HCA Healthcare Reports Second Quarter 2025 Results

Business Wire

2 days ago

NASHVILLE, Tenn.--(BUSINESS WIRE)-- HCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the second quarter ended June 30, 2025.
Key second quarter metrics (all percentage changes compare 2Q 2025 to 2Q 2024 unless otherwise noted):
'We are pleased to report strong financial results for the second quarter. They reflected solid revenue growth, improved margins, and better outcomes for our patients. I want to thank our exceptional colleagues for their great work and continuous efforts to improve,' said Sam Hazen, Chief Executive Officer of HCA Healthcare.
Revenues in the second quarter of 2025 totaled $18.605 billion, compared to $17.492 billion in the second quarter of 2024. Net income attributable to HCA Healthcare, Inc. totaled $1.653 billion, or $6.83 per diluted share, compared to $1.461 billion, or $5.53 per diluted share, in the second quarter of 2024. Results for the second quarter of 2025 include losses on sales of facilities of $3 million, or $0.01 per diluted share, compared to gains on sales of facilities of $12 million, or $0.03 per diluted share, in the second quarter of 2024.
For the second quarter of 2025, Adjusted EBITDA totaled $3.849 billion, compared to $3.550 billion in the second quarter of 2024. Diluted earnings per share, as adjusted, and Adjusted EBITDA are non-GAAP financial measures. A table providing supplemental information on these non-GAAP financial measures and reconciling GAAP measures of financial performance to them is included in this release.
Same facility admissions increased 1.8 percent and same facility equivalent admissions increased 1.7 percent in the second quarter of 2025, compared to the prior year period. Same facility emergency room visits increased 1.3 percent in the second quarter of 2025, compared to the prior year period. Same facility inpatient surgeries declined 0.3 percent, and same facility outpatient surgeries declined 0.6 percent in the second quarter of 2025, compared to the same period of 2024. Same facility revenue per equivalent admission increased 4.0 percent in the second quarter of 2025, compared to the second quarter of 2024.
Balance Sheet and Cash Flows from Operations
As of June 30, 2025, HCA Healthcare, Inc.'s balance sheet reflected cash and cash equivalents of $939 million, total debt of $44.483 billion, and total assets of $59.536 billion. During the second quarter of 2025, capital expenditures totaled $1.176 billion, excluding acquisitions. Cash flows provided by operating activities in the second quarter of 2025 totaled $4.210 billion, compared to $1.971 billion in the second quarter of 2024.
During the second quarter of 2025, the Company repurchased 7.031 million shares of its common stock at a cost of $2.505 billion. The Company had $5.753 billion remaining under its repurchase authorization as of June 30, 2025. As of June 30, 2025, the Company had $6.208 billion of availability under its credit facility (after giving effect to letters of credit and amounts reserved to backstop our commercial paper program).
Dividend
HCA today announced that its Board of Directors declared a quarterly cash dividend of $0.72 per share on the Company's common stock. The dividend will be paid on September 30, 2025 to stockholders of record at the close of business on September 16, 2025.
The declaration and payment of any future dividend will be subject to the discretion of the Board of Directors and will depend on a variety of factors, including the Company's financial condition and results of operations. Future dividends are expected to be funded by cash balances and future cash flows from operations.
2025 Guidance Update
Today, the Company is updating its 2025 estimated guidance ranges issued on January 24, 2025.
Capital expenditures for 2025, excluding acquisitions, are estimated to be approximately $5.0 billion.
The Company's guidance contains a number of assumptions, including, among others, the Company's current expectations regarding volume growth coupled with an anticipated mostly stable operating environment, payer mix, the ongoing impacts of the two major 2024 hurricanes, the impact of current and future health care public policy developments, as well as general business or economic conditions, including inflation, and the impact of trade policies, including tariffs, and excludes the impact of items such as, but not limited to, gains or losses on sales of facilities, losses on retirement of debt, legal claims costs and impairment of long-lived assets.
Adjusted EBITDA is a non-GAAP financial measure. A table reconciling forecasted net income attributable to HCA Healthcare, Inc. to forecasted Adjusted EBITDA is included in this release.
