HCA Healthcare, Inc.

Previous wording

This quarterly report on Form 10-Q includes certain disclosures that contain “forward-looking statements” within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements include statements regarding expected capital expenditures, expected dividends, expected share repurchases, expected net claim payments, expected inflationary pressures, expected labor costs and all other statements that do not relate solely to historical or current facts, and can be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “plan,” “initiative” or “continue.” These forward-looking statements are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and expectations and our future financial position and results of operations. These factors include, but are not limited to, (1) changes in or related to general economic or business conditions nationally and regionally in our markets, including inflation, and the impact of trade policies, including changes in, or the imposition of, tariffs and/or trade barriers; changes in revenues resulting from declining patient volumes; changes in payer mix (including increases in uninsured and underinsured patients); potential increased expenses related to labor, pharmaceuticals, supply chain or other expenditures; workforce disruptions; supply and pharmaceutical shortages and disruptions (including as a result of tariffs or geopolitical disruptions); and the impact of potential federal government shutdowns, holds on or cancellations of congressionally authorized spending and interruptions in the distribution of governmental funds, (2) the impact of current and future health care public policy developments and the implementation of new, and possible changes to existing, federal, state or local laws and regulations affecting the health care industry, including the expiration of enhanced premium tax credits (“EPTCs”) for individuals eligible to purchase insurance coverage through federal and state-based health insurance marketplaces, changes in the structure and administration of, and funding for, federal and state agencies and programs, and effects of the One Big Beautiful Bill Act (the “OBBBA”), (3) the impact of our significant indebtedness and the ability to refinance such indebtedness on acceptable terms, (4) the effects related to the implementation of sequestration spending reductions required under the Budget Control Act of 2011, related legislation extending these reductions, and those that may be required under the Pay-As-You-Go Act of 2010 as a result of the federal budget deficit impact of the OBBBA, and the potential for future deficit reduction legislation that may alter these spending reductions, which include cuts to Medicare payments, or create additional spending red…

Excerpt shortened here; the source contains the full paragraph.

Current wording

This quarterly report on Form 10-Q includes certain disclosures that contain “forward-looking statements” within the meaning of the federal securities laws, which involve risks and uncertainties. Forward-looking statements include statements regarding expected capital expenditures, expected dividends, expected share repurchases, expected net claim payments, expected inflationary pressures, expected labor costs and all other statements that do not relate solely to historical or current facts, and can be identified by the use of words like “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “plan,” “initiative” or “continue.” These forward-looking statements are based on our current plans and expectations and are subject to a number of known and unknown uncertainties and risks, many of which are beyond our control, which could significantly affect current plans and expectations and our future financial position and results of operations. These factors include, but are not limited to, (1) changes in or related to general economic or business conditions nationally and regionally in our markets, including inflation, and the impact of trade policies, including changes in, or the imposition of, tariffs and/or trade barriers; changes in revenues resulting from declining patient volumes; changes in payer mix (including increases in uninsured and underinsured patients); potential increased expenses related to labor, pharmaceuticals, supply chain or other expenditures; workforce disruptions; supply and pharmaceutical shortages and disruptions (including as a result of tariffs or geopolitical disruptions); and the impact of federal government shutdowns, holds on or cancellations of congressionally authorized spending and interruptions in the distribution of governmental funds, (2) the impact of current and future health care public policy developments and the implementation of new, and possible changes to existing, federal, state or local laws and regulations affecting the health care industry, including the expiration of enhanced premium tax credits (“EPTCs”) currently scheduled to take effect after December 31, 2025, for individuals eligible to purchase insurance coverage through federal and state-based health insurance marketplaces, changes in the structure and administration of, and funding for, federal and state agencies and programs, and effects of the One Big Beautiful Bill Act (the “OBBBA”), (3) the impact of our significant indebtedness and the ability to refinance such indebtedness on acceptable terms, (4) the effects related to the implementation of sequestration spending reductions required under the Budget Control Act of 2011, related legislation extending these reductions, and those that may be required under the Pay-As-You-Go Act of 2010 as a result of the federal budget deficit impact of the OBBBA, and the potential for future deficit reduction legislation that may alter these spending reductions, which include cuts to Me…

Excerpt shortened here; the source contains the full paragraph.

Previous wording

Revenues increased 6.4% on a consolidated basis and 5.8% on a same facility basis for the quarter ended June 30, 2025, compared to the quarter ended June 30, 2024. The increase in consolidated revenues can be primarily attributed to the combined impact of a 3.9% increase in revenue per equivalent admission and a 2.3% increase in equivalent admissions. The same facility revenues increase primarily resulted from the combined impact of a 4.0% increase in same facility revenue per equivalent admission and a 1.7% increase in same facility equivalent admissions.

