third quarter of 2026
Filed Oct 27, 2026Third-quarter net revenues increased by 5.3% to $4.733 billion, while reported net income attributable to UHS was $308.7 million, or $5.22 per diluted share.
Revenue and same-facility volumes increased in both care businesses, but reported net income, operating income, EBITDA and EBITDA margins were below the prior-year quarter.
Key metrics
shortened, hover for the filing’s print| Metric | Value | q/q | y/y |
|---|---|---|---|
| Net revenues - three months ended September 30, 2026GAAP | $4.73B | – | 5.3% |
| Income from operations - three months ended September 30, 2026GAAP | $454.4M | – | – |
| Net income attributable to UHS - three months ended September 30, 2026GAAP | $308.7M | – | – |
| Diluted earnings per share attributable to UHS - three months ended September 30, 2026GAAP | $ 5.22 | – | – |
| Adjusted net income attributable to UHS - three months ended September 30, 2026non-GAAP | $308.7M | – | – |
| Adjusted diluted earnings per share - three months ended September 30, 2026non-GAAP | $ 5.22 | – | – |
| EBITDA net of NCI - three months ended September 30, 2026non-GAAP | $640.4M | – | – |
| EBITDA Margin net of NCI - three months ended September 30, 2026non-GAAP | 13.5% | – | – |
| Adjusted EBITDA net of NCI - three months ended September 30, 2026non-GAAP | $624.6M | – | – |
| Adjusted EBITDA Margin net of NCI - three months ended September 30, 2026non-GAAP | 13.2% | – | – |
| Cash Flow From Operations - third quarter ended September 30, 2026GAAP | $636.6M | – | – |
| Capital Expenditures - third quarter ended September 30, 2026other | $214.9M | – | – |
| Net revenues - nine months ended September 30, 2026GAAP | $13.87B | – | 7.7% |
| Income from operations - nine months ended September 30, 2026GAAP | $1.47B | – | – |
| Net income attributable to UHS - nine months ended September 30, 2026GAAP | $1.02B | – | – |
| Diluted earnings per share attributable to UHS - nine months ended September 30, 2026GAAP | $ 16.86 | – | – |
| Adjusted net income attributable to UHS - nine months ended September 30, 2026non-GAAP | $1.01B | – | – |
| Adjusted diluted earnings per share - nine months ended September 30, 2026non-GAAP | $ 16.83 | – | – |
| EBITDA net of NCI - nine months ended September 30, 2026non-GAAP | $1.97B | – | – |
| EBITDA Margin net of NCI - nine months ended September 30, 2026non-GAAP | 14.2% | – | – |
| Adjusted EBITDA net of NCI - nine months ended September 30, 2026non-GAAP | $1.95B | – | – |
| Adjusted EBITDA Margin net of NCI - nine months ended September 30, 2026non-GAAP | 14.1% | – | – |
| Net cash provided by operating activities - nine months ended September 30, 2026GAAP | $1.48B | – | 14.9% |
| Property and equipment additions - nine months ended September 30, 2026GAAP | $659.7M | – | – |
Segments
| Segment | Revenue | q/q | y/y |
|---|---|---|---|
| All Acute Care Hospital Services - three months ended September 30, 2026Same-facility adjusted admissions and adjusted patient days each increased by 4.9%, while net revenue per adjusted admission and net revenue per adjusted patient day each decreased by 1.7%. | $2.76B | – | – |
| Same Facility Acute Care Hospital Services - three months ended September 30, 2026Adjusted admissions and adjusted patient days each increased by 4.9%. | $2.61B | – | 4.7% |
| All Behavioral Health Care Services - three months ended September 30, 2026Same-facility adjusted admissions increased by 2.5% and adjusted patient days increased by 2.1%. | $1.97B | – | – |
| Same Facility Behavioral Health Care Services - three months ended September 30, 2026Net revenue per adjusted admission increased by 1.7% and net revenue per adjusted patient day increased by 2.1%. | $1.86B | – | 4.0% |
| All Acute Care Hospital Services - nine months ended September 30, 2026Same-facility adjusted admissions increased by 2.6% and adjusted patient days increased by 2.9%. | $7.98B | – | – |
| Same Facility Acute Care Hospital Services - nine months ended September 30, 2026Net revenue per adjusted admission increased by 2.4% and net revenue per adjusted patient day increased by 2.1%. | $7.59B | – | 7.0% |
| All Behavioral Health Care Services - nine months ended September 30, 2026Same-facility adjusted admissions increased by 1.4% and adjusted patient days increased by 1.7%. | $5.87B | – | – |
| Same Facility Behavioral Health Care Services - nine months ended September 30, 2026Net revenue per adjusted admission increased by 4.9% and net revenue per adjusted patient day increased by 4.7%. | $5.61B | – | 6.2% |
Amounts quoted below without a unit are in thousands, as in the filing’s tables. Per-share figures are as printed.
