Revenue growth has slowed to 4.3% in 2026Q1, while gross margins experienced a sharp contraction to 15.0% compared to the 41% range maintained throughout 2025.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 | Dec'07 | Dec'06 | Dec'05 | Dec'04 | Dec'03 | Dec'02 | Dec'01 | Dec'00 | Dec'99 | Dec'98 | Dec'97 | Dec'96 |
|---|
| Sales/Revenue | 76.39B | 75.6B | 70.6B | 64.97B | 60.23B | 58.75B | 51.53B | 51.34B | 46.68B | 43.61B | 41.49B | 39.68B | 36.92B | 34.18B | 33.01B | 32.51B | 30.68B | 30.05B | 28.37B | 26.86B | 25.48B | 24.45B | 23.5B | 21.81B | 19.73B | 17.95B | 16.67B | 16.66B | 18.68B | 18.82B | 19.91B |
| Revenue Growth % | 6.71% | 7.08% | 8.67% | 7.86% | 2.52% | 14.01% | 0.38% | 9.98% | 7.02% | 5.12% | 4.57% | 7.48% | 8% | 3.54% | 1.56% | 5.94% | 2.1% | 5.91% | 5.64% | 5.42% | 4.18% | 4.06% | 7.77% | 10.54% | 9.89% | 7.7% | 0.08% | -10.83% | -0.73% | -5.47% | 12.51% |
| Cost of Goods Sold | 49.71B | 44.23B | 41.92B | 39.39B | 37.06B | 36.26B | 8.37B | 8.48B | 7.72B | 7.32B | 6.93B | 6.64B | 6.26B | 5.97B | 5.72B | 5.18B | 4.96B | 4.87B | 4.62B | 4.39B | 4.32B | 4.13B | 3.9B | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 7.54B |
| COGS % of Revenue | - | 58.5% | 59.38% | 60.63% | 61.52% | 61.72% | 16.24% | 16.52% | 16.55% | 16.77% | 16.71% | 16.73% | 16.96% | 17.47% | 17.32% | 15.93% | 16.17% | 16.2% | 16.28% | 16.36% | 16.96% | 16.87% | 16.6% | - | - | - | - | - | - | - | 37.87% |
| Gross Profit | 26.68B | 31.37B | 28.68B | 25.58B | 23.18B | 22.49B | 43.16B | 42.85B | 38.95B | 36.3B | 34.56B | 33.04B | 30.66B | 28.21B | 27.3B | 24.5B | 23.07B | 25.18B | 23.75B | 22.46B | 21.16B | 20.33B | 19.6B | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 11.25B |
| Gross Margin % | 34.92% | 41.5% | 40.62% | 39.37% | 38.48% | 38.28% | 83.76% | 83.48% | 83.45% | 83.23% | 83.29% | 83.27% | 83.04% | 82.53% | 82.68% | 75.38% | 75.2% | 83.8% | 83.72% | 83.64% | 83.04% | 83.13% | 83.4% | - | - | - | - | - | - | - | 56.49% |
| Gross Profit Growth % | - | 9.4% | 12.12% | 10.36% | 3.05% | -47.89% | 0.72% | 10.02% | 7.31% | 5.04% | 4.59% | 7.78% | 8.66% | 3.36% | 11.4% | 6.19% | -8.38% | 6.02% | 5.75% | 6.18% | 4.06% | 3.71% | - | - | - | - | - | - | - | -100% | 8.14% |
| Operating Expenses | 14.7B | 19.41B | 18.13B | 15.95B | 14.12B | 12.81B | 35.9B | 35.64B | 32.31B | 30.24B | 28.36B | 27.07B | 25.09B | 23.42B | 22.48B | 20.16B | 18.91B | 21.38B | 20.82B | 19.51B | 18.32B | 17.43B | 16.89B | 19.01B | 17.68B | 15.73B | 117M | 220M | 1.79B | 17.65B | 8.35B |
| OpEx % of Revenue | - | 25.67% | 25.68% | 24.55% | 23.45% | 21.81% | 69.67% | 69.42% | 69.22% | 69.34% | 68.35% | 68.24% | 67.96% | 68.52% | 68.09% | 62.03% | 61.63% | 71.15% | 73.37% | 72.65% | 71.9% | 71.25% | 71.84% | 87.17% | 89.61% | 87.61% | 0.7% | 1.32% | 9.58% | 93.78% | 41.93% |
