At a glance
HCA Holdings Inc is worth $97.71B, about 17 times its fiscal 2025 earnings. Revenue grew 7.1% to $75.60B in fiscal 2025, with 9.0% kept as profit; over 5 years it has grown 8.0% a year. It pays a 0.65% dividend yield, raised every year for at least 5 years, and returned $38.44B to shareholders in dividends and buybacks over FY2021–FY2025. The stock returned +2.4% over the past year with dividends reinvested and +14.4% a year over five years, against +11.5% and +11.7% for the S&P 500. At its worst it fell 54.5% in the 2020 crash (S&P 500: 33.7%) and 39.5% in the 2022 bear market (S&P 500: 24.5%), and was back at its earlier high 8 months and 9 months after the lows.
The business in plain English
HCA Healthcare runs hospitals and outpatient centers, mostly in the United States. As of December 31, 2025, it operated 190 hospitals. Of these, 179 were general acute care hospitals, meaning full-service hospitals with emergency rooms, surgery and intensive care. Seven were behavioral (mental health) hospitals and four were rehabilitation hospitals. It also ran 121 freestanding ambulatory surgery centers, where patients have same-day operations, and 31 endoscopy centers. Its facilities are in 19 states and England, and many are in Florida and Texas. The company is based in Nashville, Tennessee.
HCA earns money by treating patients. That covers hospital stays, surgery, emergency visits, imaging, cancer care, mental health treatment and rehabilitation. Private health insurers, government health programs and patients themselves pay the bills. A central support team handles supply contracts, equipment purchasing, IT, accounting and compliance, which lets HCA spread costs across a large network. Revenue was $75.6 billion in fiscal 2025, and net income was $6.8 billion.
HCA reports results in three operating groups. In fiscal 2025, the American Group brought in $26.4 billion (35% of revenue). The Atlantic Group brought in $24.7 billion (32.7%) and the National Group $21.3 billion (28.1%). Most of its surgery centers are run as partnerships, and an HCA company usually holds the majority stake.
Price history
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HCA +2.4% over the year to Nov 2, 2026, total return with dividends reinvested.
How it makes money
By business segment
| American Group | $26.45B | 35% |
| Atlantic Group | $24.71B | 32.7% |
| National Group | $21.28B | 28.1% |
Latest results
- In Q3 FY2026 (ended Sep 30, 2026), revenue was $19.85B, up 3.6% from a year earlier, and net income was $1.58B (-3.9%).
- For fiscal 2025, revenue was $75.60B (+7.1% year over year; +8.0% a year from FY2020 to FY2025) with a 9% net margin.
Financial health check
| Revenue growth a year (FY2020–FY2025) | +8.0% good |
|---|---|
| Free cash flow margin | 10.2% good |
| Return on assets (FY2025) | 11.2% good |
| Net cash (cash minus debt) | $-43.40B weak |
| Fiscal year | Revenue | Net income | Free cash flow |
|---|---|---|---|
| FY2020 | $51.53B | $3.75B | $6.40B |
| FY2021 | $58.75B | $6.96B | $5.38B |
| FY2022 | $60.23B | $5.64B | $4.13B |
| FY2023 | $64.97B | $5.24B | $4.69B |
| FY2024 | $70.60B | $5.76B | $5.64B |
| FY2025 | $75.60B | $6.78B | $7.69B |
Valuation snapshot
| Market value | $97.71B |
|---|---|
| P/E ratio | 16.5 |
| Dividend yield | 0.65% |
Rank among 1514 US companies
Market value at each year end
HCA Holdings’s market value went from $27.73B at the end of 2016 to $97.71B on Nov 2, 2026, about 3.5 times as much; since the end of 2025 it is down 8%.
