Shares of HCA Healthcare Inc. (NYSE:HCA) fell nearly 8% in premarket trading on Friday, even after the company delivered first-quarter results that slightly exceeded expectations.
Modest Beat Overshadowed by Volume Trends
The group reported adjusted earnings per share of $7.15, just ahead of the $7.14 consensus estimate. Revenue came in at $19.11 billion, narrowly topping forecasts of $19.09 billion and rising 4.3% from $18.32 billion a year earlier.
However, investor sentiment was weighed down by weaker-than-expected patient volumes and the absence of typical seasonal trends.
Decline in Respiratory-Driven Activity
HCA said it did not see the usual seasonal uplift in volumes, largely due to reduced respiratory-related activity. Admissions linked to respiratory conditions dropped 42%, while related emergency room visits declined 32% compared with the same period last year.
A winter storm in January also disrupted activity in certain regions, further impacting patient volumes.
These pressures were largely offset by the recognition of certain Medicaid supplemental programmes that had not been included in the company’s initial 2026 guidance.
Mixed Operational Metrics
Same-facility admissions rose just 0.9%, while equivalent admissions increased 1.3% during the quarter.
Inpatient surgeries at the same facilities slipped 0.3%, and outpatient procedures declined 1.7%. Meanwhile, revenue per equivalent admission increased 3.1%.
“The start of the year presented a dynamic environment for HCA Healthcare. I want to recognize our colleagues for continuing to demonstrate a remarkable ability to adapt to changing conditions and deliver for our patients, communities, and stakeholders,” said Sam Hazen.
Profit Growth and Outlook Maintained
Net income attributable to HCA rose 0.6% to $1.62 billion, or $7.15 per diluted share, compared with $1.61 billion, or $6.45 per share, in the first quarter of 2025.
Adjusted EBITDA increased 1.9% to $3.80 billion, while operating cash flow jumped 22.0% to $2.01 billion.
The company reaffirmed its full-year 2026 guidance, expecting revenue between $76.5 billion and $80.0 billion, and adjusted EBITDA in the range of $15.55 billion to $16.45 billion.