Current wording

Revenues increased 9.6% on a consolidated basis and 9.2% on a same facility basis for the quarter ended September 30, 2025, compared to the quarter ended September 30, 2024. The increase in consolidated revenues can be primarily attributed to the combined impact of a 6.1% increase in revenue per equivalent admission and a 3.2% increase in equivalent admissions. The same facility revenues increase primarily resulted from the combined impact of a 6.6% increase in same facility revenue per equivalent admission and a 2.4% increase in same facility equivalent admissions.

Previous wording

During the quarter ended June 30, 2025, consolidated admissions increased 2.1% and same facility admissions increased 1.8% compared to the quarter ended June 30, 2024. Inpatient surgical volumes increased 0.2% on a consolidated basis and declined 0.3% on a same facility basis during the quarter ended June 30, 2025, compared to the quarter ended June 30, 2024. Outpatient surgical volumes declined 0.2% on a consolidated basis and 0.6% on a same facility basis during the quarter ended June 30, 2025, compared to the quarter ended June 30, 2024. Emergency department visits increased 1.0% on a consolidated basis and 1.3% on a same facility basis during the quarter ended June 30, 2025, compared to the quarter ended June 30, 2024. Consolidated and same facility uninsured admissions increased 1.1% and 0.4%, respectively, for the quarter ended June 30, 2025, compared to the quarter ended June 30, 2024.

Current wording

During the quarter ended September 30, 2025, consolidated admissions increased 2.8% and same facility admissions increased 2.1% compared to the quarter ended September 30, 2024. Inpatient surgical volumes increased 2.0% on a consolidated basis and 1.4% on a same facility basis during the quarter ended September 30, 2025, compared to the quarter ended September 30, 2024. Outpatient surgical volumes increased 1.6% on a consolidated basis and 1.1% on a same facility basis during the quarter ended September 30, 2025, compared to the quarter ended September 30, 2024. Emergency department visits increased 1.2% on a consolidated basis and 1.3% on a same facility basis during the quarter ended September 30, 2025, compared to the quarter ended September 30, 2024. Consolidated and same facility uninsured admissions declined 1.3% and 2.0%, respectively, for the quarter ended September 30, 2025, compared to the quarter ended September 30, 2024.

Previous wording

Cash flows from operating activities increased $2.239 billion, from $1.971 billion for the second quarter of 2024 to $4.210 billion for the second quarter of 2025. The increase in cash provided by operating activities was primarily related to a $216 million increase in net income, excluding the non-cash impact of losses and gains on sales of facilities, favorable working capital changes of $1.186 billion, including increased collections on accounts receivable, as well as a decline in income taxes paid of $862 million related to an IRS deferral of quarterly estimated income tax payments for Tennessee-based taxpayers until the fourth quarter of 2025.

Current wording

Cash flows from operating activities increased $901 million, from $3.515 billion for the third quarter of 2024 to $4.416 billion for the third quarter of 2025. The increase in cash provided by operating activities was primarily related to a $418 million increase in net income, excluding the non-cash impact of losses on sales of facilities, and a decline in income taxes paid of $406 million related to an Internal Revenue Service (“IRS”) deferral of quarterly estimated income tax payments for Tennessee-based taxpayers until the fourth quarter of 2025.

Previous wording

We are monitoring and engaged in advocacy efforts around these and other health care policy changes and reform initiatives. In addition, we are working to develop and implement resiliency plans designed to enhance efficiency and reduce costs in response to the potential impact of these developments, as well as the scheduled expiration of EPTCs for individuals eligible to purchase coverage through federal and state health insurance marketplaces and potential impacts of changes to U.S. trade policy and tariff levels. However, our ability to develop and implement such plans and to offset to the extent possible impacts from these matters is subject to known and unknown risks and uncertainties. See Item 1A, “Risk Factors” from our Annual Report on Form 10-K for the year ended December 31, 2024 for additional information.

Current wording

We are working to develop and implement resiliency plans designed to enhance efficiency and reduce costs in response to the potential impact of these developments. However, our ability to develop and implement such plans and to offset to the extent possible impacts from these matters is subject to known and unknown risks and uncertainties. See Item 1A, “Risk Factors” from our Annual Report on Form 10-K for the year ended December 31, 2024 for additional information.

Previous wording

Revenues increased 6.4% from $17.492 billion in the second quarter of 2024 to $18.605 billion in the second quarter of 2025. Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual adjustments under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured and other discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay revenues at the estimated amounts we expect to collect. Patients treated at our hospitals for non-elective care, who have income at or below 400% of the federal poverty level, are eligible for charity care. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. Our revenues by primary third-party payer classification and other (including uninsured patients) for the quarters and six months ended June 30, 2025 and 2024 are summarized in the following table (dollars in millions):

