HCA US S&P 500Russell 1000 Earnings call · transcribed from the recording
HCA Healthcare (HCA) · Q3 2026 results and valuation
Share price: $506.04 · 2026-11-11
HCA Healthcare provides a range of healthcare services including acute care, behavioral health, and outpatient services. The company operates hospitals, surgery centers, and emergency facilities across 19 states and England. Source: 10-K annual report (2026-02-10)
Results Q3 2026 vs Q1 2026 · previous quarter · published 27 Oct 2026 and 24 Apr 2026
Management sounded about as positive as a typical company call, in its script and in answers to analysts.
1 · Numbers
—
Figures not yet filed
Outlook given
2 · How management spoke
Typical
More upbeat than 53% of company calls
Answers to analysts: typical, in line with the script.
Similar to last call.
3 · What stood out
HCA expects to receive $550 million to $650 million less in Medicaid supplemental payment net benefits due to state programs receiving grandfather approvals in 2026.
Valuation
Is HCA Healthcare undervalued?
Reverse DCF. Free cash flow from the last full fiscal year (2025-12-31), grown for 10 years, discounted back, plus a terminal value. “Implied growth” is the rate the current price assumes.
At 7.9% growth a year (3-year revenue growth), the model's fair value is $473.97 a share — the stock trades 7% above it. Today's price assumes 8.5% growth a year.
Current price
$506.04
close of 2026-11-11
Market implies growth of iThe yearly free-cash-flow growth, for the next 10 years, that today’s share price already assumes. If you believe the company grows faster than this, the stock is cheap under this model; slower, and it is expensive.
+8.5% for 10 yrs
Fair value / share
$473.97
Buy below
$355.47
Price vs fair value
Overvalued 7%
Price vs buy-below price
Overvalued 42%
Read between the lines
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Guidance
HCA expects to receive $550 million to $650 million less in Medicaid supplemental payment net benefits due to state programs receiving grandfather approvals in 2026 for services provided in prior years.
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Figure
A shift in the payer mix from exchanges to uninsured patients resulted in an unfavorable impact on adjusted EBITDA of approximately 400 million in a quarter.
Source quote
“We estimate the payer mix shift from exchanges to uninsured resulted in an unfavorable impact on adjusted EBITDA of approximately 400 million in a quarter.”
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Figure
The third quarter marked the 22nd consecutive quarter of volume growth for the company.
Source quote
“The third quarter reflected the 22nd consecutive quarter of volume growth for the company.”
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Figure
HCA anticipates that its earnings in 2027 will be generally consistent with 2026 based on preliminary observations.
Source quote
“When we aggregate these preliminary observations, we anticipate our earnings in 2027 will be generally consistent with 2026.”
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Guidance
HCA expects to land in the upper half of its annual guidance ranges based on third quarter performance.
4 more
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Key theme
HCA reported no significant change to its market configuration due to several years of intentional portfolio optimization aimed at providing value to patients and the organization.
Source quote
“So I don't see any significant change to our market configuration at this particular point, because we've been intentional over the past few years to optimize the portfolio, if you will, and put ourselves in a position where we can succeed and build out the model that we think adds value to our patients and adds value to the organization as a whole.”
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Key theme
HCA is moving the cost agenda systematically by expanding its shared service platform through new technology and capabilities.
Source quote
“We now have new capabilities. We have new technology. We're expanding our shared service platform as a result of that. And we're able to move the cost agenda systematically as a company today.”
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Figure
Medicare rose 3.2%, Medicaid rose 2.7%, and commercial excluding exchanges rose 2.7%, while exchanges fell 19% compared to the primary quarter.
Source quote
“Medicare is up 3.2%. Medicaid is up 2.7%. Commercial excluding the exchanges are up 2.7%. And then the exchanges are down 19% to the primary quarter.”
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Figure
HCA grew to almost 3,000 units through the acquisition of urgent care, ambulatory surgery centers, and outpatient facilities to provide more convenient and accessible locations for patients.
Source quote
“We're up to almost 3,000 units through acquisition of urgent care, ambulatory surgery centers, and other outpatient facilities that complement our hospital's ecosystem and create for our patients a more convenient and accessible location and efficient service.”
Tone
How upbeat the language was, compared with other companiesiTone counts positive minus negative finance words, adjusted for length. Executives mostly speak positively, so the labels compare each call with every company's latest call: “typical” is the middle third, “very upbeat” the top tenth, “cautious” the bottom tenth.. Dot: Q3 2026. Ring: Q1 2026.
Script and answers carried a similar tone, so the script's message held up under questioning.
Sentences that drove the tone
“These factors, coupled with improved cost results, contributed to solid financial performance in the quarter that slightly exceeded our expectations.”
“As we typically see an increase sequentially from second quarter to third quarter, this outcome reflects strong operating discipline from our teams.”
“First, demand for our services continued to grow at a solid rate.”
