Why did Vectorial Data pick HCA?

HCA at $429.01 means buying the #1 U.S. hospital operator at a forward P/E of 12.94x — a historical discount vs. its own 5-year average (~14.5x), right when the market is over-pricing the headwind from ACA subsidy expiration and the One Big Beautiful Bill Act. Specific reasons: (1) Q1 2026 was cleaner than the pricing suggests — reported April 24, 2026: revenue $19.109B (+4.3% YoY) in line, EPS GAAP $7.15 (+10.9% YoY) in line with consensus, same-facility revenue per equivalent admission +3.1%. Weak volume (respiratory admissions -42% YoY due to a very weak flu season) is one-off, not structural. (2) FY2026 guidance reaffirmed: revenue $76.5–$80.0B, Adj EBITDA $15.55–$16.45B, diluted EPS $29.10–$31.50 = midpoint $30.30, implied fwd P/E ~14.2x on midpoint. If HCA hits the high end, fwd P/E falls to 13.6x. (3) Massive capital return quantified: new $10B buyback authorization announced January 27, 2026 (=10.5% of current market cap). Q1 2026: $1.571B in repurchases (3.157M shares), $9.179B remaining. Dividend raised +8.3% to $0.78/quarter ($3.12/year forward). Share retirement run-rate: ~5–7% per year = a compounding mechanism outside of operating growth. (4) ACA subsidy headwind already priced in: $150M Q1 + guided $600M–$900M FY2026 = midpoint $750M ÷ revenue $78B = ~1% impact. Real pain but contained. Uninsured admissions +16% YoY = HCA captures volume that previously paid through ACA. If Congress renews subsidies in Q3–Q4 2026 debate, there is reversal upside not priced in. (5) OBBBA Medicaid phase-down not until January 1, 2028: state-directed payments capped, but 10pp/year phase-down = 5 years of runway. HCA has time to reprice and shift mix. Tennessee (HCA's home state) had increased state-directed payments by +$3.2B before the law = high base going into phase-down. (6) Sarah Cannon Research as a hidden crown jewel: >4,500 oncology trial enrollments/year, >750 first-in-human studies/year, contributor to the majority of FDA oncology approvals in the past decade. Potentially worth $5–10B standalone in a spin-out — not priced in HCA. (7) Sunbelt concentration = structural demographics: TX+FL are the fastest-growing U.S. states (TX +1.5%/year, FL +1.2%/year), with an influx of retirees (medical consumption per capita 2–3x average). HCA holds the #1 hospital share in Houston, Dallas-Fort Worth, Austin, Miami, Tampa and Orlando. Demand is structurally rising. (8) 212,000 babies/year = ~5.9% of ALL U.S. births delivered in HCA hospitals. Irreplaceable OB volume. (9) Analyst consensus 19–27 analysts: ~37% Strong Buy + ~37% Buy + ~21% Hold; mean target ~$505 = +17.7% upside. Post Q1, several cut targets but maintained Buy.

What are the risks of investing in HCA?

The risks are specifically measurable: (1) ACA enhanced subsidy expiration confirmed January 1, 2026 — premiums more than doubled on average. Q1 2026 already cost $150M; HCA guided $600M–$900M FY2026 ($750M midpoint). ACA admissions -15% YoY. If uninsured admissions don't compensate (Q1: +16% YoY) and bad-debt expense surges, the hit could slide toward the high end. Without legislative renewal in 2026, FY2027 run-rate could be similar or worse. (2) One Big Beautiful Bill Act (signed July 4, 2025): CBO estimates >$1T in federal healthcare cuts + 10M more uninsured nationally. Caps state-directed Medicaid payments at 100% Medicare in expansion states / 110% in non-expansion; existing arrangements phase down 10 percentage points/year from January 1, 2028. Tennessee had increased state-directed payments by +$3.2B before the law = high base going into phase-down. (3) Operating margin visibly compressing: 12.0% Q1 2026 vs. 12.7% Q1 2025 = -70bps. If labor inflation (nursing wages, agency staff) accelerates + payer mix shifts toward expanded Medicaid (lower reimbursement), margins may keep compressing 50–100bps additionally in 2026–2027. (4) Respiratory volume -42% YoY in Q1 2026: hurts comparables — very weak flu season (not structural but weighs on the quarter). If 2026–27 season is also not strong, Q4 2026 comparables suffer. (5) Geographic concentration TX+FL >50%: hurricanes (Helene + Milton 2024 cost ~$250M total: $50M Q3 + ~$200M Q4 2024). 2025 season without a major new hit. 2026 season remains a recurring risk (June–November). A major hurricane in Houston or Tampa can erase $200–400M of revenue + repair capex. (6) Premium vs. peers: forward P/E 12.94 vs. Tenet (THC) and Universal Health (UHS) trading lower — HCA trades at a modest premium justified by scale/margins but narrative compression can equalize multiples. (7) Recurring legislative risk: every change of administration can bring new Medicare reimbursement cuts, surprise billing legislation (No Surprises Act), 340B drug pricing reform, and site-neutral payment reforms (HCA operates many hospital outpatient departments that receive higher payments than independent clinics — site-neutral would eliminate that premium). (8) Labor cost trends: nurse-to-patient staffing ratios (California already mandated, Massachusetts and NY proposing) increase mandatory headcount. Agency nursing rates still 30–40% above pre-pandemic. Healthcare professional salary inflation runs 4–5% annually vs. CPI ~2.5%. (9) Tort/litigation: no material new cases identified in the past 6 months, but healthcare is a structurally litigious industry — there are always class actions, billing fraud allegations (False Claims Act), antitrust scrutiny in markets where HCA holds >50% local share.

