HCA HEALTHCARE, INC., 10-Q filed on 10/30/2025
Quarterly Report
v3.25.3
Cover Page - shares
 9 Months Ended
Sep. 30, 2025
Oct. 27, 2025
Cover [Abstract]    
Document Type 10-Q  
Amendment Flag false  
Document Period End Date Sep. 30, 2025  
Document Fiscal Year Focus 2025  
Document Fiscal Period Focus Q3  
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   228,193,900
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, $.01 par value  
Security Exchange Name NYSE  
v3.25.3
Condensed Consolidated Income Statements (Unaudited) - USD ($)
shares in Thousands, $ in Millions
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Income Statement [Abstract]        
Revenues $ 19,161 $ 17,487 $ 56,087 $ 52,318
Salaries and benefits 8,364 7,861 24,499 23,253
Supplies 2,782 2,657 8,390 7,962
Other operating expenses 4,161 3,717 11,799 10,946
Equity in earnings of affiliates (16) (15) (53) (13)
Depreciation and amortization 889 842 2,612 2,456
Interest expense 561 515 1,676 1,533
Losses (gains) on sales of facilities 2 4 4 (209)
Total expenses including equity in earnings of affiliates 16,743 15,581 48,927 45,928
Income before income taxes 2,418 1,906 7,160 6,390
Provision for income taxes 515 424 1,541 1,419
Net income 1,903 1,482 5,619 4,971
Net income attributable to noncontrolling interests 260 212 713 649
Net income attributable to HCA Healthcare, Inc. $ 1,643 $ 1,270 $ 4,906 $ 4,322
Per share data:        
Basic earnings $ 7.05 $ 4.94 $ 20.47 $ 16.57
Diluted earnings $ 6.96 $ 4.88 $ 20.23 $ 16.37
Shares used in earnings per share calculations (in millions):        
Basic 232,891 256,763 239,615 260,770
Diluted 236,181 259,917 242,459 263,987
v3.25.3
Condensed Consolidated Comprehensive Income Statements (Unaudited) - USD ($)
$ in Millions
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Statement of Comprehensive Income [Abstract]        
Net income $ 1,903 $ 1,482 $ 5,619 $ 4,971
Other comprehensive income (loss) before taxes:        
Foreign currency translation (14) 55 71 48
Unrealized gains on available-for-sale securities 3 13 12 10
Defined benefit plans 0 0 0 0
Pension costs included in salaries and benefits 0 (1) 0 (1)
Total defined benefit plans 0 (1) 0 (1)
Other comprehensive income (loss) before taxes (11) 67 83 57
Income taxes (benefits) related to other comprehensive income items (3) 12 13 10
Other comprehensive (loss) income (8) 55 70 47
Comprehensive income 1,895 1,537 5,689 5,018
Comprehensive income attributable to noncontrolling interests 260 212 713 649
Comprehensive income attributable to HCA Healthcare, Inc. $ 1,635 $ 1,325 $ 4,976 $ 4,369
v3.25.3
Condensed Consolidated Balance Sheets - USD ($)
$ in Millions
Sep. 30, 2025
Dec. 31, 2024
Current assets:    
Cash and cash equivalents $ 997 $ 1,933
Accounts receivable 10,428 10,751
Inventories 1,734 1,738
Other 2,126 1,992
Total current assets 15,285 16,414
Property and equipment, at cost 65,489 62,514
Accumulated depreciation (34,921) (33,100)
Property and equipment, net 30,568 29,414
Investments of insurance subsidiaries 573 569
Investments in and advances to affiliates 654 662
Goodwill and other intangible assets 10,275 10,093
Right-of-use operating lease assets 2,115 2,131
Other 277 230
Total assets 59,747 59,513
Current liabilities:    
Accounts payable 4,552 4,276
Accrued salaries 2,294 2,304
Other accrued expenses 4,940 3,899
Short-term borrowings and long-term debt due within one year 6,110 4,698
Total current liabilities 17,896 15,177
Long-term debt, less debt issuance costs and discounts of $416 and $369 38,401 38,333
Professional liability risks 1,462 1,544
Right-of-use operating lease obligations 1,838 1,863
Income taxes and other liabilities 2,309 2,041
Stockholders' (deficit) equity:    
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding 229,845,100 shares - 2025 and 249,981,400 shares - 2024 2 3
Accumulated other comprehensive loss (317) (387)
Retained deficit (5,020) (2,115)
Stockholders' deficit attributable to HCA Healthcare, Inc. (5,335) (2,499)
Noncontrolling interests 3,176 3,054
Total stockholders' equity (2,159) 555
Total liabilities and stockholders' equity $ 59,747 $ 59,513
v3.25.3
Condensed Consolidated Balance Sheets (Parenthetical) - USD ($)
$ in Millions
Sep. 30, 2025
Dec. 31, 2024
Statement of Financial Position [Abstract]    
Debt issuance costs $ 416 $ 369
Common stock, par value $ 0.01 $ 0.01
Common stock, shares authorized 1,800,000,000 1,800,000,000
Common stock, shares outstanding 229,845,100 249,981,400
v3.25.3
Condensed Consolidated Statements of Stockholders' Equity (DEFICIT) (Unaudited) - USD ($)
shares in Thousands, $ 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, 2023 $ 1,060 $ 3   $ (425) $ (1,352) $ 2,834
Balance, shares at Dec. 31, 2023   265,537        
Comprehensive income (loss) 1,794     (8) 1,591 211
Repurchase of common stock (1,187)       (1,187)  
Repurchase of common stock, shares   (3,894)        
Share-based benefit plans (68)       (68)  
Share-based benefit plans, shares   1,573        
Cash dividends declared (176)       (176)  
Distributions (152)         (152)
Other (1)       7 (8)
Balance at Mar. 31, 2024 1,270 $ 3   (433) (1,185) 2,885
Balance, shares at Mar. 31, 2024   263,216        
Comprehensive income (loss) 1,687       1,461 226
Repurchase of common stock (1,380)   $ (68)   (1,312)  
Repurchase of common stock, shares   (4,217)        
Share-based benefit plans 136   68   68  
Share-based benefit plans, shares   239        
Cash dividends declared (174)       (174)  
Distributions (186)         (186)
Other (14)       (28) 14
Balance at Jun. 30, 2024 1,339 $ 3   (433) (1,170) 2,939
Balance, shares at Jun. 30, 2024   259,238        
Comprehensive income (loss) 1,537     55 1,270 212
Repurchase of common stock (1,812)   (88)   (1,724)  
Repurchase of common stock, shares   (4,948)        
Share-based benefit plans 88   88      
Share-based benefit plans, shares   228        
Cash dividends declared (170)       (170)  
Distributions (192)         (192)
Other (4)       (13) 9
Balance at Sep. 30, 2024 786 $ 3   (378) (1,807) 2,968
Balance, shares at Sep. 30, 2024   254,518        
Comprehensive income (loss) 1,677     (9) 1,438 248
Repurchase of common stock (1,685)   (105)   (1,580)  
Repurchase of common stock, shares   (4,739)        
Share-based benefit plans 105   105      
Share-based benefit plans, shares   202        
Cash dividends declared (168)       (168)  
Distributions (181)         (181)
Other 21       2 19
Balance at Dec. 31, 2024 555 $ 3   (387) (2,115) 3,054
Balance, shares at Dec. 31, 2024   249,981        
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)        
Share-based benefit plans 57   57      
Share-based benefit plans, shares   736        
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        
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)        
Share-based benefit plans 126   126      
Share-based benefit plans, shares   220        
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        
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)        
Share-based benefit plans 123   $ 123      
Share-based benefit plans, shares   215        
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        
v3.25.3
Condensed Consolidated Statements of Stockholders' Equity (DEFICIT) (Parenthetical) (Unaudited) - $ / shares
 3 Months Ended
Sep. 30, 2025
Jun. 30, 2025
Mar. 31, 2025
Dec. 31, 2024
Sep. 30, 2024
Jun. 30, 2024
Mar. 31, 2024
Statement of Stockholders' Equity [Abstract]              
Cash dividends declared, per share $ 0.72 $ 0.72 $ 0.72 $ 0.66 $ 0.66 $ 0.66 $ 0.66
v3.25.3
Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Cash flows from operating activities:    
Net income $ 5,619 $ 4,971
Increase (decrease) in cash from operating assets and liabilities:    
Accounts receivable 345 55
Inventories and other assets (125) 184
Accounts payable and accrued expenses 29 77
Depreciation and amortization 2,612 2,456
Income taxes 1,314 (67)
Losses (gains) on sales of facilities 4 (209)
Amortization of debt issuance costs and discounts 32 26
Share-based compensation 301 275
Other 146 187
Net cash provided by operating activities 10,277 7,955
Cash flows from investing activities:    
Purchase of property and equipment (3,455) (3,590)
Acquisition of hospitals and health care entities (361) (224)
Sales of hospitals and health care entities 177 312
Change in investments (26) (85)
Other (6) 0
Net cash used in investing activities (3,671) (3,587)
Cash flows from financing activities:    
Issuance of long-term debt 5,233 7,495
Net change in short-term borrowings and revolving credit facilities 1,906 (1,880)
Repayment of long-term debt (5,834) (2,346)
Distributions to noncontrolling interests (631) (530)
Payment of debt issuance costs (57) (67)
Payment of dividends (517) (525)
Repurchase of common stock (7,509) (4,342)
Other (142) (224)
Net cash used in financing activities (7,551) (2,419)
Effect of exchange rate changes on cash and cash equivalents 9 4
Change in cash and cash equivalents (936) 1,953
Cash and cash equivalents at beginning of period 1,933 935
Cash and cash equivalents at end of period 997 2,888
Interest payments 1,696 1,405
Income tax payments, net $ 227 $ 1,486
v3.25.3
Pay vs Performance Disclosure - USD ($)
$ in Millions
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Pay vs Performance Disclosure        
Net Income (Loss) $ 1,643 $ 1,270 $ 4,906 $ 4,322
v3.25.3
Insider Trading Arrangements
 3 Months Ended
Sep. 30, 2025
Trading Arrangements, by Individual  
Material Terms of Trading Arrangement c) During the three months ended September 30, 2025, no director or officer (as defined in Rule 16a-1(f) of the Securities Exchange Act of 1934 (the “Exchange Act”)) of the Company adopted or terminated a “Rule 10b5-1 trading arrangement” or “non-Rule 10b5-1 trading arrangement,” as each term is defined in Item 408(a) of Regulation S-K.

