HCA HEALTHCARE, INC., 10-Q filed on 4/29/2026
Quarterly Report
v3.26.1
Cover Page - shares
 3 Months Ended
Mar. 31, 2026
Apr. 27, 2026
Cover [Abstract]    
Document Type 10-Q  
Amendment Flag false  
Document Period End Date Mar. 31, 2026  
Document Fiscal Year Focus 2026  
Document Fiscal Period Focus Q1  
Trading Symbol HCA  
Entity Registrant Name HCA Healthcare, Inc.  
Entity Central Index Key 0000860730  
Current Fiscal Year End Date --12-31  
Entity Current Reporting Status Yes  
Entity Filer Category Large Accelerated Filer  
Entity Shell Company false  
Entity Small Business false  
Entity Emerging Growth Company false  
Entity Common Stock, Shares Outstanding   221,839,800
Entity Interactive Data Current Yes  
Entity File Number 1-11239  
Entity Incorporation, State or Country Code DE  
Entity Tax Identification Number 27-3865930  
Entity Address, Address Line One One Park Plaza  
Entity Address, City or Town Nashville  
Entity Address, State or Province TN  
Entity Address, Postal Zip Code 37203  
City Area Code 615  
Local Phone Number 344-9551  
Document Quarterly Report true  
Document Transition Report false  
Title of 12(b) Security Voting common stock, $.01 par value  
Security Exchange Name NYSE  
v3.26.1
Condensed Consolidated Income Statements (Unaudited) - USD ($)
shares in Thousands, $ in Millions
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Income Statement [Abstract]    
Revenues $ 19,109 $ 18,321
Salaries and benefits 8,283 7,997
Supplies 2,853 2,764
Other operating expenses 4,180 3,845
Equity in earnings of affiliates (9) (18)
Depreciation and amortization 930 860
Interest expense 584 547
Losses (gains) on sales of facilities 1 (1)
Total expenses including equity in earnings of affiliates 16,822 15,994
Income before income taxes 2,287 2,327
Provision for income taxes 430 502
Net income 1,857 1,825
Net income attributable to noncontrolling interests 237 215
Net income attributable to HCA Healthcare, Inc. $ 1,620 $ 1,610
Per share data:    
Basic earnings $ 7.25 $ 6.52
Diluted earnings $ 7.15 $ 6.45
Shares used in earnings per share calculations (in millions):    
Basic 223,588 246,936
Diluted 226,652 249,440
v3.26.1
Condensed Consolidated Comprehensive Income Statements (Unaudited) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Statement of Comprehensive Income [Abstract]    
Net income $ 1,857 $ 1,825
Other comprehensive income (loss) before taxes:    
Foreign currency translation (24) 30
Unrealized (losses) gains on available-for-sale securities (1) 6
Other comprehensive (loss) income before taxes (25) 36
Income taxes (benefits) related to other comprehensive income items (3) 6
Other comprehensive (loss) income (22) 30
Comprehensive income 1,835 1,855
Comprehensive income attributable to noncontrolling interests 237 215
Comprehensive income attributable to HCA Healthcare, Inc. $ 1,598 $ 1,640
v3.26.1
Condensed Consolidated Balance Sheets - USD ($)
$ in Millions
Mar. 31, 2026
Dec. 31, 2025
Current assets:    
Cash and cash equivalents $ 940 $ 1,040
Accounts receivable 11,324 10,867
Inventories 1,681 1,652
Other 2,107 2,224
Total current assets 16,052 15,783
Property and equipment, at cost 67,365 66,275
Accumulated depreciation (35,893) (35,134)
Property and equipment, net 31,472 31,141
Investments of insurance subsidiaries 387 485
Investments in and advances to affiliates 615 633
Goodwill and other intangible assets 10,504 10,293
Right-of-use operating lease assets 2,094 2,130
Other 326 255
Total assets 61,450 60,720
Current liabilities:    
Accounts payable 4,806 4,659
Accrued salaries 2,022 2,525
Other accrued expenses 3,898 4,277
Short-term borrowings and long-term debt due within one year 8,532 4,889
Total current liabilities 19,258 16,350
Long-term debt, less debt issuance costs and discounts of $433 and $436 39,491 41,603
Professional liability risks 1,509 1,466
Right-of-use operating lease obligations 1,822 1,853
Income taxes and other liabilities 2,348 2,219
Stockholders' (deficit) equity:    
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 222,530,900 shares - 2026 and 224,605,100 shares - 2025 2 2
Accumulated other comprehensive loss (327) (305)
Retained deficit (5,978) (5,724)
Stockholders' deficit attributable to HCA Healthcare, Inc. (6,303) (6,027)
Noncontrolling interests 3,325 3,256
Total stockholders' (deficit) equity (2,978) (2,771)
Total liabilities and stockholders' (deficit) equity $ 61,450 $ 60,720
v3.26.1
Condensed Consolidated Balance Sheets (Parenthetical) - USD ($)
$ in Millions
Mar. 31, 2026
Dec. 31, 2025
Statement of Financial Position [Abstract]    
Debt issuance costs $ 433 $ 436
Common stock, par value $ 0.01 $ 0.01
Common stock, shares authorized 1,800,000,000 1,800,000,000
Common stock, shares issued not disclosed true true
Common stock, shares outstanding 222,530,900 224,605,100
v3.26.1
Condensed Consolidated Statements of Stockholders' (Deficit) Equity (Unaudited) - USD ($)
$ in Millions
Total
Common Stock [Member]
Capital in Excess of Par Value [Member]
Accumulated Other Comprehensive Loss [Member]
Retained Deficit [Member]
Equity Attributable to Noncontrolling Interests [Member]
Balances at Dec. 31, 2024 $ 555 $ 3   $ (387) $ (2,115) $ 3,054
Balance, shares at Dec. 31, 2024   249,981,000        
Comprehensive income (loss) 1,855     30 1,610 215
Repurchase of common stock (2,528) $ (1) $ (57)   (2,470)  
Repurchase of common stock, shares   (7,762,000)        
Share-based benefit plans 57   57      
Share-based benefit plans, shares   736,000        
Cash dividends declared (178)       (178)  
Distributions (220)         (220)
Other 21       (11) 32
Balance at Mar. 31, 2025 (438) $ 2   (357) (3,164) 3,081
Balance, shares at Mar. 31, 2025   242,955,000        
Comprehensive income (loss) 1,939     48 1,653 238
Repurchase of common stock (2,530)   (126)   (2,404)  
Repurchase of common stock, shares   (7,031,000.000)        
Share-based benefit plans 126   126      
Share-based benefit plans, shares   220,000        
Cash dividends declared (173)       (173)  
Distributions (174)         (174)
Other 12       1 11
Balance at Jun. 30, 2025 (1,238) $ 2   (309) (4,087) 3,156
Balance, shares at Jun. 30, 2025   236,144,000        
Comprehensive income (loss) 1,895     (8) 1,643 260
Repurchase of common stock (2,522)   (123)   (2,399)  
Repurchase of common stock, shares   (6,514,000)        
Share-based benefit plans 123   123      
Share-based benefit plans, shares   215,000        
Cash dividends declared (169)       (169)  
Distributions (237)         (237)
Other (11)       (8) (3)
Balance at Sep. 30, 2025 (2,159) $ 2   (317) (5,020) 3,176
Balance, shares at Sep. 30, 2025   229,845,000        
Comprehensive income (loss) 2,175     (12) 1,878 285
Repurchase of common stock (2,530)   (111)   (2,419)  
Repurchase of common stock, shares   (5,432,000)        
Share-based benefit plans 111   $ 111      
Share-based benefit plans, shares   192,000        
Cash dividends declared (164)       (164)  
Distributions (196)         (196)
Other (8)       1 (9)
Balance at Dec. 31, 2025 (2,771) $ 2   (305) (5,724) 3,256
Balance, shares at Dec. 31, 2025   224,605,000        
Comprehensive income (loss) 1,835     (22) 1,620 237
Repurchase of common stock (1,581)       (1,581)  
Repurchase of common stock, shares   (3,157,000)        
Share-based benefit plans (116)       (116)  
Share-based benefit plans, shares   1,155,000        
Cash dividends declared (176)       (176)  
Distributions (191)         (191)
Other 22       (1) 23
Other, Shares   (72,000.000)        
Balance at Mar. 31, 2026 $ (2,978) $ 2   $ (327) $ (5,978) $ 3,325
Balance, shares at Mar. 31, 2026   222,531,000        
v3.26.1
Condensed Consolidated Statements of Stockholders' (Deficit) Equity (Parenthetical) (Unaudited) - $ / shares
 3 Months Ended
Mar. 31, 2026
Dec. 31, 2025
Sep. 30, 2025
Jun. 30, 2025
Mar. 31, 2025
Statement of Stockholders' Equity [Abstract]          
Cash dividends declared, per share $ 0.78 $ 0.72 $ 0.72 $ 0.72 $ 0.72
v3.26.1
Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Cash flows from operating activities:    
Net income $ 1,857 $ 1,825
Increase (decrease) in cash from operating assets and liabilities:    
Accounts receivable (463) (327)
Inventories and other assets 80 (360)
Accounts payable and accrued expenses (990) (1,000)
Depreciation and amortization 930 860
Income taxes 435 492
Losses (gains) on sales of facilities 1 (1)
Amortization of debt issuance costs and discounts 11 11
Share-based compensation 86 98
Other 67 53
Net cash provided by operating activities 2,014 1,651
Cash flows from investing activities:    
Purchase of property and equipment (1,119) (991)
Acquisition of hospitals and health care entities (265) (227)
Sales of hospitals and health care entities 3 161
Change in investments 103 28
Other (4) (3)
Net cash used in investing activities (1,282) (1,032)
Cash flows from financing activities:    
Issuance of long-term debt 0 5,233
Net change in short-term borrowings and revolving credit facilities 1,435 220
Repayment of long-term debt (58) (3,895)
Distributions to noncontrolling interests (191) (220)
Payment of debt issuance costs 0 (57)
Payment of dividends (183) (180)
Repurchase of common stock (1,571) (2,506)
Other (262) (90)
Net cash used in financing activities (830) (1,495)
Effect of exchange rate changes on cash and cash equivalents (2) 3
Change in cash and cash equivalents (100) (873)
Cash and cash equivalents at beginning of period 1,040 1,933
Cash and cash equivalents at end of period 940 1,060
Interest payments 569 539
Income tax (refunds) payments, net $ (5) $ 10
v3.26.1
Pay vs Performance Disclosure - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Pay vs Performance Disclosure    
Net Income (Loss) $ 1,620 $ 1,610
v3.26.1
Insider Trading Arrangements
 3 Months Ended
Mar. 31, 2026
Trading Arrangements, by Individual  
Rule 10b5-1 Arrangement Adopted false
Non-Rule 10b5-1 Arrangement Adopted false
Rule 10b5-1 Arrangement Terminated false
Non-Rule 10b5-1 Arrangement Terminated false
v3.26.1
Basis of Presentation and Significant Accounting Policies
 3 Months Ended
Mar. 31, 2026
Accounting Policies [Abstract]  
Basis of Presentation and Significant Accounting Policies

NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

Reporting Entity

HCA Healthcare, Inc. is a holding company whose affiliates own and operate hospitals and related health care entities. The term “affiliates” includes direct and indirect subsidiaries of HCA Healthcare, Inc. and partnerships and joint ventures in which such subsidiaries are partners. At March 31, 2026, these affiliates owned and operated 189 hospitals, 119 freestanding surgery centers and 30 freestanding endoscopy centers and provided extensive outpatient and ancillary services. HCA Healthcare, Inc.’s facilities are located in 19 states and England. The terms “Company,” “HCA,” “we,” “our” or “us,” as used herein and unless otherwise stated or indicated by context, refer to HCA Healthcare, Inc. and its affiliates. The terms “facilities” or “hospitals” refer to entities owned and operated by affiliates of HCA and the term “employees” refers to employees of affiliates of HCA.

Basis of Presentation

The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete consolidated financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included and are of a normal and recurring nature.

The majority of our expenses are “costs of revenues” items. Costs that could be classified as general and administrative would include our corporate office costs, which were $133 million and $126 million for the quarters ended March 31, 2026 and 2025, respectively. Operating results for the quarter are not necessarily indicative of the results that may be expected for the year ending December 31, 2026. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K for the year ended December 31, 2025.

Revenues

Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals.

NOTE 1 — BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES (continued)

Revenues (continued)

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 these 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 ended March 31, 2026 and 2025 are summarized in the following table (dollars in millions):

 

2026

 

 

Ratio

 

 

2025

 

 

Ratio

 

Medicare

 

$

3,058

 

 

 

16.0

%

 

$

2,895

 

 

 

15.8

%

Managed Medicare

 

 

3,508

 

 

 

18.4

 

 

 

3,299

 

 

 

18.0

 

Medicaid

 

 

1,444

 

 

 

7.6

 

 

 

1,190

 

 

 

6.5

 

Managed Medicaid

 

 

939

 

 

 

4.9

 

 

 

879

 

 

 

4.8

 

Managed care and insurers

 

 

9,084

 

 

 

47.5

 

 

 

9,041

 

 

 

49.4

 

International (managed care and insurers)

 

 

499

 

 

 

2.6

 

 

 

445

 

 

 

2.4

 

Other

 

 

577

 

 

 

3.0

 

 

 

572

 

 

 

3.1

 

Revenues

 

$

19,109

 

 

 

100.0

%

 

$

18,321

 

 

 

100.0

%

As expected, during the quarter ended March 31, 2026, our revenues from managed care and insurers were unfavorably impacted by the expiration of the enhanced premium tax credits at the end of 2025 and administrative reforms, both related to insurance purchased through the federal and state-based health insurance marketplaces (“Exchanges”).

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 ended March 31, 2026 and 2025 follows (dollars in millions):

 

2026

 

 

2025

 

Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation
   and amortization)

 

$

16,246

 

 

$

15,466

 

Cost-to-charges ratio (patient care costs as a percentage of gross patient charges)

 

 

9.2

%

 

 

9.6

%

Total uncompensated care

 

$

13,612

 

 

$

10,993

 

Multiply by the cost-to-charges ratio

 

 

9.2

%

 

 

9.6

%

Estimated cost of total uncompensated care

 

$

1,252

 

 

$

1,055

 

 

The total uncompensated care amounts for the quarters ended March 31, 2026 and 2025 include charity care of $5.513 billion and $3.644 billion, respectively, and the related estimated costs of charity care were $507 million and $350 million, respectively.

Reclassifications

Certain prior year amounts have been reclassified to conform to the current year presentation.
v3.26.1
Acquisitions and Dispositions
 3 Months Ended
Mar. 31, 2026
Business Combination [Abstract]  
Acquisitions and Dispositions

NOTE 2 — ACQUISITIONS AND DISPOSITIONS

During the quarter ended March 31, 2026, we paid $265 million to acquire nonhospital health care entities. During the quarter ended March 31, 2025, we paid $190 million to acquire two hospital facilities in New Hampshire and Florida and $37 million to acquire nonhospital health care entities.

During the quarter ended March 31, 2026, we received proceeds of $3 million and recognized a pretax loss of $1 million related to sales of real estate and other health care entity investments. During the quarter ended March 31, 2025, we received proceeds of $157 million related to the sale of a hospital facility in California. We also received proceeds of $4 million and recognized a pretax gain of $1 million related to sales of real estate and other health care entity investments.

v3.26.1
Income Taxes
 3 Months Ended
Mar. 31, 2026
Income Tax Disclosure [Abstract]  
Income Taxes

NOTE 3 — INCOME TAXES

Our provisions for income taxes for the quarters ended March 31, 2026 and 2025 were $430 million and $502 million, respectively, and the effective tax rate was was 18.8% and 21.6% (21.0% and 23.8% excluding net income attributable to noncontrolling interests as it relates to consolidated partnerships), respectively. The decline in the effective tax rate for the quarter ended March 31, 2026 is related primarily to an increase in the amount of deductible share-based compensation for vested employee equity awards. Our provisions for income taxes included tax benefits related to settlements of employee equity awards of $103 million and $24 million for the quarters ended March 31, 2026 and 2025, respectively.