Does HCA pay dividends?

Yes. HCA Healthcare, Inc. pays a dividend of about 0.72% per year.

How can I buy HCA with little money?

You can buy fractional shares of HCA starting from a few dollars with any broker that offers fractional shares. The Vectorial Data method: invest the same amount in every pick, every time.

When was this HCA analysis last updated?

The HCA analysis was last updated on Invalid Date.

Stocks/HCA

HCA — HCA Healthcare, Inc.

Q: What does HCA Healthcare, Inc. do?

HCA Healthcare is the largest private hospital system in the United States, founded in 1968 in Nashville, Tennessee by Dr. Thomas Frist Sr. (father of former Senator Bill Frist) and Jack Massey. Today it operates 188 hospitals + more than 2,400 outpatient sites (surgery centers, freestanding ERs, urgent care, physician clinics, imaging) in 19–20 U.S. states + the United Kingdom. ~280,000 employees. CEO: Sam Hazen (Chairman + CEO since January 1, 2019, 41+ years at HCA). CFO: Mike Marks since May 2024 (~30 years at HCA). Geographic footprint (heavy sunbelt concentration): Texas (73 hospitals) + Florida (49) = >50% of total. Other core markets: Tennessee (HQ), Virginia (HCA Virginia), Colorado (HCA HealthONE Denver), Utah/Idaho (MountainStar Healthcare), Kansas/Missouri, Las Vegas, Nashville (TriStar). UK operates 6 hospitals in London under HCA UK. Flagship brands/systems: HCA Florida (largest network in the state), HCA Houston, HCA Virginia, HCA HealthONE (Colorado), MountainStar (Utah/Idaho), TriStar Health (Tennessee), and Sarah Cannon Research Institute — the oncology research arm with >4,500 clinical trial enrollments/year and >750 first-in-human studies/year, contributing to the majority of new oncology therapies approved by the FDA in the past decade (UK + US presence). 2025 revenue structure ($75.6B total, +6.4% YoY): acute-care hospitals ~75–80% of revenue, outpatient ~15–20%, other ~5%. ~50% of revenue comes from combined Medicare/Medicaid, ~40% from commercial/managed care, ~10% other (uninsured, self-pay). The outpatient segment (surgery centers, freestanding ERs, urgent care) is where HCA is growing fastest — higher margin, less regulated. Aggressive historical capital return: HCA is one of the most prolific buyback programs in the S&P 500 — since 2017 it has retired >$50B in shares (more than 50% of current market cap). Combines a growing dividend (raised 8.3% in January 2026) with a $10B buyback program authorized.

Health CareNorth AmericaUnited StatesBlockchain certified

$429.01

Target: $505.00 (+17.7%)

P/E Ratio

14.8

P/E Forward

12.9

Dividend

0.72%

Market Cap

$95.17B

EPS

$29.02

Consensus

Buy

What they do

HCA Healthcare is the largest private hospital system in the United States, founded in 1968 in Nashville, Tennessee by Dr. Thomas Frist Sr. (father of former Senator Bill Frist) and Jack Massey. Today it operates 188 hospitals + more than 2,400 outpatient sites (surgery centers, freestanding ERs, urgent care, physician clinics, imaging) in 19–20 U.S. states + the United Kingdom. ~280,000 employees. CEO: Sam Hazen (Chairman + CEO since January 1, 2019, 41+ years at HCA). CFO: Mike Marks since May 2024 (~30 years at HCA).

