8-K
0000860730false00008607302025-07-252025-07-25

 

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549

 

FORM 8-K

 

CURRENT REPORT

Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): July 25, 2025

 

 

HCA Healthcare, Inc.

(Exact name of Registrant as Specified in Its Charter)

 

 

Delaware

001-11239

27-3865930

(State or Other Jurisdiction
of Incorporation)

(Commission File Number)

(IRS Employer
Identification No.)

 

 

 

 

 

One Park Plaza

 

Nashville, Tennessee

 

37203

(Address of Principal Executive Offices)

 

(Zip Code)

 

Registrant’s Telephone Number, Including Area Code: (615) 344-9551

 

Not Applicable

(Former Name or Former Address, if Changed Since Last Report)

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

☐Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
☐Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
☐Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
☐Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:


Title of each class

 

Trading
Symbol(s)

 


Name of each exchange on which registered

Common Stock, $0.01 par value per share

 

HCA

 

New York Stock Exchange

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

Emerging growth company ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

 

Item 2.02. Results of Operations and Financial Condition.

On July 25, 2025, HCA Healthcare, Inc. (the “Company”) issued a press release announcing, among other matters, its results of operations for the second quarter ended June 30, 2025, the text of which is set forth as Exhibit 99.1.

Item 7.01. Regulation FD Disclosure.

On July 25, 2025, the Company issued a press release announcing, among other matters, its results of operations for the second quarter ended June 30, 2025, the text of which is set forth as Exhibit 99.1.

Item 8.01. Other Events.

On July 25, 2025, the Company announced that its Board of Directors had declared a quarterly cash dividend of $0.72 per share of 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.

Item 9.01. Financial Statements and Exhibits.

(d) Exhibits:

 

Exhibit 99.1

Press Release, dated July 25, 2025

Exhibit 104

Cover Page Interactive Data File (embedded within the Inline XBRL document)

 

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

 

 

HCA HEALTHCARE, INC.

 

 

 

 

Date:

July 25, 2025

By:

/s/ Michael A. Marks

 

 

 

Michael A. Marks
Executive Vice President and Chief Financial Officer

 

Exhibit 99.1

img60930783_0.jpg

FOR IMMEDIATE RELEASE

 

INVESTOR CONTACT:

 

MEDIA CONTACT:

Frank Morgan

 

Harlow Sumerford

615-344-2688

 

615-344-1851

 

HCA Healthcare reports SECOND quarter 2025 results

RAISES 2025 Guidance

Nashville, Tenn., July 25, 2025 – 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):

•
Revenues increased 6.4 percent to $18.605 billion
•
Net income attributable to HCA Healthcare, Inc. increased 13.1 percent to $1.653 billion
•
Diluted earnings per share increased 23.5 percent to $6.83 per diluted share, and diluted earnings per share, as adjusted, increased 24.4 percent to $6.84 per diluted share
•
Adjusted EBITDA increased 8.4 percent to $3.849 billion
•
Cash flows from operating activities totaled $4.210 billion, compared to $1.971 billion in the second quarter of 2024
•
Same facility admissions increased 1.8 percent and same facility equivalent admissions increased 1.7 percent

“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

1

 

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.

 

Previous 2025 Guidance Range, as of January 24, 2025

Revised 2025 Guidance Range, as of July 25, 2025

Revenues

$72.80 to $75.80 billion

$74.00 to $76.00 billion

Net Income Attributable to HCA Healthcare, Inc.

$5.85 to $6.29 billion

$6.11 to $6.48 billion

Adjusted EBITDA

$14.30 to $15.10 billion

$14.70 to $15.30 billion

EPS (diluted)

$24.05 to $25.85 per diluted share

$25.50 to $27.00 per diluted share

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.

2

 

 

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

3

 

 

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.
 

4

 

 

HCA Healthcare, Inc.