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
v3.25.3
Basis of Presentation and Significant Accounting Policies
 9 Months Ended
Sep. 30, 2025
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 September 30, 2025, these affiliates owned and operated 191 hospitals, 123 freestanding surgery centers, 29 freestanding endoscopy centers and provided extensive outpatient and ancillary services. HCA Healthcare, Inc.’s facilities are located in 20 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 $139 million and $111 million for the quarters ended September 30, 2025 and 2024, respectively, and $395 million and $301 million for the nine months ended September 30, 2025 and 2024, respectively. Operating results for the quarter and nine months ended September 30, 2025 are not necessarily indicative of the results that may be expected for the year ending December 31, 2025. 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, 2024.

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 and nine months ended September 30, 2025 and 2024 are summarized in the following table (dollars in millions):

 

 

Quarter

 

 

2025

 

 

Ratio

 

 

2024

 

 

Ratio

 

Medicare

 

$

2,728

 

 

 

14.2

%

 

$

2,584

 

 

 

14.8

%

Managed Medicare

 

 

3,306

 

 

 

17.3

 

 

 

2,949

 

 

 

16.9

 

Medicaid

 

 

1,783

 

 

 

9.3

 

 

 

1,127

 

 

 

6.4

 

Managed Medicaid

 

 

949

 

 

 

4.9

 

 

 

1,031

 

 

 

5.9

 

Managed care and insurers

 

 

9,267

 

 

 

48.4

 

 

 

8,497

 

 

 

48.6

 

International (managed care and insurers)

 

 

484

 

 

 

2.5

 

 

 

424

 

 

 

2.4

 

Other

 

 

644

 

 

 

3.4

 

 

 

875

 

 

 

5.0

 

Revenues

 

$

19,161

 

 

 

100.0

%

 

$

17,487

 

 

 

100.0

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nine Months

 

 

2025

 

 

Ratio

 

 

2024

 

 

Ratio

 

Medicare

 

$

8,426

 

 

 

15.0

%

 

$

8,043

 

 

 

15.4

%

Managed Medicare

 

 

9,957

 

 

 

17.8

 

 

 

8,888

 

 

 

17.0

 

Medicaid

 

 

4,413

 

 

 

7.9

 

 

 

3,316

 

 

 

6.3

 

Managed Medicaid

 

 

2,727

 

 

 

4.9

 

 

 

3,042

 

 

 

5.8

 

Managed care and insurers

 

 

27,432

 

 

 

48.8

 

 

 

25,591

 

 

 

49.0

 

International (managed care and insurers)

 

 

1,390

 

 

 

2.5

 

 

 

1,252

 

 

 

2.4

 

Other

 

 

1,742

 

 

 

3.1

 

 

 

2,186

 

 

 

4.1

 

Revenues

 

$

56,087

 

 

 

100.0

%

 

$

52,318

 

 

 

100.0

%

 

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

 

 

Quarter

 

 

Nine Months

 

 

2025

 

 

2024

 

 

2025

 

 

2024

 

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

 

$

16,196

 

 

$

15,077

 

 

$

47,300

 

 

$

44,617

 

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

 

 

10.0

%

 

 

10.3

%

 

 

9.7

%

 

 

10.2

%

Total uncompensated care

 

$

12,015

 

 

$

10,958

 

 

$

34,633

 

 

$

31,571

 

Multiply by the cost-to-charges ratio

 

 

10.0

%

 

 

10.3

%

 

 

9.7

%

 

 

10.2

%

Estimated cost of total uncompensated care

 

$

1,188

 

 

$

1,138

 

 

$

3,359

 

 

$

3,220

 

 

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

Revenues (continued)

The total uncompensated care amounts include charity care of $4.131 billion and $4.001 billion, respectively, and the related estimated costs of charity care were $408 million and $416 million, respectively, for the quarters ended September 30, 2025 and 2024. The total uncompensated care amounts include charity care of $11.887 billion and $12.091 billion, respectively, and the related estimated costs of charity care were $1.153 billion and $1.233 billion, respectively, for the nine months ended September 30, 2025 and 2024.

