity-6.0-6.6
Leverage
Debt / EBITDA
3.15×
Debt / equity
–
Leases (12/31/25)
$3.0B
Capital
Diluted shares
223M
Book value / share
−$29.81
Price / book
–
Net cash / share
−$218.58
Market cap
$96.3B
Enterprise value
$145.1B

Per-share record

Fiscal years and TTM
Scale
$0$100$200$300$400'16'17'18'19'20'21'22'23'24315.66'25350.10TTM
Revenue per shareCash flow per share

Key indicators

Latest: Q2 '26
IndicatorLatestVs year agoLast 8 quarters
Revenue growth8.7%+2.4 pts
Operating margin15.2%-0.7 pts
FCF margin5.5%-10.9 pts
Capex / revenue6.1%-0.2 pts
Hospitals190-1%
Freestanding surgery centers118-5%
Estimated cost of uncompensated care$1.4B+29%
Salaries and benefits$8.3B+2%
Same-facility admissions growth+3%+1 pts

Margins and growth from reported quarters; company KPIs as reported in results releases.

About HCA

HCA Healthcare runs hospitals and outpatient facilities in the United States and England. Its local networks make it easier to refer patients across care settings, while shared purchasing, revenue collection and clinical systems spread costs.

Revenue mix
Hospitals and related healthcare entities 100.0%
  • Permits Rights Of Way

    In many states, hospital/facility expansion and certain service-line additions face licensing and certificate-of-need style approvals, slowing entrants and capacity additions.

  • Scope Economies

    Large multi-market footprint supports centralized shared services (revenue cycle, purchasing, supply chain, staffing) that can lower unit costs and improve operational execution versus smaller systems.

  • Physical Network Density

    Dense local footprints (hospitals plus outpatient sites) improve access, referral capture, physician alignment, and make full replacement by a new entrant capital-intensive and slow.

Timeline
  1. Sep 15, 2026

    HCA completed its purchase of the College of Health Care Professions, adding allied-health training for more than 8,000 students; the purchase price was not disclosed.

  2. Sep 8, 2026

    The North Carolina Business Court denied class certification in the Mission antitrust case without prejudice; plaintiffs can renew their motion, so this did not end the litigation.

  3. Sep 1, 2026

    Michael Schlosser became chief clinical officer and Charles Gressle began leading the new Ambulatory Operations Group, bringing clinical technology and outpatient operations under dedicated leaders.

  4. Aug 2026

    HCA’s MEDITECH Expanse rollout reached 72 hospitals, creating a broader common clinical platform; patient-care and cost improvements remain to be demonstrated.

  5. Jul 28, 2026

    North Carolina’s Mission Hospital contract case advanced toward trial, keeping emergency and cancer-care commitments under legal scrutiny.

Ownership

To 10/9/26
CEO
Samuel N. Hazen
Since 2019 · 7 yrs
Professional CEOSingle share class
Insider trades36
Planned sales4

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Financial record

Fiscal year2016201720182019202020212022202320242025TTMTrendChange 2016–25
Per share ($)
Revenue104.81117.17131.37147.42149.98178.71204.41235.04269.68315.66350.10+13.0%/yr
Cash flow14.2814.5819.0321.8326.8727.2528.9234.1240.1652.7649.92+15.6%/yr
Earnings7.305.9510.6610.0710.9321.1619.1518.9622.0028.3330.70+16.3%/yr
Free cash flow7.316.488.979.8918.6216.3714.0116.9621.5432.1226.91+17.9%/yr
Capex6.978.1010.0611.948.2510.8814.9217.1618.6220.6423.01+12.8%/yr
Dividends0.000.001.371.580.451.902.222.392.642.843.06–
Book value-18.45-18.28-13.93-8.061.66-2.84-9.39-6.42-9.55-25.17-29.81–
Diluted shares (M)396372355348344329295276262239223-5.4%/yr
Totals ($B)
Revenue41.543.646.751.351.558.860.265.070.675.678.0+6.9%/yr
Operating income6.56.17.17.27.311.310.49.610.612.012.1+7.1%/yr
Net income2.92.23.83.53.87.05.65.25.86.86.8+9.9%/yr
Free cash flow2.92.43.23.46.45.44.14.75.67.76.0+11.5%/yr
Buybacks2.82.11.51.00.48.27.03.86.010.18.7+15.5%/yr
Dividends0.00.00.50.60.20.60.70.70.70.70.7–
Net cash-30.7-32.3-32.3-32.5-28.6-32.4-36.5-38.0-40.3-44.7-48.7−$14.0B
Margins & returns (%)
Operating margin15.613.915.114.114.119.217.214.815.015.915.5+0.3 pts
Net margin7.05.18.16.87.311.89.48.18.29.08.8+2.0 pts
FCF margin7.05.56.86.712.49.26.97.28.010.27.7+3.2 pts
ROIC21.718.720.319.219.628.324.221.022.024.522.7+2.7 pts
Stock pay % of revenue0.60.60.60.70.70.70.60.40.50.50.5-0.1 pts
Capex % of revenue6.76.97.78.15.56.17.37.36.96.56.6-0.1 pts

Change uses 2016 and 2025 only: compound annual growth for amounts, points for margins and returns, and the change in amount for net cash. A dash means no 2016 base. Trend shows the fiscal years.