Geographic footprint (heavy sunbelt concentration): Texas (73 hospitals) + Florida (49) = >50% of total. Other core markets: Tennessee (HQ), Virginia (HCA Virginia), Colorado (HCA HealthONE Denver), Utah/Idaho (MountainStar Healthcare), Kansas/Missouri, Las Vegas, Nashville (TriStar). UK operates 6 hospitals in London under HCA UK.

Flagship brands/systems: HCA Florida (largest network in the state), HCA Houston, HCA Virginia, HCA HealthONE (Colorado), MountainStar (Utah/Idaho), TriStar Health (Tennessee), and Sarah Cannon Research Institute — the oncology research arm with >4,500 clinical trial enrollments/year and >750 first-in-human studies/year, contributing to the majority of new oncology therapies approved by the FDA in the past decade (UK + US presence).

2025 revenue structure ($75.6B total, +6.4% YoY): acute-care hospitals ~75–80% of revenue, outpatient ~15–20%, other ~5%. ~50% of revenue comes from combined Medicare/Medicaid, ~40% from commercial/managed care, ~10% other (uninsured, self-pay). The outpatient segment (surgery centers, freestanding ERs, urgent care) is where HCA is growing fastest — higher margin, less regulated.

Aggressive historical capital return: HCA is one of the most prolific buyback programs in the S&P 500 — since 2017 it has retired >$50B in shares (more than 50% of current market cap). Combines a growing dividend (raised 8.3% in January 2026) with a $10B buyback program authorized.

Why we like it

HCA at $429.01 means buying the #1 U.S. hospital operator at a forward P/E of 12.94x — a historical discount vs. its own 5-year average (~14.5x), right when the market is over-pricing the headwind from ACA subsidy expiration and the One Big Beautiful Bill Act. Specific reasons:

Q1 2026 was cleaner than the pricing suggests — reported April 24, 2026: revenue $19.109B (+4.3% YoY) in line, EPS GAAP $7.15 (+10.9% YoY) in line with consensus, same-facility revenue per equivalent admission +3.1%. Weak volume (respiratory admissions -42% YoY due to a very weak flu season) is one-off, not structural.
FY2026 guidance reaffirmed: revenue $76.5–$80.0B, Adj EBITDA $15.55–$16.45B, diluted EPS $29.10–$31.50 = midpoint $30.30, implied fwd P/E ~14.2x on midpoint. If HCA hits the high end, fwd P/E falls to 13.6x.
Massive capital return quantified: new $10B buyback authorization announced January 27, 2026 (=10.5% of current market cap). Q1 2026: $1.571B in repurchases (3.157M shares), $9.179B remaining. Dividend raised +8.3% to $0.78/quarter ($3.12/year forward). Share retirement run-rate: ~5–7% per year = a compounding mechanism outside of operating growth.
ACA subsidy headwind already priced in: $150M Q1 + guided $600M–$900M FY2026 = midpoint $750M ÷ revenue $78B = ~1% impact. Real pain but contained. Uninsured admissions +16% YoY = HCA captures volume that previously paid through ACA. If Congress renews subsidies in Q3–Q4 2026 debate, there is reversal upside not priced in.
OBBBA Medicaid phase-down not until January 1, 2028: state-directed payments capped, but 10pp/year phase-down = 5 years of runway. HCA has time to reprice and shift mix. Tennessee (HCA's home state) had increased state-directed payments by +$3.2B before the law = high base going into phase-down.
Sarah Cannon Research as a hidden crown jewel: >4,500 oncology trial enrollments/year, >750 first-in-human studies/year, contributor to the majority of FDA oncology approvals in the past decade. Potentially worth $5–10B standalone in a spin-out — not priced in HCA.
Sunbelt concentration = structural demographics: TX+FL are the fastest-growing U.S. states (TX +1.5%/year, FL +1.2%/year), with an influx of retirees (medical consumption per capita 2–3x average). HCA holds the #1 hospital share in Houston, Dallas-Fort Worth, Austin, Miami, Tampa and Orlando. Demand is structurally rising.
212,000 babies/year = ~5.9% of ALL U.S. births delivered in HCA hospitals. Irreplaceable OB volume.
Analyst consensus 19–27 analysts: ~37% Strong Buy + ~37% Buy + ~21% Hold; mean target ~$505 = +17.7% upside. Post Q1, several cut targets but maintained Buy.

