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Relative valuation derived from Healthcare sector median benchmarks. Model weights: EV/EBITDA (40%), P/B (35%), P/S (25%). Multiples adjusted for extreme outliers and non-recurring volatility.
Auditing capital efficiency...
Quality Profile Audit
Score: 50GRADE C+
Composite assessment of profitability, capital efficiency, and financial strength. Top-tier entities demonstrate sustainable cash flow generation.
Return on Equity
Profit generated per dollar of shareholder equity
-1256.0%
Sector: -43.5%
Dividend Analysis audit
GROWTH
0.66%
Trailing Yield
$0.66
Per $100 Invested
Modest dividend — capital prioritized for reinvestment.
Est. Payout Ratio
10%SAFE
Analyst Projections
Analyst Consensus
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Based on our 6-factor quantitative model, HCA Healthcare, Inc. (HCA) receives a "Hold" rating with a composite score of 50.5/100, ranked #709 out of 4446 stocks. Key factor scores: Quality 50/100, Value 46/100, Momentum 60/100. This is quantitative analysis only — not investment advice.
HCA Healthcare, Inc. (HCA) Stock Analysis — April 2026 Rating, Price, and Forecast
Company Overview — What Does HCA Healthcare, Inc. Do?
HCA Healthcare, Inc., through its subsidiaries, provides health care services company in the United States. The company operates general and acute care hospitals that offers medical and surgical services, including inpatient care, intensive care, cardiac care, diagnostic, and emergency services; and outpatient services, such as outpatient surgery, laboratory, radiology, respiratory therapy, cardiology, and physical therapy. It also operates outpatient health care facilities consisting of freestanding ambulatory surgery centers, freestanding emergency care facilities, urgent care facilities, walk-in clinics, diagnostic and imaging centers, rehabilitation and physical therapy centers, radiation and oncology therapy centers, physician practices, and various other facilities. In addition, the company operates psychiatric hospitals, which provide therapeutic programs comprising child, adolescent and adult psychiatric care, adolescent and adult alcohol, drug abuse treatment, and counseling services. As of December 31, 2021, it operated 182 hospitals, including 175 general and acute care hospitals, five psychiatric hospitals, and two rehabilitation hospitals; 125 freestanding surgery centers; and 21 freestanding endoscopy centers in 20 states and England. The company was formerly known as HCA Holdings, Inc. HCA Healthcare, Inc. was founded in 1968 and is headquartered in Nashville, Tennessee. HCA Healthcare, Inc. (HCA) is classified as a large-cap stock in the Healthcare sector. The company is led by CEO Samuel N. Hazen and employs approximately 294,000 people, headquartered in NASHVILLE, Tennessee. With a market capitalization of $106.1B, HCA is one of the prominent companies in the Healthcare sector.
HCA Healthcare, Inc. (HCA) Stock Rating — Hold (April 2026)
As of April 2026, HCA Healthcare, Inc. receives a Hold rating with a composite score of 50.5/100 and 3 out of 5 stars from the Blank Capital Research quantitative model.HCA ranks #709 out of 4,446 stocks in our coverage universe. Within the Healthcare sector, HCA Healthcare, Inc. ranks #45 of 838 stocks, placing it in the top 10% of its Healthcare peers. The rating is generated by a multi-factor model that weighs quality (30%), momentum (25%), value (15%), investment (10%), stability (10%), and short interest (10%).
HCA Stock Price and 52-Week Range
HCA Healthcare, Inc. (HCA) currently trades at $495.47. The stock lost $11.72 (2.3%) in the most recent trading session. The 52-week high for HCA is $556.52, which means the stock is currently trading -11.0% from its annual peak. The 52-week low is $314.43, putting the stock 57.6% above its annual trough. Recent trading volume was 734K shares, suggesting relatively thin trading activity.