Reclassifications

Certain prior year amounts have been reclassified to conform to the current year presentation.

v3.25.3
Acquisitions and Dispositions
 9 Months Ended
Sep. 30, 2025
Business Combination [Abstract]  
Acquisitions and Dispositions

NOTE 2 — ACQUISITIONS AND DISPOSITIONS

During the nine months ended September 30, 2025, we paid $190 million to acquire two hospital facilities in New Hampshire and Florida and $171 million to acquire nonhospital health care entities. During the nine months ended September 30, 2024, we paid $112 million to acquire three hospital facilities in Texas and $112 million to acquire nonhospital health care entities. Purchase price amounts have been allocated to the related assets acquired and liabilities assumed based upon their respective fair values.

During the nine months ended September 30, 2025, we received proceeds of $155 million related to the sale of a hospital facility in California and $22 million related to sales of real estate and other health care entity investments. We recognized pretax losses of $4 million for these transactions. During the nine months ended September 30, 2024, we received proceeds of $295 million for the sale of a hospital facility in California and $17 million related to sales of real estate and other health care entity investments. We recognized pretax gains of $209 million for these transactions.

v3.25.3
Income Taxes
 9 Months Ended
Sep. 30, 2025
Income Tax Disclosure [Abstract]  
Income Taxes

NOTE 3 — INCOME TAXES

Our provisions for income taxes for the quarters ended September 30, 2025 and 2024 were $515 million and $424 million, respectively, and the effective tax rates were 23.9% and 25.0%, respectively. Our provisions for income taxes for the nine months ended September 30, 2025 and 2024 were $1.541 billion and $1.419 billion, respectively, and the effective tax rates were 23.9% and 24.7%, respectively. The decline in the effective tax rate for the quarter and nine months ended September 30, 2025 is related primarily to adjustments to our liability for unrecognized tax benefits. Our provisions for income taxes included tax benefits related to settlements of employee equity awards of $45 million and $93 million for the nine months ended September 30, 2025 and 2024, respectively.

The One Big Beautiful Bill Act (the “OBBBA”), which was enacted on July 4, 2025, makes numerous tax changes, including reinstatement of 100% bonus depreciation for qualifying property placed in service after January 19, 2025, that we expect to change the timing of cash tax payments made in 2025 and future tax years. We do not expect the tax provisions of the OBBBA will have a material impact on our effective tax rate.

Our gross unrecognized tax benefits were $515 million, excluding accrued interest and penalties of $143 million, as of September 30, 2025 ($504 million and $115 million, respectively, as of December 31, 2024). Unrecognized tax benefits of $332 million ($295 million as of December 31, 2024) would affect the effective rate, if recognized.

The Internal Revenue Service (“IRS”) concluded its examination of the Company's 2022 and 2023 income tax returns during the quarter ended September 30, 2025, resolving all federal income tax matters for those years. Completion of the examination had no material impact on our results of operations or financial position. At September 30, 2025, the IRS was examining the 2019 income tax returns of certain affiliates. Depending on the resolution of any federal, state and foreign tax disputes, the completion of examinations by federal, state or foreign taxing authorities, or the expiration of statutes of limitation for specific taxing jurisdictions, we believe it is reasonably possible that our liability for unrecognized tax benefits may significantly increase or decrease within the next 12 months. However, we are currently unable to estimate the range of any possible change.

v3.25.3
Earnings Per Share
 9 Months Ended
Sep. 30, 2025
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.

NOTE 4 — EARNINGS PER SHARE (continued)

The following table sets forth the computation of basic and diluted earnings per share for the quarters and nine months ended September 30, 2025 and 2024 (dollars and shares in millions, except per share amounts):

 

 

Quarter

 

 

Nine Months

 

 

2025

 

 

2024

 

 

2025

 

 

2024

 

Net income attributable to HCA Healthcare, Inc.

 

$

1,643

 

 

$

1,270

 

 

$

4,906

 

 

$

4,322

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weighted average common shares outstanding

 

 

232.891

 

 

 

256.763

 

 

 

239.615

 

 

 

260.770

 

Effect of dilutive incremental shares

 

 

3.290

 

 

 

3.154

 

 

 

2.844

 

 

 

3.217

 

Shares used for diluted earnings per share

 

 

236.181

 

 

 

259.917

 

 

 

242.459

 

 

 

263.987

 

Earnings per share:

 

 

 

 

 

 

 

 

 

 

 

 

Basic earnings

 

$

7.05

 

 

$

4.94

 

 

$

20.47

 

 

$

16.57

 

Diluted earnings

 

$

6.96

 

 

$

4.88

 

 

$

20.23

 

 

$

16.37

 
v3.25.3
Investments of Insurance Subsidiaries
 9 Months Ended
Sep. 30, 2025
Investments, Debt and Equity Securities [Abstract]  
Investments of Insurance Subsidiaries

NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES

A summary of our insurance subsidiaries’ investments at September 30, 2025 and December 31, 2024 follows (dollars in millions):

 

 

September 30, 2025

 

 

 

 

 

Unrealized
Amounts

 

 

 

 

 

Amortized
Cost

 

 

Gains

 

 

Losses

 

 

Fair
Value

 

Debt securities

 

$

343

 

 

$

1

 

 

$

(16

)

 

$

328

 

Money market funds and other

 

 

339

 

 

 

—

 

 

 

—

 

 

 

339

 

 

$

682

 

 

$

1

 

 

$

(16

)

 

 

667

 

Amounts classified as current assets

 

 

 

 

 

 

 

 

 

 

 

(94

)

Investment carrying value

 

 

 

 

 

 

 

 

 

 

$

573

 

 

 

December 31, 2024

 

 

 

 

 

Unrealized
Amounts

 

 

 

 

 

Amortized
Cost

 

 

Gains

 

 

Losses

 

 

Fair
Value

 

Debt securities

 

$

388

 

 

$

—

 

 

$

(27

)

 

$

361

 

Money market funds and other

 

 

296

 

 

 

—

 

 

 

—

 

 

 

296

 

 

$

684

 

 

$

—

 

 

$

(27

)

 

 

657

 

Amounts classified as current assets

 

 

 

 

 

 

 

 

 

 

 

(88

)

Investment carrying value

 

 

 

 

 

 

 

 

 

 

$

569

 

 

At September 30, 2025 and December 31, 2024, 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.