Show as a table
| Year end | Market value | Change |
|---|---|---|
| Nov 2, 2026 | $97.71B | -8.3% |
| 2025 | $106.53B | +40.1% |
| 2024 | $76.03B | +4.9% |
| 2023 | $72.45B | +6.8% |
| 2022 | $67.84B | -15.1% |
| 2021 | $79.91B | +43.6% |
| 2020 | $55.65B | +11.0% |
| 2019 | $50.13B | +17.1% |
| 2018 | $42.83B | +37.7% |
| 2017 | $31.10B | +12.1% |
| 2016 | $27.73B |
Price behavior
| YTD | 1 yr | 3 yr | 5 yr | 10 yr | |
|---|---|---|---|---|---|
| HCA price data to Nov 2, 2026 | +0.7% | +2.4% | +28.0% | +14.4% | +21.0% |
Show as a table
| Year | Price data |
|---|---|
| 2026 (to date) | +0.7% |
| 2025 | +56.7% |
| 2024 | +11.8% |
| 2023 | +13.8% |
| 2022 | -5.7% |
| 2021 | +57.6% |
| 2020 | +12.1% |
| 2019 | +20.3% |
| 2018 | +43.4% |
| 2017 | +18.7% |
| 2016 | +9.4% |
| 2015 | -7.8% |
| 2014 | +53.8% |
| 2013 | +58.1% |
| 2012 | +71.3% |
| 2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009 | Before this security existed |
|---|---|
| 2020 COVID crash stocks fell Feb 19, 2020 – Mar 23, 2020 | Lost 47.3% over that stretch · deepest drop along the way 54.5%, back to its old high 7.8 months after the low |
| 2022 bear market stocks fell Jan 3, 2022 – Oct 12, 2022 | Lost 20.5% over that stretch · deepest drop along the way 39.5%, back to its old high 9.2 months after the low |
Insider activity
Form 4 filings from 2025-11-03 to 2026-11-03 (25 read): 0 open-market purchases and 4 sales ($7.1M).
| Date | Insider | Type | Value |
|---|---|---|---|
| Feb 11, 2026 | Jennifer Berres SVP & Chief Human Res. Officer | sell | $2.1M |
| Feb 11, 2026 | Christopher F. Wyatt SVP & Controller | sell | $2.0M |
| Feb 11, 2026 | Jennifer Berres SVP & Chief Human Res. Officer | sell | $2.0M |
| Feb 18, 2026 | Michael R McAlevey EVP & Chief Legal & Admin Off. | sell | $904K |
Who owns it
Large shareholders (13G filings)
| Vanguard Capital Management | 5.25% | Mar 31, 2026 |
| BlackRock, Inc. | 4.9% | Mar 31, 2025 |
ETFs with the most weight in HCA
| IHF iShares U.S. Healthcare Providers ETF | 4.61% |
| BWTG Brendan Wood TopGun ETF | 4.49% |
| YALL God Bless America ETF | 4.3% |
| STNC Hennessy Stance ESG ETF | 4.15% |
| AMID Argent Mid Cap ETF | 3.7% |
| LSAT Leadershares Alphafactor Tactical Focused ETF | 3.42% |
| PKW Invesco BuyBack Achievers™ ETF | 3.31% |
| JPEF JPMorgan Equity Focus ETF | 2.55% |
What could go wrong
- Heavy reliance on Florida and Texas. Many HCA facilities are in Florida and Texas. Changes in state rules, local economies or competition there, or hurricanes and other severe weather, could hit a large part of the business at once.
- A large debt load. Total debt was $46.5 billion at December 31, 2025. Debt payments use cash that could fund growth, buybacks or dividends. Refinancing could cost more if rates rise or credit ratings fall.
- Shortages of nurses and doctors. HCA competes hard for nurses, other health care workers and physicians. Staff shortages, union activity and rising pay can push up labor costs and make hospitals harder to staff.
- Pressure from private insurers. Privately insured patients matter to revenue. Revenue could shrink if fewer patients have private insurance, if more patients are uninsured and cannot pay, or if insurers push lower rates and fewer hospital stays.