Capital returns
- During the third quarter of 2026, UHS repurchased 1.35 million shares at an aggregate cost of approximately $242.1 million.
- During the first nine months of 2026, UHS repurchased 3.915 million shares at an aggregate cost of approximately $689.6 million.
- As of September 30, 2026, aggregate available repurchase authorization was approximately $735.4 million.
- Dividends paid during the first nine months of 2026 were $36,552.
What drove it
- Third-quarter net revenues included an aggregate net favorable pre-tax impact of approximately $21 million: a favorable net pre-tax impact of $47 million from increases in Medicaid supplemental payment programs, partially offset by an unfavorable pre-tax impact of $26 million from increased self-insured professional and general liability reserves.
- Third-quarter acute same-facility revenue growth reflected 4.9% increases in adjusted admissions and adjusted patient days, partially offset by 1.7% decreases in both net revenue per adjusted admission and net revenue per adjusted patient day.
- Third-quarter behavioral same-facility revenue growth reflected higher admissions, patient days and revenue per adjusted admission and patient day.
- The first nine months of 2026 operating cash flow increase included favorable changes of $178 million in accounts receivable, $90 million in accrued insurance expense net of payments, $77 million in accrued and deferred income taxes, and $26 million of other combined net favorable changes.
Concerns
- Income from operations was $ 454,449 in the third quarter of 2026, compared with $ 521,688 in the third quarter of 2025.
- Third-quarter EBITDA Margin net of NCI was 13.5%, compared with 15.2%, and Adjusted EBITDA Margin net of NCI was 13.2%, compared with 14.9%.
- Acute same-facility net revenue per adjusted admission and net revenue per adjusted patient day each decreased by 1.7% in the third quarter.
- Interest expense, net was $ 56,277 in the third quarter of 2026, compared with $ 38,431 in the third quarter of 2025.
- Legislation adopted on July 4, 2025 attaches work and community service requirements to Medicaid eligibility, limits provider fees used to increase federal Medicaid funding to states, and eliminated certain exchange premium tax credits beyond 2025.
- In August 2026, UHS reached a tentative settlement agreement in the Cumberland Litigation, subject to execution of final releases and certain court approvals.
What to watch
- Continuation and qualification for Medicaid supplemental payment programs and the necessary Inter-Governmental Transfers for Medicaid disproportionate-share programs.
- Acute Care net revenue per adjusted admission and net revenue per adjusted patient day after their third-quarter decreases of 1.7%.
- Operating expense trends, including salaries, wages and benefits and other operating expenses, given the year-over-year EBITDA margin reduction.
- Integration and realization of benefits and synergies from the Talkspace, Inc. acquisition completed in August 2026.
- Finalization of the Cumberland Litigation settlement, including final release agreements and required court approvals.
- Debt, borrowing rates and cash flow following $1,800,040 of additional borrowings and $828,487 of debt repayments during the first nine months of 2026.
