# HCA Healthcare (HCA.US)

Canonical: https://gigainvestors.com/s/HCA

Analysis as of: 2026-10-16T07:28:58.378Z. Financial observations: FY1996–FY2026.

Listing currency: USD. Reporting currency: USD.

## Verdict

Not a wonderful business

Quality tests for Buy: not passed (profit record: pass; earnings resilience is evidence only). Published buy qualification: no.

Share price: $468.50 per share; close as of 2026-10-15.

Estimated value: low $375.04 per share, central $514.52 per share, high $603.27 per share. Buy at or below the central value $514.52 per share. Valuation as of 2026-10-16T07:28:58.378Z; scenarios are not confidence intervals.

Expected annual return: 10.7% at the stated quote. About 10.7% a year at today's price (required return 10.0%). required return 10.0% a year (10% floor; US 10-year bond 5.1% + 4 points).

## Checklist

### understandable: pass

- 0 revenue declines in the last 10 years (informational)

- Financial history: 10 years

- Years with declining revenue: 0

- Years with a net loss: 0

- Operating margin variation: 0.05×

Chart: Operating margin; fiscal year observations.

- FY2017: 0.14×

- FY2018: 0.14×

- FY2019: 0.14×

- FY2020: 0.14×

- FY2021: 0.16×

- FY2022: 0.15×

- FY2023: 0.15×

- FY2024: 0.15×

- FY2025: 0.16×

- LTM to Jun 2026: 0.15×

### moat: fail

- Recent gross margin fell 21.7pp below the typical margin (limit 4pp)

- ROIC, median of available years: 26.2%

- ROIC, second-lowest year: 23.6%

- Typical minus recent gross margin: 21.7 pp

- Typical gross margin (annual median): 62.4%

- Recent gross margin (lower of latest and 3-year median): 40.6%

- Years with nonpositive capital: 0

- Capital spending / revenue: 6.9%

- ROIC including acquisitions, ten-year median: 13.1%

Chart: ROIC excluding acquisitions; fiscal year observations.

- FY2016: 25.9%

- FY2017: 21.3%

- FY2018: 27.7%

- FY2019: 23.6%

- FY2020: 24.8%

- FY2021: 30.1%

- FY2022: 26.5%

- FY2023: 25.8%

- FY2024: 26.6%

- FY2025: 30.2%

### economics: pass

- Owner earnings / net income, 5-yr: 0.98×

- Cash conversion uses consolidated totals: No

- Owner earnings, five-year total: $30B

- Net income, five-year total: $30B

- Return on incremental invested capital: 38.2%

- Working capital / revenue, annual change: -0.2 pp

- Working capital / revenue, change between three-year averages: -1.1 pp

- Working capital / revenue, final three-year average: 11.3%

Chart: Annual owner cash / profit; fiscal year observations.

- FY2021: 1.00×

- FY2022: 0.87×

- FY2023: 1.00×

- FY2024: 1.00×

- FY2025: 1.00×

### management: pass

- Historical market-dollar context (not the management verdict): 2016 to 2025 (9 years)

- buybacks leaned toward cheaper years (informational)

- ROIC first 3 years vs last 3 years: 25.9% vs 26.6%

- Per-share earnings: 5.95 to 22.00 (three-year endpoint medians)

- Management verdict uses per-share economic progress: Yes

- Ordinary dilution, 10-year annual growth: -5.6%

- Ordinary dilution, 5-year annual growth: -7.0%

- Market cap gain: $77B

- Cumulative retained earnings: $1.2B

- Diluted shares, 10-year annual growth: -5.6%

- Diluted shares, 5-year annual growth: -7.0%

- $1 test, starting fiscal year: FY2016

- $1 test, ending fiscal year: FY2025

- Per-share value growth: 17.7%

- Per-share value change: $16.05

- Per-share value, starting three-year median: $5.95

- Per-share value, ending three-year median: $22.00

- Buybacks concentrated in cheaper years (correlation): 0.45

- Average buyback yield: 6.7%

- Buyback history: 10 years

- Debt-funded buybacks: No

- Acquisition spending: $14B

- Cumulative net income, 10 years: $47B

- ROIC, first three-year median: 25.9%

- ROIC, last three-year median: 26.6%

Chart: Earnings per share; fiscal year observations.

