HCA Healthcare earnings: third quarter 2026

HCA Healthcare, the largest US hospital chain, grew its sales in the third quarter of 2026, but profit before tax slipped about 2%. The company blames a rise in uninsured patients, many of them people who lost subsidised insurance bought on the government exchanges. Earnings per share still rose, helped by heavy share buybacks, and came in above what analysts expected. The company now expects the full year to land in the upper half of the ranges it set in July. ¹

Against what analysts expected

Earnings per share came in at $7.27, or $7.22 on the company's adjusted basis; both are about 7% above the $6.74 analysts expected on average, according to Nasdaq's earnings calendar. ¹²

The strong points

• The hospitals still produced plenty of cash: $4.461 billion from operations in the quarter, slightly more than a year ago, even as profit fell. ¹
• Sales for the first nine months of the year rose about 5.5% on a year earlier. ¹
• The two biggest costs, staff pay and supplies, took a smaller share of sales than a year ago. ¹

The weak points

• The company says more uninsured patients, mainly people who lost exchange coverage, cut its profit before tax by about $400 million in the quarter. ¹
• Costs other than pay and supplies grew about 9.3%, far faster than sales, so the profit measure the company watches most kept less of each dollar of sales. ¹
• Over nine months HCA paid out more to shareholders in buybacks and dividends than the cash left after investing in its hospitals, and borrowed $3.5 billion short-term to help fill the gap. ¹

What the company expects

• HCA now expects its full-year 2026 results to land in the upper half of the ranges it gave on 14 July; it kept the ranges themselves, and the release does not repeat the figures. ¹
• That outlook assumes more patients, a mostly stable environment and a steady mix of insured and uninsured patients, including the expected effect of the end of enhanced exchange subsidies. ¹

Our verdict on the quarter

A strong report. Sales grew, earnings per share came in well above what analysts expected and the company nudged its outlook for the year upward, but the soft spot is real: profit before tax fell as more patients arrived uninsured, and the per-share rise leans on buybacks partly paid for with borrowing.

The results as published

• The results release itself
• The filing it came with (SEC)

Notes

1. HCA Healthcare's results release, 27 October 2026: sec.gov. ↩
2. Nasdaq's earnings calendar, 27 October 2026. ↩