 

NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES (continued)

 

Scheduled maturities of investments in debt securities at September 30, 2025 were as follows (dollars in millions):

 

 

Amortized
Cost

 

 

Fair
Value

 

Due in one year or less

 

$

18

 

 

$

17

 

Due after one year through five years

 

 

151

 

 

 

147

 

Due after five years through ten years

 

 

114

 

 

 

107

 

Due after ten years

 

 

60

 

 

 

57

 

 

$

343

 

 

$

328

 

 

The average expected maturity of the investments in debt securities at September 30, 2025 was 4.0 years, compared to the average scheduled maturity of 8.1 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.

v3.25.3
Assets and Liabilities Measured at Fair Value
 9 Months Ended
Sep. 30, 2025
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 September 30, 2025 and December 31, 2024, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):

 

 

September 30, 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

 

 

339

 

 

 

339

 

 

 

—

 

 

 

—

 

Investments of insurance subsidiaries

 

 

667

 

 

 

340

 

 

 

327

 

 

 

—

 

Less amounts classified as current assets

 

 

(94

)

 

 

(94

)

 

 

—

 

 

 

—

 

 

$

573

 

 

$

246

 

 

$

327

 

 

$

—

 

 

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

 

 

December 31, 2024

 

 

 

 

 

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

 

$

361

 

 

$

—

 

 

$

361

 

 

$

—

 

Money market funds and other

 

 

296

 

 

 

296

 

 

 

—

 

 

 

—

 

Investments of insurance subsidiaries

 

 

657

 

 

 

296

 

 

 

361

 

 

 

—

 

Less amounts classified as current assets

 

 

(88

)

 

 

(88

)

 

 

—

 

 

 

—

 

 

$

569

 

 

$

208

 

 

$

361

 

 

$

—

 

 

The estimated fair value of our debt was $43.898 billion and $40.845 billion at September 30, 2025 and December 31, 2024, respectively, compared to carrying amounts, excluding debt issuance costs and discounts, aggregating $44.927 billion and $43.400 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 long-term debt with the same maturities.

v3.25.3
Debt
 9 Months Ended
Sep. 30, 2025
Debt Disclosure [Abstract]  
Debt

NOTE 7 — DEBT

A summary of our debt at September 30, 2025 and December 31, 2024, including related interest rates at September 30, 2025, follows (dollars in millions):

 

 

September 30,
2025

 

 

December 31,
2024

 

Short-term borrowings:

 

 

 

 

 

Commercial paper (average life of 17 days, weighted average rate of 4.7%)

$

1,910

 

 

$

—

 

Long-term debt:

 

 

 

 

 

Senior secured term loan facility

 

—

 

 

 

1,238

 

Other senior secured debt (effective interest rate of 4.4%)

 

1,067

 

 

 

1,046

 

Senior unsecured credit facilities

 

—

 

 

 

—

 

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

 

41,950

 

 

 

41,116

 

Debt issuance costs and discounts

 

(416

)

 

 

(369

)

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

 

42,601

 

 

 

43,031

 

Total debt

 

44,511

 

 

 

43,031

 

Less amounts due within one year

 

6,110

 

 

 

4,698

 

$

38,401

 

 

$

38,333

 

 

During February 2025, we repaid all $2.600 billion aggregate principal amount of 5.375% senior notes due 2025 at maturity. We entered into a new credit agreement that provides for $8.000 billion of senior unsecured revolving credit commitments with a term of five years (“senior unsecured credit facility”). Borrowings under the senior unsecured credit facility bear interest at a rate equal to the Secured Overnight Financing Rate plus 1.250% (plus, until October 23, 2025, a 0.10% credit spread adjustment, as the unsecured credit facility was amended on that date to remove the credit spread adjustment). We concurrently borrowed funds from the senior unsecured credit facility and repaid outstanding borrowings under our $4.500 billion senior secured asset-based revolving credit facility and our senior secured term loan facility of $1.238 billion. We terminated these senior secured credit facilities along with our $3.500 billion senior secured revolving cash flow credit facility.

NOTE 7 — DEBT (continued)

During February 2025, we also issued $5.250 billion aggregate principal amount of senior notes comprised of (i) $700 million aggregate principal amount of 5.000% senior notes due 2028, (ii) $300 million aggregate principal amount of floating rate senior notes due 2028, (iii) $750 million aggregate principal amount of 5.250% senior notes due 2030, (iv) $750 million aggregate principal amount of 5.500% senior notes due 2032, (v) $1.500 billion aggregate principal amount of 5.750% senior notes due 2035 and (vi) $1.250 billion aggregate principal amount of 6.200% senior notes due 2055. We used the net proceeds to repay borrowings under the senior unsecured credit facility and for general corporate purposes.

During June 2025, we established a commercial paper program under which we may issue unsecured commercial paper notes from time to time up to a maximum aggregate face or principal amount of $4.000 billion outstanding at any time. Amounts available under the program may be borrowed, repaid and reborrowed from time to time. The maturities of the commercial paper notes borrowings may vary, but will not exceed 397 days from the date of issue, and the proceeds from the program will be used for general corporate purposes. In connection with the commercial paper program, we intend to maintain a minimum available borrowing capacity under our $8.000 billion senior unsecured credit facility equal to the aggregate amount outstanding under the commercial paper program. At September 30, 2025, we had $1.910 billion of commercial paper outstanding, and there were no borrowings outstanding under our senior unsecured credit facility.

During April 2025, June 2025 and September 2025, we repaid at maturity, utilizing our senior unsecured credit facility or commercial paper program, as applicable, all $1.400 billion aggregate principal amount of 5.25% senior notes, $291 million aggregate principal amount of 7.69% senior notes and $125 million aggregate principal amount of 7.58% medium-term notes, respectively.

v3.25.3
Contingencies
 9 Months Ended
Sep. 30, 2025
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.
v3.25.3
Share Repurchase Transactions and Other Comprehensive Loss
 9 Months Ended
Sep. 30, 2025
Equity [Abstract]  
Share Repurchases Transactions and Other Comprehensive Loss

NOTE 9 — SHARE REPURCHASE TRANSACTIONS AND OTHER COMPREHENSIVE LOSS

During January 2025 and 2024, our Board of Directors authorized share repurchase programs for up to $10 billion and $6 billion, respectively, of our outstanding common stock. During the nine months ended September 30, 2025, we repurchased 21.307 million shares of our common stock at an average price of $352.40 per share through market purchases pursuant to the January 2024 authorization (which was completed during the first quarter of 2025) and the January 2025 authorization. At September 30, 2025, we had $3.256 billion of repurchase authorization available under the January 2025 authorization.

NOTE 9 — SHARE REPURCHASE TRANSACTIONS AND OTHER COMPREHENSIVE LOSS (continued)

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

 

Unrealized
Gains (Losses) on
Available-for-Sale
Securities

 

 

Foreign
Currency
Translation
Adjustments

 

 

Defined
Benefit
Plans

 

 

Total

 

Balances at December 31, 2024

$

(21

)

 

$

(353

)

 

$

(13

)

 

$

(387

)

Unrealized gains on available-for-sale
   securities, net of $3 of income taxes

 

9

 

 

 

 

 

 

 

 

 

9

 

Foreign currency translation adjustments, net
   of $10 of income taxes

 

 

 

 

61

 

 

 

 

 

 

61

 

Balances at September 30, 2025

$

(12

)

 

$

(292

)

 

$

(13

)

 

$

(317

)
v3.25.3
Segment and Geographic Information
 9 Months Ended
Sep. 30, 2025
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 September 30, 2025, the National Group included 54 hospitals located in Alaska, California, Idaho, Indiana, 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 eight hospitals we operate in England are included in the Corporate and other group.