The Company's guidance is based on current plans and expectations and are subject to a number of known and unknown uncertainties and risks, including those set forth below in the Company's 'Forward-Looking Statements.'
Earnings Conference Call
HCA Healthcare will host a conference call for investors at 9:00 a.m. Central Time today. All interested investors are invited to access a live audio broadcast of the call via webcast. The broadcast also will be available on a replay basis beginning this afternoon. The webcast can be accessed through the Company's Investor Relations web page at https://investor.hcahealthcare.com/events-and-presentations/default.aspx.
About the Company
As of June 30, 2025, HCA operated 191 hospitals and approximately 2,500 ambulatory sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics, in 20 states and the United Kingdom.
Forward-Looking Statements
This press release contains forward-looking statements within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements include the Company's financial guidance for the year ending December 31, 2025, as well as other statements that do not relate solely to historical or current facts. Forward-looking statements can be identified by the use of words like 'may,' 'believe,' 'will,' 'expect,' 'project,' 'estimate,' 'anticipate,' 'plan,' 'initiative' or 'continue.' These forward-looking statements are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and expectations and our future financial position and results of operations. These factors include, but are not limited to, (1) changes in or related to general economic or business conditions nationally and regionally in our markets, including inflation, and the impact of trade policies, including changes in, or the imposition of, tariffs and/or trade barriers; changes in revenues resulting from declining patient volumes; changes in payer mix (including increases in uninsured and underinsured patients); potential increased expenses related to labor, pharmaceuticals, supply chain or other expenditures; workforce disruptions; supply and pharmaceutical shortages and disruptions (including as a result of tariffs or geopolitical disruptions); and the impact of potential federal government shutdowns, holds on or cancellations of congressionally authorized spending and interruptions in the distribution of governmental funds, (2) the impact of current and future health care public policy developments and the implementation of new, and possible changes to existing, federal, state or local laws and regulations affecting the health care industry, including the expiration of enhanced premium tax credits ('EPTCs') for individuals eligible to purchase insurance coverage through federal and state-based health insurance marketplaces, changes in the structure and administration of, and funding for, federal and state agencies and programs, and effects of the One Big Beautiful Bill Act ('OBBBA'), (3) the impact of our significant indebtedness and the ability to refinance such indebtedness on acceptable terms, (4) the effects related to the implementation of sequestration spending reductions required under the Budget Control Act of 2011, related legislation extending these reductions, and those that may be required under the Pay-As-You-Go Act of 2010 as a result of the federal budget deficit impact of OBBBA, and the potential for future deficit reduction legislation that may alter these spending reductions, which include cuts to Medicare payments, or create additional spending reductions, (5) the ability to achieve operating and financial targets, develop and execute resiliency plans to offset to the extent possible impacts from OBBBA, the scheduled expiration of EPTCs and tariffs, attain expected levels of patient volumes and revenues, and control the costs of providing services, (6) possible reductions or other changes in Medicare, Medicaid and other state programs, including Medicaid supplemental payment programs, Medicaid waiver programs and state directed payment arrangements, any of which may negatively impact reimbursements to health care providers and insurers and the size of the uninsured or underinsured population, (7) increases in the amount and risk of collectability of uninsured accounts and deductibles and copayment amounts for insured