HCA Healthcare’s third quarter was marked by broad-based growth in patient volumes, improved payer mix, and higher utilization of complex services. Management highlighted the impact of increased Medicaid supplemental payments, particularly from Tennessee, Kansas, and Texas, as a significant factor supporting both revenue and margins. CEO Sam Hazen cited the “broad-based volume growth, improved payer mix, more utilization of complex services and additional revenue from Medicaid supplemental programs” as key drivers. The company also emphasized disciplined cost controls and operational execution, contributing to stronger operating margins compared to last year.
Is now the time to buy HCA? Find out in our full research report (it’s free for active Edge members).
HCA Healthcare (HCA) Q3 CY2025 Highlights:
- Revenue: $19.16 billion vs analyst estimates of $18.55 billion (9.6% year-on-year growth, 3.3% beat)
- EPS (GAAP): $6.96 vs analyst estimates of $5.70 (22.2% beat)
- Adjusted EBITDA: $3.87 billion vs analyst estimates of $3.48 billion (20.2% margin, 11.1% beat)
- The company slightly lifted its revenue guidance for the full year to $75.75 billion at the midpoint from $75 billion
- EPS (GAAP) guidance for the full year is $27.50 at the midpoint, beating analyst estimates by 4.5%
- EBITDA guidance for the full year is $15.45 billion at the midpoint, above analyst estimates of $15.08 billion
- Operating Margin: 15.5%, up from 13.8% in the same quarter last year
- Same-Store Sales rose 2.1% year on year (4.5% in the same quarter last year)
- Market Capitalization: $109.2 billion
While we enjoy listening to the management's commentary, our favorite part of earnings calls are the analyst questions. Those are unscripted and can often highlight topics that management teams would rather avoid or topics where the answer is complicated. Here is what has caught our attention.
Our Top 5 Analyst Questions From HCA Healthcare’s Q3 Earnings Call
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Ann Hynes (Mizuho Securities) asked about pending Medicaid program approvals and potential financial impact. CFO Mike Marks explained that several state applications are under review but did not quantify the upside, stressing guidance excludes unapproved programs.
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A.J. Rice (Credit Suisse) questioned potential impacts of changes in public exchange coverage on procedure volumes. Marks said it’s too early to size the effect, noting HCA is preparing resources to help patients manage coverage transitions.
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Pito Chickering (Deutsche Bank) asked why full-year guidance wasn’t raised more after a strong quarter. Marks cited expected declines in supplemental payments and hurricane impacts in Q4, but said underlying growth remains solid.
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Brian Tanquilut (Jefferies) inquired about supply cost management and resiliency plans. Marks discussed ongoing contract renewals, technology adoption, and efforts to mitigate tariff risks, while CEO Sam Hazen highlighted cultural and operational aspects of resiliency.
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Matthew Gillmor (KeyBanc) requested detail on surgery line performance. Hazen pointed to strength in general surgery, urology, neurosciences, and orthopedics, while noting minor declines in gynecology and neurosurgery services.
Catalysts in Upcoming Quarters
In the coming quarters, the StockStory team will be monitoring (1) progress on Medicaid supplemental payment approvals in key states, (2) trends in commercial and Medicare patient volumes as the healthcare environment evolves, and (3) the effectiveness of HCA’s resiliency and digital transformation initiatives in driving margin improvements. Execution on capital investments and policy developments impacting patient coverage will also be important to track.
HCA Healthcare currently trades at $462.34, up from $440.07 just before the earnings. At this price, is it a buy or sell? See for yourself in our full research report (it’s free for active Edge members).
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