Current wording

Revenues increased 9.6% from $17.487 billion in the third quarter of 2024 to $19.161 billion in the third quarter of 2025. Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual adjustments under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured and other discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay revenues at the estimated amounts we expect to collect. Patients treated at our hospitals for non-elective care, who have income at or below 400% of the federal poverty level, are eligible for charity care. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. Our revenues by primary third-party payer classification and other (including uninsured patients) for the quarters and nine months ended September 30, 2025 and 2024 are summarized in the following table (dollars in millions):

Previous wording

Consolidated and same facility revenue per equivalent admission increased 3.9% and 4.0%, respectively, in the second quarter of 2025, compared to the second quarter of 2024. Consolidated and same facility equivalent admissions increased 2.3% and 1.7%, respectively, in the second quarter of 2025, compared to the second quarter of 2024. Consolidated and same facility outpatient surgeries declined 0.2% and 0.6%, respectively, in the second quarter of 2025, compared to the second quarter of 2024. Consolidated and same facility inpatient surgeries increased 0.2% and declined 0.3%, respectively, in the second quarter of 2025, compared to the second quarter of 2024. Consolidated and same facility emergency department visits increased 1.0% and 1.3%, respectively, in the second quarter of 2025, compared to the second quarter of 2024.

Current wording

Consolidated and same facility revenue per equivalent admission increased 6.1% and 6.6%, respectively, in the third quarter of 2025, compared to the third quarter of 2024. Consolidated and same facility equivalent admissions increased 3.2% and 2.4%, respectively, in the third quarter of 2025, compared to the third quarter of 2024. Consolidated and same facility outpatient surgeries increased 1.6% and 1.1%, respectively, in the third quarter of 2025, compared to the third quarter of 2024. Consolidated and same facility inpatient surgeries increased 2.0% and 1.4%, respectively, in the third quarter of 2025, compared to the third quarter of 2024. Consolidated and same facility emergency department visits increased 1.2% and 1.3%, respectively, in the third quarter of 2025, compared to the third quarter of 2024.

Previous wording

To quantify the total impact of the trends related to uninsured patient accounts, we believe it is beneficial to view total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. A summary of the estimated cost of total uncompensated care for the quarters and six months ended June 30, 2025 and 2024 follows (dollars in millions):

Current wording

To quantify the total impact of the trends related to uninsured patient accounts, we believe it is beneficial to view total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. A summary of the estimated cost of total uncompensated care for the quarters and nine months ended September 30, 2025 and 2024 follows (dollars in millions):

Previous wording

Same facility uninsured admissions increased 0.4% in the second quarter of 2025 compared to the second quarter of 2024. Same facility uninsured admissions declined 0.7% in the first quarter of 2025 compared to the first quarter of 2024. Same facility uninsured admissions in 2024, compared to 2023, increased 0.1% in the fourth quarter, declined 1.8% in the third quarter, increased 3.5% in the second quarter and increased 2.4% in the first quarter.

Current wording

Same facility uninsured admissions in 2025, compared to 2024, decreased 2.0% in the third quarter, increased 0.4% in the second quarter and declined 0.7% in the first quarter. Same facility uninsured admissions in 2024, compared to 2023, increased 0.1% in the fourth quarter, declined 1.8% in the third quarter, increased 3.5% in the second quarter and increased 2.4% in the first quarter.

Previous wording

The approximate percentages of our admissions related to Medicare, managed Medicare, Medicaid, managed Medicaid, managed care and insurers and the uninsured for the quarters and six months ended June 30, 2025 and 2024 are set forth in the following table.

Current wording

The approximate percentages of our admissions related to Medicare, managed Medicare, Medicaid, managed Medicaid, managed care and insurers and the uninsured for the quarters and nine months ended September 30, 2025 and 2024 are set forth in the following table.

Previous wording

The approximate percentages of our inpatient revenues related to Medicare, managed Medicare, Medicaid, managed Medicaid, managed care and insurers for the quarters and six months ended June 30, 2025 and 2024 are set forth in the following table.

Current wording

The approximate percentages of our inpatient revenues related to Medicare, managed Medicare, Medicaid, managed Medicaid, managed care and insurers for the quarters and nine months ended September 30, 2025 and 2024 are set forth in the following table.

Previous wording

At June 30, 2025, we had 102 hospitals in the states of Texas and Florida. During the quarter ended June 30, 2025, 59% of our admissions and 52% of our revenues were generated by these hospitals. Uninsured admissions in Texas and Florida represented 73% of our uninsured admissions during the quarter ended June 30, 2025.

Current wording

At September 30, 2025, we had 102 hospitals in the states of Texas and Florida. During the quarter ended September 30, 2025, 59% of our admissions and 51% of our revenues were generated by these hospitals. Uninsured admissions in Texas and Florida represented 73% of our uninsured admissions during the quarter ended September 30, 2025.