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 and nine months ended September 30, 2025 and 2024 and assets at September 30, 2025 and December 31, 2024:

 

 

Quarter

 

 

Nine Months

 

 

2025

 

 

National
Group

 

Atlantic
Group

 

American
Group

 

 

National
Group

 

Atlantic
Group

 

American
Group

 

Revenues

$

5,525

 

$

6,142

 

$

6,688

 

 

$

15,790

 

$

18,431

 

$

19,512

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

1,970

 

 

2,288

 

 

2,275

 

 

 

5,848

 

 

6,750

 

 

6,687

 

Supplies

 

742

 

 

889

 

 

1,053

 

 

 

2,238

 

 

2,738

 

 

3,140

 

Other operating expenses

 

1,466

 

 

1,627

 

 

1,796

 

 

 

3,954

 

 

4,793

 

 

5,156

 

Equity in earnings of affiliates

 

(1

)

 

(1

)

 

(16

)

 

 

(1

)

 

(3

)

 

(47

)

 

 

4,177

 

 

4,803

 

 

5,108

 

 

 

12,039

 

 

14,278

 

 

14,936

 

Adjusted segment EBITDA

$

1,348

 

$

1,339

 

$

1,580

 

 

$

3,751

 

$

4,153

 

$

4,576

 

 

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

 

Quarter

 

 

Nine Months

 

 

2024

 

 

National
Group

 

Atlantic
Group

 

American
Group

 

 

National
Group

 

Atlantic
Group

 

American
Group

 

Revenues

$

4,931

 

$

5,738

 

$

6,078

 

 

$

14,622

 

$

17,429

 

$

18,105

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

1,897

 

 

2,190

 

 

2,176

 

 

 

5,656

 

 

6,500

 

 

6,405

 

Supplies

 

696

 

 

858

 

 

1,007

 

 

 

2,094

 

 

2,651

 

 

2,965

 

Other operating expenses

 

1,270

 

 

1,555

 

 

1,549

 

 

 

3,668

 

 

4,581

 

 

4,689

 

Equity in (earnings) losses of affiliates

 

—

 

 

—

 

 

(18

)

 

 

2

 

 

(2

)

 

(49

)

 

 

3,863

 

 

4,603

 

 

4,714

 

 

 

11,420

 

 

13,730

 

 

14,010

 

Adjusted segment EBITDA

$

1,068

 

$

1,135

 

$

1,364

 

 

$

3,202

 

$

3,699

 

$

4,095

 

 

 

 

Quarter

 

 

Nine Months

 

 

 

2025

 

 

2024

 

 

2025

 

 

2024

 

Adjusted segment EBITDA:

 

 

 

 

 

 

 

 

 

 

 

 

National Group

 

$

1,348

 

 

$

1,068

 

 

$

3,751

 

 

$

3,202

 

Atlantic Group

 

 

1,339

 

 

 

1,135

 

 

 

4,153

 

 

 

3,699

 

American Group

 

 

1,580

 

 

 

1,364

 

 

 

4,576

 

 

 

4,095

 

 

 

 

4,267

 

 

 

3,567

 

 

 

12,480

 

 

 

10,996

 

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

 

 

 

 

 

 

 

 

 

 

 

 

Corporate and Other

 

 

397

 

 

 

300

 

 

 

1,028

 

 

 

826

 

Depreciation and amortization

 

 

889

 

 

 

842

 

 

 

2,612

 

 

 

2,456

 

Interest expense

 

 

561

 

 

 

515

 

 

 

1,676

 

 

 

1,533

 

Losses (gains) on sales of facilities

 

 

2

 

 

 

4

 

 

 

4

 

 

 

(209

)

Income before income taxes

 

$

2,418

 

 

$

1,906

 

 

$

7,160

 

 

$

6,390

 

 

 

 

Quarter

 

 

Nine Months

 

 

2025

 

 

2024

 

 

2025

 

 

2024

 

Revenues:

 

 

 

 

 

 

 

 

 

 

 

 

National Group

 

$

5,525

 

 

$

4,931

 

 

$

15,790

 

 

$

14,622

 

Atlantic Group

 

 

6,142

 

 

 

5,738

 

 

 

18,431

 

 

 

17,429

 

American Group

 

 

6,688

 

 

 

6,078

 

 

 

19,512

 

 

 

18,105

 

Corporate and other

 

 

806

 

 

 

740

 

 

 

2,354

 

 

 

2,162

 

 

$

19,161

 

 

$

17,487

 

 

$

56,087

 

 

$

52,318

 

Depreciation and amortization:

 

 

 

 

 

 

 

 

 

 

 

 

National Group

 

$

226

 

 

$

214

 

 

$

675

 

 

$

637

 

Atlantic Group

 

 

281

 

 

 

271

 

 

 

830

 

 

 

790

 

American Group

 

 

283

 

 

 

277

 

 

 

839

 

 

 

799

 

Corporate and other

 

 

99

 

 

 

80

 

 

 

268

 

 

 

230

 

 

$

889

 

 

$

842

 

 

$

2,612

 

 

$

2,456

 

 

 

 

September 30,
2025

 

 

December 31,
2024

 

Assets:

 

 

 

 

 

 

National Group

 

$

13,274

 

 

$

12,855

 

Atlantic Group

 

 

17,573

 

 

 

17,168

 

American Group

 

 

20,889

 

 

 

20,714

 

Corporate and other

 

 

8,011

 

 

 

8,776

 

 

 

$

59,747

 

 

$

59,513

 
v3.25.3
Basis of Presentation and Significant Accounting Policies (Policies)
 9 Months Ended
Sep. 30, 2025
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 $139 million and $111 million for the quarters ended September 30, 2025 and 2024, respectively, and $395 million and $301 million for the nine months ended September 30, 2025 and 2024, respectively. Operating results for the quarter and nine months ended September 30, 2025 are not necessarily indicative of the results that may be expected for the year ending December 31, 2025. 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, 2024.

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 and nine months ended September 30, 2025 and 2024 are summarized in the following table (dollars in millions):

 

 

Quarter

 

 

2025

 

 

Ratio

 

 

2024

 

 

Ratio

 

Medicare

 

$

2,728

 

 

 

14.2

%

 

$

2,584

 

 

 

14.8

%

Managed Medicare

 

 

3,306

 

 

 

17.3

 

 

 

2,949

 

 

 

16.9

 

Medicaid

 

 

1,783

 

 

 

9.3

 

 

 

1,127

 

 

 

6.4

 

Managed Medicaid

 

 

949

 

 

 

4.9

 

 

 

1,031

 

 

 

5.9

 

Managed care and insurers

 

 

9,267

 

 

 

48.4

 

 

 

8,497

 

 

 

48.6

 

International (managed care and insurers)

 

 

484

 

 

 

2.5

 

 

 

424

 

 

 

2.4

 

Other

 

 

644

 

 

 

3.4

 

 

 

875

 

 

 

5.0

 

Revenues

 

$

19,161

 

 

 

100.0

%

 

$

17,487

 

 

 

100.0

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nine Months

 

 

2025

 

 

Ratio

 

 

2024

 

 

Ratio

 

Medicare

 

$

8,426

 

 

 

15.0

%

 

$

8,043

 

 

 

15.4

%

Managed Medicare

 

 

9,957

 

 

 

17.8

 

 

 

8,888

 

 

 

17.0

 

Medicaid

 

 

4,413

 

 

 

7.9

 

 

 

3,316

 

 

 

6.3

 

Managed Medicaid

 

 

2,727

 

 

 

4.9

 

 

 

3,042

 

 

 

5.8

 

Managed care and insurers

 

 

27,432

 

 

 

48.8

 

 

 

25,591

 

 

 

