HCA Healthcare beats top-line and bottom-line estimates; expects FY performance in upper

BofA Securities raised its price target on HCA Healthcare (NYSE:HCA) to $500 from $450, citing solid execution and upside from supplemental Medicaid programs. The company's Q3 EBITDA exceeded estimates, with revenue of $19.85B and EPS of $7.22. HCA maintained its guidance range but faces near-term headwinds. The stock trades at an EV/EBITDA of 9.6x and a P/E ratio of 14.85.

HCA Healthcare (HCA) reported Q3 2026 earnings, highlighting a 19% decline in exchange equivalent admissions, a $400M unfavorable EBITDA impact, and reduced elective surgical volumes. The company expects $550M-$650M less in Medicaid supplemental payments in 2027. HCA anticipates 2027 earnings to be generally consistent with 2026, citing exchange headwinds and reduced supplemental payments.

HCA Healthcare reported $50M in incremental Medicaid benefits in Q3, raising its 2026 estimate to $600M-$800M. Costs were flat, but professional fees rose 12%. HCA reaffirmed 2026 guidance, expecting upper-half results. For 2027, it anticipates strong demand and earnings similar to 2026. The company spent $1.36B on capital expenditures, repurchased $3B in shares, and paid $165M in dividends.

HCA Healthcare reported Q3 2026 revenue of $19.849 billion, up 3.6% YoY, with net income of $1.579 billion. EPS grew 4.4% to $7.27. Adjusted EBITDA rose 1.2% to $3.918 billion. Volume growth continued, but payer mix shifts impacted earnings. The company raised full-year revenue and EBITDA guidance. Management expects stable 2027 earnings despite Medicaid payment headwinds.

HCA Healthcare forecasted flat 2027 earnings, citing lower Medicaid payments and rising uninsured patients, causing shares to drop over 5%. CEO Sam Hazen attributed the outlook to a fluid policy environment. Analysts expect 2027 EPS of $32.14, below the company's implied guidance. HCA's Q3 adjusted profit was $7.22 per share on revenue of $19.85 billion, beating estimates. The company expects 2026 EPS between $28.70 and $30.50 on revenue of $77.0B-$79.5B.

HCA Healthcare reported Q3 2026 volume growth of 3%, driven by demand across various service lines. The company offset payer mix pressure through higher revenue per admission and improved contract collections. Elective surgical volumes faced challenges due to federal policy changes. HCA maintained flat same-facility costs despite inflation. The company anticipates 2027 earnings to be generally consistent with 2026, with 2% to 3% volume growth.