Previous wording

We receive a significant portion of our revenues from government health programs, principally Medicare and Medicaid, which are highly regulated and subject to frequent and substantial changes. Some states make additional payments to providers through the Medicaid program that are separate from base payments. These payments may be in the form of payments, such as upper payment limit payments, that are intended to address the difference between Medicaid fee-for-service payments and Medicare reimbursement rates, or payments under other programs that vary by state under Section 1115 waivers. In addition, many states have implemented SDP arrangements to direct certain Medicaid managed care plan expenditures. These payments are generally authorized by CMS and subject to periodic extension or reapproval. Most states in which we receive payment have adopted statewide or local provider taxes to fund the non-federal share of Medicaid programs. These additional payments supplement Medicaid base rates that, when taken together, are insufficient to cover the cost of care provided to Medicaid beneficiaries combined with the state or local provider taxes levied.

Current wording

We receive a significant portion of our revenues from government health programs, principally Medicare and Medicaid, which are highly regulated and subject to frequent and substantial changes. Some states make additional payments to providers through the Medicaid program that are separate from base payments. These payments may be in the form of payments, such as upper payment limit payments, that are intended to address the difference between Medicaid fee-for-service payments and Medicare reimbursement rates, or payments under other programs that vary by state under Section 1115 waivers. In addition, many states have implemented SDP arrangements to direct certain Medicaid managed care plan expenditures. These payments are generally authorized by the Centers for Medicare & Medicaid Services (“CMS”) and subject to periodic extension or reapproval. Most states in which we receive payment have adopted statewide or local provider taxes to fund the non-federal share of Medicaid programs. These additional payments supplement Medicaid base rates that, when taken together, are insufficient to cover the cost of care provided to Medicaid beneficiaries combined with the state or local provider taxes levied.

Previous wording

We are aware these payment programs are currently being reviewed by certain government agencies, and some states requested modifications of their existing supplemental payment programs during the annual renewal process with CMS. It is possible these reviews and requests will result in the restructuring of such supplemental payment programs and could result in the payment programs being reduced or eliminated. Because deliberations about these programs are ongoing, we are unable to estimate the financial impact the program structure modifications, if any, may have on our results of operations.

Current wording

We are aware these payment programs are currently being reviewed by certain government agencies, and some states requested modifications of their existing supplemental payment programs during the annual renewal process with CMS. It is possible these reviews and requests will result in the restructuring of such supplemental payment programs and could result in the payment programs being reduced or eliminated. Further, the OBBBA makes significant changes to Medicaid financing mechanisms, including limitations on provider taxes and SDP arrangements. However, the OBBBA grandfathers certain SDP arrangements, including those for which an application form was submitted to CMS prior to July 4, 2025, for the rating period occurring within 180 days of July 4, 2025, and those that received approval or made a good faith effort to receive approval from CMS prior to May 1, 2025. Certain states in which we operate have submitted application forms to CMS for approval where the grandfathered payments we receive could be impacted, and in some instances, increased. Beginning with the rating period on or after January 1, 2028, grandfathered payments will be reduced by 10 percentage points annually until they reach the allowable payment limits. Some states have received approval of grandfathered applications, but we are unable to predict the timing or extent of any additional approvals by CMS and the resulting recognition of the related revenues. Because these payment programs and arrangements continue to evolve, we are unable to estimate the financial impact that program structure modifications, if any, may have on our results of operations.

Previous wording

The health care industry is subject to changing political, regulatory and other influences, including health care reform efforts at the federal and state levels and the OBBBA. For example, the EPTCs for individuals eligible to purchase insurance coverage through federal and state-based health insurance marketplaces are scheduled to expire at the end of 2025, and further extension is uncertain. We are monitoring and engaged in advocacy efforts around potential health care policy changes and reform. See the "Recent Developments" section of this Quarterly Report on Form 10-Q and Item 1A, “Risk Factors” from our Annual Report on Form 10-K for the year ended December 31, 2024 for additional information.

Current wording

The health care industry is subject to changing political, regulatory and other influences, including health care reform efforts at the federal and state levels and the OBBBA. For example, the EPTCs for individuals eligible to purchase insurance coverage through federal and state-based health insurance marketplaces are scheduled to expire at the end of 2025, and further extension is uncertain. We are monitoring and engaged in advocacy efforts around potential health care policy changes and reform initiatives. See the "Recent Developments" section of this Quarterly Report on Form 10-Q and Item 1A, “Risk Factors” from our Annual Report on Form 10-K for the year ended December 31, 2024 for additional information.

Previous wording

We present certain metrics and statistical information that management uses when assessing our results of operations. We believe this information is useful to investors as it provides insight to how management evaluates operational performance and trends between reporting periods. Information on how these metrics and statistical information are defined is provided in the following tables summarizing operating results and operating data.

Current wording

We present certain metrics and statistical information that management uses when assessing our results of operations. We believe this information is useful to investors as it provides insight into how management evaluates operational performance and trends between reporting periods. Information on how these metrics and statistical information are defined is provided in the following tables summarizing operating results and operating data.

