A healthcare services company that operates one of the country's largest networks of hospitals — around 190 general acute care, behavioral, and rehabilitation facilities, plus hundreds of outpatient surgery and endoscopy centers — serving patients across 19 states and England, with most care concentrated in Florida and Texas. It was founded in 1968 in Nashville by physician father-and-son Thomas Frist Sr. and Jr., along with businessman Jack Massey, who wanted to bring the economies-of-scale model of chain retail to hospital care. The idea reportedly struck Thomas Frist Jr. while rooming in college with the son of the founder of Holiday Inn, and HCA's earliest headquarters was a small white house near its first hospital.
Q2 2026 revenue rose 8.7% to $20.2B but operating cash flow fell to $2.335B on working capital swings
Uninsured admissions rose 23.3% as premium tax credits expired. rose 8.7% to $20.2B and was not reported in the table but fell 14.4% to $2.287B from Q1 on higher other operating expenses, while a $400M Medicaid supplemental payment benefit lifted the top line. The company faces rising uncompensated load and negative equity as buybacks and debt continue.
Key takeaways
Uninsured admissions rose 23.3% on a consolidated basis after expiration of enhanced premium tax credits and administrative reforms, pressuring managed care and insurer revenues.
rose 8.7% to $20.230B, driven by a 6.0% increase in revenue per and a 2.6% rise in equivalent admissions, including a $400M net benefit from .
Other operating expenses rose to 24.9% of from 20.4% a year earlier, driven by Medicaid state directed and supplemental payment program expenses and professional fees, even as salaries and benefits improved to 41.0% from 43.7%.
Section summaries
Management's Discussion and Analysis
Q2 2026 revenue rose 8.7% to $20.2B, driven by a 6.0% increase in revenue per equivalent admission and a 2.6% rise in equivalent admissions, with a $400M net benefit from Medicaid supplemental payments.
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Consolidated revenues grew 8.7% to $20.230 billion, with same-facility revenues up 9.3%, primarily from a 6.4% increase in same-facility and a 2.7% increase in same-facility .
fell $1.875B to $2.335B from Q1's $4.210B, mainly from $1.413B unfavorable including higher Medicaid and a $594M increase in income taxes paid.
The Florida contributed $1.372B in incremental revenues and $829M in expenses for October 1, 2024 through June 30, 2026, with $980M of the from pre-2026 periods.
The company repurchased 7.909M shares in H1 2026, issued $3.0B in , and expects 2026 of $5.0B–$5.5B excluding acquisitions.
What changed
Q2 2026 of $2.335B reversed the Q2 2025 working-capital swing and IRS deferral that had lifted that quarter to $4.210B, falling $1.875B sequentially.
Uninsured admissions, flagged in Q1 2026 as up 15.5% same-facility, rose further to 23.3% consolidated as enhanced premium tax credits stayed expired.
, negative since Q1 2025 and at -$2.978B in Q1 2026, continued its deepening trajectory noted in the FY2025 10-K watch items.
The uncompensated care cost disclosure remained absent, with no update since the $3.7B FY2019 figure across every flagged quarter since.
Q2 2026 equivalent admissions rose 2.6%, reversing the Q1 2026 winter-storm and respiratory decline that had cut same-facility surgical volumes.
What to watch
Q3 2026 uninsured admissions and other operating expenses as enhanced premium tax credits remain expired
Q3 2026 against the $2.335B Q2 figure as Medicaid and tax payments normalize
2026 against the $5.0B–$5.5B plan and resulting after H1 repurchases and $3.0B note issuance
Trajectory of after -$2.978B in Q1 2026 as buybacks and continue
The Florida directed payment program contributed $1.372 billion in incremental revenues and $829 million in other operating expenses for the period October 1, 2024 through June 30, 2026, including $980 million in revenues and $557 million in expenses related to pre-2026 periods.
Uninsured admissions surged 23.3% on a consolidated basis, reflecting the expiration of enhanced premium tax credits at the end of 2025 and administrative reforms, while managed care and insurer revenues were unfavorably impacted by these same factors.
Salaries and benefits as a percentage of revenues improved to 41.0% from 43.7%, but other operating expenses rose to 24.9% from 20.4%, driven by growth in Medicaid state directed and supplemental payment program expenses and professional fees.
fell $1.875 billion to $2.335 billion, mainly due to unfavorable changes of $1.413 billion, including higher from Medicaid programs, and a $594 million increase in income taxes paid.
The company repurchased 7.909 million shares in the first six months of 2026, issued $3.0 billion in senior notes, and expects 2026 of $5.0–$5.5 billion, excluding acquisitions.
Quantitative and Qualitative Disclosures About Market Risk
The information called for by this item is provided under the caption “Market Risk” under Item 2, “Management’s Discussion and Analysis of Financial Condition and Results of Operations.”
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The information called for by this item is provided under the caption “Market Risk” under Item 2, “Management’s Discussion and Analysis of Financial Condition and Results of Operations.”
The information set forth in “Note 8 – Contingencies” in the notes to the condensed consolidated financial statements is incorporated herein by reference.
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The information set forth in “Note 8 – Contingencies” in the notes to the condensed consolidated financial statements is incorporated herein by reference.
Reference is made to the factors set forth under the caption “Forward-Looking Statements” in Part I, Item 2 of this quarterly report on Form 10-Q and other risk factors described in our annual report on Form 10-K for the year ended December 31, 2025, which are incorporated herei…
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Reference is made to the factors set forth under the caption “Forward-Looking Statements” in Part I, Item 2 of this quarterly report on Form 10-Q and other risk factors described in our annual report on Form 10-K for the year ended December 31, 2025, which are incorporated herein by reference. There have not been any material changes to the risk factors previously disclosed in our annual report on Form 10-K for the year ended December 31, 2025.