Our gross unrecognized tax benefits were $535 million, excluding accrued interest and penalties of $88 million, as of March 31, 2026 ($519 million and $78 million, respectively, as of December 31, 2025). Unrecognized tax benefits of $290 million ($274 million as of December 31, 2025) would affect the effective rate, if recognized.

At March 31, 2026, the Internal Revenue Service (“IRS”) was examining the 2019 income tax return of an affiliate of the Company. We are subject to examination by the IRS for tax years after 2023, as well as by state and foreign taxing authorities.

v3.26.1
Earnings Per Share
 3 Months Ended
Mar. 31, 2026
Earnings Per Share [Abstract]  
Earnings Per Share

NOTE 4 — EARNINGS PER SHARE

We compute basic earnings per share using the weighted average number of common shares outstanding. We compute diluted earnings per share using the weighted average number of common shares outstanding, plus the dilutive effect of outstanding equity awards, computed using the treasury stock method.

The following table sets forth the computation of basic and diluted earnings per share for the quarters ended March 31, 2026 and 2025 (dollars and shares in millions, except per share amounts):

 

 

2026

 

 

2025

 

Net income attributable to HCA Healthcare, Inc.

 

$

1,620

 

 

$

1,610

 

 

 

 

 

 

 

 

Weighted average common shares outstanding

 

 

223.588

 

 

 

246.936

 

Effect of dilutive incremental shares

 

 

3.064

 

 

 

2.504

 

Shares used for diluted earnings per share

 

 

226.652

 

 

 

249.440

 

Earnings per share:

 

 

 

 

 

 

Basic earnings

 

$

7.25

 

 

$

6.52

 

Diluted earnings

 

$

7.15

 

 

$

6.45

 

 
v3.26.1
Investments of Insurance Subsidiaries
 3 Months Ended
Mar. 31, 2026
Investments, Debt and Equity Securities [Abstract]  
Investments of Insurance Subsidiaries

NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES

A summary of our insurance subsidiaries’ investments at March 31, 2026 and December 31, 2025 follows (dollars in millions):

 

 

March 31, 2026

 

 

 

 

 

Unrealized
Amounts

 

 

 

 

 

Amortized
Cost

 

 

Gains

 

 

Losses

 

 

Fair
Value

 

Debt securities

 

$

338

 

 

$

1

 

 

$

(16

)

 

$

323

 

Money market funds and other

 

 

188

 

 

 

—

 

 

 

—

 

 

 

188

 

 

$

526

 

 

$

1

 

 

$

(16

)

 

 

511

 

Amounts classified as current assets

 

 

 

 

 

 

 

 

 

 

 

(124

)

Investment carrying value

 

 

 

 

 

 

 

 

 

 

$

387

 

 

 

December 31, 2025

 

 

 

 

 

Unrealized
Amounts

 

 

 

 

 

Amortized
Cost

 

 

Gains

 

 

Losses

 

 

Fair
Value

 

Debt securities

 

$

342

 

 

$

1

 

 

$

(15

)

 

$

328

 

Money market funds and other

 

 

260

 

 

 

—

 

 

 

—

 

 

 

260

 

 

$

602

 

 

$

1

 

 

$

(15

)

 

 

588

 

Amounts classified as current assets

 

 

 

 

 

 

 

 

 

 

 

(103

)

Investment carrying value

 

 

 

 

 

 

 

 

 

 

$

485

 

 

At March 31, 2026 and December 31, 2025, the investments in debt securities of our insurance subsidiaries were classified as “available-for-sale.” Changes in unrealized gains and losses that are not credit-related are recorded as adjustments to other comprehensive income or loss.

 

Scheduled maturities of investments in debt securities at March 31, 2026 were as follows (dollars in millions):

 

 

Amortized
Cost

 

 

Fair
Value

 

Due in one year or less

 

$

38

 

 

$

38

 

Due after one year through five years

 

 

142

 

 

 

136

 

Due after five years through ten years

 

 

103

 

 

 

97

 

Due after ten years

 

 

55

 

 

 

52

 

 

$

338

 

 

$

323

 

 

The average expected maturity of the investments in debt securities at March 31, 2026 was 3.8 years, compared to the average scheduled maturity of 7.6 years. Expected and scheduled maturities may differ because the issuers of certain securities have the right to call, prepay or otherwise redeem such obligations prior to their scheduled maturity date.
v3.26.1
Assets and Liabilities Measured at Fair Value
 3 Months Ended
Mar. 31, 2026
Fair Value Disclosures [Abstract]  
Assets and Liabilities Measured at Fair Value

NOTE 6 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE

Accounting Standards Codification 820, Fair Value Measurements and Disclosures (“ASC 820”), emphasizes fair value is a market-based measurement, and fair value measurements should be determined based on the assumptions market participants would use in pricing assets or liabilities. ASC 820 utilizes a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs classified within Levels 1 and 2 of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy).

Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity.

The investments of our insurance subsidiaries are generally classified within Level 1 or Level 2 of the fair value hierarchy because they are valued using quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price transparency.

The following tables summarize the investments of our insurance subsidiaries measured at fair value on a recurring basis as of March 31, 2026 and December 31, 2025, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):

 

 

March 31, 2026

 

 

 

 

 

Fair Value Measurements Using

 

 

Fair Value

 

 

Quoted Prices in
Active Markets for
Identical Assets
(Level 1)

 

 

Significant Other
Observable Inputs
(Level 2)

 

 

Significant
Unobservable Inputs
(Level 3)

 

Debt securities

 

$

323

 

 

$

1

 

 

$

322

 

 

$

—

 

Money market funds and other

 

 

188

 

 

 

188

 

 

 

—

 

 

 

—

 

Investments of insurance subsidiaries

 

 

511

 

 

 

189

 

 

 

322

 

 

 

—

 

Less amounts classified as current assets

 

 

(124

)

 

 

(124

)

 

 

—

 

 

 

—

 

 

$

387

 

 

$

65

 

 

$

322

 

 

$

—

 

 

 

December 31, 2025

 

 

 

 

 

Fair Value Measurements Using

 

 

Fair Value

 

 

Quoted Prices in
Active Markets for
Identical Assets
(Level 1)

 

 

Significant Other
Observable Inputs
(Level 2)

 

 

Significant
Unobservable Inputs
(Level 3)

 

Debt securities

 

$

328

 

 

$

1

 

 

$

327

 

 

$

—

 

Money market funds and other

 

 

260

 

 

 

260

 

 

 

—

 

 

 

—

 

Investments of insurance subsidiaries

 

 

588

 

 

 

261

 

 

 

327

 

 

 

—

 

Less amounts classified as current assets

 

 

(103

)

 

 

(103

)

 

 

—

 

 

 

—

 

 

$

485

 

 

$

158

 

 

$

327

 

 

$

—

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTE 6 — ASSETS AND LIABILITIES MEASURED AT FAIR VALUE (continued)

The estimated fair value of our debt was $46.653 billion and $45.911 billion at March 31, 2026 and December 31, 2025, respectively, compared to carrying amounts, excluding debt issuance costs and discounts, aggregating $48.456 billion and $46.928 billion, respectively. The estimates of fair value are generally based on Level 2 inputs, including quoted market prices or quoted market prices for similar issues of debt with the same maturities.
v3.26.1
Debt
 3 Months Ended
Mar. 31, 2026
Debt Disclosure [Abstract]  
Debt

NOTE 7 — DEBT

A summary of our debt at March 31, 2026 and December 31, 2025, including related interest rates at March 31, 2026, follows (dollars in millions):

 

 

 

2026

 

 

2025

 

Short-term borrowings:

 

 

 

 

 

 

Commercial paper (average life of 30 days, weighted average rate of 4.3%)

 

$

3,650

 

 

$

2,207

 

Long-term debt:

 

 

 

 

 

 

Other senior secured debt (effective interest rate of 4.8%)

 

 

1,106

 

 

 

1,021

 

Senior unsecured credit facilities

 

 

—

 

 

 

—

 

Senior unsecured notes payable through 2095 (effective interest rate of 5.1%)

 

 

43,700

 

 

 

43,700

 

Debt issuance costs and discounts

 

 

(433

)

 

 

(436

)

Total long-term debt (average life of 11.7 years, rates averaging 5.1%)

 

 

44,373

 

 

 

44,285

 

Total debt

 

 

48,023

 

 

 

46,492

 

Less amounts due within one year

 

 

8,532

 

 

 

4,889

 

 

$

39,491

 

 

$

41,603

 
v3.26.1
Contingencies
 3 Months Ended
Mar. 31, 2026
Commitments and Contingencies Disclosure [Abstract]  
Contingencies

NOTE 8 — CONTINGENCIES

We operate in a highly regulated and litigious industry. As a result, various lawsuits, claims and legal and regulatory proceedings have been and can be expected to be instituted or asserted against us. We are also subject to claims and suits arising in the ordinary course of business, including claims for personal injuries or wrongful restriction of, or interference with, physicians’ staff privileges. In certain of these actions the claimants may seek punitive damages against us, which may not be covered by insurance. We are also subject to claims by various taxing authorities for additional taxes and related interest and penalties. The resolution of any such lawsuits, claims or legal and regulatory proceedings could have a material, adverse effect on our results of operations, financial position or liquidity.