49.0

 

International (managed care and insurers)

 

 

1,390

 

 

 

2.5

 

 

 

1,252

 

 

 

2.4

 

Other

 

 

1,742

 

 

 

3.1

 

 

 

2,186

 

 

 

4.1

 

Revenues

 

$

56,087

 

 

 

100.0

%

 

$

52,318

 

 

 

100.0

%

 

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

 

 

Quarter

 

 

Nine Months

 

 

2025

 

 

2024

 

 

2025

 

 

2024

 

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

 

$

16,196

 

 

$

15,077

 

 

$

47,300

 

 

$

44,617

 

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

 

 

10.0

%

 

 

10.3

%

 

 

9.7

%

 

 

10.2

%

Total uncompensated care

 

$

12,015

 

 

$

10,958

 

 

$

34,633

 

 

$

31,571

 

Multiply by the cost-to-charges ratio

 

 

10.0

%

 

 

10.3

%

 

 

9.7

%

 

 

10.2

%

Estimated cost of total uncompensated care

 

$

1,188

 

 

$

1,138

 

 

$

3,359

 

 

$

3,220

 

 

Revenues (continued)

The total uncompensated care amounts include charity care of $4.131 billion and $4.001 billion, respectively, and the related estimated costs of charity care were $408 million and $416 million, respectively, for the quarters ended September 30, 2025 and 2024. The total uncompensated care amounts include charity care of $11.887 billion and $12.091 billion, respectively, and the related estimated costs of charity care were $1.153 billion and $1.233 billion, respectively, for the nine months ended September 30, 2025 and 2024.
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.

v3.25.3
Basis of Presentation and Significant Accounting Policies (Tables)
 9 Months Ended
Sep. 30, 2025
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 and nine months ended September 30, 2025 and 2024 are summarized in the following table (dollars in millions):

 

 

Quarter

 

 

2025

 

 

Ratio

 

 

2024

 

 

Ratio

 

Medicare

 

$

2,728

 

 

 

14.2

%

 

$

2,584

 

 

 

14.8

%

Managed Medicare

 

 

3,306

 

 

 

17.3

 

 

 

2,949

 

 

 

16.9

 

Medicaid

 

 

1,783

 

 

 

9.3

 

 

 

1,127

 

 

 

6.4

 

Managed Medicaid

 

 

949

 

 

 

4.9

 

 

 

1,031

 

 

 

5.9

 

Managed care and insurers

 

 

9,267

 

 

 

48.4

 

 

 

8,497

 

 

 

48.6

 

International (managed care and insurers)

 

 

484

 

 

 

2.5

 

 

 

424

 

 

 

2.4

 

Other

 

 

644

 

 

 

3.4

 

 

 

875

 

 

 

5.0

 

Revenues

 

$

19,161

 

 

 

100.0

%

 

$

17,487

 

 

 

100.0

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nine Months

 

 

2025

 

 

Ratio

 

 

2024

 

 

Ratio

 

Medicare

 

$

8,426

 

 

 

15.0

%

 

$

8,043

 

 

 

15.4

%

Managed Medicare

 

 

9,957

 

 

 

17.8

 

 

 

8,888

 

 

 

17.0

 

Medicaid

 

 

4,413

 

 

 

7.9

 

 

 

3,316

 

 

 

6.3

 

Managed Medicaid

 

 

2,727

 

 

 

4.9

 

 

 

3,042

 

 

 

5.8

 

Managed care and insurers

 

 

27,432

 

 

 

48.8

 

 

 

25,591

 

 

 

49.0

 

International (managed care and insurers)

 

 

1,390

 

 

 

2.5

 

 

 

1,252

 

 

 

2.4

 

Other

 

 

1,742

 

 

 

3.1

 

 

 

2,186

 

 

 

4.1

 

Revenues

 

$

56,087

 

 

 

100.0

%

 

$

52,318

 

 

 

100.0

%
Schedule of Estimated Cost of Uncompensated Care A summary of the estimated cost of total uncompensated care for the quarters and nine months ended September 30, 2025 and 2024 follows (dollars in millions):

 

 

Quarter

 

 

Nine Months

 

 

2025

 

 

2024

 

 

2025

 

 

2024

 

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

 

$

16,196

 

 

$

15,077

 

 

$

47,300

 

 

$

44,617

 

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

 

 

10.0

%

 

 

10.3

%

 

 

9.7

%

 

 

10.2

%

Total uncompensated care

 

$

12,015

 

 

$

10,958

 

 

$

34,633

 

 

$

31,571

 

Multiply by the cost-to-charges ratio

 

 

10.0

%

 

 

10.3

%

 

 

9.7

%

 

 

10.2

%

Estimated cost of total uncompensated care

 

$

1,188

 

 

$

1,138

 

 

$

3,359

 

 

$

3,220

 

 
v3.25.3
Earnings Per Share (Tables)
 9 Months Ended
Sep. 30, 2025
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 and nine months ended September 30, 2025 and 2024 (dollars and shares in millions, except per share amounts):

 

 

Quarter

 

 

Nine Months

 

 

2025

 

 

2024

 

 

2025

 

 

2024

 

Net income attributable to HCA Healthcare, Inc.

 

$

1,643

 

 

$

1,270

 

 

$

4,906

 

 

$

4,322

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weighted average common shares outstanding

 

 

232.891

 

 

 

256.763

 

 

 

239.615

 

 

 

260.770

 

Effect of dilutive incremental shares

 

 

3.290

 

 

 

3.154

 

 

 

2.844

 

 

 

3.217

 

Shares used for diluted earnings per share

 

 

236.181

 

 

 

259.917

 

 

 

242.459

 

 

 

263.987

 

Earnings per share:

 

 

 

 

 

 

 

 

 

 

 

 

Basic earnings

 

$

7.05

 

 

$

4.94

 

 

$

20.47

 

 

$

16.57

 

Diluted earnings

 

$

6.96

 

 

$

4.88

 

 

$

20.23

 

 

$

16.37

 
v3.25.3
Investments of Insurance Subsidiaries (Tables)
 9 Months Ended
Sep. 30, 2025
Investments, Debt and Equity Securities [Abstract]  
Schedule of Investments

A summary of our insurance subsidiaries’ investments at September 30, 2025 and December 31, 2024 follows (dollars in millions):

 

 

September 30, 2025

 

 

 

 

 

Unrealized
Amounts

 

 

 

 

 

Amortized
Cost

 

 

Gains

 

 

Losses

 

 

Fair
Value

 

Debt securities

 

$

343

 

 

$

1

 

 

$

(16

)

 

$

328

 

Money market funds and other

 

 

339

 

 

 

—

 

 

 

—

 

 

 

339

 

 

$

682

 

 

$

1

 

 

$

(16

)

 

 

667

 

Amounts classified as current assets

 

 

 

 

 

 

 

 

 

 

 

(94

)

Investment carrying value

 

 

 

 

 

 

 

 

 

 

$

573

 

 

 

December 31, 2024

 

 

 

 

 

Unrealized
Amounts

 

 

 

 

 

Amortized
Cost

 

 

Gains

 

 

Losses

 

 

Fair
Value

 

Debt securities

 

$

388

 

 

$

—

 

 

$

(27

)

 

$

361

 

Money market funds and other

 

 

296

 

 