Key Risk

The risks are specifically measurable:

ACA enhanced subsidy expiration confirmed January 1, 2026 — premiums more than doubled on average. Q1 2026 already cost $150M; HCA guided $600M–$900M FY2026 ($750M midpoint). ACA admissions -15% YoY. If uninsured admissions don't compensate (Q1: +16% YoY) and bad-debt expense surges, the hit could slide toward the high end. Without legislative renewal in 2026, FY2027 run-rate could be similar or worse.
One Big Beautiful Bill Act (signed July 4, 2025): CBO estimates >$1T in federal healthcare cuts + 10M more uninsured nationally. Caps state-directed Medicaid payments at 100% Medicare in expansion states / 110% in non-expansion; existing arrangements phase down 10 percentage points/year from January 1, 2028. Tennessee had increased state-directed payments by +$3.2B before the law = high base going into phase-down.
Operating margin visibly compressing: 12.0% Q1 2026 vs. 12.7% Q1 2025 = -70bps. If labor inflation (nursing wages, agency staff) accelerates + payer mix shifts toward expanded Medicaid (lower reimbursement), margins may keep compressing 50–100bps additionally in 2026–2027.
Respiratory volume -42% YoY in Q1 2026: hurts comparables — very weak flu season (not structural but weighs on the quarter). If 2026–27 season is also not strong, Q4 2026 comparables suffer.
Geographic concentration TX+FL >50%: hurricanes (Helene + Milton 2024 cost ~$250M total: $50M Q3 + ~$200M Q4 2024). 2025 season without a major new hit. 2026 season remains a recurring risk (June–November). A major hurricane in Houston or Tampa can erase $200–400M of revenue + repair capex.
Premium vs. peers: forward P/E 12.94 vs. Tenet (THC) and Universal Health (UHS) trading lower — HCA trades at a modest premium justified by scale/margins but narrative compression can equalize multiples.
Recurring legislative risk: every change of administration can bring new Medicare reimbursement cuts, surprise billing legislation (No Surprises Act), 340B drug pricing reform, and site-neutral payment reforms (HCA operates many hospital outpatient departments that receive higher payments than independent clinics — site-neutral would eliminate that premium).
Labor cost trends: nurse-to-patient staffing ratios (California already mandated, Massachusetts and NY proposing) increase mandatory headcount. Agency nursing rates still 30–40% above pre-pandemic. Healthcare professional salary inflation runs 4–5% annually vs. CPI ~2.5%.
Tort/litigation: no material new cases identified in the past 6 months, but healthcare is a structurally litigious industry — there are always class actions, billing fraud allegations (False Claims Act), antitrust scrutiny in markets where HCA holds >50% local share.

This is educational and informational content, not financial advice. Always consult a qualified financial advisor before making investment decisions.

Vectorial Data picked HCA on 2026-05-04 at $429.01.

Last updated: Invalid Date

Dividends received by the Vectorial portfolio

What this stock has paid the model since we bought it. Your actual amount depends on when you replicated.

Ex-div date	Per share	Shares	Total to portfolio
Jun 16, 2026	$0.7800	0.1162	$0.09

Total received: $0.09

Full Research

HCA Healthcare (HCA) — Research Completo

Precio: $429.01 | P/E TTM: 14.78 | P/E Forward: 12.94 | Div Yield: 0.72% | Market Cap: $95.17B

¿Qué es HCA Healthcare?

HCA Healthcare es el sistema hospitalario privado más grande de Estados Unidos, fundado en 1968 en Nashville, Tennessee por el Dr. Thomas Frist Sr. (padre del ex-Senador Bill Frist) y Jack Massey. Originalmente Hospital Corporation of America. Hoy opera 188 hospitales + más de 2,400 sitios ambulatorios (surgery centers, freestanding ERs, urgent care, clínicas físicas, imaging) en 19-20 estados de EE.UU. + Reino Unido.

CEO: Sam Hazen (1-ene-2019, 41+ años en HCA). CFO: Mike Marks (mayo 2024).

Footprint Geográfico

Estado	Hospitales
Texas	73
Florida	49
Tennessee (HQ)	~16
Virginia	~13
Colorado	~8
Otros 14 estados + UK	~29

TX + FL = >50% del total = exposición concentrada a huracanes y políticas estatales de Medicaid (state-directed payments).