Balance sheet and cash flow
- Cash and cash equivalents were $ 168,749 as of September 30, 2026, compared with $ 137,797 as of December 31, 2025.
- Debt was $5,707,341 as of September 30, 2026, compared with $4,691,120 as of September 30, 2025.
- Long-term debt was $ 5,627,528 as of September 30, 2026; current maturities of long-term debt were $ 79,813.
- Available borrowing capacity under the $1.5 billion revolving credit facility was $1.187 billion, net of outstanding borrowings of $310 million and letters of credit of $3 million.
- Net cash provided by operating activities for the first nine months of 2026 was $1.481 billion, compared with $1.290 billion during the first nine months of 2025.
- Acquisition of businesses and property was $1,002,852 during the first nine months of 2026.
- Repayments of long-term debt were $828,487 and additional borrowings were $1,800,040 during the first nine months of 2026.
Analysis
UHS reported third-quarter net revenues of $ 4,733,352, compared with $ 4,495,245 in the prior-year period, with the release stating a 5.3% increase. Volume was positive in both operating businesses on a same-facility basis. Acute Care adjusted admissions and adjusted patient days each increased by 4.9%, while Behavioral Health adjusted admissions increased by 2.5% and adjusted patient days increased by 2.1%.
Revenue realization differed between the segments. Acute Care same-facility net revenue per adjusted admission and per adjusted patient day each decreased by 1.7% in the quarter, while the corresponding Behavioral Health measures increased by 1.7% and 2.1%, respectively. Same-facility revenue increased 4.7% in Acute Care and 4.0% in Behavioral Health. The quarter also included an aggregate net favorable pre-tax impact of approximately $21 million from Medicaid supplemental payments and higher liability reserves.
Profitability was lower than the prior-year quarter. Income from operations was $ 454,449 versus $ 521,688, net income attributable to UHS was $ 308,684 versus $ 372,957, and diluted earnings per share was $ 5.22 versus $ 5.86. EBITDA net of NCI was $ 640,383 with a 13.5% margin, compared with $ 684,229 and a 15.2% margin. Adjusted EBITDA net of NCI was $ 624,645 with a 13.2% margin, compared with $ 670,600 and a 14.9% margin. Interest expense, net also increased to $ 56,277 from $ 38,431.
For the first nine months, net revenues increased by 7.7% to $ 13,866,546 and net cash provided by operating activities increased by 14.9% to $ 1,481,487. UHS deployed $ 1,002,852 toward acquisition of businesses and property, repurchased 3.915 million shares at an aggregate cost of approximately $689.6 million, and paid $36,552 in dividends. Cash and cash equivalents were $ 168,749 at September 30, 2026, while debt was $5,707,341.
The filing did not provide forward financial guidance. Reported risks emphasize Medicaid program funding and eligibility changes, higher borrowing rates, trade restrictions, litigation exposure and the integration of Talkspace, Inc. The principal operating measures to monitor are Acute Care pricing metrics, the lower EBITDA margin, ongoing Medicaid supplemental payment support, and the final terms and approvals associated with the Cumberland Litigation settlement.
Not in the filing
stated, not guessed- Forward financial guidance was not provided.
- Previous-release outlook was not provided.
- Gross margin was not reported.
- Free cash flow was not reported.
- A GAAP or non-GAAP effective tax rate was not reported.
- Management quotes from named executives were not provided.
- Quarterly segment revenue year-over-year percentage changes for All Acute Care Hospital Services and All Behavioral Health Care Services were not explicitly reported on their revenue rows.
- Cash and debt prior-quarter balances were not reported.
AlphAI analysis generated from the company’s SEC earnings filing (Form 8-K Item 2.02, or Form 6-K for a foreign private issuer). Every figure was cross-checked against the filing text; consensus estimates, price targets and share-price reactions are not shown because they are not in the filing. AI-generated research, not investment advice.