Health care companies are subject to numerous investigations by various governmental agencies. Under the federal False Claims Act (“FCA”), private parties have the right to bring qui tam, or “whistleblower,” suits against companies that submit false claims for payments to, or improperly retain overpayments from, the government. Some states have adopted similar state whistleblower and false claims provisions. Certain of our individual facilities have received, and from time to time other facilities may receive, government inquiries from, and may be subject to investigation by, federal and state agencies. Depending on whether the underlying conduct in these or future inquiries or investigations could be considered systemic, their resolution could have a material, adverse effect on our results of operations, financial position or liquidity.

We accrue for such contingencies to the extent that it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. If we are a party to any proceeding that, either individually or in the aggregate, is probable or reasonably possible of having a material, adverse effect on the business, our results of operations, financial position or liquidity, we disclose a summary of such contingencies and the amount or range of reasonably possible losses in excess of recorded amounts or that we are unable to reasonably estimate the amount or range of losses.
v3.26.1
Capital Stock, Share Repurchase Transactions and Other Comprehensive Loss
 3 Months Ended
Mar. 31, 2026
Equity [Abstract]  
Capital Stock, Share Repurchase Transactions and Other Comprehensive Loss

NOTE 9 — CAPITAL STOCK, SHARE REPURCHASE TRANSACTIONS AND OTHER COMPREHENSIVE LOSS

On February 6, 2026, the Company entered into an Exchange Agreement with an entity controlled by the Company’s founder, Dr. Thomas F. Frist, Jr. and certain of his affiliates. Under the Exchange Agreement, the Company exchanged 36,629,188 shares of our common stock delivered to the Company for 36,557,141 new shares of our common stock (the “Exchange”). Upon receipt of the exchanged shares, the Company retired and canceled the shares, which ceased to be outstanding and returned to the status of authorized but unissued shares. As a result, the net effect of the Exchange was a decrease of 72,047 shares of our outstanding common stock.

During each of January 2026 and January 2025, our Board of Directors authorized share repurchase programs, both of which were for up to $10 billion of our outstanding common stock. During the quarter ended March 31, 2026, we repurchased 3.157 million shares of our common stock at an average price of $497.63 per share through market purchases pursuant to the January 2025 authorization (which was fully utilized during the first quarter of 2026) and the January 2026 authorization. At March 31, 2026, we had $9.179 billion of repurchase authorization available under the January 2026 authorization.

The components of accumulated other comprehensive loss are as follows (dollars in millions):

 

Unrealized
Losses on
Available-for-Sale
Securities

 

 

Foreign
Currency
Translation
Adjustments

 

 

Defined
Benefit
Plans

 

 

Total

 

Balances at December 31, 2025

$

(11

)

 

$

(299

)

 

$

5

 

 

$

(305

)

Unrealized losses on available-for-sale
   securities

 

(1

)

 

 

 

 

 

 

 

 

(1

)

Foreign currency translation adjustments, net
   of $3 income tax benefit

 

 

 

 

(21

)

 

 

 

 

 

(21

)

Balances at March 31, 2026

$

(12

)

 

$

(320

)

 

$

5

 

 

$

(327

)
v3.26.1
Segment and Geographic Information
 3 Months Ended
Mar. 31, 2026
Segment Reporting [Abstract]  
Segment and Geographic Information

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION

We operate in one line of business, which is operating hospitals and related health care entities. We operate in three geographically organized groups: the National, Atlantic and American Groups. At March 31, 2026, the National Group included 53 hospitals located in Alaska, California, Idaho, Kentucky, Nevada, New Hampshire, North Carolina, Tennessee, Utah and Virginia; the Atlantic Group included 63 hospitals located in Florida, Georgia, Northern Kansas, Missouri and South Carolina; and the American Group included 66 hospitals located in Colorado, Central Kansas, Louisiana and Texas. The seven hospitals we operate in England are included in the Corporate and other group.

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses and gains on sales of facilities, losses on retirement of debt, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry, and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, salaries and benefits, supplies, other operating expenses, equity in earnings of affiliates, adjusted segment EBITDA, depreciation and amortization and assets that are provided to the Chief Operating Decision Maker, which is the Chief Executive Officer, are summarized in the following tables (dollars in millions) and represent the operating segments for the quarters ended March 31, 2026 and 2025 and assets at March 31, 2026 and December 31, 2025:

 

 

2026

 

 

 

National
Group

 

 

Atlantic
Group

 

 

American
Group

 

Revenues

 

$

5,321

 

 

$

6,363

 

 

$

6,566

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

1,966

 

 

 

2,286

 

 

 

2,277

 

Supplies

 

 

763

 

 

 

944

 

 

 

1,059

 

Other operating expenses

 

 

1,334

 

 

 

1,695

 

 

 

1,831

 

Equity in earnings of affiliates

 

 

—

 

 

 

(1

)

 

 

(15

)

 

 

 

4,063

 

 

 

4,924

 

 

 

5,152

 

Adjusted segment EBITDA

 

$

1,258

 

 

$

1,439

 

 

$

1,414

 

 

 

 

2025

 

 

 

National
Group

 

 

Atlantic
Group

 

 

American
Group

 

Revenues

 

$

5,065

 

 

$

6,167

 

 

$

6,331

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

1,959

 

 

 

2,216

 

 

 

2,196

 

Supplies

 

 

741

 

 

 

914

 

 

 

1,020

 

Other operating expenses

 

 

1,233

 

 

 

1,576

 

 

 

1,711

 

Equity in earnings of affiliates

 

 

—

 

 

 

(1

)

 

 

(14

)

 

 

 

3,933

 

 

 

4,705

 

 

 

4,913

 

Adjusted segment EBITDA

 

$

1,132

 

 

$

1,462

 

 

$

1,418

 

 

 

 

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

 

 

2026

 

 

2025

 

Adjusted segment EBITDA:

 

 

 

 

 

 

National Group

 

$

1,258

 

 

$

1,132

 

Atlantic Group

 

 

1,439

 

 

 

1,462

 

American Group

 

 

1,414

 

 

 

1,418

 

 

 

 

4,111

 

 

 

4,012

 

Adjustments to reconcile Total Adjusted segment
  EBITDA to consolidated Income before income taxes:

 

 

 

 

 

 

Corporate and Other

 

 

309

 

 

 

279

 

Depreciation and amortization

 

 

930

 

 

 

860

 

Interest expense

 

 

584

 

 

 

547

 

Losses (gains) on sales of facilities

 

 

1

 

 

 

(1

)

Income before income taxes

 

$

2,287

 

 

$

2,327

 

 

 

2026

 

 

2025

 

 

Revenues:

 

 

 

 

 

 

 

National Group

 

$

5,321

 

 

$

5,065

 

 

Atlantic Group

 

 

6,363

 

 

 

6,167

 

 

American Group

 

 

6,566

 

 

 

6,331

 

 

Corporate and other

 

 

859

 

 

 

758

 

 

 

$

19,109

 

 

$

18,321

 

 

Depreciation and amortization:

 

 

 

 

 

 

 

National Group

 

$

236

 

 

$

226

 

 

Atlantic Group

 

 

298

 

 

 

274

 

 

American Group

 

 

295

 

 

 

279

 

 

Corporate and other

 

 

101

 

 

 

81

 

 

 

$

930

 

 

$

860

 

 

 

 

 

 

 

 

 

 

 

 

 

 

March 31,
2026

 

 

December 31,
2025

 

Assets:

 

 

 

 

 

 

National Group

 

$

13,596

 

 

$

13,596

 

Atlantic Group

 

 

18,691

 

 

 

17,945

 

American Group

 

 

21,251

 

 

 

21,217

 

Corporate and other

 

 

7,912

 

 

 

7,962

 

 

 

$

61,450

 

 

$

60,720

 
v3.26.1
Basis of Presentation and Significant Accounting Policies (Policies)
 3 Months Ended
Mar. 31, 2026
Accounting Policies [Abstract]  
Basis of Presentation

Basis of Presentation

The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete consolidated financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included and are of a normal and recurring nature.