Is HCA Overvalued or Undervalued? — Valuation Analysis
HCA Healthcare, Inc. (HCA) carries a value factor score of 46/100 in the Blank Capital model, indicating fair valuation relative to historical norms. The trailing price-to-earnings ratio is 15.90x, compared to the Healthcare sector average of 23.63x — a discount of 33%. The price-to-sales ratio is 1.53x, compared to 1.66x for the average Healthcare stock. On an enterprise value basis, HCA trades at 14.82x EV/EBITDA, versus 6.34x for the sector.
Overall, HCA's valuation appears roughly in line with sector benchmarks, suggesting the market is pricing the stock fairly given its current fundamentals and growth trajectory. Neither deep value nor significantly overpriced, the stock occupies a middle ground on valuation.
HCA Healthcare, Inc. Profitability — ROE, Margins, and Quality Score
HCA Healthcare, Inc. (HCA) earns a quality factor score of 50/100, indicating solid business quality with consistent operational execution. The return on equity (ROE) is -1256.0%, compared to the Healthcare sector average of -43.5%, which is below typical expectations for high-quality companies. Return on assets (ROA) comes in at 11.9% versus the sector average of -33.1%.
On a margin basis, HCA Healthcare, Inc. reports gross margins of 56.3%, compared to 71.5% for the sector. The operating margin is 13.0% (sector: -66.1%). Net profit margin stands at 9.6%, versus -58.7% for the average Healthcare stock. Revenue growth is running at 9.5% on a trailing basis, compared to 10.6% for the sector. The overall profitability profile is adequate, though there may be room for margin expansion.
HCA Debt, Balance Sheet, and Financial Health
HCA Healthcare, Inc. has a debt-to-equity ratio of -2062.0%, compared to the Healthcare sector average of 32.0%. The low leverage indicates a conservative balance sheet with significant financial flexibility. The current ratio is 0.85x, which may signal near-term liquidity tightness. Total debt on the balance sheet is $42.60B. Cash and equivalents stand at $997M.
HCA has a beta of 0.48, meaning it is less volatile than the S&P 500, making it a relatively defensive holding. The stability factor score for HCA Healthcare, Inc. is 89/100, indicating low-volatility characteristics and consistent price behavior that appeals to risk-averse investors.
HCA Healthcare, Inc. Revenue and Earnings History — Quarterly Trend
In TTM 2026, HCA Healthcare, Inc. reported revenue of $73.57B and earnings per share (EPS) of $7.05. Net income for the quarter was $7.10B. Gross margin was 56.3%. Operating income came in at $9.62B.
In Q3 2025, HCA Healthcare, Inc. reported revenue of $19.16B and earnings per share (EPS) of $7.05. Net income for the quarter was $1.90B. Revenue grew 9.6% year-over-year compared to Q3 2024. Operating income came in at $2.42B.
In Q2 2025, HCA Healthcare, Inc. reported revenue of $18.61B and earnings per share (EPS) of $6.91. Net income for the quarter was $1.89B. Gross margin was 56.3%. Revenue grew 6.4% year-over-year compared to Q2 2024. Operating income came in at $2.96B.
In Q1 2025, HCA Healthcare, Inc. reported revenue of $18.32B and earnings per share (EPS) of $6.52. Net income for the quarter was $1.82B. Revenue grew 5.7% year-over-year compared to Q1 2024. Operating income came in at $2.33B.
Over the past 8 quarters, HCA Healthcare, Inc. has demonstrated a growth trajectory, with revenue expanding from $17.34B to $73.57B. Investors analyzing HCA stock should weigh these quarterly trends alongside the valuation and quality metrics discussed above.
HCA Dividend Yield and Income Analysis
HCA Healthcare, Inc. (HCA) currently pays a dividend yield of 0.7%. At this yield, a $10,000 investment in HCA stock would generate approximately $$66.00 in annual dividend income. The net margin of 9.6% provides reasonable coverage for the dividend, though investors should monitor payout sustainability.
HCA Momentum and Technical Analysis Profile
HCA Healthcare, Inc. (HCA) has a momentum factor score of 60/100, reflecting neutral trend characteristics. The stock is neither significantly outperforming nor underperforming the broader market on a momentum basis. The investment factor score is 29/100, which measures capital allocation efficiency and asset growth patterns. The short interest score of 20/100 signals elevated short interest, which can indicate bearish sentiment among institutional investors.