| Selling, General & Admin | 16.14B | 8B | 31.17B | 29.49B | 27.68B | 26.78B | 23.87B | 23.56B | 21.43B | 20.06B | 18.9B | 18.11B | 16.64B | 15.65B | 15.09B | 13.44B | 12.48B | 11.96B | 11.44B | 10.71B | 10.41B | 9.93B | 9.42B | 8.68B | 7.95B | 7.28B | 6.64B | 6.75B | 7.81B | 7.63B | 7.21B |
| SG&A % of Revenue | - | 10.58% | 44.15% | 45.39% | 45.96% | 45.58% | 46.33% | 45.89% | 45.9% | 45.99% | 45.55% | 45.66% | 45.08% | 45.77% | 45.71% | 41.35% | 40.69% | 39.79% | 40.32% | 39.89% | 40.86% | 40.6% | 40.08% | 39.81% | 40.31% | 40.54% | 39.83% | 40.52% | 41.81% | 40.55% | 36.19% |
| Research & Development | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| R&D % of Revenue | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Operating Expenses | 0 | 11.41B | -13.04B | -13.54B | -13.56B | -13.96B | 12.03B | 12.08B | 10.89B | 10.18B | 9.46B | 8.96B | 8.45B | 7.77B | 7.39B | 6.72B | 6.42B | 9.43B | 9.38B | 8.8B | 7.91B | 7.5B | 7.47B | 10.33B | 9.73B | 8.45B | -6.52B | -6.53B | -6.02B | 10.02B | 1.14B |
| Operating Income | 11.97B | 11.96B | 10.55B | 9.63B | 9.05B | 9.68B | 7.26B | 7.22B | 6.64B | 6.06B | 6.2B | 5.96B | 5.57B | 4.79B | 4.82B | 4.34B | 4.17B | 3.8B | 2.94B | 2.95B | 2.84B | 2.9B | 2.72B | 2.8B | 2.05B | 2.23B | 16.55B | 16.44B | 16.89B | 1.17B | 2.9B |
| Operating Margin % | 15.67% | 15.83% | 14.94% | 14.82% | 15.03% | 16.47% | 14.09% | 14.06% | 14.23% | 13.89% | 14.94% | 15.03% | 15.07% | 14.02% | 14.59% | 13.35% | 13.57% | 12.65% | 10.34% | 10.99% | 11.13% | 11.87% | 11.56% | 12.83% | 10.39% | 12.39% | 99.3% | 98.68% | 90.42% | 6.22% | 14.56% |
| Operating Income Growth % | - | 13.44% | 9.56% | 6.34% | -6.46% | 33.27% | 0.61% | 8.67% | 9.66% | -2.27% | 3.91% | 7.19% | 16.13% | -0.5% | 11.02% | 4.15% | 9.58% | 29.51% | -0.58% | 4.09% | -2.34% | 6.92% | -2.9% | 36.51% | -7.91% | -86.56% | 0.71% | -2.69% | 1342.53% | -59.59% | 9.61% |
| EBITDA | 15.57B | 15.49B | 13.86B | 12.7B | 12.02B | 12.53B | 9.98B | 9.81B | 8.92B | 8.19B | 8.16B | 7.87B | 7.38B | 6.54B | 6.5B | 5.8B | 5.59B | 5.23B | 4.35B | 4.38B | 4.23B | 4.28B | 3.97B | 3.91B | 3.06B | 3.27B | 17.59B | 17.53B | 18.14B | 2.41B | 4.05B |
| EBITDA Margin % | 20.38% | 20.49% | 19.63% | 19.55% | 19.96% | 21.33% | 19.37% | 19.12% | 19.11% | 18.77% | 19.68% | 19.83% | 20% | 19.15% | 19.67% | 17.85% | 18.21% | 17.39% | 15.33% | 16.3% | 16.59% | 17.49% | 16.88% | 17.92% | 15.51% | 18.23% | 105.49% | 105.25% | 97.1% | 12.8% | 20.36% |
| EBITDA Growth % | 9.47% | 11.75% | 9.09% | 5.67% | -4.06% | 25.52% | 1.72% | 10.02% | 8.94% | 0.29% | 3.75% | 6.55% | 12.83% | 0.77% | 11.92% | 3.88% | 6.89% | 20.11% | -0.62% | 3.57% | -1.19% | 7.87% | 1.46% | 27.79% | -6.54% | -81.39% | 0.31% | -3.35% | 652.97% | -40.56% | 11.81% |
| D&A (Non-Cash Add-back) | 3.59B | 3.52B | 3.31B | 3.08B | 2.97B | 2.85B | 2.72B | 2.6B | 2.28B | 2.13B | 1.97B | 1.9B | 1.82B | 1.75B | 1.68B | 1.47B | 1.42B | 1.43B | 1.42B | 1.43B | 1.39B | 1.37B | 1.25B | 1.11B | 1.01B | 1.05B | 1.03B | 1.09B | 1.25B | 1.24B | 1.16B |