Previous wording

The following is a comparative summary of results of operations for the quarters and six months ended June 30, 2025 and 2024 (dollars in millions):

Current wording

The following is a comparative summary of results of operations for the quarters and nine months ended September 30, 2025 and 2024 (dollars in millions):

Previous wording

Revenues increased 6.4% on a consolidated basis and 5.8% on a same facility basis for the quarter ended June 30, 2025, compared to the quarter ended June 30, 2024. The increase in consolidated revenues can be primarily attributed to the combined impact of a 3.9% increase in revenue per equivalent admission and a 2.3% increase in equivalent admissions. The same facility revenues increase primarily resulted from the combined impact of a 4.0% increase in same facility revenue per equivalent admission and a 1.7% increase in same facility equivalent admissions.

Current wording

Revenues increased 9.6% on a consolidated basis and 9.2% on a same facility basis for the quarter ended September 30, 2025, compared to the quarter ended September 30, 2024. The increase in consolidated revenues can be primarily attributed to the combined impact of a 6.1% increase in revenue per equivalent admission and a 3.2% increase in equivalent admissions. The same facility revenues increase primarily resulted from the combined impact of a 6.6% increase in same facility revenue per equivalent admission and a 2.4% increase in same facility equivalent admissions. The increases in consolidated and same facility revenue per equivalent admission were favorably impacted by an increase in state supplemental Medicaid revenue during the quarter related to recently approved programs.

Previous wording

Salaries and benefits, as a percentage of revenues, were 43.7% in the second quarter of 2025 and 43.9% in the second quarter of 2024. Salaries and benefits per equivalent admission increased 3.5% in the second quarter of 2025, compared to the second quarter of 2024. Same facility salaries and benefits per full time equivalent increased 3.4% for the second quarter of 2025, compared to the second quarter of 2024.

Current wording

Salaries and benefits, as a percentage of revenues, were 43.6% in the third quarter of 2025 and 45.0% in the third quarter of 2024. The decrease in salaries and benefits, as a percentage of revenues, is primarily related to continued improvements in salaries and contract labor growth resulting from our labor management initiatives combined with the increase in revenues for the quarter ended September 30, 2025. Salaries and benefits per equivalent admission increased 3.0% in the third quarter of 2025, compared to the third quarter of 2024. Same facility salaries and benefits per full time equivalent increased 4.0% for the third quarter of 2025, compared to the third quarter of 2024.

Previous wording

Supplies, as a percentage of revenues, were 15.3% in the second quarter of 2025 and 15.1% in the second quarter of 2024. Supply costs per equivalent admission increased 5.5% in the second quarter of 2025, compared to the second quarter of 2024. Supply costs per equivalent admission increased 10.2% for medical devices and 2.1% for general medical and surgical items and declined 0.3% for pharmacy supplies in the second quarter of 2025, compared to the second quarter of 2024. The increase in supply costs per equivalent admission for medical devices is primarily related to cardiovascular technologies.

Current wording

Supplies, as a percentage of revenues, were 14.5% in the third quarter of 2025 and 15.2% in the third quarter of 2024. Supply costs per equivalent admission increased 1.4% in the third quarter of 2025, compared to the third quarter of 2024. Supply costs per equivalent admission increased 7.0% for medical devices and declined 8.7% for pharmacy supplies and 1.1% for general medical and surgical items in the third quarter of 2025, compared to the third quarter of 2024. The increase in supply costs per equivalent admission for medical devices is primarily related to cardiovascular technologies. The decline in supply costs per equivalent admission for pharmacy supplies is primarily related to a decrease in the costs of certain drugs.

Previous wording

Other operating expenses, as a percentage of revenues, were 20.4% in the second quarter of 2025 and 20.7% in the second quarter of 2024. Other operating expenses are primarily comprised of contract services, professional fees, repairs and maintenance, rents and leases, utilities, insurance (including professional liability insurance) and nonincome taxes. We have seen inflation have a negative impact on certain of these expenses and expect inflationary pressures will continue to impact operating expenses in the future.

Current wording

Other operating expenses, as a percentage of revenues, were 21.8% in the third quarter of 2025 and 21.2% in the third quarter of 2024. Other operating expenses are primarily comprised of contract services, professional fees, repairs and maintenance, rents and leases, utilities, insurance (including professional liability insurance) and nonincome taxes. The increase in other operating expenses, as a percentage of revenues, is primarily related to growth in state supplemental Medicaid program expenses and higher professional fees. We have seen inflation have a negative impact on certain of these expenses and expect inflationary pressures will continue to impact operating expenses in the future.

Previous wording

Equity in earnings of affiliates was $19 million and less than $1 million in the second quarters of 2025 and 2024, respectively.

Current wording

Equity in earnings of affiliates was $16 million and $15 million in the third quarters of 2025 and 2024, respectively.

