New York, January 27, 2026, 21:18 ET — Market closed
- Shares of HCA climbed 7.1% to $505.84 following an upgraded 2026 outlook from the company
- The hospital operator greenlit a fresh $10 billion share buyback plan
- Investors are weighing the hit from policy-driven volume risk as ACA exchange subsidies expire
HCA Healthcare (HCA) jumped 7.1% to $505.84 on Tuesday following the hospital operator’s upbeat 2026 profit forecast, which topped Wall Street estimates, and the announcement of a new $10 billion share repurchase program. The stock outpaced the Health Care Select Sector SPDR ETF, which slipped 1.7%, and saw a trading range from $459.28 to $527.57.
This shift is significant as hospital operators face a year packed with policy changes, with pandemic-era support for Affordable Care Act coverage winding down and patient demographics expected to change. HCA is wagering that demand for care will remain steady, despite a drop in exchange coverage enrollment.
The stage is set for the next session. Traders will see if the guidance and capital-return plan can sustain the stock’s rally or if concerns over softer volumes and rising uncompensated care drag it down.
HCA reported a 6.7% jump in fourth-quarter revenue to $19.513 billion, while net income rose to $1.878 billion. Adjusted earnings hit $8.01 per share. The company projects 2026 earnings between $29.10 and $31.50 per share, with revenue forecasted at $76.5 billion to $80 billion. CEO Sam Hazen noted, “We finished 2025 with strong performance consistent with previous quarters.” 1
HCA is bracing for a drop in coverage as Affordable Care Act (ACA) subsidies—commonly known as Obamacare subsidies—phase out. CFO Mike Marks flagged a “decline of about 30% in utilization” among those who lose exchange coverage compared to when they were insured, and spelled out roughly $400 million in cost savings. The company is leaning heavily on advanced analytics, AI, automation, and shared service platforms. 2
Operating trends showed a mixed picture. Same-facility inpatient surgeries held steady during the quarter, but outpatient procedures slipped 0.5%.
HCA reported a 2.9% increase in revenue per “equivalent admission,” its combined measure of inpatient and outpatient activity. This figure is closely watched by investors since it reflects changes in both patient volume and pricing.
HCA forecasted adjusted EBITDA between $15.55 billion and $16.45 billion for 2026. This metric, which excludes interest, taxes, and certain non-core expenses, is widely used in healthcare as a stand-in for operating profit.
A regulatory filing revealed the board approved an extra $10 billion share buyback and announced a quarterly cash dividend of $0.78 per share. The dividend is set for payment on March 31 to shareholders recorded by March 17. 3
BofA Securities bumped up its price target on HCA to $540 from $485 but maintained a neutral rating. Analyst Joanna Gajuk noted that the current guidance factors in pressure from exchanges and softer state supplemental payment programs, balanced somewhat by the company’s cost-cutting efforts. 4
Healthcare stocks took a hit Tuesday following the Trump administration’s proposal for a 2027 Medicare Advantage payment increase that fell well short of expectations. Final payment rates are set to be announced in April. 5
The bigger threat for HCA lies closer to home. If more exchange members lose coverage than anticipated, hospitals could face a drop in elective procedures alongside a rise in uninsured care—potentially leading to increased bad debt.
Markets reopen Wednesday, and all eyes will be on whether HCA can keep its post-guidance gains. Traders will also be tracking how fast buybacks start hitting the tape. The next key date is March 17, the record date for the $0.78 dividend.