The majority of our expenses are “costs of revenues” items. Costs that could be classified as general and administrative would include our corporate office costs, which were $133 million and $126 million for the quarters ended March 31, 2026 and 2025, respectively. Operating results for the quarter are not necessarily indicative of the results that may be expected for the year ending December 31, 2026. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K for the year ended December 31, 2025.

Revenues

Revenues

Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the health insurance exchanges) and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals.

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 these 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 ended March 31, 2026 and 2025 are summarized in the following table (dollars in millions):

 

2026

 

 

Ratio

 

 

2025

 

 

Ratio

 

Medicare

 

$

3,058

 

 

 

16.0

%

 

$

2,895

 

 

 

15.8

%

Managed Medicare

 

 

3,508

 

 

 

18.4

 

 

 

3,299

 

 

 

18.0

 

Medicaid

 

 

1,444

 

 

 

7.6

 

 

 

1,190

 

 

 

6.5

 

Managed Medicaid

 

 

939

 

 

 

4.9

 

 

 

879

 

 

 

4.8

 

Managed care and insurers

 

 

9,084

 

 

 

47.5

 

 

 

9,041

 

 

 

49.4

 

International (managed care and insurers)

 

 

499

 

 

 

2.6

 

 

 

445

 

 

 

2.4

 

Other

 

 

577

 

 

 

3.0

 

 

 

572

 

 

 

3.1

 

Revenues

 

$

19,109

 

 

 

100.0

%

 

$

18,321

 

 

 

100.0

%

As expected, during the quarter ended March 31, 2026, our revenues from managed care and insurers were unfavorably impacted by the expiration of the enhanced premium tax credits at the end of 2025 and administrative reforms, both related to insurance purchased through the federal and state-based health insurance marketplaces (“Exchanges”).

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 ended March 31, 2026 and 2025 follows (dollars in millions):

 

2026

 

 

2025

 

Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation
   and amortization)

 

$

16,246

 

 

$

15,466

 

Cost-to-charges ratio (patient care costs as a percentage of gross patient charges)

 

 

9.2

%

 

 

9.6

%

Total uncompensated care

 

$

13,612

 

 

$

10,993

 

Multiply by the cost-to-charges ratio

 

 

9.2

%

 

 

9.6

%

Estimated cost of total uncompensated care

 

$

1,252

 

 

$

1,055

 

 

The total uncompensated care amounts for the quarters ended March 31, 2026 and 2025 include charity care of $5.513 billion and $3.644 billion, respectively, and the related estimated costs of charity care were $507 million and $350 million, respectively.
Reclassifications

Reclassifications

Certain prior year amounts have been reclassified to conform to the current year presentation.
Earnings Per Share We compute basic earnings per share using the weighted average number of common shares outstanding. We compute diluted earnings per share using the weighted average number of common shares outstanding, plus the dilutive effect of outstanding equity awards, computed using the treasury stock method.
Fair Value Measurements and Disclosures

Accounting Standards Codification 820, Fair Value Measurements and Disclosures (“ASC 820”), emphasizes fair value is a market-based measurement, and fair value measurements should be determined based on the assumptions market participants would use in pricing assets or liabilities. ASC 820 utilizes a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs classified within Levels 1 and 2 of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy).

Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates, and yield curves observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity’s own assumptions, as there is little, if any, related market activity.
Investment Securities

The investments of our insurance subsidiaries are generally classified within Level 1 or Level 2 of the fair value hierarchy because they are valued using quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price transparency.

v3.26.1
Basis of Presentation and Significant Accounting Policies (Tables)
 3 Months Ended
Mar. 31, 2026
Accounting Policies [Abstract]  
Schedule of Revenues from Third Party Payers, Uninsured and Other Payers Our revenues by primary third-party payer classification and other (including uninsured patients) for the quarters ended March 31, 2026 and 2025 are summarized in the following table (dollars in millions):

 

2026

 

 

Ratio

 

 

2025

 

 

Ratio

 

Medicare

 

$

3,058

 

 

 

16.0

%

 

$

2,895

 

 

 

15.8

%

Managed Medicare

 

 

3,508

 

 

 

18.4

 

 

 

3,299

 

 

 

18.0

 

Medicaid

 

 

1,444

 

 

 

7.6

 

 

 

1,190

 

 

 

6.5

 

Managed Medicaid

 

 

939

 

 

 

4.9

 

 

 

879

 

 

 

4.8

 

Managed care and insurers

 

 

9,084

 

 

 

47.5

 

 

 

9,041

 

 

 

49.4

 

International (managed care and insurers)

 

 

499

 

 

 

2.6

 

 

 

445

 

 

 

2.4

 

Other

 

 

577

 

 

 

3.0

 

 

 

572

 

 

 

3.1

 

Revenues

 

$

19,109

 

 

 

100.0

%

 

$

18,321

 

 

 

100.0

%
Schedule of Estimated Cost of Uncompensated Care A summary of the estimated cost of total uncompensated care for the quarters ended March 31, 2026 and 2025 follows (dollars in millions):

 

2026

 

 

2025

 

Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation
   and amortization)

 

$

16,246

 

 

$

15,466

 

Cost-to-charges ratio (patient care costs as a percentage of gross patient charges)

 

 

9.2

%

 

 

9.6

%

Total uncompensated care

 

$

13,612

 

 

$

10,993

 

Multiply by the cost-to-charges ratio

 

 

9.2

%

 

 

9.6

%

Estimated cost of total uncompensated care

 

$

1,252

 

 

$

1,055

 
v3.26.1
Earnings Per Share (Tables)
 3 Months Ended
Mar. 31, 2026
Earnings Per Share [Abstract]  
Schedule of Computations of Basic and Diluted Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share for the quarters ended March 31, 2026 and 2025 (dollars and shares in millions, except per share amounts):

 

 

2026

 

 

2025

 

Net income attributable to HCA Healthcare, Inc.

 

$

1,620

 

 

$

1,610

 

 

 

 

 

 

 

 

Weighted average common shares outstanding

 

 

223.588

 

 

 

246.936

 

Effect of dilutive incremental shares

 

 

3.064

 

 

 

2.504

 

Shares used for diluted earnings per share

 

 

226.652

 

 

 

249.440

 

Earnings per share:

 

 

 

 

 

 

Basic earnings

 

$

7.25

 

 

$

6.52

 

Diluted earnings

 

$

7.15

 

 

$

6.45

 

 
v3.26.1
Investments of Insurance Subsidiaries (Tables)
 3 Months Ended
Mar. 31, 2026
Investments, Debt and Equity Securities [Abstract]  
Schedule of Investments

A summary of our insurance subsidiaries’ investments at March 31, 2026 and December 31, 2025 follows (dollars in millions):

 

 

March 31, 2026

 

 

 

 

 

Unrealized
Amounts

 

 

 

 

 

Amortized
Cost

 

 

Gains

 

 

Losses

 

 

Fair
Value

 

Debt securities

 

$

338

 

 

$

1

 

 

$

(16

)

 

$

323

 

Money market funds and other

 

 

188

 

 

 

—

 

 

 

—

 

 

 

188

 

 

$

526

 

 

$

1

 

 

$

(16

)

 

 

511

 

Amounts classified as current assets

 

 

 

 

 

 

 

 

 

 

 

(124

)

Investment carrying value

 

 

 

 

 

 

 

 

 

 

$

387

 

 

 