Previous wording

Depreciation and amortization increased $44 million, from $819 million in the second quarter of 2024 to $863 million in the second quarter of 2025. The increase in depreciation relates primarily to capital expenditures at our existing facilities.

Current wording

Depreciation and amortization increased $47 million, from $842 million in the third quarter of 2024 to $889 million in the third quarter of 2025. The increase in depreciation relates primarily to capital expenditures at our existing facilities.

Previous wording

Interest expense was $568 million in the second quarter of 2025 and $506 million in the second quarter of 2024. Our average debt balance was $44.506 billion for the second quarter of 2025, compared to $40.292 billion for the second quarter of 2024. The average effective interest rate for our debt was 5.1% for both of the quarters ended June 30, 2025 and 2024.

Current wording

Interest expense was $561 million in the third quarter of 2025 and $515 million in the third quarter of 2024. Our average debt balance was $44.400 billion for the third quarter of 2025, compared to $41.846 billion for the third quarter of 2024. The average effective interest rate for our debt was 5.0% and 4.9% for the quarters ended September 30, 2025 and 2024, respectively.

Previous wording

During the second quarters of 2025 and 2024, we recorded losses on sales of facilities of $3 million and gains on sales of facilities of $12 million, respectively.

Current wording

During the third quarters of 2025 and 2024, we recorded losses on sales of facilities of $2 million and $4 million, respectively.

Previous wording

The effective tax rates were 24.1% and 27.4% for the second quarters of 2025 and 2024, respectively. The effective tax rate computations exclude net income attributable to noncontrolling interests as it relates to consolidated partnerships. The decline in the effective tax rate for the quarter ended June 30, 2025 is related primarily to adjustments to our liability for unrecognized tax benefits recorded in the second quarter of 2024.

Current wording

The effective tax rates were 23.9% and 25.0% for the third quarters of 2025 and 2024, respectively. The effective tax rate computations exclude net income attributable to noncontrolling interests as it relates to consolidated partnerships. The decline in the effective tax rate for the quarter ended September 30, 2025 is related primarily to adjustments to our liability for unrecognized tax benefits.

Previous wording

Six Months Ended June 30, 2025 and 2024 (continued)

Current wording

Quarters Ended September 30, 2025 and 2024 (continued)

Previous wording

Net income attributable to noncontrolling interests increased from $226 million for the second quarter of 2024 to $238 million for the second quarter of 2025. The increase in net income attributable to noncontrolling interests related primarily to the operations of one of our Texas markets.

Current wording

Net income attributable to noncontrolling interests increased from $212 million for the third quarter of 2024 to $260 million for the third quarter of 2025. The increase in net income attributable to noncontrolling interests related primarily to the operations of two of our Texas markets.

Previous wording

Revenues increased to $36.926 billion in the first six months of 2025 from $34.831 billion in the first six months of 2024. Net income attributable to HCA Healthcare, Inc. totaled $3.263 billion, or $13.28 per diluted share, for the six months ended June 30, 2025, compared to $3.052 billion, or $11.47 per diluted share, for the six months ended June 30, 2024. Results for the first six months of 2025 and 2024 include losses on sales of facilities of $2 million, or $0.01 per diluted share, and gains on sales of facilities of $213 million, or $0.61 per diluted share, respectively. Our provision for income taxes for the first six months of 2025 and 2024 included tax benefits of $33 million, or $0.13 per diluted share, and $79 million, or $0.30 per diluted share, respectively, related to employee equity award settlements. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes. Shares used for diluted earnings per share were 245.654 million shares for the six months ended June 30, 2025 and 266.044 million shares for the six months ended June 30, 2024. During 2024 and the first six months of 2025, we repurchased 17.798 million shares and 14.793 million shares, respectively, of our common stock.

Current wording

Revenues increased to $56.087 billion in the first nine months of 2025 from $52.318 billion in the first nine months of 2024. Net income attributable to HCA Healthcare, Inc. totaled $4.906 billion, or $20.23 per diluted share, for the nine months ended September 30, 2025, compared to $4.322 billion, or $16.37 per diluted share, for the nine months ended September 30, 2024. Results for the first nine months of 2025 and 2024 include losses on sales of facilities of $4 million, or $0.01 per diluted share, and gains on sales of facilities of $209 million, or $0.61 per diluted share, respectively. Our provision for income taxes for the first nine months of 2025 and 2024 included tax benefits of $45 million, or $0.19 per diluted share, and $93 million, or $0.35 per diluted share, respectively, related to employee equity award settlements. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes. Shares used for diluted earnings per share were 242.459 million shares for the nine months ended September 30, 2025 and 263.987 million shares for the nine months ended September 30, 2024. During 2024 and the first nine months of 2025, we repurchased 17.798 million shares and 21.307 million shares, respectively, of our common stock.