- Changes to government health programs. Government health programs pay part of HCA's revenue. Changes to those programs or to wider health policy could cut revenue. The company says it cannot predict what changes will come or when.
- Cyberattacks and a new records system. A cyberattack could disrupt hospitals, harm patients and bring lawsuits. HCA is also moving to a new electronic health record platform (its digital patient records), and a badly managed switch could hurt operations.
Recent events
- Other company announcement
- Quarterly results released; Investor presentation or announcement; Other company announcement
- New debt or financial obligation; Other company announcement
- Quarterly results released; Investor presentation or announcement; Other company announcement
- Quarterly results released; Investor presentation or announcement
- Executive or board change
- Major agreement signed; New debt or financial obligation; Other company announcement
- Shareholder vote results
- Other company announcement
- Quarterly results released; Investor presentation or announcement; Other company announcement
For income and retirement investors
HCA pays a dividend, but a small one: the yield was 0.65% as of October 30, 2026. Dividends per share rose in each fiscal year from 2021 through 2025, reaching $2.88. Dividends used about 10% of fiscal 2025 earnings and 8.8% of free cash flow, the cash left after running and investing in the business. Buybacks are the much bigger return: $35.1 billion over fiscal 2021–2025, against $3.3 billion in dividends. The share count fell 31.2% between January 2022 and October 2026. On its own, HCA would give an income investor little cash income.
The stock has dropped sharply in sell-offs. In the 2020 COVID crash it fell 54.5% in under a month, then recovered by November 2020. In the 2022 bear market it fell 39.5% and did not recover until April 2023. HCA's annual report (10-K) warns that there is no guarantee it will keep paying dividends. A single stock carries more risk than a diversified fund holding many companies.
Questions investors ask
How does HCA Healthcare make money?
HCA makes money by treating patients in its hospitals and outpatient centers. It bills private insurers, government health programs and patients. As of December 31, 2025, it operated 190 hospitals, 121 freestanding ambulatory surgery centers and 31 endoscopy centers in 19 states and England. Revenue was $75.6 billion in fiscal 2025. The American Group brought in 35% of that, the Atlantic Group 32.7% and the National Group 28.1%.
Does HCA raise its dividend every year?
Yes, in every fiscal year from 2021 through 2025, which makes five increases in a row. Dividends per share grew from $1.92 in fiscal 2021 to $2.88 in fiscal 2025. The yield is small, at 0.65% as of October 30, 2026. Dividends used about 10% of fiscal 2025 earnings. HCA's annual report (10-K) warns that there is no guarantee it will keep paying dividends.
Does HCA buy back its own shares?
Yes, on a large scale. HCA spent $35.1 billion on buybacks over fiscal 2021 through 2025, far more than the $3.3 billion it paid in dividends. Buybacks reached $10.1 billion in fiscal 2025 alone. The share count fell 31.2%, from about 303.6 million in January 2022 to about 208.9 million in October 2026. With fewer shares, each one claims a bigger slice of profit. But HCA also carried about $44.8 billion of debt as of September 30, 2026.
How much debt does HCA Healthcare have?
A lot. Total debt was about $44.8 billion as of September 30, 2026, against about $1.4 billion of cash and investments. Shareholders' equity was negative $8.1 billion on that date, meaning its recorded debts and other obligations were larger than its recorded assets. HCA's annual report (10-K) lists debt first among its risks. It warns that debt payments leave less cash for operations and investment, and that refinancing could cost more if interest rates are high or credit ratings fall.
How has HCA stock performed over the long term?
Over the 10 years to October 30, 2026, HCA's share price rose about 20.8% a year, or 563% in total. Over five years the gain was 14.5% a year, and over one year it was 2.1%. The ride has been bumpy. Calendar-year price returns ranged from a 56.71% gain in 2025 to a 7.85% loss in 2015. The stock also fell 54.5% in the 2020 COVID crash. Past returns do not predict future results.