HCA Healthcare, Inc. HCA
HCA Healthcare is a buy: the company delivered accelerating Q2 2026 revenue growth of 8.7% YoY (up from 4.3% in Q1 2026), FY2025 diluted EPS of $28.38 (up 29% YoY), and $7.7B in free cash flow, while expanding operating margins to 15.8% from 14.9% in FY2024. The stock trades at a 44% PE discount and 44% EV/EBITDA discount to the healthcare peer median, yet smart money has inflected positive (0.0354 as of Q2 2026 from -0.1934 a year prior) with BlackRock disclosing a 6.01% position.
Negative equity of -$6.0B and $50.2B in total debt are longstanding features offset by $12.6B in operating cash flow, and the stock's position below its 200-day MA of $453.33 reflects already-discounted concerns rather than fresh deterioration.
What could go wrong
- Leverage and negative equity. Total debt of $50.2B against negative stockholders' equity of -$6.0B as of FY2025 elevates sensitivity to rate changes and constrains financial flexibility.
- Persistent insider selling. Over the trailing 24 months, insiders net sold approximately 37M shares worth $60.9M, with no meaningful insider buying to offset the trend.
- Technical overhang. Stock at $414.45 trades below its 200-day MA of $453.33 as of 2026-08-31, with a negative MACD histogram, indicating ongoing bearish momentum.
- Payer and cost pressure. Recent Zacks commentary highlights ongoing payer pressures that could compress margins despite the resiliency program's cost-control efforts.
What would change my mind
Where this comes from: Quarterly results, Q2 and Q1 2026 · Fundamentals and derived_metrics FY2025 · Derived_metrics FY2025 and FY2024 · Peer_relative. Orin's read on HCA; not advice.
Twelve months actual closes to 2026-09-24 · actual filings
50-day average 200-day average · volume below
On file
All HCA filingsLargest holders · 13F Q2 2026
Money flow| Filer | Position | Of fund |
|---|---|---|
| Vanguard Capital Management | $4.0B | 0.1% of fund |
| State Street | $2.9B | 0.1% of fund |
| Wellington Management Group Llp | $1.8B | 0.3% of fund |
| Geode Capital Management | $1.4B | 0.1% of fund |
| Vanguard Portfolio Management | $1.1B | 0.0% of fund |
| Morgan Stanley | $1.0B | 0.1% of fund |
102 filers · quarter ended Q2 2026 · positions, not flows
Insiders, last 24 months: 113 Form 4 filings, net −$60.9M. Of the 50 on hand, 0 were open-market purchases and 4 sales— the rest are grants, option exercises and tax withholding.
Ask Orin about HCA
Orin answers questions about HCA from its filings, transcripts and numbers — with the source behind every claim. Your own desk starts with 3 free days, card required.
Start 3 free days →Where it trades
| Metric | Now | Own median | Sector |
|---|---|---|---|
| P/E | 14.1× | 13.5× | 26.4× |
| EV/EBITDA | 8.8× | 8.7× | — |
| P/S | 1.18× | 1.16× | — |
Its P/E sits 80th percentile of its own last 5 years (+0.43σ from its own mean).
0.6%
free-cash-flow growth every year for 10 years, discounted at 10%, is what today’s price implies — starting from $7.7B of trailing free cash flow. It is an assumption the market is making, not a forecast Orin is making.
What Wall Street published
$458
$369 – $579 · +6% against today's price
- 29 buy or overweight
- 15 hold
- 2 underweight or sell
The analysts’ consensus and their own ratings, not Orin’s. A target is a twelve-month opinion published by the firm that wrote it.
Against the companies it is compared to
| Company | Market cap | P/E | EV/EBITDA | Gross | Net | ROE |
|---|---|---|---|---|---|---|
| HCAHCA Healthcare, Inc. | $92B | 14.1× | 8.8× | 28.4% | 8.8% | -113% |
| BMYBristol-Myers Squibb Company | $126B | 13.5× | 9.6× | 70.2% | 18.9% | 47% |
| CVSCVS Health Corporation | $109B | 22.2× | 12.9× | 14.2% | 1.2% | 6% |
| MCKMcKesson Corporation | $102B | 23.2× | 15.2× | 3.6% | 1.1% | -194% |
| MDTMedtronic plc | $113B | 21.6× | 14.8× | 66.7% | 13.9% | 11% |
| PFEPfizer Inc. | $162B | 37.6× | 17.8× | 71.3% | 6.8% | 5% |
| SYKStryker Corporation | $103B | 27.7× | 18.4× | 65.2% | 14.4% | 16% |
| VRTXVertex Pharmaceuticals Incorporated | $133B | 30.2× | 23.6× | 86.0% | 34.9% | 23% |
The median is of the 7 peers listed above and nothing else — check it against the column. This company trades 39.0% below it. The peer set is the vendor’s, so a company can appear here that a person would not have chosen.
What it has traded at
What its sector has traded at
Two scales, drawn separately on purpose: a sector median and one company’s multiple are not the same number and putting them on one axis invites a comparison neither series supports.
Discounted cash flow
| Model | Fair value | Against | Computed |
|---|---|---|---|
| Standard DCF | $362 | $374.65 · −3% | 2026-06-10 |
| Levered DCF | $348 | $374.65 · −7% | 2026-06-10 |
The vendor’s intrinsic-value models. Treat them as a low-growth anchor — for a fast grower the market routinely pays well above a DCF. These were computed against the price in the “against” column, not today’s.
Every estimate on one scale
The vertical rule is the current price. Ranges and point estimates are the backend’s, published as they were calculated; an arrow means the estimate sits beyond this scale, and its number is on the right.