HCA Healthcare, Inc. Revenue & Financials

HCA Healthcare reported FY2024 revenue of $70.603 billion, an increase of 8.7% from $64.968 billion in 2023. Net income attributable to HCA Healthcare, Inc. was $5.760 billion, or $22.00 per diluted share, compared to $5.242 billion, or $18.97 per diluted share, in 2023—representing 9.9% net income growth. Operating income was $10.547 billion, producing an operating margin of 14.9%. Adjusted EBITDA totaled $13.882 billion, up 9.1% from $12.726 billion in 2023, with an adjusted EBITDA margin of 19.7%. Revenue growth was driven by same-facility admissions growth of 4.9%, same-facility equivalent admissions growth of 4.5%, same-facility emergency room visit growth of 4.9%, and a 3.2% increase in revenue per equivalent admission to $17,695. The company's cost structure reflects the labor-intensive nature of hospital operations: salaries and benefits represent approximately 45.4% of revenue, supply costs are the second-largest expense, and professional fees continue to grow as physician employment subsidies remain a structural challenge. Interest expense was $2.061 billion in 2024, up from $1.938 billion in 2023, reflecting the company's leveraged capital structure. Cash flow from operating activities totaled $10.514 billion, up 11.5% from $9.431 billion in 2023, demonstrating strong cash conversion. Capital expenditures were $4.9 billion, while share repurchases totaled $6.042 billion and dividends were $599 million—returning $6.6 billion to shareholders. The balance sheet carries $43.031 billion in total debt, $1.933 billion in cash, and negative shareholders' equity of $2.499 billion. Total assets were $59.513 billion. The net debt to adjusted EBITDA ratio was approximately 2.96x, within the company's target range of 2.75x–3.75x. HCA's 2025 guidance calls for revenue of $72.8 billion to $75.8 billion (midpoint $74.3 billion, up 5.2%), net income of $5.85 billion to $6.29 billion (midpoint $6.07 billion, up 5.4%), adjusted EBITDA of $14.3 billion to $15.1 billion (midpoint $14.7 billion, up 5.9%), and diluted EPS of $24.05 to $25.85 (midpoint $24.95, up 13.4%). Capital expenditures are estimated at $5.0 billion to $5.2 billion. Q1 2026 revenue was $19.11 billion with net income of $1.62 billion. The stock trades at approximately $372.13 per share with a P/E ratio of 12.82x and a forward P/E of 12.27x, reflecting the market's view of HCA as a mature, cash-generative business with limited growth optionality.