Full figures
Q3 2026 figures are not available yet: the company files its quarterly report (10-Q) a few weeks after the call. This page compares what management said; the figures are added when the report is filed.
Topics
Most discussed now
- These factors, coupled with improved cost results, contributed to solid financial performance in the quarter that slightly exceeded HCA…
- HCA Healthcare had a modest incremental net benefit of $50 million in the quarter from Medicaid supplemental payment programs, primarily...
- I've often mentioned that HDA has strong staying power because of its scale, the important role HCA Healthcare plays in providing...
- Same facility equivalent admissions in HCA Healthcare's insured population, excluding exchanges, increased approximately 3% in the third…
- HCA Healthcare's approach to its networks is continuing to advance with respect to its ambulatory platform.
Faded since Q1 2026
- Fading As mentioned over the last several quarters, HCA Healthcare's teams have been focused on a broad resiliency plan designed to generate...
- Fading This produced a drag on HCA Healthcare's quarterly volume growth in admissions and ER visits, up 70 basis points and 140...
- Fading Adjusted EBITDA margin decreased 50 basis points versus prior year quarter.
- Fading Those were primarily related to opportunities in urgent care and ambulatory surgery and in HCA Healthcare's freestanding emergency room…
Latest announcements
Official filings, newest first. Summaries are generated from each filing and its attachment; every figure is checked against the source.
- Material agreement; New financial obligation; Other events · SEC 8-K
- Other events · SEC 8-K
- Results of operations; Regulation FD disclosure; Other events · SEC 8-K
HCA Healthcare reported third-quarter revenues of $19.849 billion, up 3.6 percent from $19.161 billion in the third quarter of 2025, while net income fell 3.9 percent to $1.579 billion.
- New financial obligation; Other events · SEC 8-K
HCA Inc. increased the maximum aggregate face amount of its unsecured commercial paper program from $4.0 billion to $8.0 billion on July 29, 2026.
- Results of operations; Regulation FD disclosure; Other events · SEC 8-K
HCA Healthcare reported second-quarter revenue of $20.230 billion, up 8.7 percent from $18.605 billion in the second quarter of 2025, and declared a quarterly cash dividend of $0.78 per share.
- Results of operations; Regulation FD disclosure · SEC 8-K
HCA Healthcare reported preliminary second-quarter 2026 revenues of approximately $20.230 billion, up from $18.605 billion in the second quarter of 2025, with net income of $1.699 billion compared to $1.653 billion.
- Director or officer change · SEC 8-K
Dr. Michael Cuffe will step down as Executive Vice President and Chief Clinical Officer of HCA Healthcare, Inc. effective August 31, 2026, and remain in a transitional role until February 2027.
- Material agreement; New financial obligation; Other events · SEC 8-K
HCA Inc. completed the public offering of $3,000,000,000 in senior notes consisting of 2031, 2033, and 2036 notes.
Balance sheet & ownership
From SEC filings; short interest is FINRA data via Yahoo. Collected 2026-10-29.
Cash & runway
Cash & equivalents
$940.0M
2026-03-31
Short-term investments
$121.0M
Long-term investments
$387.0M
total liquidity $1.45B
Implied runway
—
operating cash flow positive over the TTM window
Dilution
weighted-average basic shares, per quarter. Change: -9.5% YoY.
| Quarter | Shares |
|---|---|
| Q2 2024 | 261.2M |
| Q3 2024 | 256.8M |
| Q1 2025 | 246.9M |
| Q2 2025 | 239.2M |
| Q3 2025 | 232.9M |
| Q1 2026 | 223.6M |
Insider transactions
Form 4 open-market trades (codes S/P), trailing 12 months. 40 filings parsed.
Sold by insiders
62.0K shares
$31.1M · 13 transactions
Bought by insiders
0 shares
0 transactions
Net direction
net selling
Catalyst calendar
management-stated targets — from the latest earnings call; plans, not promises.
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January
provision of full year guidance
Source quote
“As we look ahead to 2027, let me share a few preliminary observations around certain aspects of our business before we provide our full year guidance in January.”
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2027
demand for services to remain strong with volume growth forecasted to increase be two to three percent
Source quote
“First, we expect demand for services to remain strong with volume growth forecasted to increase be two to three percent this range is consistent with our long-term thinking within the demand environment we believe it's reasonable to assume for 2027 that fewer people will lose their coverage on on the health insurance exchanges than we experienced in 2026.”
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2027
earnings will be generally consistent with 2026
Source quote
“When we aggregate these preliminary observations, we anticipate our earnings in 2027 will be generally consistent with 2026.”
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Beyond 2027
performance more in line with our long-term growth targets
Source quote
“Beyond 2027, we anticipate performance more in line with our long-term growth targets.”
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full year 2026
revenue range
Source quote
“be between $600 million and $800 million for the full year 2026.”