December 31, 2025

 

 

 

 

 

Unrealized
Amounts

 

 

 

 

 

Amortized
Cost

 

 

Gains

 

 

Losses

 

 

Fair
Value

 

Debt securities

 

$

342

 

 

$

1

 

 

$

(15

)

 

$

328

 

Money market funds and other

 

 

260

 

 

 

—

 

 

 

—

 

 

 

260

 

 

$

602

 

 

$

1

 

 

$

(15

)

 

 

588

 

Amounts classified as current assets

 

 

 

 

 

 

 

 

 

 

 

(103

)

Investment carrying value

 

 

 

 

 

 

 

 

 

 

$

485

 
Schedule of Maturities of Investments

Scheduled maturities of investments in debt securities at March 31, 2026 were as follows (dollars in millions):

 

 

Amortized
Cost

 

 

Fair
Value

 

Due in one year or less

 

$

38

 

 

$

38

 

Due after one year through five years

 

 

142

 

 

 

136

 

Due after five years through ten years

 

 

103

 

 

 

97

 

Due after ten years

 

 

55

 

 

 

52

 

 

$

338

 

 

$

323

 
v3.26.1
Assets and Liabilities Measured at Fair Value (Tables)
 3 Months Ended
Mar. 31, 2026
Fair Value Disclosures [Abstract]  
Summary of Investments of Insurance Subsidiaries Measured at Fair Value on Recurring Basis

The following tables summarize the investments of our insurance subsidiaries measured at fair value on a recurring basis as of March 31, 2026 and December 31, 2025, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):

 

 

March 31, 2026

 

 

 

 

 

Fair Value Measurements Using

 

 

Fair Value

 

 

Quoted Prices in
Active Markets for
Identical Assets
(Level 1)

 

 

Significant Other
Observable Inputs
(Level 2)

 

 

Significant
Unobservable Inputs
(Level 3)

 

Debt securities

 

$

323

 

 

$

1

 

 

$

322

 

 

$

—

 

Money market funds and other

 

 

188

 

 

 

188

 

 

 

—

 

 

 

—

 

Investments of insurance subsidiaries

 

 

511

 

 

 

189

 

 

 

322

 

 

 

—

 

Less amounts classified as current assets

 

 

(124

)

 

 

(124

)

 

 

—

 

 

 

—

 

 

$

387

 

 

$

65

 

 

$

322

 

 

$

—

 

 

 

December 31, 2025

 

 

 

 

 

Fair Value Measurements Using

 

 

Fair Value

 

 

Quoted Prices in
Active Markets for
Identical Assets
(Level 1)

 

 

Significant Other
Observable Inputs
(Level 2)

 

 

Significant
Unobservable Inputs
(Level 3)

 

Debt securities

 

$

328

 

 

$

1

 

 

$

327

 

 

$

—

 

Money market funds and other

 

 

260

 

 

 

260

 

 

 

—

 

 

 

—

 

Investments of insurance subsidiaries

 

 

588

 

 

 

261

 

 

 

327

 

 

 

—

 

Less amounts classified as current assets

 

 

(103

)

 

 

(103

)

 

 

—

 

 

 

—

 

 

$

485

 

 

$

158

 

 

$

327

 

 

$

—

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
v3.26.1
Debt (Tables)
 3 Months Ended
Mar. 31, 2026
Debt Disclosure [Abstract]  
Schedule of Debt

A summary of our debt at March 31, 2026 and December 31, 2025, including related interest rates at March 31, 2026, follows (dollars in millions):

 

 

 

2026

 

 

2025

 

Short-term borrowings:

 

 

 

 

 

 

Commercial paper (average life of 30 days, weighted average rate of 4.3%)

 

$

3,650

 

 

$

2,207

 

Long-term debt:

 

 

 

 

 

 

Other senior secured debt (effective interest rate of 4.8%)

 

 

1,106

 

 

 

1,021

 

Senior unsecured credit facilities

 

 

—

 

 

 

—

 

Senior unsecured notes payable through 2095 (effective interest rate of 5.1%)

 

 

43,700

 

 

 

43,700

 

Debt issuance costs and discounts

 

 

(433

)

 

 

(436

)

Total long-term debt (average life of 11.7 years, rates averaging 5.1%)

 

 

44,373

 

 

 

44,285

 

Total debt

 

 

48,023

 

 

 

46,492

 

Less amounts due within one year

 

 

8,532

 

 

 

4,889

 

 

$

39,491

 

 

$

41,603

 
v3.26.1
Capital Stock, Share Repurchase Transactions and Other Comprehensive Loss (Tables)
 3 Months Ended
Mar. 31, 2026
Equity [Abstract]  
Components of Accumulated Other Comprehensive Loss

The components of accumulated other comprehensive loss are as follows (dollars in millions):

 

Unrealized
Losses on
Available-for-Sale
Securities

 

 

Foreign
Currency
Translation
Adjustments

 

 

Defined
Benefit
Plans

 

 

Total

 

Balances at December 31, 2025

$

(11

)

 

$

(299

)

 

$

5

 

 

$

(305

)

Unrealized losses on available-for-sale
   securities

 

(1

)

 

 

 

 

 

 

 

 

(1

)

Foreign currency translation adjustments, net
   of $3 income tax benefit

 

 

 

 

(21

)

 

 

 

 

 

(21

)

Balances at March 31, 2026

$

(12

)

 

$

(320

)

 

$

5

 

 

$

(327

)
v3.26.1
Segment and Geographic Information (Tables)
 3 Months Ended
Mar. 31, 2026
Segment Reporting [Abstract]  
Schedule of Geographic Distributions of Revenues, Equity in Earnings or Losses of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization The geographic distributions of our revenues, salaries and benefits, supplies, other operating expenses, equity in earnings of affiliates, adjusted segment EBITDA, depreciation and amortization and assets that are provided to the Chief Operating Decision Maker, which is the Chief Executive Officer, are summarized in the following tables (dollars in millions) and represent the operating segments for the quarters ended March 31, 2026 and 2025 and assets at March 31, 2026 and December 31, 2025:

 

 

2026

 

 

 

National
Group

 

 

Atlantic
Group

 

 

American
Group

 

Revenues

 

$

5,321

 

 

$

6,363

 

 

$

6,566

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

1,966

 

 

 

2,286

 

 

 

2,277

 

Supplies

 

 

763

 

 

 

944

 

 

 

1,059

 

Other operating expenses

 

 

1,334

 

 

 

1,695

 

 

 

1,831

 

Equity in earnings of affiliates

 

 

—

 

 

 

(1

)

 

 

(15

)

 

 

 

4,063

 

 

 

4,924

 

 

 

5,152

 

Adjusted segment EBITDA

 

$

1,258

 

 

$

1,439

 

 

$

1,414

 

 

 

 

2025

 

 

 

National
Group

 

 

Atlantic
Group

 

 

American
Group

 

Revenues

 

$

5,065

 

 

$

6,167

 

 

$

6,331

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

1,959

 

 

 

2,216

 

 

 

2,196

 

Supplies

 

 

741

 

 

 

914

 

 

 

1,020

 

Other operating expenses

 

 

1,233

 

 

 

1,576

 

 

 

1,711

 

Equity in earnings of affiliates

 

 

—

 

 

 

(1

)

 

 

(14

)

 

 

 

3,933

 

 

 

4,705

 

 

 

4,913

 

Adjusted segment EBITDA

 

$

1,132

 

 

$

1,462

 

 

$

1,418

 

 

 

 

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

 

 

2026

 

 

2025

 

Adjusted segment EBITDA:

 

 

 

 

 

 

National Group

 

$

1,258

 

 

$

1,132

 

Atlantic Group

 

 

1,439

 

 

 

1,462

 

American Group

 

 

1,414

 

 

 

1,418

 

 

 

 

4,111

 

 

 

4,012

 

Adjustments to reconcile Total Adjusted segment
  EBITDA to consolidated Income before income taxes:

 

 

 

 

 

 

Corporate and Other

 

 

309

 

 

 

279

 

Depreciation and amortization

 

 

930

 

 

 

860

 

Interest expense

 

 

584

 

 

 

547

 

Losses (gains) on sales of facilities

 

 

1

 

 

 

(1

)

Income before income taxes

 