Condensed Consolidated Comprehensive Income Statements

Second Quarter

Unaudited

(Dollars in millions, except per share amounts)

 

 

 

 

 

 

2025

 

 

 

2024

 

 

 

 

 

Amount

 

 

Ratio

 

 

 

Amount

 

 

Ratio

 

 

Revenues

 

$

18,605

 

 

 

100.0

 

%

 

$

17,492

 

 

 

100.0

 

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

 

8,138

 

 

 

43.7

 

 

 

 

7,685

 

 

 

43.9

 

 

Supplies

 

 

 

2,844

 

 

 

15.3

 

 

 

 

2,634

 

 

 

15.1

 

 

Other operating expenses

 

 

 

3,793

 

 

 

20.4

 

 

 

 

3,623

 

 

 

20.7

 

 

Equity in earnings of affiliates

 

 

 

(19

)

 

 

(0.1

)

 

 

 

—

 

 

 

—

 

 

Depreciation and amortization

 

 

 

863

 

 

 

4.7

 

 

 

 

819

 

 

 

4.7

 

 

Interest expense

 

 

568

 

 

 

3.0

 

 

 

 

506

 

 

 

2.9

 

 

Losses (gains) on sales of facilities

 

 

3

 

 

 

—

 

 

 

 

(12

)

 

 

(0.1

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16,190

 

 

 

87.0

 

 

 

 

15,255

 

 

 

87.2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Income before income taxes

 

 

 

2,415

 

 

 

13.0

 

 

 

 

2,237

 

 

 

12.8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Provision for income taxes

 

 

 

524

 

 

 

2.8

 

 

 

 

550

 

 

 

3.2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income

 

 

 

1,891

 

 

 

10.2

 

 

 

 

1,687

 

 

 

9.6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income attributable to noncontrolling interests

 

 

 

238

 

 

 

1.3

 

 

 

 

226

 

 

 

1.2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income attributable to HCA Healthcare, Inc.

 

 

$

1,653

 

 

 

8.9

 

 

 

$

1,461

 

 

 

8.4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Diluted earnings per share

 

$

6.83

 

 

 

 

 

 

$

5.53

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shares used in computing diluted earnings per share (millions)

 

 

241.911

 

 

 

 

 

 

 

264.071

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Comprehensive income attributable to HCA Healthcare, Inc.

 

$

1,701

 

 

 

 

 

 

$

1,461

 

 

 

 

 

 

 

5

 

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Diluted earnings per share

 

$

13.28

 

 

 

 

 

 

$

11.47

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shares used in computing diluted earnings per share (millions)

 

 

245.654

 

 

 

 

 

 

 

266.044

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Comprehensive income attributable to HCA Healthcare, Inc.

 

$

3,341

 

 

 

 

 

 

$

3,044

 

 

 

 

 

 

6

 

 

HCA Healthcare, Inc.

Condensed Consolidated Balance Sheets

Unaudited

(Dollars in millions)

 

 

 

June 30,

 

 

March 31,

 

 

December 31,

 

 

 

2025

 

 

2025

 

 

2024

 

ASSETS

 

 

 

 

 

 

 

 

 

Current assets:

 

 

 

 

 

 

 

 

 

Cash and cash equivalents

$

939

 

 

$

1,060

 

 

$

1,933

 

Accounts receivable

 

10,459

 

 

 

11,088

 

 

 

10,751

 

Inventories

 

1,792

 

 

 

1,794

 

 

 

1,738

 

Other

 

2,373

 

 

 

2,316

 

 

 

1,992

 

 

15,563

 

 

 

16,258

 

 

 

16,414

 

 

 

 

 

 

 

 

 

 

Property and equipment, at cost

 

64,388

 

 

 

63,680

 

 

 

62,514

 

Accumulated depreciation

 

(34,265

)

 

 

(33,942

)

 

 

(33,100

)

 

 

30,123

 

 

 

29,738

 

 

 

29,414

 

 

 

 

 

 

 

 

 

 

Investments of insurance subsidiaries

 

531

 

 

 

550

 

 

 

569

 

Investments in and advances to affiliates

 

654

 

 

 

657

 

 

 

662

 

Goodwill and other intangible assets

 

10,273

 

 

 

10,237

 

 

 

10,093

 

Right-of-use operating lease assets

 

2,156

 

 

 

2,132

 

 

 

2,131

 

Other

 

236

 

 

 

226

 

 

 

230

 

 

 

 

 

 

 

 

 

 

 

 

$

59,536

 

 

$

59,798

 

 

$

59,513

 

 

 

 

 

 

 

 

 

 

LIABILITIES AND STOCKHOLDERS' (DEFICIT) EQUITY

 

 

 

 

 

 

 

 

 

Current liabilities:

 

 

 

 

 

 

 

 

 