TTM = four quarters to Jun 30, 2026. Per-share values use diluted weighted shares.ROIC = operating income × (1 − 21.2% tax rate, the company's own over three fiscal years excluding one-offs) ÷ (equity + debt − cash and current securities). Returns show a dash when their base is negative or under 10% of revenue. Free cash flow = operating cash flow − capex. Debt is all borrowings; net cash counts long-term securities and excludes leases.

Moat

Moat scorecard

Moat score78
Strength
Confidence
Structure
Oligopoly
Durability
medium
Trajectory
stable
Pricing power
moderate
Segments
  • Hospitals and related healthcare entities100.0%
    3 claims

Moat claims

Applies to
Hospitals and related healthcare entities
Confidence
Durability
medium
Trajectory
stableas of Oct 9, 2026
Why it holds

In many states, hospital/facility expansion and certain service-line additions face licensing and certificate-of-need style approvals, slowing entrants and capacity additions.

Why stable

State approvals still limit some new hospitals, but HCA gives no evidence of stronger protection. Ambulatory competitors can expand with fewer entry barriers.

Indicators
  • Hospitals190-1%
Risks
  • CON deregulation or higher thresholds for review
  • Care shifting to less-regulated outpatient settings

Profile change log

  1. Oct 9, 2026 · business change

    HCA’s MEDITECH Expanse rollout reached 72 hospitals, creating a broader common clinical platform; patient-care and cost improvements remain to be demonstrated.

  2. Oct 9, 2026 · business change

    HCA completed its purchase of the College of Health Care Professions, adding allied-health training for more than 8,000 students; the purchase price was not disclosed.

  3. Oct 9, 2026 · business change

    The North Carolina Business Court denied class certification in the Mission antitrust case without prejudice; plaintiffs can renew their motion, so this did not end the litigation.

  4. Oct 9, 2026 · business change

    Michael Schlosser became chief clinical officer and Charles Gressle began leading the new Ambulatory Operations Group, bringing clinical technology and outpatient operations under dedicated leaders.

  5. Oct 9, 2026 · business change

    North Carolina’s Mission Hospital contract case advanced toward trial, keeping emergency and cancer-care commitments under legal scrutiny.

  6. Oct 9, 2026 · business change

    HCA cut 2026 net-income guidance from $6.495–$7.035 billion to $6.300–$6.700 billion as exchange coverage losses outweighed part of the supplemental-payment benefit.

  7. Oct 9, 2026 · analyst revision

    Separated Florida’s prior-period directed-payment catch-up from continuing reimbursement and uninsured mix; used the newer filing tax provision of $564 million for Q2 rather than the release’s $562 million.

  8. Oct 9, 2026 · analyst revision

    Retained three moat ratings and judged their trajectories stable; added payer-mix, surgery, debt and care-quality tests and clarified that the operating groups are geographic.

  9. Oct 9, 2026 · analyst revision

    Identified the material 2017 deferred-tax law charge, large 2021–2022 portfolio-sale gains, California facility-sale loss and Florida prior-period payment effect; retained recurring award taxes and uninsured mix in reported profit.

Industry & peers

Peer map

0%10%20%30%40%50%60708090100Moat scoreHCA
No peer numbers yet

Peers appear on the map as their numbers are collected.

U.S. hospital and ambulatory care

As of Oct 9, 2026
CompetitiveLow cyclicality

U.S. acute-care hospital systems and their outpatient departments, surgery centers, clinics and emergency facilities. Excludes health-insurance underwriting, stand-alone drug retail and the U.K. private-hospital market.

StocksMoatGross m.Op. m.
HCA78–15.5%
Industry median577––
Sector median557661.5%17.0%
All stocks median3987652.9%19.6%

Moat medians cover every stock. Margin medians count only stocks with collected numbers and need at least three.

Drivers & risks

Demand drivers
  • Population aging and chronic illness support recurring demand for inpatient and ambulatory care.
  • Growing metropolitan populations favor systems with accessible local facilities and referral relationships.
  • Care moving to outpatient facilities creates growth where systems own the relevant sites and physician relationships.
  • Shared purchasing, revenue collection and clinical systems can spread fixed costs and reduce staffing bottlenecks.
  • Annual Medicare rates and state Medicaid approvals move realized revenue independently of patient volume.
Risks
  • Loss of exchange or Medicaid coverage raises unpaid care and can delay elective procedures; demand alone does not assure cash collection.
  • Nursing shortages, physician costs, drug prices and tariffs can raise costs faster than regulated reimbursement.
  • Independent surgery centers and payer steering can take profitable procedures while hospitals retain emergency and complex care.
  • Medicaid provider-tax and directed-payment limits can reduce support; catch-up approvals can make one quarter unusually strong.
  • High fixed costs and borrowing requirements expose providers to refinancing rates, hurricane disruption and clinical-quality litigation.

Bulls & bears

Key question · as of Oct 9, 2026

Can HCA’s local care networks and cost controls protect profit as insured patients become uninsured and supplemental payments face policy limits?

Arguments

3 forFaded: weakening or settled5 against

What to watch

  1. 1Same-facility equivalent admissions and inpatient/outpatient surgeries
  2. 2Estimated uncompensated-care cost and exchange-related pretax impact
  3. 3Medicaid supplemental revenue, provider-tax expense and cash collection

Next check: October 27, 2026 Q3 results: test insured mix, surgery demand, directed-payment collections and the full-year profit forecast.

Sources: company filings and dated sources collected for Find My Moat; market cap as of Oct 8, 2026. Not investment advice.

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Moat Score 78/100 by <a href="https://www.findmymoat.com/stocks/XNYS:HCA">Find My Moat</a> (as of September 2026)

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