U.S.-based hospital HCA Healthcare Inc. (NYSE:HCA) released third-quarter 2026 revenues of $19.849 billion, representing a 3.6% year-over-year increase, beating the consensus estimate of $19.332 billion.
The company reported adjusted earnings of $7.22, up from $6.96 a year ago, surpassing the Wall Street estimates of $6.66.
Adjusted EBITDA reached $3.918 billion, compared to $3.87 billion a year ago.
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Patient Volume Growth Countered by Falling Surgery Rates
Same-facility admissions increased 2.7%, and same-facility equivalent admissions increased 3%. Same facility emergency room visits increased 5.1%.
Same facility inpatient surgeries declined 1.4%, and outpatient surgeries declined 3.7% in the quarter. Same facility revenue per equivalent admission increased marginally by 0.6%.
During the third quarter, HCA Healthcare experienced a payer mix shift driven by an increase in uninsured volume, primarily due to patients who lost coverage on the health insurance exchanges.
Uninsured Patient Volume and $400 Million Payer Mix Headwind
The company estimates this payer mix shift had an unfavorable impact on income before income taxes of approximately $400 million during the third quarter.
Despite the unfavorable payer mix shift, the company’s third-quarter results reflected improvement in key areas of its business: growth accelerated in same facility equivalent admissions and insured revenue per equivalent admission (excluding Medicaid Supplemental Payment Programs); cost results improved; and the net benefit from Medicaid Supplemental Payment Programs modestly increased.
Management Commentary on Medicaid Supplemental Payments and 2027 Policy Fluidity
“Despite the challenges brought about by federal policy changes this year, our colleagues have continued to provide high-quality care to patients, and we believe HCA Healthcare is positioned to end the year positively,” said Sam Hazen, CEO of HCA Healthcare.
Hazen, in an earnings call, said, “We expect to receive approximately $550 million to $650 million less in Medicaid supplemental payment net benefits due to various state programs that received grandfather approvals in 2026 and reimbursed us for services we provided in prior years.”
Hazen further said, “…we are still early in our planning process, and there are several important areas that remain fluid, including the policy environment. First, we expect demand for services to remain strong with volume growth forecasted to be 2% to 3%. 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 the health insurance exchanges than we experienced in 2026.”
Fiscal 2026 Guidance Raised
HCA Healthcare raised fiscal 2026 earnings guidance from $28.70-$30.50 per share to $29.60-$30.50 per share compared to the consensus of $29.46.
The company raised its fiscal 2026 sales guidance from $77 billion-$79.50 billion to $78.250 billion-$79.50 billion compared to the consensus of $78.517 billion.
HCA Price Action: HCA Healthcare shares were down 4.68% at $443.50 at the time of publication on Tuesday, according to Benzinga Pro data.
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