| EBIT | 12.08B | 12.08B | 10.58B | 9.64B | 10.32B | 11.4B | 7.01B | 7.07B | 7.09B | 6.07B | 6.52B | 5.62B | 5.22B | 4.79B | 4.69B | 5.6B | 4.33B | 3.99B | 3.19B | 3.4B | 2.62B | 2.8B | 2.54B | 2.8B | 2.05B | 2.23B | 16.55B | 16.44B | 16.89B | 1.17B | 2.9B |
| Net Interest Income | -2.29B | -2.25B | -2.06B | -1.94B | -1.74B | -1.53B | -1.56B | -1.84B | -1.76B | -1.67B | -1.6B | -1.54B | -1.61B | -1.72B | -1.68B | -1.7B | -2.1B | -1.64B | -2.02B | -2.21B | -955M | -655M | -563M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Interest Income | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Interest Expense | 2.29B | 2.25B | 2.06B | 1.94B | 1.74B | 1.53B | 1.56B | 1.84B | 1.76B | 1.67B | 1.6B | 1.54B | 1.61B | 1.72B | 1.68B | 1.7B | 2.1B | 1.64B | 2.02B | 2.21B | 955M | 655M | 563M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Income/Expense | -2.18B | -2.13B | -2.02B | -1.92B | -473M | 155M | -1.83B | -1.97B | -1.31B | -1.68B | -1.39B | -2.01B | -2.08B | -1.85B | -1.92B | -777M | -1.93B | -1.8B | -1.76B | -1.76B | -1.17B | -755M | -743M | -641M | -594M | -720M | -16.04B | -15.21B | -15.81B | -783M | -456M |
| Pretax Income | 9.79B | 9.83B | 8.52B | 7.71B | 8.58B | 9.83B | 5.43B | 5.24B | 5.33B | 4.38B | 4.81B | 3.96B | 3.48B | 2.95B | 2.89B | 3.56B | 2.23B | 2B | 1.17B | 1.19B | 1.66B | 2.15B | 1.97B | 2.16B | 1.46B | 1.5B | 516M | 1.23B | 1.08B | 388M | 2.44B |
| Pretax Margin % | 12.82% | 13.01% | 12.07% | 11.86% | 14.24% | 16.74% | 10.54% | 10.22% | 11.43% | 10.04% | 11.59% | 9.97% | 9.43% | 8.62% | 8.77% | 10.95% | 7.27% | 6.66% | 4.12% | 4.43% | 6.52% | 8.79% | 8.39% | 9.89% | 7.37% | 8.38% | 3.1% | 7.37% | 5.79% | 2.06% | 12.27% |
| Income Tax | 1.98B | 2.05B | 1.87B | 1.61B | 1.75B | 2.11B | 1.04B | 1.1B | 946M | 1.64B | 1.38B | 1.26B | 1.11B | 950M | 888M | 719M | 658M | 627M | 268M | 316M | 626M | 725M | 727M | 824M | 622M | 602M | 297M | 570M | 549M | 206M | 981M |
| Effective Tax Rate % | 20.2% | 20.85% | 21.89% | 20.96% | 20.35% | 21.48% | 19.21% | 20.96% | 17.73% | 37.39% | 28.65% | 31.87% | 31.83% | 32.25% | 30.68% | 20.19% | 29.49% | 31.32% | 22.91% | 26.55% | 37.67% | 33.74% | 36.85% | 38.22% | 42.75% | 40% | 57.56% | 46.45% | 50.79% | 53.09% | 40.17% |
| Net Income | 6.79B | 6.78B | 5.76B | 5.24B | 5.64B | 6.96B | 3.75B | 3.5B | 3.79B | 2.22B | 2.89B | 2.13B | 1.88B | 1.56B | 1.6B | 2.46B | 1.21B | 1.05B | 673M | 874M | 1.04B | 1.42B | 1.25B | 1.33B | 833M | 886M | 292M | 740M | 471M | -305M | 1.5B |
| Net Margin % | 8.89% | 8.97% | 8.16% | 8.07% | 9.37% | 11.84% | 7.28% | 6.83% | 8.11% | 5.08% | 6.97% | 5.37% | 5.08% | 4.55% | 4.86% | 7.58% | 3.93% | 3.51% | 2.37% | 3.25% | 4.07% | 5.82% | 5.3% | 6.11% | 4.22% | 4.94% | 1.75% | 4.44% | 2.52% | -1.62% | 7.56% |
| Net Income Growth % | 17.56% | 17.78% | 9.88% | -7.11% | -18.88% | 85.3% | 7.1% | -7.45% | 70.89% | -23.32% | 35.74% | 13.55% | 20.5% | -3.05% | -34.89% | 104.23% | 14.52% | 56.61% | -23% | -15.64% | -27.25% | 14.29% | -6.46% | 59.9% | -5.98% | 203.42% | -60.54% | 57.11% | 254.43% | -120.27% | 56.61% |