$

2,287

 

 

$

2,327

 

 

 

2026

 

 

2025

 

 

Revenues:

 

 

 

 

 

 

 

National Group

 

$

5,321

 

 

$

5,065

 

 

Atlantic Group

 

 

6,363

 

 

 

6,167

 

 

American Group

 

 

6,566

 

 

 

6,331

 

 

Corporate and other

 

 

859

 

 

 

758

 

 

 

$

19,109

 

 

$

18,321

 

 

Depreciation and amortization:

 

 

 

 

 

 

 

National Group

 

$

236

 

 

$

226

 

 

Atlantic Group

 

 

298

 

 

 

274

 

 

American Group

 

 

295

 

 

 

279

 

 

Corporate and other

 

 

101

 

 

 

81

 

 

 

$

930

 

 

$

860

 

 

 

 

 

 

 

 

 

 

 

 

 

 

March 31,
2026

 

 

December 31,
2025

 

Assets:

 

 

 

 

 

 

National Group

 

$

13,596

 

 

$

13,596

 

Atlantic Group

 

 

18,691

 

 

 

17,945

 

American Group

 

 

21,251

 

 

 

21,217

 

Corporate and other

 

 

7,912

 

 

 

7,962

 

 

 

$

61,450

 

 

$

60,720

 
v3.26.1
Basis of Presentation and Significant Accounting Policies - Additional Information (Detail)
$ in Millions
 1 Months Ended 3 Months Ended
Nov. 30, 2017
Mar. 31, 2026
USD ($)
Hospital
EndoscopyCenter
SurgeryCenter
State
Mar. 31, 2025
USD ($)
Summary Of Significant Accounting Policies [Line Items]      
Number of owned and operated hospitals | Hospital   189  
Number of freestanding surgery centers | SurgeryCenter   119  
Number of freestanding endoscopy centers | EndoscopyCenter   30  
Number of facilities locations | State   19  
General and administrative expense   $ 133 $ 126
Charity care amount   5,513 3,644
Estimated costs of charity care   $ 507 $ 350
Inpatient Services [Member]      
Summary Of Significant Accounting Policies [Line Items]      
Performance obligations for inpatient/ outpatient services satisfied period   Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges  
Maximum [Member]      
Summary Of Significant Accounting Policies [Line Items]      
Percentage of income of federal poverty level eligible for charity care 400.00%    
Maximum [Member] | Outpatient Services [Member]      
Summary Of Significant Accounting Policies [Line Items]      
Performance obligations for inpatient/ outpatient services satisfied period   Our performance obligations for outpatient services are generally satisfied over a period of less than one day  
v3.26.1
Basis of Presentation and Significant Accounting Policies - Schedule of Revenues from Third Party Payers, Uninsured and Other Payers (Detail) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Revenues From Third Party Payers [Line Items]    
Revenues $ 19,109 $ 18,321
Revenues ratio from third party payers 100.00% 100.00%
Medicare [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 3,058 $ 2,895
Revenues from third party payers, Ratio 16.00% 15.80%
Managed Medicare [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 3,508 $ 3,299
Revenues from third party payers, Ratio 18.40% 18.00%
Medicaid [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 1,444 $ 1,190
Revenues from third party payers, Ratio 7.60% 6.50%
Managed Medicaid [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 939 $ 879
Revenues from third party payers, Ratio 4.90% 4.80%
Managed Care and Insurers [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 9,084 $ 9,041
Revenues from third party payers, Ratio 47.50% 49.40%
International (Managed Care and Insurers) [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 499 $ 445
Revenues from third party payers, Ratio 2.60% 2.40%
Other [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues $ 577 $ 572
Other, Ratio 3.00% 3.10%
v3.26.1
Basis of Presentation and Significant Accounting Policies - Schedule of Estimated Cost of Uncompensated Care (Detail) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Accounting Policies [Abstract]    
Patient care costs (salaries and benefits, supplies, other operating expenses and depreciation and amortization) $ 16,246 $ 15,466
Cost-to-charges ratio (patient care costs as percentage of gross patient charges) 9.20% 9.60%
Total uncompensated care $ 13,612 $ 10,993
Multiply by the cost-to-charges ratio 9.20% 9.60%
Estimated cost of total uncompensated care $ 1,252 $ 1,055
v3.26.1
Acquisitions and Dispositions - Additional Information (Detail)
$ in Millions
 3 Months Ended
Mar. 31, 2026
USD ($)
Mar. 31, 2025
USD ($)
Hospital
Business Combination [Line Items]    
Proceeds from sale of business $ 3 $ 161
Hospital Facility [Member]    
Business Combination [Line Items]    
Aggregate purchase price   $ 190
Number of hospitals purchased | Hospital   2
Proceeds from sale of business   $ 157
Healthcare Entity [Member]    
Business Combination [Line Items]    
Aggregate purchase price 265 37
Real Estate and Other Investments [Member]    
Business Combination [Line Items]    
Proceeds from sale of business 3 4
Pretax gain (loss) before tax $ (1) $ 1
v3.26.1
Income Taxes - Additional Information (Detail) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Income Tax Disclosure [Abstract]      
Provision for income taxes $ 430 $ 502  
Effective income tax rate reconciliation excluding net income attributable to noncontrolling interests 21.00% 23.80%  
Percentage of net income attributable to noncontrolling interests 18.80% 21.60%  
Gross unrecognized tax benefits, excluding accrued interest and penalties $ 535   $ 519
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued 88   78
Provision for tax benefits related to settlement of employee awards 103 $ 24  
Unrecognized tax benefits that would impact effective tax rate $ 290   $ 274
v3.26.1
Earnings Per Share - Schedule of Computations of Basic and Diluted Earnings Per Share (Detail) - USD ($)
$ / shares in Units, shares in Thousands, $ in Millions
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Earnings Per Share [Abstract]    
Net income attributable to HCA Healthcare, Inc. $ 1,620 $ 1,610
Weighted average common shares outstanding 223,588 246,936
Effect of dilutive incremental shares 3,064 2,504
Shares used for diluted earnings per share 226,652 249,440
Basic earnings $ 7.25 $ 6.52
Diluted earnings $ 7.15 $ 6.45
v3.26.1
Investments of Insurance Subsidiaries - Schedule of Investments (Detail) - USD ($)
$ in Millions
Mar. 31, 2026
Dec. 31, 2025
Debt Securities, Available-for-sale [Line Items]    
Amounts classified as current assets $ (124) $ (103)
Investment carrying value 387 485
Money market funds and other, Amortized Cost 188 260
Money market funds and other, Unrealized Gains 0 0
Money market funds and other, Unrealized Losses 0 0
Money market funds and other, Fair Value 188 260
Investment Owned, at Cost, Total 526 602
Investment Gains 1 1
Investment Losses (16) (15)
Investment Fiar Value 511 588
Debt Securities [Member]    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 338 342
Unrealized Amounts, Gains 1 1
Unrealized Amounts, Losses (16) (15)
Fair Value $ 323 $ 328
v3.26.1
Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail)
$ in Millions
Mar. 31, 2026
USD ($)
Investments, Debt and Equity Securities [Abstract]  
Due in one year or less, Amortized Cost $ 38
Due after one year through five years, Amortized Cost 142
Due after five years through ten years, Amortized Cost 103
Due after ten years, Amortized Cost 55
Amortized Cost, Total 338
Due in one year or less, Fair Value 38
Due after one year through five years, Fair Value 136
Due after five years through ten years, Fair Value 97
Due after ten years, Fair Value 52
Fair Value, Total $ 323
v3.26.1
Investments of Insurance Subsidiaries - Additional Information (Detail)
 3 Months Ended
Mar. 31, 2026
Investments, Debt and Equity Securities [Abstract]  
Available for sale securities expected maturity of debt securities 3 years 9 months 18 days
Available for sale securities average scheduled maturity 7 years 7 months 6 days
v3.26.1
Assets and Liabilities Measured at Fair Value - Summary of Investments of Insurance Subsidiaries Measured at Fair Value on Recurring Basis (Detail) - USD ($)
$ in Millions
Mar. 31, 2026
Dec. 31, 2025
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]    
Money market funds and other $ 188 $ 260
Investments of insurance subsidiaries 511 588