 

—

 

 

 

—

 

 

 

296

 

 

$

684

 

 

$

—

 

 

$

(27

)

 

 

657

 

Amounts classified as current assets

 

 

 

 

 

 

 

 

 

 

 

(88

)

Investment carrying value

 

 

 

 

 

 

 

 

 

 

$

569

 
Schedule of Maturities of Investments

Scheduled maturities of investments in debt securities at September 30, 2025 were as follows (dollars in millions):

 

 

Amortized
Cost

 

 

Fair
Value

 

Due in one year or less

 

$

18

 

 

$

17

 

Due after one year through five years

 

 

151

 

 

 

147

 

Due after five years through ten years

 

 

114

 

 

 

107

 

Due after ten years

 

 

60

 

 

 

57

 

 

$

343

 

 

$

328

 
v3.25.3
Assets and Liabilities Measured at Fair Value (Tables)
 9 Months Ended
Sep. 30, 2025
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 September 30, 2025 and December 31, 2024, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):

 

 

September 30, 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

 

 

339

 

 

 

339

 

 

 

—

 

 

 

—

 

Investments of insurance subsidiaries

 

 

667

 

 

 

340

 

 

 

327

 

 

 

—

 

Less amounts classified as current assets

 

 

(94

)

 

 

(94

)

 

 

—

 

 

 

—

 

 

$

573

 

 

$

246

 

 

$

327

 

 

$

—

 

 

 

December 31, 2024

 

 

 

 

 

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

 

$

361

 

 

$

—

 

 

$

361

 

 

$

—

 

Money market funds and other

 

 

296

 

 

 

296

 

 

 

—

 

 

 

—

 

Investments of insurance subsidiaries

 

 

657

 

 

 

296

 

 

 

361

 

 

 

—

 

Less amounts classified as current assets

 

 

(88

)

 

 

(88

)

 

 

—

 

 

 

—

 

 

$

569

 

 

$

208

 

 

$

361

 

 

$

—

 
v3.25.3
Debt (Tables)
 9 Months Ended
Sep. 30, 2025
Debt Disclosure [Abstract]  
Schedule of Debt

A summary of our debt at September 30, 2025 and December 31, 2024, including related interest rates at September 30, 2025, follows (dollars in millions):

 

 

September 30,
2025

 

 

December 31,
2024

 

Short-term borrowings:

 

 

 

 

 

Commercial paper (average life of 17 days, weighted average rate of 4.7%)

$

1,910

 

 

$

—

 

Long-term debt:

 

 

 

 

 

Senior secured term loan facility

 

—

 

 

 

1,238

 

Other senior secured debt (effective interest rate of 4.4%)

 

1,067

 

 

 

1,046

 

Senior unsecured credit facilities

 

—

 

 

 

—

 

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

 

41,950

 

 

 

41,116

 

Debt issuance costs and discounts

 

(416

)

 

 

(369

)

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

 

42,601

 

 

 

43,031

 

Total debt

 

44,511

 

 

 

43,031

 

Less amounts due within one year

 

6,110

 

 

 

4,698

 

$

38,401

 

 

$

38,333

 
v3.25.3
Share Repurchase Transactions and Other Comprehensive Loss (Tables)
 9 Months Ended
Sep. 30, 2025
Equity [Abstract]  
Components of Accumulated Other Comprehensive Loss

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

 

Unrealized
Gains (Losses) on
Available-for-Sale
Securities

 

 

Foreign
Currency
Translation
Adjustments

 

 

Defined
Benefit
Plans

 

 

Total

 

Balances at December 31, 2024

$

(21

)

 

$

(353

)

 

$

(13

)

 

$

(387

)

Unrealized gains on available-for-sale
   securities, net of $3 of income taxes

 

9

 

 

 

 

 

 

 

 

 

9

 

Foreign currency translation adjustments, net
   of $10 of income taxes

 

 

 

 

61

 

 

 

 

 

 

61

 

Balances at September 30, 2025

$

(12

)

 

$

(292

)

 

$

(13

)

 

$

(317

)
v3.25.3
Segment and Geographic Information (Tables)
 9 Months Ended
Sep. 30, 2025
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 and nine months ended September 30, 2025 and 2024 and assets at September 30, 2025 and December 31, 2024:

 

 

Quarter

 

 

Nine Months

 

 

2025

 

 

National
Group

 

Atlantic
Group

 

American
Group

 

 

National
Group

 

Atlantic
Group

 

American
Group

 

Revenues

$

5,525

 

$

6,142

 

$

6,688

 

 

$

15,790

 

$

18,431

 

$

19,512

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

1,970

 

 

2,288

 

 

2,275

 

 

 

5,848

 

 

6,750

 

 

6,687

 

Supplies

 

742

 

 

889

 

 

1,053

 

 

 

2,238

 

 

2,738

 

 

3,140

 

Other operating expenses

 

1,466

 

 

1,627

 

 

1,796

 

 

 

3,954

 

 

4,793

 

 

5,156

 

Equity in earnings of affiliates

 

(1

)

 

(1

)

 

(16

)

 

 

(1

)

 

(3

)

 

(47

)

 

 

4,177

 

 

4,803

 

 

5,108

 

 

 

12,039

 

 

14,278

 

 

14,936

 

Adjusted segment EBITDA

$

1,348

 

$

1,339

 

$

1,580

 

 

$

3,751

 

$

4,153

 

$

4,576

 

 

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

 

Quarter

 

 

Nine Months

 

 

2024

 

 

National
Group

 

Atlantic
Group

 

American
Group

 

 

National
Group

 

Atlantic
Group

 

American
Group

 

Revenues

$

4,931

 

$

5,738

 

$

6,078

 

 

$

14,622

 

$

17,429

 

$

18,105

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

1,897

 

 

2,190

 

 

2,176

 

 

 

5,656

 

 

6,500

 

 

6,405

 

Supplies

 

696

 

 

858

 

 

1,007

 

 

 

2,094

 

 

2,651

 

 

2,965

 

Other operating expenses

 

1,270

 

 

1,555

 

 

1,549

 

 

 

3,668

 

 

4,581

 

 

4,689

 

Equity in (earnings) losses of affiliates

 

—

 

 

—

 

 

(18

)

 

 

2

 

 

(2

)

 

(49

)

 

 

3,863

 

 

4,603

 

 

4,714

 

 

 

11,420

 

 

13,730

 

 

14,010

 

Adjusted segment EBITDA

$

1,068

 

$

1,135

 

$

1,364

 

 

$

3,202

 

$

3,699

 

$

4,095

 

 

 

 

Quarter

 

 

Nine Months

 

 

 

2025

 

 

2024

 

 

2025

 

 

2024

 

Adjusted segment EBITDA:

 

 

 

 

 

 

 

 

 

 

 

 

National Group

 

$

1,348

 

 

$

1,068

 

 

$

3,751

 

 

$

3,202

 

Atlantic Group

 

 

1,339

 

 

 

1,135

 

 

 

4,153

 

 

 

3,699

 

American Group

 

 

1,580

 

 

 

1,364

 

 

 

4,576

 

 

 

4,095

 

 

 

 

4,267

 

 

 

3,567

 

 

 

12,480

 

 

 

10,996

 

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

 

 

 

 

 

 

 

 

 

 

 