Accounts payable

$

4,250

 

 

$

4,488

 

 

$

4,276

 

Accrued salaries

 

2,072

 

 

 

1,857

 

 

 

2,304

 

Other accrued expenses

 

4,513

 

 

 

3,767

 

 

 

3,899

 

Short-term borrowings and long-term debt due within one
   year

 

5,104

 

 

 

3,519

 

 

 

4,698

 

 

 

15,939

 

 

 

13,631

 

 

 

15,177

 

 

 

 

 

 

 

 

 

 

 

Long-term debt, less debt issuance costs and discounts
   of $429, $432 and $369

 

39,379

 

 

 

41,057

 

 

 

38,333

 

Professional liability risks

 

1,506

 

 

 

1,497

 

 

 

1,544

 

Right-of-use operating lease obligations

 

1,881

 

 

 

1,860

 

 

 

1,863

 

Income taxes and other liabilities

 

2,069

 

 

 

2,191

 

 

 

2,041

 

 

 

 

 

 

 

 

 

 

 

Stockholders' (deficit) equity:

 

 

 

 

 

 

 

 

 

Stockholders' deficit attributable to HCA Healthcare, Inc.

 

(4,394

)

 

 

(3,519

)

 

 

(2,499

)

Noncontrolling interests

 

3,156

 

 

 

3,081

 

 

 

3,054

 

 

(1,238

)

 

 

(438

)

 

 

555

 

 

 

$

59,536

 

 

$

59,798

 

 

$

59,513

 

 

7

 

 

HCA Healthcare, Inc.

Condensed Consolidated Statements of Cash Flows

For the Six Months Ended June 30, 2025 and 2024

Unaudited

(Dollars in millions)

 

 

 

2025

 

 

2024

 

Cash flows from operating activities:

 

 

 

 

 

 

Net income

 

$

3,716

 

 

$

3,489

 

Adjustments to reconcile net income to net cash provided by operating activities:

 

 

 

 

 

 

Increase (decrease) in cash from operating assets and liabilities:

 

 

 

 

 

 

Accounts receivable

 

 

320

 

 

 

(285

)

Inventories and other assets

 

 

(427

)

 

 

(68

)

Accounts payable and accrued expenses

 

 

(676

)

 

 

(459

)

Depreciation and amortization

 

 

1,723

 

 

 

1,614

 

Income taxes

 

 

880

 

 

 

(4

)

Losses (gains) on sales of facilities

 

 

2

 

 

 

(213

)

Amortization of debt issuance costs and discounts

 

 

25

 

 

 

17

 

Share-based compensation

 

 

197

 

 

 

199

 

Other

 

 

101

 

 

 

150

 

 

 

 

 

 

 

 

Net cash provided by operating activities

 

 

5,861

 

 

 

4,440

 

 

 

 

 

 

 

 

Cash flows from investing activities:

 

 

 

 

 

 

Purchase of property and equipment

 

 

(2,167

)

 

 

(2,399

)

Acquisition of hospitals and health care entities

 

 

(326

)

 

 

(131

)

Sales of hospitals and health care entities

 

 

167

 

 

 

311

 

Change in investments

 

 

41

 

 

 

(14

)

Other

 

 

2

 

 

 

(2

)

 

 

 

 

 

 

 

Net cash used in investing activities

 

 

(2,283

)

 

 

(2,235

)

 

 

 

 

 

 

 

Cash flows from financing activities:

 

 

 

 

 

 

Issuances of long-term debt

 

 

5,233

 

 

 

4,483

 

Net change in short-term borrowings and revolving credit facilities

 

 

1,768

 

 

 

(1,030

)

Repayment of long-term debt

 

 

(5,660

)

 

 

(2,269

)

Distributions to noncontrolling interests

 

 

(394

)

 

 

(338

)

Payment of debt issuance costs

 

 

(57

)

 

 

(40

)

Payment of dividends

 

 

(351

)

 

 

(356

)

Repurchase of common stock

 

 

(5,011

)

 

 

(2,547

)

Other

 

 

(112

)

 

 

(212

)

 

 

 

 

 

 

 

Net cash used in financing activities

 

 

(4,584

)

 

 

(2,309

)

 

 

 

 

 

 

 

Effect of exchange rate changes on cash and cash equivalents

 

 

12

 

 

 

-

 

 

 

 

 

 

 

 

Change in cash and cash equivalents

 

 

(994

)

 

 

(104

)

Cash and cash equivalents at beginning of period

 

 

1,933

 

 

 

935

 

 

 

 

 

 

 

 

Cash and cash equivalents at end of period

 

$

939

 

 

$

831

 

 

 

 

 

 

 

 

Interest payments

 

$

1,074

 

 

$

943

 

Income tax payments, net

 

$

146

 

 

$

999

 

 

8

 

 

HCA Healthcare, Inc.