Q1 2026 — Reportado 24 abril 2026

Revenue: $19.109B (+4.3% YoY), en línea con consenso $19.08B
Diluted EPS GAAP: $7.15 (+10.9% YoY desde $6.45). Consenso non-GAAP: $7.13
Same-facility admissions: +0.9% YoY
Same-facility equivalent admissions: +1.3% YoY
Same-facility revenue per equivalent admission: +3.1% YoY
Operating income: $2.29B / margen 12.0% (vs $2.33B / 12.7% en Q1 2025) — margen contraído
Cash from ops: $2.014B (+22.0% YoY)
Headwind clave: admisiones respiratorias -42% YoY (temporada de gripe muy débil)
Buybacks Q1: 3.157M acciones por $1.571B; $9.179B disponibles post Q1

Guidance FY2026 (reafirmado en Q1)

Métrica	Rango
Revenue	$76.5-$80.0B
Adj EBITDA	$15.55-$16.45B
Net income	$6.5-$7.0B
Diluted EPS	$29.10-$31.50

Capital Return — Aumento Reciente

Dividendo subió de $0.72 → $0.78 trimestral anunciado 27-ene-2026 (con resultados Q4 2025). Anualizado forward: $3.12/año (yield real ~0.73% al precio actual). Yahoo muestra $2.94 trailing porque promedia 3 pagos $0.72 + 1 pago $0.78.
Nuevo programa de buybacks de $10B autorizado 27-ene-2026.
Buybacks históricos: HCA ha retirado >$50B en acciones desde 2017 (>50% del market cap actual).

Catalysts y Riesgos Macro

ACA Enhanced Subsidies — Expiraron 1-ene-2026

Congreso no las renovó a finales de 2025. Primas individuales de salud más que se duplicaron en promedio. Impacto Q1 2026 en HCA: $150M. Guidance FY2026: $600M-$900M de hit total (midpoint $750M ≈ ~1% del revenue). Admisiones ACA -15% YoY (extremo bajo del rango -15/-20% guiado). Admisiones uninsured +16% YoY como compensación parcial.

One Big Beautiful Bill Act (firmada 4-jul-2025)

CBO estima >$1T en recortes federales a salud + 10M más sin seguro nacional. Limita state-directed Medicaid payments a 100% Medicare en estados expansion / 110% en non-expansion; arrangements existentes phasedown 10 pp/año desde 1-ene-2028. Tennessee había aumentado state-directed payments por +$3.2B pre-ley.

Huracanes (riesgo recurrente)

Helene + Milton 2024: ~$250M de impacto total ($50M Q3 + ~$200M Q4 2024). Temporada 2025 sin hit material reportado. Temporada 2026 (junio-noviembre) sigue como riesgo.

Brands & Crown Jewels

HCA Florida — red más grande del estado
HCA Houston / HCA Virginia / HCA HealthONE (Colorado)
MountainStar Healthcare (Utah/Idaho)
TriStar Health (Tennessee)
Sarah Cannon Research Institute — >4,500 oncology trial enrollments/año, >750 first-in-human studies/año. Contribuyó a la mayoría de aprobaciones oncológicas FDA en la última década. UK + US presence.

Wow Data Points

HCA entrega ~212,000 bebés al año = ~5.9% de todos los nacimientos de EE.UU. (CDC: ~3.6M nacimientos/año). Más que cualquier otro health system del país.
HCA opera el #1 hospital share en mercados como Houston, Dallas-Fort Worth, Austin, Miami, Tampa, Orlando.

Analyst Consensus (mayo 2026)

Rating compuesto: Buy. MarketBeat (19 analistas): 37% Strong Buy + 37% Buy + 21% Hold + 5% Sell + 0% Strong Sell.
Mean target: ~$505 (TipRanks 19 analistas $510.21; consenso amplio 27 $505.04; mediana 45 $490, rango $368-$525).
Upside vs $429.01: +17.7% al mean target.
Post-Q1 2026: varios analistas recortaron targets (volúmenes débiles), mantuvieron Buy rating.

Riesgos Clave Cuantificados

ACA subsidy lapse: $600M-$900M FY2026 ($750M midpoint = ~1% revenue). Sin renovación legislativa, run-rate FY2027 similar.
OBBBA Medicaid phase-down: comienza 1-ene-2028, 10pp/año, durante 5 años.
Margen operativo comprimido: -70bps Q1 2026 vs Q1 2025.
Concentración TX+FL >50%: huracanes + políticas estatales.
Labor cost inflation: nurse-to-patient ratios, agency rates 30-40% sobre prepandemia.

Tesis en una línea

Comprar el operador de hospitales #1 de EE.UU. a P/E forward 12.94x — descuento vs históricos — con $10B nuevo buyback (10.5% market cap), dividendo +8.3%, y >$50B retirados de acciones desde 2017. ACA + OBBBA headwinds están priced; demografía sunbelt + Sarah Cannon están subpriced.

Research fecha: 4 May 2026 | Próxima revisión: Nov 2026

Esto no es asesoría financiera.

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Researched: 5/4/2026Updated: 5/4/2026Next review: 11/4/2026

This is not financial advice. Consult a certified financial advisor.

The author may hold positions in the securities discussed.

Past performance does not guarantee future results.