HCA vs Competitors — Healthcare Sector Ranking and Peer Comparison
Comparing HCA against the S&P 500 benchmark is also instructive for understanding relative performance. Investors can view the full HCA vs S&P 500 (SPY) comparison to assess how HCA Healthcare, Inc. stacks up against the broader market across all factor dimensions.
HCA Next Earnings Date
HCA Healthcare, Inc. (HCA) is scheduled to report earnings on April 24, 2026 for Q1 2026. Analysts estimate EPS of $7.19. Revenue is estimated at $19.09B.Investors can track all upcoming reports on the earnings calendar.
Should You Buy HCA? — Investment Thesis Summary
HCA Healthcare, Inc. presents a balanced picture with arguments on both sides. Price momentum is positive at 60/100, suggesting the trend favors buyers. Low volatility (stability score 89/100) reduces downside risk.
In summary, HCA Healthcare, Inc. (HCA) earns a Hold rating with a composite score of 50.5/100 as of April 2026. The rating is derived from the Blank Capital Research methodology, which combines six factor dimensions into a single quantitative ranking. Investors should consider these quantitative signals alongside their own fundamental research, risk tolerance, and investment time horizon before making buy or sell decisions on HCA stock.
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Institutional Research Dossier
HCA Healthcare, Inc. (HCA) Deep Dive Analysis
Published on March 24, 2026
Action RatingHold
Sections
Executive Summary
We maintain a Hold rating on HCA Healthcare (HCA). While the company demonstrates strong operational efficiency and benefits from the relatively stable demand for healthcare services, its high valuation, significant debt burden, and regulatory risks temper our enthusiasm. The company's ability to generate consistent profits and cash flow is undeniable, but the current market price appears to already reflect much of this potential, leaving limited upside for investors.
HCA's scale and geographic diversification provide a degree of resilience, but the healthcare industry faces ongoing pressures from reimbursement rates, labor costs, and evolving regulatory landscapes. The company's aggressive acquisition strategy, while contributing to growth, also adds complexity and integration challenges. Therefore, we believe a Hold rating is warranted, reflecting a balanced view of HCA's strengths and weaknesses in the context of its current valuation.
Business Strategy & Overview
HCA Healthcare operates as one of the largest for-profit hospital operators in the United States, deriving revenue primarily from patient services across its network of hospitals, surgery centers, and other outpatient facilities. The company's core strategy revolves around providing a comprehensive range of medical and surgical services, including inpatient care, intensive care, cardiac care, diagnostic, and emergency services. A significant portion of HCA's revenue is generated from government-sponsored healthcare programs like Medicare and Medicaid, making it susceptible to changes in reimbursement policies.
HCA's strategic positioning emphasizes geographic diversification, operating facilities in 20 states and England. This diversification mitigates the impact of regional economic downturns and regulatory changes. The company also focuses on expanding its service offerings, particularly in high-growth areas such as outpatient surgery and specialized medical treatments. This expansion is often achieved through acquisitions of existing facilities and the development of new centers.
A key element of HCA's strategy is its focus on operational efficiency and cost management. The company leverages its scale to negotiate favorable contracts with suppliers and implement standardized processes across its facilities. This emphasis on efficiency helps to maintain profitability in a challenging reimbursement environment. Furthermore, HCA invests in technology and data analytics to improve patient care and streamline operations.
The healthcare industry is characterized by intense competition, with HCA competing against other for-profit hospital operators, non-profit hospital systems, and physician-owned practices. The company's ability to attract and retain patients depends on factors such as the quality of its services, the convenience of its locations, and its reputation. HCA's brand recognition and established presence in many markets provide a competitive advantage, but it must continuously adapt to evolving patient preferences and technological advancements.
Execution Benchmarks audit
Revenue Growth
YOY expansion rate
9.5%
Sector: 10.6%
-10% VS SCTR
Economic Moat Analysis
HCA Healthcare possesses a Narrow economic moat, primarily derived from its scale and geographic diversification, which create cost advantages and some degree of local market power. While not insurmountable, these factors provide a degree of protection against competitors.
