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HCA Healthcare Q1 Earnings Beat on Growing Patient Volumes

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HCA Healthcare, Inc. (HCA - Free Report) reported first-quarter 2025 adjusted earnings per share (EPS) of $6.45, which outpaced the Zacks Consensus Estimate of $5.77. The bottom line advanced 20.3% year over year. (See the Zacks Earnings Calendar to stay ahead of market-making news.)

Revenues rose 5.7% year over year to $18.3 billion. The top line beat the consensus mark by 0.1%.

The strong first-quarter results benefited from higher patient volumes, which led to an increased number of inpatient surgeries, emergency room visits and same-facility emergency room visits. However, the upside was partly offset by elevated salaries and benefits expenses and other operating expenses.

HCA Healthcare, Inc. Price, Consensus and EPS Surprise

HCA Healthcare, Inc. Price, Consensus and EPS Surprise

HCA Healthcare, Inc. price-consensus-eps-surprise-chart | HCA Healthcare, Inc. Quote

HCA’s Quarterly Details

Same-facility equivalent admissions improved 2.6% year over year in the first quarter, while same-facility admissions advanced 2.8% year over year. However, the metrics fell short of our growth estimates of 4.3% and 4.9%.

Same-facility revenue per equivalent admission grew 2.9% year over year and missed our growth estimate of 3%. 

Same-facility inpatient surgeries increased 0.2% year over year but were lower than our growth estimate of 2.2%. Same-facility outpatient surgeries dipped 2.1% year over year. Additionally, same-facility emergency room visits rose 4% year over year in the first quarter. 

Salaries and benefits, supplies and other operating expenses increased 4.4% year over year to $14.6 billion but were lower than our estimate of $14.8 billion.

Adjusted EBITDA of $3.7 billion increased from the year-ago figure of $3.4 billion.

HCA Healthcare operated 192 hospitals and roughly 2,500 ambulatory sites of care across 20 states and the United Kingdom as of March 31, 2025.

HCA’s Financial Update (as of March 31, 2025)

HCA Healthcare exited the first quarter with cash and cash equivalents of $1 billion, which is less than $1.9 billion as of the 2024-end level. It had a leftover capacity of approximately $7.8 billion under its credit facilities at the first-quarter end.

Total assets of $59.8 billion increased from $59.5 billion at 2024-end. 

Long-term debt, excluding debt issuance costs and discounts, was $41.1 billion, up from the figure of $38.3 billion as of Dec. 31, 2024.

Capital expenditures were $991 million minus acquisitions during the quarter.

HCA’s Cash Flow

HCA Healthcare generated $1.7 billion in cash from operations in 2025, which was lower from the year-ago figure of $2.5 billion.

HCA Healthcare’s Capital Deployment Update

HCA bought back shares worth $2.5 billion in the first quarter. It had a leftover capacity of $8.3 billion under its buyback authorization as of March 31, 2025.

The board of directors also announced a dividend of 72 cents per share, which will be paid on June 30, 2025, to its shareholders of record as of June 16.

2025 Guidance Affirmed

Annual revenues are presently anticipated to be between $72.8 billion and $75.8 billion in 2025. The midpoint of the outlook indicates a 5.2% rise from the 2024 figure.

Management estimates adjusted EBITDA to be in the range of $14.3-$15.1 billion. The midpoint of the outlook indicates 5.9% growth from the 2024 figure. Net income attributable to HCA Healthcare is presently expected to be between $5.85 billion and $6.29 billion.

EPS is forecasted to be in the $24.05-$25.85 band. The midpoint of the guidance implies a 13.6% rise from the 2024 figure.

Capital expenditures, excluding acquisitions, were earlier expected to be within $5-$5.2 billion.

HCA’s Zacks Rank & Key Picks

HCA currently carries a Zacks Rank #3 (Hold).

Some better-ranked stocks in the broader medical space are Aveanna Healthcare Holdings Inc. (AVAH - Free Report) , Addus Homecare Corporation (ADUS - Free Report) and Option Care Health, Inc. (OPCH - Free Report) , each sporting a Zacks Rank #1 (Strong Buy) at present. You can see the complete list of today’s Zacks #1 Rank stocks here.

The Zacks Consensus Estimate for Aveanna Healthcare’s current-year earnings of 12 cents per share has witnessed one upward revision in the past month against none in the opposite direction. Aveanna Healthcare beat earnings estimates in each of the trailing four quarters, with the average surprise being 163.3%. The consensus estimate for current-year revenues is pegged at $2.1 billion, implying 4.6% year-over-year growth.

The Zacks Consensus Estimate for Addus HomeCare’s current-year earnings is pegged at $6.03 per share. Addus HomeCare beat earnings estimates in each of the trailing four quarters, with the average surprise being 5.8%. The consensus estimate for current-year revenues is pegged at $1.4 billion, implying 21.1% year-over-year growth.

The Zacks Consensus Estimate for Option Care Health’s current-year earnings stands at $1.68 per share. It has remained stable over the past week. Option Care Health beat earnings estimates in each of the trailing four quarters, with the average surprise being 15.9%. The consensus estimate for current-year revenues is pegged at $5.4 billion, calling for 8.9% year-over-year growth.

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