Cash generation remains sensitive to portfolio restructuring, evidenced by free cash flow margins that swung from a negative 13.0% in 2024Q4 to a robust 27.2% in 2026Q1.
| 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 | May'02 | May'00 | May'99 | May'98 | May'97 | May'96 | May'95 |
|---|
| Cash from Operations | 4.37B | 3.54B | 2.05B | 2.37B | 1.08B | 1.57B | 3.41B | 1.23B | 1.05B | 1.2B | 558M | 1.03B | 687M | 589M | 593M | 497M | 472M | 425M | 208M | 326M | -462M | 763M | -82M | 838M | 1.82B | 869M | 582M | 403M | 404M | 195M | -7M |
| Operating CF Margin % | - | 16.61% | 9.91% | 11.55% | 5.65% | 8.05% | 19.31% | 6.67% | 5.73% | 6.26% | 2.84% | 5.51% | 4.14% | 5.31% | 6.5% | 5.74% | 5.71% | 4.71% | 2.42% | 4.03% | -5.47% | 9.16% | -0.94% | 8.34% | 13.07% | 7.21% | 5.1% | 3.7% | 4.08% | 2.24% | -0.09% |
| Operating CF Growth % | 448.74% | 72.94% | -13.77% | 119.21% | -30.93% | -53.98% | 176.32% | 17.54% | -12.58% | 115.05% | -45.61% | 49.34% | 16.64% | -0.67% | 19.32% | 5.3% | 11.06% | 104.33% | -36.2% | 170.56% | -160.55% | 1030.49% | -109.79% | -53.91% | 109.21% | 49.31% | 44.42% | -0.25% | 107.18% | 2885.71% | -104.76% |
| Net Income | 1.7B | 1.41B | 4.06B | 1.31B | 1B | 1.48B | 768M | 171M | 459M | -320M | 176M | 78M | 76M | -104M | 133M | 94M | 1.15B | 197M | 32M | -84M | -813M | -288M | -2.81B | -1.48B | 785M | 643M | 321M | 249M | 378M | -207M | 473M |
| Depreciation & Amortization | 891M | 886M | 818M | 870M | 841M | 855M | 857M | 850M | 802M | 870M | 850M | 797M | 849M | 545M | 430M | 398M | 380M | 413M | 371M | 336M | 337M | 327M | 388M | 380M | 604M | 554M | 533M | 556M | 460M | 443M | 419M |
| Stock-Based Compensation | 108M | 104M | 67M | 66M | 56M | 56M | 44M | 42M | 46M | 59M | 68M | 69M | 51M | 36M | 32M | 24M | 22M | 23M | 33M | 40M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Deferred Taxes | 7M | 0 | -103M | 52M | 209M | 250M | -128M | 144M | 147M | 200M | 41M | 42M | 30M | -67M | 92M | 81M | -952M | 20M | -14M | 2M | -68M | -62M | -545M | -563M | 90M | 48M | 2M | 101M | 131M | -219M | 247M |
| Other Non-Cash Items | 748M | 1.19B | -2.94B | 4M | 119M | -332M | 274M | 344M | -41M | 1.9B | 1.13B | 1.68B | 1.34B | 1.32B | 826M | 885M | 758M | 519M | 520M | 660M | 1.06B | 832M | 3.87B | 3.35B | 1.55B | 1.1B | 1.21B | 1.12B | 462M | 1.39B | 150M |
| Working Capital Changes | 234M | -44M | 136M | 71M | -1.14B | -737M | 1.59B | -318M | -364M | -1.5B | -1.71B | -1.64B | -1.66B | -1.14B | -920M | -985M | -888M | -747M | -734M | -628M | -975M | -46M | -988M | -855M | -711M | -527M | -1.2B | -1.45B | -1.03B | -998M | -940M |
| Change in Receivables | 61M | 20M | 245M | -29M | -140M | -197M | 195M | -247M | -134M | -1.45B | -1.6B | -1.63B | -1.9B | -987M | -868M | -850M | -731M | -646M | -647M | -623M | -453M | -609M | -889M | -1.1B | -1.07B | -735M | -1.14B | -1.35B | -988M | -791M | -709M |
| Change in Inventory | 93M | -73M | -86M | -139M | -64M | -52M | -145M | -94M | 17M | -35M | -83M | -130M | -314M | -203M | -59M | -35M | -15M | -22M | -1M | -28M | -46M | 8M | -39M | -15M | -104M | 45M | 51M | -114M | 0 | -7M | -91M |
| Change in Payables | 68M | 0 | -30M | 215M | -898M | -584M | 1.3B | 12M | -142M | -10M | -51M | 68M | 505M | 38M | 9M | -32M | -87M | 12M | -29M | -99M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Cash from Investing | -1.41B | -1.27B | 3.43B | -969M | -808M | -714M | -1.61B | -619M | -115M | 21M | -430M | -1.32B | -1.32B | -2.16B | -662M | -503M | -420M | -125M | -274M | -520M | -379M | -392M | -12M | -333M | -1.23B | -574M | -36M | -1.15B | -1.08B | -1.13B | -800M |