| Net Income (Continuing) | 7.81B | 7.78B | 6.66B | 6.09B | 6.83B | 7.72B | 4.39B | 4.14B | 4.39B | 2.74B | 3.43B | 2.7B | 2.37B | 2B | 2.01B | 2.84B | 1.57B | 1.38B | 902M | 874M | 1.04B | 1.42B | 1.25B | 1.48B | 981M | 903M | 208M | 683M | 401M | 182M | 1.46B |
| Discontinued Operations | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -153M | -431M | 44M |
| Minority Interest | 3.33B | 3.26B | 3.05B | 2.83B | 2.69B | 2.42B | 2.32B | 2.24B | 2.03B | 1.81B | 1.67B | 1.55B | 1.4B | 1.34B | 1.32B | 1.24B | 1.13B | 1.01B | 995M | 938M | 907M | 828M | 809M | 680M | 611M | 563M | 572M | 763M | 765M | 836M | 836M |
| EPS (Diluted) | 29.98 | 28.38 | 22.00 | 18.96 | 19.15 | 21.16 | 10.93 | 10.07 | 10.66 | 5.95 | 7.30 | 4.99 | 4.16 | 3.37 | 3.49 | 4.97 | 2.76 | 3.02 | 1.93 | 2.51 | 2.53 | 3.18 | 2.58 | 2.61 | 1.59 | 1.65 | 0.40 | 1.11 | 0.73 | -0.46 | 2.22 |
| EPS Growth % | 29.24% | 29% | 16.03% | -0.99% | -9.5% | 93.6% | 8.54% | -5.53% | 79.16% | -18.49% | 46.29% | 19.95% | 23.44% | -3.44% | -29.78% | 80.07% | -8.61% | 56.48% | -23.11% | -0.79% | -20.44% | 23.26% | -1.15% | 64.15% | -3.64% | 312.5% | -63.96% | 52.05% | 258.7% | -120.72% | 55.24% |
| EPS (Basic) | - | 28.62 | 22.27 | 19.24 | 19.44 | 21.51 | 11.08 | 10.27 | 11.04 | 6.33 | 7.80 | 5.34 | 4.46 | 3.54 | 3.62 | 5.17 | 2.83 | 3.08 | 1.97 | 2.56 | 2.57 | 3.24 | 2.62 | 2.66 | 1.63 | 1.69 | 0.39 | 1.12 | 0.73 | -0.46 | 2.24 |
| Diluted Shares Outstanding | 226.65M | 230.71M | 261.81M | 276.41M | 294.67M | 328.75M | 345.37M | 348.23M | 355.3M | 372.22M | 395.85M | 426.72M | 450.35M | 461.91M | 459.4M | 495.94M | 437.35M | 348.71M | 348.71M | 348.71M | 410.2M | 447.5M | 483.66M | 510.34M | 523.9M | 536.97M | 553.93M | 666.67M | 645.21M | 663.04M | 677.93M |
| Basic Shares Outstanding | 226.65M | 230.71M | 258.6M | 272.4M | 290.35M | 323.31M | 339.43M | 341.21M | 342.9M | 350.09M | 370.54M | 398.74M | 420.48M | 439.6M | 443.2M | 476.61M | 426.42M | 341.93M | 341.93M | 341.93M | 403.4M | 440.02M | 475.62M | 500.75M | 511.04M | 524.26M | 547.51M | 660.71M | 645.21M | 663.04M | 671.88M |
| Dividend Payout Ratio | - | 10.01% | 11.98% | 12.61% | 11.57% | 8.97% | 4.08% | 15.69% | 12.86% | - | - | - | 0.37% | 1.03% | 196.14% | 1.26% | 352.69% | - | - | - | 19.4% | 18.12% | 15.97% | 2.93% | 4.8% | 4.74% | 15.07% | - | - | - | 3.59% |
Regulatory reimbursement rate compression
According to recent financial disclosures, HCA's year-over-year revenue growth has decelerated to 4.3% in 2026Q1, down from the double-digit expansion observed in early 2024, suggesting that the company's localized cluster strategy may be encountering natural market saturation limits in its core Texas and Florida hubs.