The company's extensive network of hospitals and outpatient facilities allows it to achieve economies of scale in purchasing, administration, and technology investments. This scale advantage translates into lower operating costs compared to smaller, independent hospitals. HCA can negotiate more favorable contracts with suppliers of medical equipment, pharmaceuticals, and other essential resources. Furthermore, its centralized administrative functions reduce overhead expenses.
Geographic diversification also contributes to HCA's moat. By operating in multiple states, the company reduces its reliance on any single market or regulatory environment. This diversification provides a buffer against regional economic downturns and changes in state-level healthcare policies. In some local markets, HCA may hold a dominant market share, giving it pricing power and the ability to attract patients and physicians.
However, the healthcare industry is subject to significant regulatory oversight and reimbursement pressures, which limit HCA's ability to fully exploit its scale advantages. Government-sponsored healthcare programs like Medicare and Medicaid account for a substantial portion of HCA's revenue, and changes in reimbursement rates can significantly impact profitability. Furthermore, the rise of alternative healthcare delivery models, such as telehealth and urgent care centers, poses a competitive threat to traditional hospital systems.
While HCA's scale and geographic diversification provide a degree of competitive advantage, they are not sufficient to create a Wide moat. The company faces ongoing challenges from regulatory changes, reimbursement pressures, and evolving patient preferences. Therefore, we believe a Narrow moat is the most appropriate assessment of HCA's competitive position.
Financial Health & Profitability
HCA Healthcare's financial health presents a mixed picture. While the company generates substantial revenue and profits, its high debt levels and negative ROE raise concerns. The company's revenue has shown consistent growth, increasing from $60.23 billion in FY2022 to $70.60 billion in FY2024 and reaching $19.16 billion in Q3 FY2025. This growth reflects HCA's ability to expand its service offerings and acquire new facilities.
However, the company's profitability metrics are less impressive. While operating margins have remained relatively stable, ranging from 10.1% to 15.9% over the past several quarters, the company's net margin of 9.6% (TTM) is significantly higher than the sector average of -54.1%. This indicates strong operational efficiency compared to its peers. However, the reported ROE of -1,256.0% is extremely concerning and warrants further investigation into the underlying causes, potentially related to accounting practices or specific one-time events.
HCA's balance sheet is heavily leveraged, with total debt of $42.60 billion and a current ratio of 0.85, indicating potential liquidity challenges. The debt-to-equity ratio of -2,062.00 is also highly unusual and suggests a significant imbalance between debt and equity. This high level of debt increases the company's financial risk and limits its flexibility to pursue growth opportunities or weather economic downturns. The company's cash position of $997.00 million provides some cushion, but it is relatively small compared to its debt obligations.
The company's free cash flow generation has been strong in recent years, with $6.33 billion generated in FY2024. This cash flow provides the company with the resources to service its debt, invest in capital expenditures, and return capital to shareholders. However, the lack of free cash flow data for recent quarters makes it difficult to assess the company's current cash flow trends. Overall, HCA's financial health is characterized by strong revenue growth and profitability, but also by high debt levels and a concerning ROE figure. The company's ability to manage its debt and maintain its profitability will be critical to its long-term success.
Valuation Assessment
HCA Healthcare's valuation appears stretched based on several key metrics. The company's P/E ratio of 70.1x is significantly higher than the healthcare sector average of 24.3x, suggesting that investors are paying a premium for its earnings. This premium may be justified by HCA's strong market position and consistent profitability, but it also increases the risk of a valuation correction if the company's growth slows or its earnings disappoint.
Similarly, HCA's EV/EBITDA ratio of 15.8x is considerably higher than the sector average of 6.4x. This indicates that the company is expensive relative to its earnings before interest, taxes, depreciation, and amortization. The high EV/EBITDA ratio may reflect investors' expectations for future growth, but it also suggests that the company is fully valued or even overvalued.
