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Can HCA Q4 Earnings Withstand Higher Costs & Lower Outpatient Cases?

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Key Takeaways

  • HCA is expected to post Q4 EPS of $7.37 on $19.68B in revenues, implying 18.5% and 7.6% year-over-year growth.
  • Consensus points to higher admissions, occupancy gains and rising revenue per admission versus last year.
  • Higher operating expenses, supply-cost inflation & fewer outpatient surgeries add pressure to Q4 results.

Hospital operator HCA Healthcare, Inc. (HCA - Free Report) is set to report fourth-quarter 2025 results on Jan. 27, 2026, before the opening bell. The Zacks Consensus Estimate for the to-be-reported quarter’s earnings is currently pegged at $7.37 per shareon revenues of $19.68 billion.

The fourth-quarter earnings estimate has remained stable over the past week. The bottom-line projection indicates year-over-year growth of 18.5%. Also, the Zacks Consensus Estimate for quarterly revenues implies a year-over-year increase of 7.6%.

Zacks Investment Research Image Source: Zacks Investment Research

For 2025, the Zacks Consensus Estimate for HCA Healthcare’s revenues is pegged at $75.77 billion, implying a rise of 7.3% year over year. The consensus mark for 2025 EPS is pegged at $27.60, implying an increase of 25.7%, year over year.

HCA Healthcare’s earnings beat estimates in each of the last four quarters, with the average surprise being 12.4%. This is depicted in the figure below.

HCA Healthcare, Inc. Price and EPS Surprise

HCA Healthcare, Inc. Price and EPS Surprise

HCA Healthcare, Inc. price-eps-surprise | HCA Healthcare, Inc. Quote

Q4 Earnings Whispers for HCA Healthcare

However, our proven model does not conclusively predict an earnings beat for the company this time around. The combination of a positive Earnings ESP and a Zacks Rank #1 (Strong Buy), 2 (Buy) or 3 (Hold) increases the odds of an earnings beat. That’s not the case here.

HCA has an Earnings ESP of 0.00% and a Zacks Rank #4 (Sell). You can uncover the best stocks to buy or sell before they’re reported with our Earnings ESP Filter.

What’s Shaping HCA Healthcare’s Q4 Results?

The Zacks Consensus Estimate for HCA Healthcare’s fourth-quarter equivalent admissions indicates 3.4% year-over-year growth, while our model estimate anticipates a 3.3% increase. The consensus mark for revenue per equivalent admission signals a 3.9% rise from a year ago, while we expect 3.6% growth.

The consensus estimate for occupancy is pegged at 73.1%, up from 71.7% a year ago. Also, the Zacks Consensus Estimate for average length of stay indicates a 2.6% decline from the year-ago period.

The Zacks Consensus Estimate for equivalent patient days indicates 0.8% year-over-year growth. While these factors are likely to have positioned HCA Healthcare for growth from the year-ago quarter, rising expenses and lower average length of stay make an earnings beat uncertain.

Our model estimate for fourth-quarter total operating expenses indicates a 7.1% increase from a year ago, due to higher salaries & benefits, supply costs and other operating expenses. We expect supply costs to jump more than 7% in the to-be-reported quarter. Moreover, both the consensus estimate and our model estimate for outpatient surgery cases imply a 0.9% fall from a year ago.

Stocks That Warrant a Look

While an earnings beat looks uncertain for HCA Healthcare, here are some companies from the broader Medical space that you may want to consider, as our model shows that these have the right combination of elements to post an earnings beat this time around:

Universal Health Services, Inc. (UHS - Free Report) has an Earnings ESP of +8.33% and a Zacks Rank #2. You can see the complete list of today’s Zacks #1 Rank stocks here.

The Zacks Consensus Estimate for Universal Health’s bottom line for the to-be-reported quarter of $5.91 indicates 20.1% year-over-year growth. It has witnessed one upward revision against no downward movement over the past week. The consensus mark for Universal Health’s revenues is pegged at $4.48 billion, a 9% increase from a year ago.

Merit Medical Systems, Inc. (MMSI - Free Report) has an Earnings ESP of +2.09% and a Zacks Rank of 2.

The Zacks Consensus Estimate for Merit Medical’s bottom line for the to-be-reported quarter is pegged at 96 cents, which indicates 3.2% year-over-year growth. The company’s earnings beat estimates in each of the trailing four quarters, with an average surprise of 14.1%. The consensus estimate for MMSI’s revenues signals 9.4% growth.

Moderna, Inc. (MRNA - Free Report) has an Earnings ESP of +10.96% and a Zacks Rank of 3.

The Zacks Consensus Estimate for Moderna’s bottom line for the to-be-reported quarter remained stable over the past week. Its earnings beat estimates in each of the past four quarters, with an average surprise of 31.5%. Moderna’s revenues for the to be reported quarter are pegged at $662.39 million.

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