| Capital Expenditures | -1.02B | -1.01B | -931M | -751M | -762M | -658M | -540M | -670M | -617M | -707M | -875M | -842M | -933M | -691M | -508M | -475M | -463M | -456M | -547M | -743M | -693M | -578M | -558M | -833M | -889M | -630M | -657M | -1.24B | -1.21B | -406M | -472M |
| CapEx % of Revenue | 4.74% | 4.74% | 4.51% | 3.65% | 3.97% | 3.38% | 3.06% | 3.63% | 3.37% | 3.69% | 4.46% | 4.52% | 5.62% | 6.23% | 5.57% | 5.49% | 5.6% | 5.06% | 6.37% | 9.19% | 8.2% | 6.94% | 6.36% | 8.29% | 6.39% | 5.23% | 5.76% | 11.38% | 12.26% | 4.67% | 6.13% |
| Acquisitions | -15M | -308M | -571M | -224M | -234M | -1.22B | -1.18B | -25M | -113M | -50M | -156M | -1.07B | -440M | -1.52B | -211M | -84M | -78M | 0 | -92M | -36M | -28M | 0 | 0 | -39M | -324M | 0 | 0 | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | -377M | 43M | 4.96B | 60M | 204M | 1.24B | 94M | 56M | 564M | 823M | 539M | 539M | -1M | 31M | 40M | -3M | 37M | 232M | 159M | 174M | 352M | 139M | 549M | 646M | -14M | 56M | 621M | 91M | 130M | -719M | -328M |
| Cash from Financing | -2.99B | -2.4B | -3.69B | -1.03B | -1.78B | -936M | 385M | -763M | -1.13B | -1.33B | 232M | 454M | 715M | 1.32B | 320M | -286M | -337M | -117M | 1M | -18M | 252M | 348M | 129M | -96M | -1.11B | -1.32B | -727M | 571M | 668M | 653M | 398M |
| Debt Issued (Net) | -65M | -96M | -2.22B | -172M | -828M | -349M | 525M | -482M | -289M | -406M | 606M | 889M | 740M | 1.78B | 764M | 137M | -285M | -406M | -1M | -22M | 243M | 335M | 119M | 102M | -641M | -1.56B | -787M | 549M | 587M | 605M | -29M |
| Equity Issued (Net) | -1.04B | -1.44B | -672M | -200M | -250M | 0 | 23M | 12M | 16M | 7M | 4M | -25M | 26M | -378M | -418M | -374M | 0 | 334M | 0 | 0 | 0 | 12M | 2M | -203M | -421M | 269M | 45M | 36M | 97M | 71M | 432M |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -14M | -24M | -32M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | -1.36B | -1.44B | -672M | -200M | -250M | 0 | 0 | 0 | 0 | 0 | 0 | -40M | 0 | -400M | -418M | -374M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -208M | -715M | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Financing | -1.89B | -868M | -793M | -663M | -703M | -587M | -163M | -293M | -845M | -982M | -374M | -395M | -25M | -55M | -12M | -25M | -28M | -38M | 2M | 4M | 9M | 1M | 8M | 5M | -50M | -28M | 15M | -14M | -16M | -23M | -5M |
| Net Change in Cash | -32M | -136M | 1.79B | 370M | -1.51B | -82M | 2.18B | -149M | -200M | -105M | 360M | 163M | 80M | -251M | 251M | -292M | -285M | 183M | -65M | -212M | -589M | 719M | 35M | 409M | -73M | 106M | 6M | -12M | -68M | -66M | -158M |
| Free Cash Flow | 3.35B | 2.53B | 1.12B | 1.62B | 321M | 910M | 2.87B | 563M | 432M | 493M | -317M | 184M | -246M | -102M | 85M | 22M | -4M | -31M | -339M | -403M | -1.1B | 185M | -640M | -34M | 1.19B | 212M | -656M | -810M | -2M | -175M | -1.7B |
| FCF Margin % | 15.61% | 11.87% | 5.4% | 7.9% | 1.67% | 4.67% | 16.25% | 3.05% | 2.36% | 2.57% | -1.62% | 0.99% | -1.48% | -0.92% | 0.93% | 0.25% | -0.05% | -0.34% | -3.95% | -4.99% | -13.07% | 2.22% | -7.3% | -0.34% | 8.54% | 1.76% | -5.75% | -7.44% | -0.02% | -2.01% | -22.06% |
| FCF Growth % | 135.51% | 126.7% | -31.24% | 405.61% | -64.73% | -68.26% | 409.24% | 30.32% | -12.37% | 255.52% | -272.28% | 174.8% | -141.18% | -220% | 286.36% | 650% | 87.1% | 90.86% | 15.88% | 63.53% | -697.3% | 128.91% | -1782.35% | -102.86% | 460.38% | 132.32% | 19.01% | -40400% | 98.86% | 89.71% | -4373.68% |
| FCF per Share | 38.23 | 27.85 | 11.40 | 15.49 | 2.90 | 8.38 | 26.98 | 5.44 | 4.16 | 4.90 | -3.19 | 1.86 | -2.45 | -1.00 | 0.78 | 0.18 | -0.03 | -0.24 | -2.83 | -3.41 | -9.39 | 1.58 | -5.49 | -0.29 | 9.68 | 1.80 | -5.58 | -6.93 | -0.02 | -2.19 | -22.54 |