The absence of readily available free cash flow data makes it difficult to assess the company's valuation based on FCF yield. However, given the company's high debt levels and capital expenditure requirements, it is unlikely that its FCF yield is particularly attractive. Overall, HCA's valuation appears to be at the higher end of its historical range and above the sector average. This suggests that the stock is not currently a bargain and that investors should exercise caution before investing.
While HCA's strong market position and consistent profitability may justify a premium valuation, the company's high debt levels and regulatory risks warrant a more conservative approach. The current valuation appears to already reflect much of the company's potential upside, leaving limited room for error. Therefore, we believe that the stock is fairly valued at its current price and that a Hold rating is appropriate.
Risk & Uncertainty
HCA Healthcare faces several significant risks that could negatively impact its financial performance and stock price. One of the most pressing risks is regulatory uncertainty. The healthcare industry is heavily regulated, and changes in government policies, such as reimbursement rates for Medicare and Medicaid, could significantly affect HCA's revenue and profitability. Furthermore, the ongoing debate over healthcare reform could lead to further regulatory changes that are unfavorable to for-profit hospital operators.
Another key risk is competition. The healthcare industry is highly competitive, with HCA competing against other for-profit hospital operators, non-profit hospital systems, and physician-owned practices. The company's ability to attract and retain patients depends on factors such as the quality of its services, the convenience of its locations, and its reputation. Increased competition could lead to lower prices and reduced market share.
HCA's high debt levels also pose a significant risk. The company has a substantial amount of debt outstanding, which increases its financial risk and limits its flexibility to pursue growth opportunities or weather economic downturns. Rising interest rates could further increase the company's debt service costs and reduce its profitability. Furthermore, a downgrade in the company's credit rating could make it more difficult and expensive to access capital markets.
Labor costs represent another significant risk. The healthcare industry is facing a shortage of nurses and other healthcare professionals, which is driving up labor costs. HCA must attract and retain qualified employees to maintain the quality of its services. Increased labor costs could reduce the company's profitability and competitiveness.
Bulls Say / Bears Say
The Bull Case
BULL VIEWHCA's scale and geographic diversification provide a significant competitive advantage, allowing it to achieve economies of scale and mitigate regional economic risks, leading to consistent profitability.
BULL VIEWThe aging population and increasing demand for healthcare services will drive continued revenue growth for HCA, as the company is well-positioned to capitalize on these demographic trends.
BULL VIEWHCA's focus on operational efficiency and cost management will enable it to maintain strong margins even in a challenging reimbursement environment, making it a resilient investment.
The Bear Case
BEAR VIEWHCA's high debt levels and stretched valuation make it vulnerable to a market correction or a slowdown in revenue growth, potentially leading to significant downside risk.
BEAR VIEWRegulatory uncertainty and potential changes in reimbursement rates for Medicare and Medicaid could significantly impact HCA's profitability, eroding its competitive advantage.
BEAR VIEWIncreased competition from alternative healthcare delivery models, such as telehealth and urgent care centers, could reduce HCA's market share and limit its growth potential.
About the Author
Marques Blank
Founder & Chief Investment Officer, Blank Capital
Marques brings 15 years of institutional finance and investing experience, having overseen financial planning for a $1.6B defense business unit. He developed the proprietary 6-factor quantitative model used to score HCA and 4,400+ other equities.
HCA Healthcare, Inc. exhibits a 1817% valuation discount relative to institutional benchmarks. This represents a constructive entry window based on current multiples.
Return on Assets
Efficiency of asset utilization
11.9%
Sector: -33.1%
Gross Margin
Pricing power and cost efficiency
56.3%
Sector: 71.5%
Operating Margin
Core business profitability
13.0%
Sector: -66.1%
Net Margin
Bottom-line profitability
9.6%
Sector: -58.7%
Factor Methodology
The Quality factor evaluates the persistence and magnitude of cash flows. Companies with scores >70 exhibit superior competitive moats and financial resilience through economic cycles.
Sector Avg Yield0.00%
Yield Delta—
Income Projection audit
A $10,000 investment would generate approximately $66 annually in dividends at the current trailing rate.