Less amounts classified as current assets (124) (103)
Asset fair value 387 485
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member]    
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]    
Money market funds and other 188 260
Investments of insurance subsidiaries 189 261
Less amounts classified as current assets (124) (103)
Asset fair value 65 158
Significant Other Observable Inputs (Level 2) [Member]    
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]    
Investments of insurance subsidiaries 322 327
Asset fair value 322 327
Debt Securities [Member]    
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]    
Debt securities 323 328
Debt Securities [Member] | Quoted Prices in Active Markets for Identical Assets (Level 1) [Member]    
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]    
Debt securities 1 1
Debt Securities [Member] | Significant Other Observable Inputs (Level 2) [Member]    
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]    
Debt securities $ 322 $ 327
v3.26.1
Assets and Liabilities Measured at Fair Value - Additional Information (Detail) - USD ($)
$ in Millions
Mar. 31, 2026
Dec. 31, 2025
Fair Value Disclosures [Abstract]    
Estimated fair value of long-term debt $ 46,653 $ 45,911
Carrying amounts of long-term debt $ 48,456 $ 46,928
v3.26.1
Debt - Schedule of Debt (Detail) - USD ($)
$ in Millions
Mar. 31, 2026
Dec. 31, 2025
Debt Instrument [Line Items]    
Debt issuance costs and discounts $ (433) $ (436)
Total long-term debt (average life of 11.7 years, rates averaging 5.1%) 44,373 44,285
Total debt 48,023 46,492
Less amounts due within one year 8,532 4,889
Long-term debt 39,491 41,603
Commercial Paper [Member]    
Debt Instrument [Line Items]    
Short-term borrowings 3,650 2,207
Other Senior Secured Debt [Member]    
Debt Instrument [Line Items]    
Other senior secured debt 1,106 1,021
Senior Unsecured Credit Facilities [Member]    
Debt Instrument [Line Items]    
Senior unsecured debt 0 0
Senior Unsecured Notes Payable Through 2095 [Member]    
Debt Instrument [Line Items]    
Senior unsecured debt $ 43,700 $ 43,700
v3.26.1
Debt - Schedule of Debt (Parenthetical) (Detail)
 3 Months Ended
Mar. 31, 2026
Debt Instrument [Line Items]  
Total debt average term 11 years 8 months 12 days
Total debt average rate 5.10%
Commercial Paper [Member]  
Debt Instrument [Line Items]  
Short term debt average term 30 years
Weighted average rate 4.30%
Other Senior Secured Debt [Member]  
Debt Instrument [Line Items]  
Effective interest rate 4.80%
Senior Unsecured Notes Payable Through 2095 [Member]  
Debt Instrument [Line Items]  
Effective interest rate 5.10%
Payable year 2095
v3.26.1
Capital Stock, Share Repurchase Transactions and Other Comprehensive Loss - Additional Information (Detail) - USD ($)
$ / shares in Units, $ in Millions
 3 Months Ended
Feb. 06, 2026
Mar. 31, 2026
Jan. 31, 2026
Dec. 31, 2025
Jan. 31, 2025
Capital Structure [Line Items]          
Common Stock, Shares, Outstanding   222,530,900   224,605,100  
Repurchase of common stock, shares   3,157,000      
Repurchase price of common stock, per share   $ 497.63      
Frisco, Inc [Member]          
Capital Structure [Line Items]          
Effect of decline of outstanding common stock 72,047        
Frisco, Inc [Member] | Common Stock [Member]          
Capital Structure [Line Items]          
Number of shares exchanged 36,629,188        
New shares of common stock 36,557,141        
Board of Directors Chairman [Member]          
Capital Structure [Line Items]          
Stock repurchase program remaining amount of authorization   $ 9,179      
Board of Directors Chairman [Member] | Maximum [Member]          
Capital Structure [Line Items]          
Share repurchase program authorized amount     $ 10,000   $ 10,000
v3.26.1
Capital Stock, Share Repurchase Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Detail)
$ in Millions
 3 Months Ended
Mar. 31, 2026
USD ($)
Equity [Abstract]  
Unrealized losses on available-for-sale securities, beginning balances $ (11)
Unrealized losses on available-for-sale securities (1)
Unrealized losses on available-for-sale securities, ending balances (12)
Foreign currency translation adjustments, beginning balances (299)
Foreign currency translation adjustments, net of income taxes (21)
Foreign currency translation adjustments, ending balances (320)
Defined benefit plans, beginning balances 5
Defined benefit plans, ending balances 5
Accumulated other comprehensive loss, net of tax, beginning balances (305)
Unrealized losses on available-for-sale securities (1)
Foreign currency translation adjustments, net of income tax benefit (21)
Accumulated other comprehensive loss, net of tax, ending balances $ (327)
v3.26.1
Capital Stock, Share Repurchase Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail)
$ in Millions
 3 Months Ended
Mar. 31, 2026
USD ($)
Equity [Abstract]  
Foreign currency translation adjustments, net of income taxes $ 3
v3.26.1
Segment and Geographic Information - Additional Information (Detail)
 3 Months Ended
Mar. 31, 2026
Hospital
Segment Reporting Information [Line Items]  
Number of geographically organized groups 3
Number of owned and operated hospitals 189
Reorganization Group [Member] | National Group [Member]  
Segment Reporting Information [Line Items]  
Number of owned and operated hospitals 53
Reorganization Group [Member] | American Group [Member]  
Segment Reporting Information [Line Items]  
Number of owned and operated hospitals 66
Reorganization Group [Member] | Atlantic Group [Member]  
Segment Reporting Information [Line Items]  
Number of owned and operated hospitals 63
Reorganization Group [Member] | Corporate and Other [Member]  
Segment Reporting Information [Line Items]  
Number of owned and operated hospitals 7
v3.26.1
Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings or Losses of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization (Detail) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Segment Reporting Information [Line Items]      
Revenues $ 19,109 $ 18,321  
Salaries and benefits 8,283 7,997  
Supplies 2,853 2,764  
Other operating expenses 4,180 3,845  
Equity in earnings of affiliates (9) (18)  
Depreciation and amortization 930 860  
Interest expense 584 547  
Losses (gains) on sales of facilities 1 (1)  
Income before income taxes 2,287 2,327  
Assets 61,450   $ 60,720
Operating Segments [Member]      
Segment Reporting Information [Line Items]      
Adjusted segment EBITDA 4,111 4,012  
Eliminations and Reconciling Items [Member]      
Segment Reporting Information [Line Items]      
Corporate and Other 309 279  
Depreciation and amortization 930 860  
Interest expense 584 547  
Losses (gains) on sales of facilities 1 (1)  
Income before income taxes 2,287 2,327  
National Group [Member] | Operating Segments [Member]      
Segment Reporting Information [Line Items]      
Revenues 5,321 5,065  
Salaries and benefits 1,966 1,959  
Supplies 763 741  
Other operating expenses 1,334 1,233  
Equity in earnings of affiliates 0 0  
Operating expenses 4,063 3,933  
Adjusted segment EBITDA 1,258 1,132  
Depreciation and amortization 236 226  
Assets 13,596   13,596
Atlantic Group [Member] | Operating Segments [Member]      
Segment Reporting Information [Line Items]      
Revenues 6,363 6,167  
Salaries and benefits 2,286 2,216  
Supplies 944 914  
Other operating expenses 1,695 1,576  
Equity in earnings of affiliates (1) (1)  
Operating expenses 4,924 4,705  
Adjusted segment EBITDA 1,439 1,462  
Depreciation and amortization 298 274  
Assets 18,691   17,945
American Group [Member] | Operating Segments [Member]      
Segment Reporting Information [Line Items]      
Revenues 6,566 6,331  
Salaries and benefits 2,277 2,196  
Supplies 1,059 1,020  
Other operating expenses 1,831 1,711  
Equity in earnings of affiliates (15) (14)  
Operating expenses 5,152 4,913  
Adjusted segment EBITDA 1,414 1,418  
Depreciation and amortization 295 279  
Assets 21,251   21,217
Corporate and Other [Member]      
Segment Reporting Information [Line Items]      
Revenues 859 758  
Depreciation and amortization 101 $ 81  
Assets $ 7,912   $ 7,962