accounts, (8) personnel-related capacity constraints, increases in wages and the ability to attract, utilize and retain qualified management and other personnel, including affiliated physicians, nurses and medical and technical support personnel, (9) the highly competitive nature of the health care business, (10) changes in service mix, revenue mix and surgical volumes, including potential declines in the population covered under third-party payer agreements, the ability to enter into and renew third-party payer provider agreements on acceptable terms and the impact of consumer-driven health plans and physician utilization trends and practices, (11) the efforts of health insurers, health care providers, large employer groups and others to contain health care costs, (12) the outcome of our continuing efforts to monitor, maintain and comply with appropriate laws, regulations, policies and procedures, (13) the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities, (14) changes in accounting practices, (15) the emergence of and effects related to pandemics, epidemics and outbreaks of infectious diseases or other public health crises, (16) future divestitures which may result in charges and possible impairments of long-lived assets, (17) changes in business strategy or development plans, (18) delays in receiving payments for services provided, (19) the outcome of pending and any future tax audits, disputes and litigation associated with our tax positions, (20) the impact of known and unknown government investigations, litigation and other claims that may be made against us, (21) the impact of actual and potential cybersecurity incidents or security breaches involving us or our vendors and other third parties, (22) our ongoing ability to demonstrate meaningful use of certified electronic health record technology and the impact of interoperability requirements, (23) the impact of natural disasters, such as hurricanes and floods, including Hurricanes Milton and Helene, physical risks from changing global weather patterns or similar events beyond our control on our assets and activities and the communities we serve, (24) changes in U.S. federal, state, or foreign tax laws, interpretations of tax laws by taxing authorities, other standard setting bodies or judicial decisions, (25) the results of our efforts to use technology and resilience initiatives, including artificial intelligence and machine learning, to drive efficiencies, better outcomes and an enhanced patient experience and (26) other risk factors described in our annual report on Form 10-K for the year ended December 31, 2024 and our other filings with the Securities and Exchange Commission. Many of the factors that will determine our future results are beyond our ability to control or predict. In light of the significant uncertainties inherent in the forward-looking statements contained herein, readers should not place undue reliance on forward-looking statements, which reflect management's views only as of the date hereof. We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise. All references to 'Company,' 'HCA' and 'HCA Healthcare' as used throughout this release refer to HCA Healthcare, Inc. and its affiliates.
HCA Healthcare, Inc.
Condensed Consolidated Comprehensive Income Statements
For the Six Months Ended June 30, 2025 and 2024
Unaudited
(Dollars in millions, except per share amounts)
2025
2024
Amount
Ratio
Amount
Ratio
Revenues
$
36,926
100.0
%
$
34,831
100.0
%
Salaries and benefits
16,135
43.7
15,392
44.2
Supplies
5,608
15.2
5,305
15.2
Other operating expenses
7,638
20.7
7,229
20.8
Equity in (earnings) losses of affiliates
(37
)
(0.1
)
2
—
Depreciation and amortization
1,723
4.7
1,614
4.6
Interest expense
1,115
3.0
1,018
2.9
Losses (gains) on sales of facilities
2
—
(213
)
(0.6
)
32,184
87.2
30,347
87.1
Income before income taxes
4,742
12.8
4,484
12.9
Provision for income taxes
1,026
2.7
995
2.9
Net income
3,716
10.1
3,489
10.0
Net income attributable to noncontrolling interests
453
1.3
437
1.2
Net income attributable to HCA Healthcare, Inc.
$
3,263
8.8
$
3,052
8.8
Shares used in computing diluted earnings per share (millions)
245.654
266.044
Comprehensive income attributable to HCA Healthcare, Inc.
$
3,341
$
3,044
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HCA Healthcare, Inc.