- FY2016: $7.30

- FY2017: $5.95

- FY2018: $10.66

- FY2019: $10.07

- FY2020: $10.93

- FY2021: $21.16

- FY2022: $19.15

- FY2023: $18.96

- FY2024: $22.00

- FY2025: $28.33

### accounting: pass

- Sloan accruals: -9.6%

- Receivables to sales index (DSRI): 0.94×

- Restructuring years, last five: 0

- Stock compensation / operating cash flow: 3.2%

- Earnings backed by cash: Yes

- Operating cash / earnings: 1.86×

- Accounting red flags: 0

Chart: Sloan accruals; fiscal year observations.

- FY2016: -8.2%

- FY2017: -8.8%

- FY2018: -7.6%

- FY2019: -9.1%

- FY2020: -11.5%

- FY2021: -3.9%

- FY2022: -5.5%

- FY2023: -7.5%

- FY2024: -8.0%

- FY2025: -9.6%

## Holders

- [Glenn Greenberg](https://gigainvestors.com/CCM): tracked 13F investor; follow the investor page for holding quarter and amounts.

- [Matthew McLennan](https://gigainvestors.com/FE): tracked 13F investor; follow the investor page for holding quarter and amounts.

- [Bill Nygren](https://gigainvestors.com/HA): tracked 13F investor; follow the investor page for holding quarter and amounts.

- [Thomas Gayner](https://gigainvestors.com/MKL): tracked 13F investor; follow the investor page for holding quarter and amounts.

- [Richard Pzena](https://gigainvestors.com/PIM): tracked 13F investor; follow the investor page for holding quarter and amounts.

## Price story

Price needs cash profits to grow 4.3% a year for ten years · sales +3.2%

Story as of 2026-10-16T09:58:51.903Z; price observation 2026-10-15.

Price needs cash profits to grow 4.3% a year for ten years

- 2025-05-12: HCA Q1 Earnings Call: Revenue Beats Expectations Amid Volume Growth and Margin Pressure ([finance.yahoo.com](https://finance.yahoo.com/news/hca-q1-earnings-call-revenue-124947849.html))

- 2025-07-25: HCA raises annual profit forecast on resilient demand for medical care ([investing.com](https://www.investing.com/news/stock-market-news/hca-raises-annual-profit-forecast-on-resilient-demand-for-medical-care-4153178))

- 2025-10-24: HCA Healthcare shares jump on strong Q3 results, raised guidance ([finance.yahoo.com](https://finance.yahoo.com/news/hca-healthcare-shares-jump-strong-121935946.html))

- 2025-11-03: How Strong Q3 Earnings and Raised Guidance Could Shape HCA Healthcare’s (HCA) Long-Term Outlook ([finance.yahoo.com](https://finance.yahoo.com/news/strong-q3-earnings-raised-guidance-011040518.html))

- 2026-01-27: HCA Healthcare forecasts 2026 profit above estimates on medical care demand ([finance.yahoo.com](https://finance.yahoo.com/news/hca-healthcare-forecasts-2026-profit-120745297.html))

- 2026-04-27: ACA subsidy lapse cost HCA Healthcare $150M in Q1 ([finance.yahoo.com](https://finance.yahoo.com/sectors/healthcare/articles/aca-subsidy-lapse-cost-hca-100045247.html))

### Sales · FY2025–2026

sales +3.2%; source https://www.sec.gov/Archives/edgar/data/860730/000119312526044769/hca-20251231.htm; observed 2026-02-10.

- FY2017: $44B 

- FY2018: $47B 

- FY2019: $51B 

- FY2020: $52B 

- FY2021: $59B 

- FY2022: $60B 

- FY2023: $65B 

- FY2024: $71B 

- FY2025: $76B 

- FY2026: $78B 

### Gross margin · FY2025

gross margin 41.5%; source https://www.sec.gov/Archives/edgar/data/860730/000119312526044769/hca-20251231.htm; observed 2026-02-10.