Operating Statistics

 

 

Second Quarter

 

 

For the Six Months
Ended June 30,

 

 

 

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).

** Reflects the rate of occupancy (patient days and observations) based on weighted average beds in service.

9

 

 

HCA Healthcare, Inc.

Supplemental Non-GAAP Disclosures

Operating Results Summary

(Dollars in millions, except per share amounts)

 

 

Second Quarter

 

 

For the Six Months
Ended June 30,

 

 

 

2025

 

 

2024

 

 

2025

 

 

2024

 

Revenues

$

18,605

 

 

$

17,492

 

$

36,926

 

 

$

34,831

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income attributable to HCA Healthcare, Inc.

$

1,653

 

 

$

1,461

 

$

3,263

 

 

$

3,052

 

Losses (gains) on sales of facilities (net of tax)

 

3

 

 

 

(9

)

 

2

 

 

 

(163

)

Net income attributable to HCA Healthcare, Inc.,
   as adjusted (a)

 

1,656

 

 

 

1,452

 

 

3,265

 

 

 

2,889

 

Depreciation and amortization

 

863

 

 

 

819

 

 

1,723

 

 

 

1,614

 

Interest expense

 

568

 

 

 

506

 

 

1,115

 

 

 

1,018

 

Provision for income taxes

 

524

 

 

 

547

 

 

1,026

 

 

 

945

 

Net income attributable to noncontrolling interests

 

238

 

 

 

226

 

 

453

 

 

 

437

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA (a)

 

3,849

 

 

$

3,550

 

$

7,582

 

 

$

6,903

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA margin (a)

 

20.7

%

 

 

20.3

%

 

20.5

%

 

 

19.8

%

 

 

 

 

 

 

 

 

 

 

 

 

 

Diluted earnings per share:

 

 

 

 

 

 

 

 

 

 

 

 

Net income attributable to HCA Healthcare, Inc.

$

6.83

 

 

$

5.53

 

$

13.28

 

 

$

11.47

 

Losses (gains) on sales of facilities

 

0.01

 

 

 

(0.03

)

 

0.01

 

 

 

(0.61

)

Net income attributable to HCA Healthcare, Inc.,
   as adjusted (a)

$

6.84

 

 

$

5.50

 

$

13.29

 

 

$

10.86

 

 

 

 

 

 

 

 

 

 

 

 

Shares used in computing diluted earnings per
   share (millions)

 

241.911

 

 

 

264.071

 

 

245.654

 

 

 

266.044

 

 

(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.

10

 

 

HCA Healthcare, Inc.

Supplemental Non-GAAP Disclosures

2025 Operating Results Forecast

(Dollars in millions, except per share amounts)

 

 

For the Year Ending

 

 

 

December 31, 2025

 

 

 

Low

 

 

High

 

Revenues

 

$

74,000

 

 

$

76,000

 

 

 

 

 

 

 

 

Net income attributable to HCA Healthcare, Inc. (a)

 

$

6,110

 

 

$

6,480

 

Depreciation and amortization

 

 

3,450

 

 

 

3,495

 

Interest expense

 

 

2,250

 

 

 

2,300

 

Provision for income taxes

 

 

1,930

 

 

 

2,035

 

Net income attributable to noncontrolling interests

 

 

960

 

 

 

990

 

 

 

 

 

 

 

 

Adjusted EBITDA (a) (b)

 

$

14,700

 

 

$

15,300

 

 

 

 

 

 

 

 

Diluted earnings per share:

 

 

 

 

 

 

Net income attributable to HCA Healthcare, Inc.

 

$

25.50

 

 

$

27.00

 

 

 

 

 

 

 

 

Shares used in computing diluted earnings per share (millions)

 

 

240.000

 

 

 

240.000

 

 

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.

 

11