HCA Healthcare surges on strong earnings, $10B buyback
Hospital operator beats expectations with 30% profit jump and raises 2026 guidance above analyst forecasts
HCA Healthcare shares climbed in pre-market trading Tuesday after the hospital operator reported fourth-quarter earnings that far exceeded analyst expectations, alongside a substantial increase in capital returns to shareholders.
The Nashville-based company reported diluted earnings per share of $8.01 for the quarter ended December 31, 2025, significantly topping the consensus estimate of $7.37 per share. Revenue reached $19.513 billion, representing a 6.7% increase from the prior-year period, while net income attributable to HCA Healthcare surged 30.6% year-over-year to $1.878 billion.
Perhaps more striking was the company's 2026 guidance, which projects earnings per share of $29.10 to $31.50—well above the analyst consensus of $27.70. HCA also expects revenue between $76.5 billion and $80 billion for the full year, surpassing the $75.74 billion consensus estimate.
The Board of Directors added to investor enthusiasm by authorizing a new share repurchase program of up to $10 billion, a substantial expansion of the company's capital return strategy. Additionally, HCA declared a quarterly dividend of $0.78 per share, continuing its commitment to shareholder returns.
HCA Healthcare, which operates 186 hospitals and nearly 2,000 outpatient facilities across 21 states and the United Kingdom, has been benefiting from strong patient volumes and improved operational efficiencies. The company's stock has been a strong performer, reaching a 52-week high of $519.23 and currently trading around $472.38 with a market capitalization of approximately $109 billion.
Analysts maintain a generally positive outlook on the shares, with a consensus "Buy" rating and median price target of $477.06. The $10 billion authorization represents roughly 9% of the company's market capitalization, signaling management's confidence in the business's ability to generate substantial free cash flow.
The hospital sector has faced headwinds in recent years, including rising labor costs and regulatory pressure, but HCA's scale and operational discipline have allowed it to outperform many peers. The company's 2025 full-year diluted EPS of $28.33 positions it comfortably at the lower end of its 2026 guidance range, suggesting continued momentum rather than a dramatic shift in business conditions.
Investors will be watching for details on the company's strategy for deploying the $10 billion buyback authorization, particularly given that the stock trades at approximately 18 times trailing earnings. The timing and pace of repurchases could significantly influence the stock's trajectory in the coming months.
The combination of better-than-expected earnings, raised guidance, and a massive new buyback program reflects management's confidence in HCA's competitive position and ability to generate strong returns in the evolving healthcare landscape.