- FY2016: 83.3% 

- FY2017: 83.2% 

- FY2018: 83.5% 

- FY2019: 83.5% 

- FY2020: 83.8% 

- FY2021: 38.3% 

- FY2022: 38.5% 

- FY2023: 39.4% 

- FY2024: 40.6% 

- FY2025: 41.5% 

## Owner memo

Memo as of 2026-10-16T08:06:05.509Z.

### How it makes money

Operates in medical care facilities; annual sales are USD 75.6 billion.

- Source: https://www.sec.gov/Archives/edgar/data/860730/000119312526044769/hca-20251231.htm (filed 2026-02-10); FY2025: revenue 75600000000; grossProfit 31374000000; margin = grossProfit / revenue.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-10-16); HCA.US: HCA Healthcare, Inc., through its subsidiaries, provides health care services in the United States. The company owns, manages, and operates hospitals, ASCs, freestanding emergency care facilities, urgent care facilities, walk-in clinics, diagnostic and imaging centers, radiation and oncology therapy centers, as well as rehabilitation and physical therapy centers, physician practices, home health agencies, hospices, outpatient physical therapy providers, home and community-based services providers, and various other facilities. Its general and acute care hospitals offer medical and surgical services, including inpatient care, intensive care, cardiac care, diagnostic services, and emergency services; and outpatient services, such as outpatient surgery, laboratory, radiology, respiratory therapy, cardiology, and physical therapy. The company was formerly known as HCA Holdings, Inc. HCA Healthcare, Inc. was founded in 1968 and is headquartered in Nashville, Tennessee.

### Why customers stay

Margins ranged from 39.4% to 41.5% during 2023–25; it earns 26.2% on its capital.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); FY2023: grossProfit / revenue = 39.4%.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); FY2024: grossProfit / revenue = 40.6%.

- Source: https://www.sec.gov/Archives/edgar/data/860730/000119312526044769/hca-20251231.htm (filed 2026-02-10); FY2025: grossProfit / revenue = 41.5%.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); 10-year return on capital observations [[2016,0.2586476053782171],[2017,0.2129862050311063],[2018,0.2765585230776937],[2019,0.23572710836100183],[2020,0.24833266531129128],[2021,0.301499384090426],[2022,0.26479916836862966],[2023,0.2575616935161667],[2024,0.26619289508227706],[2025,0.30203359673255387]]; median 0.2617233868734234. ROIC follows the displayed moat series; financial companies use return on tangible equity.

### Can it raise prices

Kept about a 38% gross margin through 2022 cost inflation.

- Source: https://www.sec.gov/Archives/edgar/data/860730/000119312526044769/hca-20251231.htm (filed 2026-02-10); Gross margin observations: [[2021,0.38282952069716775],[2022,0.384789069114937],[2023,0.3937169067848787]]; range within 2 percentage points.

### Where the cash goes

Spends 20.9% of cash earnings on expansion; earns 38.2% on new investment.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); FY2016: growth capex 710001055.3998213; upkeep 2049998944.6001787; owner earnings 2806001055.3998213. Growth capex / owner earnings = 0.25302950404580465.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); FY2017: growth capex 836889971.7395258; upkeep 2178110028.260474; owner earnings 2168889971.739526. Growth capex / owner earnings = 0.3858609623559238.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); FY2018: growth capex 1222090724.4747458; upkeep 2350909275.5252542; owner earnings 3714090724.4747458. Growth capex / owner earnings = 0.32904169960672575.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); FY2019: growth capex 1562000000; upkeep 2596000000; owner earnings 3505000000. Growth capex / owner earnings = 0.4456490727532097.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); FY2020: growth capex 86496768.2588706; upkeep 2748503231.7411294; owner earnings 3730465208.124869. Growth capex / owner earnings = 0.023186590259703425.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); FY2021: growth capex 724000000; upkeep 2853000000; owner earnings 6956000000. Growth capex / owner earnings = 0.10408280621046578.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); FY2022: growth capex 679881125.6605396; upkeep 3715118874.3394604; owner earnings 4896881125.66054. Growth capex / owner earnings = 0.1388396222440116.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); FY2023: growth capex 1667000000; upkeep 3077000000; owner earnings 5242000000. Growth capex / owner earnings = 0.31800839374284623.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); FY2024: growth capex 1563000000; upkeep 3312000000; owner earnings 5760000000. Growth capex / owner earnings = 0.2713541666666667.

