New York, January 27, 2026, 13:29 EST — Regular session
HCA Healthcare shares surged Tuesday following an upgrade to its 2026 profit forecast and the announcement of a fresh $10 billion share buyback plan. The stock was last trading 7.4% higher at $507.50, hitting gains as steep as 11.7% earlier in the day.
This shift is crucial as hospital operators face a coverage reset year. Investors want to understand how volumes and unpaid bills might change if fewer patients have insurance, and if large systems can trim costs enough to preserve their margins.
HCA plans to counter the impact of expiring Affordable Care Act subsidies with roughly $400 million in cost cuts, Reuters reported. CFO Mike Marks noted the company expects a roughly 30% drop in utilization among patients losing coverage. He added, “We have planned elements to drive better capacity management,” including efforts to improve patient flow and reduce length of stay. The company is also banking on analytics, AI, and automation to hit its savings targets. 1
HCA reported a 6.7% jump in fourth-quarter revenue to $19.513 billion, with adjusted earnings hitting $8.01 per share. Same-facility equivalent admissions, combining inpatient and outpatient volume, rose 2.5%. Adjusted EBITDA climbed to $4.114 billion, reflecting stronger operating profit. CEO Sam Hazen described the 2025 finish as “strong.” Looking ahead, the company projects 2026 revenue between $76.5 billion and $80.0 billion, with earnings per share expected in the $29.10 to $31.50 range. 2
HCA disclosed in an SEC filing that its board has approved a new share buyback program, allowing repurchases of up to $10 billion. The company also declared a quarterly cash dividend of $0.78 per share, set for payment on March 31 to shareholders on record as of March 17. 3
Peers showed mixed moves. Tenet Healthcare climbed around 1.4%, but Universal Health Services dropped close to 0.7%, and Community Health Systems slid about 2.2% by midday.
Investors will push for clarity on when the cost-savings plan starts impacting results and if HCA can maintain admissions growth amid shrinking exchange coverage. The speed of buybacks will also be closely watched, particularly as rates remain elevated and debt markets grow less accommodating.
Earnings for the quarter appeared solid, yet volume trends showed inconsistencies across the system. Outpatient activity, especially, will draw attention as payers continue shifting care from hospitals to lower-cost venues.
The risk is clear: if the subsidy phase-out causes uninsured patient numbers to spike faster than HCA anticipates, uncompensated care—unpaid treatment—might increase, squeezing margins. Cost-cutting efforts could also fall short if wage inflation intensifies or throughput improvements hit a snag.
Next, investors will focus on management’s update regarding the coverage shift and the $400 million savings goal. The dividend timeline provides a short-term checkpoint, keyed to the March 17 record date and the payout scheduled for March 31.
