Hospital operator HCA Healthcare (NYSE: HCA) announced better-than-expected revenue in Q3 CY2025, with sales up 9.6% year on year to $19.16 billion. The company’s full-year revenue guidance of $75.75 billion at the midpoint came in 0.9% above analysts’ estimates. Its GAAP profit of $6.96 per share was 22.2% above analysts’ consensus estimates.
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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 $15.07 billion
- Operating Margin: 15.5%, up from 13.8% in the same quarter last year
- Free Cash Flow Margin: 16.3%, up from 13.3% in the same quarter last year
- Market Capitalization: $103 billion
"Our teams continued to execute our agenda at a high level, and we remain disciplined in our efforts to improve care for our patients by increasing access, investing in advanced technology, and training our people,” said Sam Hazen, Chief Executive Officer of HCA Healthcare.
Company Overview
With roots dating back to 1968 and a network spanning 20 states, HCA Healthcare (NYSE: HCA) operates a network of 190 hospitals and 150+ outpatient facilities providing a full range of medical services across the US and England.
Revenue Growth
A company’s long-term sales performance is one signal of its overall quality. Any business can experience short-term success, but top-performing ones enjoy sustained growth for years. Thankfully, HCA Healthcare’s 7.9% annualized revenue growth over the last five years was decent. Its growth was slightly above the average healthcare company and shows its offerings resonate with customers.
Long-term growth is the most important, but within healthcare, a half-decade historical view may miss new innovations or demand cycles. HCA Healthcare’s annualized revenue growth of 8.5% over the last two years aligns with its five-year trend, suggesting its demand was stable. 
This quarter, HCA Healthcare reported year-on-year revenue growth of 9.6%, and its $19.16 billion of revenue exceeded Wall Street’s estimates by 3.3%.
Looking ahead, sell-side analysts expect revenue to grow 4% over the next 12 months, a deceleration versus the last two years. This projection is underwhelming and implies its products and services will see some demand headwinds. At least the company is tracking well in other measures of financial health.
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Operating Margin
HCA Healthcare has managed its cost base well over the last five years. It demonstrated solid profitability for a healthcare business, producing an average operating margin of 17.3%.
Analyzing the trend in its profitability, HCA Healthcare’s operating margin decreased by 5.4 percentage points over the last five years. The company’s two-year trajectory also shows it failed to get its profitability back to the peak as its margin fell by 3.6 percentage points. This performance was poor no matter how you look at it - it shows its expenses were rising and it couldn’t pass those costs onto its customers.
This quarter, HCA Healthcare generated an operating margin profit margin of 15.5%, up 1.7 percentage points year on year. This increase was a welcome development and shows it was more efficient.
Earnings Per Share
Revenue trends explain a company’s historical growth, but the long-term change in earnings per share (EPS) points to the profitability of that growth – for example, a company could inflate its sales through excessive spending on advertising and promotions.
HCA Healthcare’s EPS grew at an astounding 21.2% compounded annual growth rate over the last five years, higher than its 7.9% annualized revenue growth. This tells us the company became more profitable on a per-share basis as it expanded.
Diving into HCA Healthcare’s quality of earnings can give us a better understanding of its performance. A five-year view shows that HCA Healthcare has repurchased its stock, shrinking its share count by 31.2%. This tells us its EPS outperformed its revenue not because of increased operational efficiency but financial engineering, as buybacks boost per share earnings. 
In Q3, HCA Healthcare reported EPS of $6.96, up from $4.89 in the same quarter last year. This print easily cleared analysts’ estimates, and shareholders should be content with the results. Over the next 12 months, Wall Street expects HCA Healthcare’s full-year EPS of $25.87 to grow 8.8%.
Key Takeaways from HCA Healthcare’s Q3 Results
We enjoyed seeing HCA Healthcare beat analysts’ full-year EPS guidance expectations this quarter. We were also glad its EPS outperformed Wall Street’s estimates. Zooming out, we think this was a solid print. The stock traded up 4.2% to $458.51 immediately following the results.
HCA Healthcare put up rock-solid earnings, but one quarter doesn’t necessarily make the stock a buy. Let’s see if this is a good investment. If you’re making that decision, you should consider the bigger picture of valuation, business qualities, as well as the latest earnings. We cover that in our actionable full research report which you can read here, it’s free for active Edge members.
