HCA Healthcare, Inc.

Business model and operations

• HCA Healthcare, Inc. is a holding company whose affiliates own and operate hospitals and related health care entities.
• As of December 31, 2025, affiliates owned and operated:
  • 190 hospitals
  • 121 freestanding surgery centers
  • 31 freestanding endoscopy centers
• Geographic footprint:
  • Facilities in 19 U.S. states and England.
  • The eight hospitals operated in England are included in Corporate and Other.
• Reporting structure:
  • Three geographically organized groups: National Group, Atlantic Group, and American Group, plus Corporate and Other (England).
  • Hospital breakdown by group (2025): National Group 53, Atlantic Group 63, American Group 66, plus 8 in England (Corporate and Other).

2025 financial highlights (amounts in millions unless noted)

• Revenues: $75,600 (2025); $70,603 (2024); $64,968 (2023)
• Net income: $7,782 (2025)
  • Net income attributable to HCA Healthcare, Inc.: $6,784 (2025)
  • Net income: $6,657 (2024); $6,091 (2023)
• Earnings per share
  • Basic: $28.70 (2025)
  • Diluted: $28.33 (2025)
• Weighted average shares
  • Basic: 236.413 million (2025)
  • Diluted: 239.495 million (2025)
• Adjusted segment EBITDA by geographic group:
  • National Group: $5,103
  • Atlantic Group: $5,642
  • American Group: $6,296
  • Total Adjusted segment EBITDA: $17,041
  • Corporate and Other: $1,475
  • Combined EBITDA proxy (operating performance measure): $18,516
• Income before income taxes: $9,832
• Provision for income taxes: $2,050
• Consolidated net income after tax: $7,782
• Comprehensive income: $7,864
  • Comprehensive income attributable to noncontrolling interests: $998
  • Comprehensive income attributable to HCA Healthcare, Inc.: $6,866

Balance sheet highlights (as of December 31, 2025)

• Total assets: $60,720
• Cash and cash equivalents: $1,040
• Accounts receivable: $10,867
• Inventories: $1,652
• Property and equipment, net: $31,141
• Investments of insurance subsidiaries: $485
• Goodwill and other intangible assets: $10,293
• Right-of-use assets: $2,130
• Liabilities and equity:
  • Current liabilities: $16,350
  • Long-term debt: $41,603
  • Total debt: $46,492
  • Stockholders’ (deficit) equity: $(2,771) (total stockholders’ deficit attributable to HCA Healthcare, Inc.: $(6,027))
  • Noncontrolling interests: $3,256

Revenue recognition and payer mix

• Revenues are recognized as health care services are provided. A substantial portion of revenue is derived from third-party payers (Medicare, Medicaid, managed care, and commercial insurers).
• 2025 revenue by payer mix (amounts in millions; approximate shares):
  • Medicare: $11,273 (≈ 14.9%)
  • Managed Medicare: $13,435 (≈ 17.8%)
  • Medicaid: $5,909 (≈ 7.8%)
  • Managed Medicaid: $3,693 (≈ 4.9%)
  • Managed care and other insurers: $36,968 (≈ 48.9%)
  • International (managed care and other insurers): $1,864 (≈ 2.5%)
  • Other (including uninsured): $2,458 (≈ 3.2%)
• Uncompensated care and related items:
  • Estimated cost of total uncompensated care for 2025: $4,605
  • Charity care totaled $16.499 billion in 2025; $1.584 billion of that was recognized as charity care expense
  • Implicit price concessions at year-end 2025: $7,674 (also captured in revenue and receivables)

Capital structure and financing

• Long-term debt outstanding at year-end 2025: $41,603
• Debt issuance costs and discounts: $436 (net of amortization included in interest expense)
• 2025 financing activities included issuance of multiple series of senior unsecured notes totaling several billions, repayment of other debt, and establishment of a new $8.0 billion senior unsecured revolving credit facility
• Commercial paper program capacity: up to $4.0 billion; $2.207 billion outstanding as of December 31, 2025
• Capital expenditures (purchases of property and equipment) in 2025: $4,944
• Share repurchases: 26.739 million shares repurchased in 2025; approximately $750 million authorized for repurchases remained under the January 2025 authorization at year-end
• Exchange event: On February 6, 2026, HCA exchanged 36,629,188 shares for 36,557,141 new shares, retiring 72,047 shares

Accounting and policy highlights

• Revenue estimation includes contractual adjustments and implicit price concessions; a quarterly hindsight analysis informs revenue and receivable valuation.
• Goodwill impairment testing is performed at the reporting unit level; no goodwill impairments were recognized in 2025, 2024 or 2023.
• Investments of insurance subsidiaries are primarily available-for-sale debt securities measured at fair value; unrealized gains and losses are recorded in other comprehensive income unless related to credit risk.
• Leases: right-of-use assets and lease liabilities are recorded for operating and finance leases; the company reports substantial lease-related expenses and discloses future lease payments.

Segments and geographic information

• HCA operates as one line of business (hospitals and related health care entities) and reports performance by geographic groups:
  • National Group
  • Atlantic Group
  • American Group
  • Corporate and Other (England)
• Illustrative 2025 operating statistics by group:
  • Revenues: National $21,278; Atlantic $24,709; American $26,445; Corporate and Other $3,168; Total $75,600
  • Adjusted segment EBITDA: National $5,103; Atlantic $5,642; American $6,296; Total $17,041; Corporate and Other $1,475
  • Depreciation and amortization (consolidated): $3,523
  • Interest expense (consolidated): $2,248

Source: HCA Healthcare Form 10-K for the year ended December 31, 2025.