| FCF Conversion (FCF/Net Income) | 1.97x | 2.52x | 0.64x | 3.89x | 2.64x | 1.72x | 8.54x | -5.73x | 10.09x | -1.70x | -2.91x | -7.33x | 57.25x | -4.40x | 3.90x | 6.06x | 0.41x | 2.27x | 8.32x | -3.66x | 0.58x | -1.05x | 0.03x | -0.54x | 2.32x | 1.35x | 1.93x | 1.62x | 1.55x | -0.77x | -0.02x |
| Interest Paid | 766M | 865M | 851M | 882M | 848M | 937M | 962M | 946M | 976M | 939M | 932M | 859M | 726M | 426M | 376M | 347M | 402M | 439M | 391M | 395M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 322M | 0 | 1.27B | 243M | 161M | 92M | 12M | 12M | 25M | 56M | 33M | 7M | 8M | 6M | 13M | 10M | -34M | 43M | 4M | 162M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Working capital volatility
As reported in recent financial filings, Tenet's OCF/NI ratio has fluctuated wildly, ranging from a low of 0.27 in 2024Q1 to a high of 3.38 in 2023Q4, indicating that net income is a poor proxy for the company's actual cash-generating capacity.
The significant divergence between net income and operating cash flow suggests that non-cash items and lumpy supplemental payments frequently distort reported profitability. Investors should monitor whether this disconnect persists as the company continues its divestiture strategy, as it complicates the assessment of core earnings quality.
Based on quarterly cash flow data, Tenet's free cash flow margins have shown extreme variance, swinging from a negative 13.0% in 2024Q4 to a robust 27.2% in 2026Q1, reflecting the impact of portfolio restructuring on the company's ability to retain cash from operations.
The erratic FCF trajectory appears tied to the timing of asset sales and working capital swings rather than consistent operational improvement. This volatility warrants caution, as it suggests that free cash flow may not yet be stabilized following the company's aggressive exit from non-core hospital markets.
According to the provided cash flow statements, working capital changes have been highly erratic, including a massive $1.0 billion outflow in 2024Q4 followed by significant inflows, which suggests that the company's cash cycle is subject to unpredictable timing in collections and payables management.
These large, periodic swings in working capital suggest that the company's cash flow is highly sensitive to the timing of government supplemental payments and potential shifts in payer mix. Analysts should investigate whether these fluctuations are structural or merely reflective of the ongoing portfolio transition.
As evidenced by recent financial statements, Tenet has prioritized share repurchases, with a peak outflow of $747 million in 2025Q2, while simultaneously managing significant capital expenditures, highlighting a dual focus on returning capital to shareholders and reinvesting in the high-margin ambulatory surgery platform.
The company's willingness to deploy substantial cash toward buybacks while maintaining high levels of capital expenditure suggests management's confidence in the USPI growth engine. However, investors should monitor if this capital allocation remains sustainable if the hospital segment's cash contribution continues to exhibit its current volatility.
Quick answers to the most common questions about buying THC stock.
Tenet Healthcare Corporation (THC) generated $3.54B in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Tenet Healthcare Corporation (THC) generated $2.53B in free cash flow in 2025. Free cash flow is the cash left over after capital expenditures, which can be used to pay dividends, repurchase shares, or pay down debt.
Tenet Healthcare Corporation (THC) spent $1.01B on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.
In 2025, Tenet Healthcare Corporation (THC) spent $1.44B on share repurchases. This shows the company's commitment to returning capital to its equity investors.