Operating Statistics
2025
2024
2025
2024
Operations:
Number of Hospitals
191
188
191
188
Number of Freestanding Outpatient Surgery Centers*
124
123
124
123
Licensed Beds at End of Period
50,485
49,844
50,485
49,844
Weighted Average Beds in Service
42,858
42,624
42,860
42,594
Reported:
Admissions
566,061
554,456
1,142,422
1,115,325
% Change
2.1
%
2.4
%
Equivalent Admissions
1,017,994
994,835
2,030,084
1,976,356
% Change
2.3
%
2.7
%
Revenue per Equivalent Admission
$
18,276
$
17,583
$
18,189
$
17,624
% Change
3.9
%
3.2
%
Inpatient Revenue per Admission
$
19,656
$
18,814
$
19,501
$
18,869
% Change
4.5
%
3.3
%
Patient Days
2,675,284
2,662,550
5,511,900
5,444,146
% Change
0.5
%
1.2
%
Equivalent Patient Days
4,813,548
4,779,234
9,794,646
9,647,027
% Change
0.7
%
1.5
%
Inpatient Surgery Cases
136,122
135,860
269,881
269,258
% Change
0.2
%
0.2
%
Outpatient Surgery Cases
258,365
258,967
504,985
511,802
% Change
-0.2
%
-1.3
%
Emergency Room Visits
2,439,763
2,414,960
4,958,479
4,843,874
% Change
1.0
%
2.4
%
Outpatient Revenues as a Percentage of Patient Revenues
38.4
%
38.2
%
37.9
%
37.6
%
Average Length of Stay (days)
4.726
4.802
4.825
4.881
Occupancy**
72.0
%
71.9
%
74.4
%
73.6
%
Same Facility:
Admissions
556,544
546,945
1,123,176
1,098,367
% Change
1.8
%
2.3
%
Equivalent Admissions
990,092
973,562
1,974,543
1,930,929
% Change
1.7
%
2.3
%
Revenue per Equivalent Admission
$
18,110
$
17,408
$
18,080
$
17,456
% Change
4.0
%
3.6
%
Inpatient Revenue per Admission
$
19,576
$
18,741
$
19,470
$
18,800
% Change
4.5
%
3.6
%
Inpatient Surgery Cases
134,307
134,662
266,330
266,321
% Change
-0.3
%
0.0
%
Outpatient Surgery Cases
253,006
254,599
495,316
502,037
% Change
-0.6
%
-1.3
%
Emergency Room Visits
2,401,684
2,370,754
4,868,579
4,741,737
% Change
1.3
%
2.7
%
* Excludes freestanding endoscopy centers (29 centers at June 30, 2025 and 23 centers at June 30, 2024).
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__________________________
(a)
Net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA should not be considered as measures of financial performance under generally accepted accounting principles ("GAAP"). These non-GAAP financial measures are adjusted to exclude losses (gains) on sales of facilities and losses on retirement of debt. We believe net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA are important measures that supplement discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA as the primary measures to review and assess operating performance of its health care facilities and their management teams.
Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and GAAP net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our health care facilities. Adjusted EBITDA and the Adjusted EBITDA margin (Adjusted EBITDA divided by revenues) are utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry. It is reasonable to expect that adjustments, including losses (gains) on sales of facilities and losses on retirement of debt will occur in future periods, but the amounts recognized can vary significantly from period to period, do not directly relate to the ongoing operations of our health care facilities and complicate period comparisons of our results of operations and operations comparisons with other health care companies.
Net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA are not measures of financial performance under GAAP, and should not be considered as alternatives to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA are not measurements determined in accordance with GAAP and are susceptible to varying calculations, net income attributable to HCA Healthcare, Inc., as adjusted, diluted earnings per share, as adjusted, and Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.
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The Company's forecasted guidance is based on current plans and expectations and is subject to a number of known and unknown uncertainties and risks.
__________________________
(a)
The Company does not forecast the impact of items such as, but not limited to, losses (gains) on sales of facilities, losses on retirement of debt, legal claim costs (benefits) and impairments of long-lived assets because the Company does not believe that it can forecast these items with sufficient accuracy.
(b)
Adjusted EBITDA should not be considered a measure of financial performance under generally accepted accounting principles ("GAAP"). We believe Adjusted EBITDA is an important measure that supplements discussions and analysis of our results of operations. We believe it is useful to investors to provide disclosures of our results of operations on the same basis used by management. Management relies upon Adjusted EBITDA as a primary measure to review and assess operating performance of its health care facilities and their management teams.
Management and investors review both the overall performance (including net income attributable to HCA Healthcare, Inc.) and operating performance (Adjusted EBITDA) of our healthcare facilities. Adjusted EBITDA is utilized by management and investors to compare our current operating results with the corresponding periods during the previous year and to compare our operating results with other companies in the health care industry.
Adjusted EBITDA is not a measure of financial performance under GAAP and should not be considered as an alternative to net income attributable to HCA Healthcare, Inc. as a measure of operating performance or cash flows from operating, investing and financing activities as a measure of liquidity. Because Adjusted EBITDA is not a measurement determined in accordance with GAAP and is susceptible to varying calculations, Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures presented by other companies.
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