- Source: https://www.sec.gov/Archives/edgar/data/860730/000119312526044769/hca-20251231.htm (filed 2026-02-10); FY2025: growth capex 1421000000; upkeep 3523000000; owner earnings 6784000000. Growth capex / owner earnings = 0.2094634433962264.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); Incremental return on capital 0.38200709161963214, from the economics test's unchanged annual inputs.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); Dividend observations: [[2016,434000000],[2017,448000000],[2018,487000000],[2019,550000000],[2020,153000000],[2021,624000000],[2022,653000000],[2023,661000000],[2024,690000000],[2025,679000000]]. Zero only counted when supported by a complete cash-flow statement.

- Source: https://www.sec.gov/Archives/edgar/data/860730/000119312526044769/hca-20251231.htm (filed 2026-02-10); FY2025: cash repurchases 10067000000 USD.

### Are managers owners

Insiders own 16.6% of the company.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-10-16); HCA.US SharesStats.PercentInsiders = 16.611 percentage points; cache date 2026-10-16.

### What the price says

The price assumes cash profits grow 4.3% yearly over ten years; actual growth was 19%.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-10); Ten-year compound average after fade. Initial solved rate 0.048690983377736585. Price 468.5; FX 1; discount 0.1; same standard ten-year fade to terminal 0.03. FY2015 owner earnings/share 4.989208405492113 → FY2025 28.326269859496023. Closing-price date 2026-10-15.

