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Friday — HCA Healthcare, Inc. (NYSE:HCA) reported first-quarter results that slightly exceeded analyst expectations.
However, the company's shares plunged 7.81% in pre-market trading following the release, as investors focused on weak volume trends and the lack of typical seasonal patterns.
The hospital operator reported adjusted earnings per share of $7.15, beating analyst consensus of $7.14 by $0.01. Revenue reached $19.11 billion, slightly above expectations of $19.09 billion, representing a 4.3% year-over-year increase from $18.32 billion in the first quarter of 2025.
However, the company disclosed that it did not experience normal seasonal volume growth, primarily due to reduced respiratory illness activity. Compared to the same period last year, respiratory-related admissions fell 42%, and respiratory-related emergency room visits declined 32%. A winter storm in January further pressured volumes in certain markets.
These headwinds were partially offset by the recognition of certain Medicaid programs that were not included in the initial 2026 guidance.
Same-facility admissions grew only 0.9% in the quarter, while same-facility equivalent admissions increased 1.3%. Same-facility inpatient surgeries declined 0.3%, while outpatient surgeries fell 1.7%. Same-facility revenue per equivalent admission grew 3.1%.
"The start of the year presented a dynamic environment for HCA Healthcare. I want to thank our colleagues for continuing to demonstrate an extraordinary ability to adapt to changing conditions and serve our patients, communities, and stakeholders," said CEO Sam Hazen.
Net income attributable to HCA Healthcare increased 0.6% to $1.62 billion, or $7.15 per diluted share, compared to $1.61 billion, or $6.45 per diluted share, in the first quarter of 2025. Adjusted EBITDA grew 1.9% to $3.80 billion from $3.73 billion in the same period last year. Cash flow from operations surged 22.0% to $2.01 billion.
The company reaffirmed its full-year 2026 guidance, expecting revenue of $76.5 billion to $80.0 billion and adjusted EBITDA of $15.55 billion to $16.45 billion.