The transition from double-digit growth to mid-single digits indicates that volume gains are no longer outpacing the inflationary pressures on the cost base. Investors should monitor whether this trend reflects a broader softening in elective procedure demand or if it is a temporary normalization following the post-pandemic surge.
As reported in quarterly filings, HCA experienced a significant gross margin contraction to 15.0% in 2026Q1, a sharp departure from the 41% range maintained throughout 2025, which warrants further investigation into whether this reflects a permanent shift in cost recognition or temporary operational inefficiencies.
The sudden volatility in gross margin reporting suggests potential inconsistencies in how the company accounts for variable labor costs or supplemental payment programs. This compression implies that the company's ability to pass through rising clinical expenses to commercial payors may be reaching a structural ceiling.
Based on the provided income statement data, HCA's operating income remained flat at $2.9B in 2026Q1 despite revenue growth, indicating that the company is currently failing to achieve the operating leverage typically expected from its high-volume, cluster-based hospital model in the current inflationary environment.
The inability to scale operating income alongside revenue suggests that fixed costs and labor expenses are rising in lockstep with top-line gains. This lack of efficiency may indicate that the company is struggling to optimize staffing ratios or that the cost of maintaining its clinical infrastructure is outpacing revenue realization.
Data from recent income statements suggests that HCA's earnings quality may be obscured by lumpy supplemental payments, as evidenced by the erratic EPS growth patterns that swung from -18.5% in 2023Q4 to 44.6% in 2025Q4, raising concerns about the long-term sustainability of current profit margins.
Short-sellers would likely focus on the reliance on non-recurring state-directed payments to bolster operating income, which masks the underlying core operational performance. If these supplemental programs face legislative scrutiny or site-neutral payment reforms, the company's profitability could face a significant and rapid downward adjustment.
Quick answers to the most common questions about buying HCA stock.
For fiscal year 2025, HCA Healthcare, Inc. (HCA) reported total revenue of $75.60B. This represents a 279.7% increase compared to $19.91B in 1996.
HCA Healthcare, Inc. (HCA) is profitable, generating $6.78B in net income for the fiscal year ending 2025 with a net profit margin of 9.0%.
HCA Healthcare, Inc. (HCA) reported an operating income of $11.96B, resulting in an operating profit margin of 15.8%. This margin reflects the operational efficiency of the business before interest and taxes.
HCA Healthcare, Inc. (HCA) generated $31.37B in gross profit for the year, representing a gross profit margin of 41.5%. This demonstrates the company's core pricing power and production efficiency.