Previous wording

Salaries and benefits, as a percentage of revenues, were 43.7% in the first six months of 2025 and 44.2% in the first six months of 2024. Salaries and benefits were favorably impacted by a 4.6% decline in contract labor during the six months ended June 30, 2025, compared to the six months ended June 30, 2024. Salaries and benefits per equivalent admission increased 2.1% in the first six months of 2025, compared to the first six months of 2024. Same facility salaries and benefits per full time equivalent increased 2.8% for the first six months of 2025, compared to the first six months of 2024.

Current wording

Salaries and benefits, as a percentage of revenues, were 43.7% in the first nine months of 2025 and 44.4% in the first nine months of 2024. The decrease in salaries and benefits, as a percentage of revenues, is primarily related to continued improvements in salaries and contract labor growth resulting from our labor management initiatives combined with the increase in revenues for the nine months ended September 30, 2025. Salaries and benefits per equivalent admission increased 2.4% in the first nine months of 2025, compared to the first nine months of 2024. Same facility salaries and benefits per full time equivalent increased 3.2% for the first nine months of 2025, compared to the first nine months of 2024.

Previous wording

Supplies, as a percentage of revenues, were 15.2% in each of the first six months of 2025 and 2024. Supply costs per equivalent admission increased 2.9% in the first six months of 2025, compared to the first six months of 2024. Supply costs per equivalent admission increased 7.5% for medical devices and 0.1% for general medical and surgical items and declined 2.2% for pharmacy supplies in the first six months of 2025, compared to the first six months of 2024. The increase in supply costs per equivalent admission for medical devices is primarily related to cardiovascular technologies.

Current wording

Supplies, as a percentage of revenues, were 15.0% in the first nine months of 2025 and 15.2% in the first nine months of 2024. Supply costs per equivalent admission increased 2.4% in the first nine months of 2025, compared to the first nine months of 2024. Supply costs per equivalent admission increased 7.4% for medical devices and declined 4.3% for pharmacy supplies and 0.2% for general medical and surgical items in the first nine months of 2025, compared to the first nine months of 2024. The increase in supply costs per equivalent admission for medical devices is primarily related to cardiovascular technologies. The decline in supply costs per equivalent admission for pharmacy supplies is primarily related to a decrease in the costs of certain drugs.

Previous wording

Other operating expenses, as a percentage of revenues, were 20.7% in the first six months of 2025 and 20.8% in the first six months of 2024. Other operating expenses are primarily comprised of contract services, professional fees, repairs and maintenance, rents and leases, utilities, insurance (including professional liability insurance) and nonincome taxes. We have seen inflation have a negative impact on certain of these expenses and expect inflationary pressures will continue to impact operating expenses in the future.

Current wording

Other operating expenses, as a percentage of revenues, were 21.0% in each of the first nine months of 2025 and 2024. Other operating expenses are primarily comprised of contract services, professional fees, repairs and maintenance, rents and leases, utilities, insurance (including professional liability insurance) and nonincome taxes. We have seen inflation have a negative impact on certain of these expenses and expect inflationary pressures will continue to impact operating expenses in the future.

Previous wording

Equity in earnings of affiliates was $37 million in the first six months of 2025, and equity in losses of affiliates was $2 million in the first six months of 2024.

Current wording

Equity in earnings of affiliates was $53 million and $13 million in the first nine months of 2025 and 2024, respectively.

Previous wording

Depreciation and amortization increased $109 million, from $1.614 billion in the first six months of 2024 to $1.723 billion in the first six months of 2025. The increase in depreciation relates primarily to capital expenditures at our existing facilities.

Current wording

Depreciation and amortization increased $156 million, from $2.456 billion in the first nine months of 2024 to $2.612 billion in the first nine months of 2025. The increase in depreciation relates primarily to capital expenditures at our existing facilities.

Previous wording

Interest expense was $1.115 billion in the first six months of 2025 and $1.018 billion in the first six months of 2024. Our average debt balance was $44.061 billion for the first six months of 2025 compared to $40.359 billion for the first six months of 2024. The average effective interest rate for our debt was 5.1% for both of the six months ended June 30, 2025 and 2024.

Current wording

Interest expense was $1.676 billion in the first nine months of 2025 and $1.533 billion in the first nine months of 2024. Our average debt balance was $44.155 billion for the first nine months of 2025 compared to $40.901 billion for the first nine months of 2024. The average effective interest rate for our debt was 5.1% and 5.0% for the nine months ended September 30, 2025 and 2024, respectively.

Previous wording

During the first six months of 2025 and 2024, we recorded losses on sales of facilities of $2 million and gains on sales of facilities of $213 million, respectively. The gain for 2024 was primarily related to the sale of a hospital facility in California.

Current wording

During the first nine months of 2025 and 2024, we recorded losses on sales of facilities of $4 million and gains on sales of facilities of $209 million, respectively. The gain for 2024 was primarily related to the sale of a hospital facility in California.