## Monthly share-price history (USD per share)

- 2016-10: $76.53 per share

- 2016-11: $70.89 per share

- 2016-12: $74.02 per share

- 2017-01: $80.28 per share

- 2017-02: $87.24 per share

- 2017-03: $88.99 per share

- 2017-04: $84.21 per share

- 2017-05: $81.91 per share

- 2017-06: $87.20 per share

- 2017-07: $80.34 per share

- 2017-08: $78.66 per share

- 2017-09: $79.59 per share

- 2017-10: $75.65 per share

- 2017-11: $85.00 per share

- 2017-12: $87.84 per share

- 2018-01: $101.16 per share

- 2018-02: $99.25 per share

- 2018-03: $97.00 per share

- 2018-04: $95.74 per share

- 2018-05: $103.14 per share

- 2018-06: $102.60 per share

- 2018-07: $124.23 per share

- 2018-08: $134.11 per share

- 2018-09: $139.12 per share

- 2018-10: $133.53 per share

- 2018-11: $143.99 per share

- 2018-12: $124.45 per share

- 2019-01: $139.43 per share

- 2019-02: $139.04 per share

- 2019-03: $130.38 per share

- 2019-04: $127.23 per share

- 2019-05: $120.96 per share

- 2019-06: $135.17 per share

- 2019-07: $133.51 per share

- 2019-08: $120.20 per share

- 2019-09: $120.42 per share

- 2019-10: $133.54 per share

- 2019-11: $138.66 per share

- 2019-12: $147.81 per share

- 2020-01: $138.80 per share

- 2020-02: $127.01 per share

- 2020-03: $89.85 per share

- 2020-04: $109.88 per share

- 2020-05: $106.90 per share

- 2020-06: $97.06 per share

- 2020-07: $126.64 per share

- 2020-08: $135.72 per share

- 2020-09: $124.68 per share

- 2020-10: $123.94 per share

- 2020-11: $150.11 per share

- 2020-12: $164.46 per share

- 2021-01: $162.48 per share

- 2021-02: $172.03 per share

- 2021-03: $188.34 per share

- 2021-04: $201.06 per share

- 2021-05: $214.79 per share

- 2021-06: $206.74 per share

- 2021-07: $248.20 per share

- 2021-08: $252.98 per share

- 2021-09: $242.72 per share

- 2021-10: $250.46 per share

- 2021-11: $225.59 per share

- 2021-12: $256.92 per share

- 2022-01: $240.05 per share

- 2022-02: $250.31 per share

- 2022-03: $250.62 per share

- 2022-04: $214.55 per share

- 2022-05: $210.40 per share

- 2022-06: $168.06 per share

- 2022-07: $212.42 per share

- 2022-08: $197.87 per share

- 2022-09: $183.79 per share

- 2022-10: $217.47 per share

- 2022-11: $240.22 per share

- 2022-12: $239.96 per share

- 2023-01: $255.07 per share

- 2023-02: $243.45 per share

- 2023-03: $263.68 per share

- 2023-04: $287.33 per share

- 2023-05: $264.19 per share

- 2023-06: $303.48 per share

- 2023-07: $272.81 per share

- 2023-08: $277.30 per share

- 2023-09: $245.98 per share

- 2023-10: $226.14 per share

- 2023-11: $250.48 per share

- 2023-12: $270.68 per share

- 2024-01: $304.90 per share

- 2024-02: $311.70 per share

- 2024-03: $333.53 per share

- 2024-04: $309.82 per share

- 2024-05: $339.75 per share

- 2024-06: $321.28 per share

- 2024-07: $363.05 per share

- 2024-08: $395.59 per share

- 2024-09: $406.43 per share

- 2024-10: $358.74 per share

- 2024-11: $327.22 per share

- 2024-12: $300.15 per share

- 2025-01: $329.91 per share

- 2025-02: $306.30 per share

- 2025-03: $345.55 per share

- 2025-04: $345.08 per share

- 2025-05: $381.39 per share

- 2025-06: $383.10 per share

- 2025-07: $353.99 per share

- 2025-08: $403.96 per share

- 2025-09: $426.20 per share

- 2025-10: $459.68 per share

- 2025-11: $508.29 per share

- 2025-12: $466.86 per share

- 2026-01: $488.27 per share

- 2026-02: $529.70 per share

- 2026-03: $473.24 per share

- 2026-04: $434.45 per share

- 2026-05: $378.54 per share

- 2026-06: $389.89 per share

- 2026-07: $402.59 per share

- 2026-08: $414.45 per share

- 2026-09: $426.74 per share

- 2026-10: $460.75 per share

## Annual estimated value (USD per share)

- FY2016: low $61.70 per share, central $74.69 per share, high $87.03 per share

- FY2017: low $70.29 per share, central $86.78 per share, high $101.21 per share

- FY2018: low $84.70 per share, central $106.45 per share, high $124.28 per share

- FY2019: low $124.30 per share, central $162.35 per share, high $189.90 per share

- FY2020: low $130.74 per share, central $171.81 per share, high $200.74 per share

- FY2021: low $176.63 per share, central $252.00 per share, high $295.89 per share

- FY2022: low $218.42 per share, central $308.09 per share, high $361.69 per share

- FY2023: low $256.68 per share, central $364.99 per share, high $428.66 per share

- FY2024: low $295.19 per share, central $413.77 per share, high $485.32 per share

- FY2025: low $336.64 per share, central $461.85 per share, high $541.51 per share

Historical values use today's bond yield for every fiscal year

Historical values use today's FX rate into trading currency for every fiscal year

Historical values use current restated fundamentals and current commodity classification; they are not point-in-time estimates

Prior published observations retained from 2026-10-15T06:34:41.100Z where newer inputs omit a numeric field or fiscal period.

## Sources

[Original 10-K filing](https://www.sec.gov/Archives/edgar/data/860730/000119312526044769/hca-20251231.htm); period 2025-12-31, filed 2026-02-10.

Estimates depend on assumptions and are not guarantees or investment advice. Underlying data remains subject to its source licenses; public reading does not grant bulk redistribution rights.