Previous wording

The effective tax rates were 23.9% and 24.6% for the first six months of 2025 and 2024, respectively. The effective tax rate computations exclude net income attributable to noncontrolling interests as it relates to consolidated partnerships. The decline in the effective tax rate for the six months ended June 30, 2025 is related to adjustments to our liability for unrecognized tax benefits recorded in the second quarter of 2024, offset by a reduction in the amount of deductible share-based compensation for vested employee equity awards. Our provisions for income taxes for the first six months of 2025 and 2024 included tax benefits of $33 million and $79 million, respectively, related to employee equity award settlements.

Current wording

The effective tax rates were 23.9% and 24.7% for the first nine months of 2025 and 2024, respectively. The effective tax rate computations exclude net income attributable to noncontrolling interests as it relates to consolidated partnerships. The decline in the effective tax rate for the nine months ended September 30, 2025 is related to adjustments to our liability for unrecognized tax benefits. Our provisions for income taxes for the first nine months of 2025 and 2024 included tax benefits of $45 million and $93 million, respectively, related to employee equity award settlements.

Previous wording

Net income attributable to noncontrolling interests increased from $437 million for the first six months of 2024 to $453 million for the first six months 2025. The increase in net income attributable to noncontrolling interests related primarily to the operations of two of our Texas markets.

Current wording

Net income attributable to noncontrolling interests increased from $649 million for the first nine months of 2024 to $713 million for the first nine months 2025. The increase in net income attributable to noncontrolling interests related primarily to the operations of two of our Texas markets.

Previous wording

Cash provided by operating activities totaled $5.861 billion for the first six months of 2025 compared to $4.440 billion for the first six months of 2024. The $1.421 billion increase in cash provided by operating activities, for the first six months of 2025 compared to the first six months of 2024, related primarily to an increase in net income of $392 million, excluding the non-cash impact of losses and gains on sales of facilities, as well as a decline in income taxes paid of $853 million related to an IRS deferral of quarterly estimated income tax payments for Tennessee-based taxpayers until the fourth quarter of 2025. The combination of interest payments and net income tax payments in the first six months of 2025 and 2024 totaled $1.220 billion and $1.942 billion, respectively. We had negative working capital of $376 million at June 30, 2025 and positive working capital of $1.237 billion at December 31, 2024. The decline in working capital is primarily related to the increase in short-term borrowings and long-term debt due within one year and other accrued expenses, as well as a decline in cash and cash equivalents. We have the ability to refinance our outstanding commercial paper notes (short-term borrowings) with our senior unsecured credit facility on a long-term basis. Excluding the impact of our outstanding commercial paper notes, our working capital at June 30, 2025 would have been $1.402 billion.

Current wording

Cash provided by operating activities totaled $10.277 billion for the first nine months of 2025 compared to $7.955 billion for the first nine months of 2024. The $2.322 billion increase in cash provided by operating activities, for the first nine months of 2025 compared to the first nine months of 2024, related primarily to an increase in net income of $811 million, excluding the non-cash impact of losses and gains on sales of facilities, and a decline in income taxes paid of $1.259 billion related to an IRS deferral of quarterly estimated income tax payments for Tennessee-based taxpayers until the fourth quarter of 2025. The combination of interest payments and net income tax payments in the first nine months of 2025 and 2024 totaled $1.923 billion and $2.891 billion, respectively. We had negative working capital of $2.611 billion at September 30, 2025 and positive working capital of $1.237 billion at December 31, 2024. The decline in working capital is primarily related to the increase in short-term borrowings and long-term debt due within one year and other accrued expenses, as well as a decline in cash and cash equivalents. We have the ability to refinance our outstanding commercial paper notes (short-term borrowings) with our senior unsecured credit facility on a long-term basis. We also have the ability and the intent to refinance a portion of our long-term debt due within one year, utilizing our senior unsecured credit facility or issuing additional debt securities.

Previous wording

Cash used in investing activities was $2.283 billion in the first six months of 2025 compared to $2.235 billion in the first six months of 2024. Excluding acquisitions, capital expenditures were $2.167 billion in the first six months of 2025 and $2.399 billion in the first six months of 2024. Planned capital expenditures are expected to be approximately $5.0 billion in 2025. At June 30, 2025, there were projects under construction which had estimated additional costs to complete and equip over the next five years of approximately $5.9 billion. We expect to finance capital expenditures with internally generated and borrowed funds.

Current wording

Cash used in investing activities was $3.671 billion in the first nine months of 2025 compared to $3.587 billion in the first nine months of 2024. Excluding acquisitions, capital expenditures were $3.455 billion in the first nine months of 2025 and $3.590 billion in the first nine months of 2024. Planned capital expenditures are expected to be approximately $5.0 billion in 2025. At September 30, 2025, there were projects under construction which had estimated additional costs to complete and equip over the next five years of approximately $6.0 billion. We expect to finance capital expenditures with internally generated and borrowed funds.