 

Corporate and Other

 

 

397

 

 

 

300

 

 

 

1,028

 

 

 

826

 

Depreciation and amortization

 

 

889

 

 

 

842

 

 

 

2,612

 

 

 

2,456

 

Interest expense

 

 

561

 

 

 

515

 

 

 

1,676

 

 

 

1,533

 

Losses (gains) on sales of facilities

 

 

2

 

 

 

4

 

 

 

4

 

 

 

(209

)

Income before income taxes

 

$

2,418

 

 

$

1,906

 

 

$

7,160

 

 

$

6,390

 

 

 

 

Quarter

 

 

Nine Months

 

 

2025

 

 

2024

 

 

2025

 

 

2024

 

Revenues:

 

 

 

 

 

 

 

 

 

 

 

 

National Group

 

$

5,525

 

 

$

4,931

 

 

$

15,790

 

 

$

14,622

 

Atlantic Group

 

 

6,142

 

 

 

5,738

 

 

 

18,431

 

 

 

17,429

 

American Group

 

 

6,688

 

 

 

6,078

 

 

 

19,512

 

 

 

18,105

 

Corporate and other

 

 

806

 

 

 

740

 

 

 

2,354

 

 

 

2,162

 

 

$

19,161

 

 

$

17,487

 

 

$

56,087

 

 

$

52,318

 

Depreciation and amortization:

 

 

 

 

 

 

 

 

 

 

 

 

National Group

 

$

226

 

 

$

214

 

 

$

675

 

 

$

637

 

Atlantic Group

 

 

281

 

 

 

271

 

 

 

830

 

 

 

790

 

American Group

 

 

283

 

 

 

277

 

 

 

839

 

 

 

799

 

Corporate and other

 

 

99

 

 

 

80

 

 

 

268

 

 

 

230

 

 

$

889

 

 

$

842

 

 

$

2,612

 

 

$

2,456

 

 

 

 

September 30,
2025

 

 

December 31,
2024

 

Assets:

 

 

 

 

 

 

National Group

 

$

13,274

 

 

$

12,855

 

Atlantic Group

 

 

17,573

 

 

 

17,168

 

American Group

 

 

20,889

 

 

 

20,714

 

Corporate and other

 

 

8,011

 

 

 

8,776

 

 

 

$

59,747

 

 

$

59,513

 
v3.25.3
Basis of Presentation and Significant Accounting Policies - Additional Information (Detail)
$ in Millions
 1 Months Ended 3 Months Ended 9 Months Ended
Nov. 30, 2017
Sep. 30, 2025
USD ($)
Hospital
SurgeryCenter
EndoscopyCenter
State
Sep. 30, 2024
USD ($)
Sep. 30, 2025
USD ($)
Hospital
SurgeryCenter
EndoscopyCenter
State
Sep. 30, 2024
USD ($)
Summary Of Significant Accounting Policies [Line Items]          
Number of owned and operated hospitals | Hospital   191   191  
Number of freestanding surgery centers | SurgeryCenter   123   123  
Number of freestanding endoscopy centers | EndoscopyCenter   29   29  
Number of facilities locations | State   20   20  
General and administrative expense   $ 139 $ 111 $ 395 $ 301
Charity care amount   4,131 4,001 11,887 12,091
Estimated costs of charity care   $ 408 $ 416 $ 1,153 $ 1,233
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  
v3.25.3
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 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Revenues From Third Party Payers [Line Items]        
Revenues $ 19,161 $ 17,487 $ 56,087 $ 52,318
Revenues ratio from third party payers 100.00% 100.00% 100.00% 100.00%
Medicare [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 2,728 $ 2,584 $ 8,426 $ 8,043
Revenues from third party payers, Ratio 14.20% 14.80% 15.00% 15.40%
Managed Medicare [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 3,306 $ 2,949 $ 9,957 $ 8,888
Revenues from third party payers, Ratio 17.30% 16.90% 17.80% 17.00%
Medicaid [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 1,783 $ 1,127 $ 4,413 $ 3,316
Revenues from third party payers, Ratio 9.30% 6.40% 7.90% 6.30%
Managed Medicaid [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 949 $ 1,031 $ 2,727 $ 3,042
Revenues from third party payers, Ratio 4.90% 5.90% 4.90% 5.80%
Managed Care and Insurers [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 9,267 $ 8,497 $ 27,432 $ 25,591
Revenues from third party payers, Ratio 48.40% 48.60% 48.80% 49.00%
International (Managed Care and Insurers) [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 484 $ 424 $ 1,390 $ 1,252
Revenues from third party payers, Ratio 2.50% 2.40% 2.50% 2.40%
Other [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues $ 644 $ 875 $ 1,742 $ 2,186
Other, Ratio 3.40% 5.00% 3.10% 4.10%
v3.25.3
Basis of Presentation and Significant Accounting Policies - Schedule of Estimated Cost of Uncompensated Care (Detail) - USD ($)
$ in Millions
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Accounting Policies [Abstract]        
Patient care costs (salaries and benefits, supplies, other operating expense and depreciation and amortization) $ 16,196 $ 15,077 $ 47,300 $ 44,617
Cost-to-charges ratio (patient care costs as percentage of gross patient charges) 10.00% 10.30% 9.70% 10.20%
Total uncompensated care $ 12,015 $ 10,958 $ 34,633 $ 31,571
Multiply by the cost-to-charges ratio 10.00% 10.30% 9.70% 10.20%
Estimated cost of total uncompensated care $ 1,188 $ 1,138 $ 3,359 $ 3,220
v3.25.3
Acquisitions and Dispositions - Additional Information (Detail)
$ in Millions
 9 Months Ended
Sep. 30, 2025
USD ($)
Hospital
Sep. 30, 2024
USD ($)
Hospital
Business Acquisition [Line Items]    
Proceeds from sale of business $ 177 $ 312
Pretax gain (loss) before tax (4) 209
Real Estate and Other Investments [Member]    
Business Acquisition [Line Items]    
Proceeds from sale of business 22 17
Healthcare Entity [Member]    
Business Acquisition [Line Items]    
Aggregate purchase price 171 112
Hospital Facility [Member]    
Business Acquisition [Line Items]    
Aggregate purchase price $ 190 $ 112
Number of hospitals purchased | Hospital 2 3
Proceeds from sale of business $ 155 $ 295
Number of hospitals sold | Hospital 1 1
v3.25.3
Income Taxes - Additional Information (Detail) - USD ($)
$ in Millions
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Dec. 31, 2024
Income Tax Disclosure [Abstract]          
Provision for income taxes $ 515 $ 424 $ 1,541 $ 1,419  
Effective tax rate 23.90% 25.00% 23.90% 24.70%  
Provision for tax benefits related to settlement of employee awards     $ 45 $ 93  
Gross unrecognized tax benefits, excluding accrued interest and penalties $ 515   515   $ 504
Unrecognized tax benefits, accrued interest and penalties 143   143   115
Unrecognized tax benefits that would impact effective tax rate $ 332   $ 332   $ 295
v3.25.3
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 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Earnings Per Share [Abstract]        
Net income attributable to HCA Healthcare, Inc. $ 1,643 $ 1,270 $ 4,906 $ 4,322
Weighted average common shares outstanding 232,891 256,763 239,615 260,770
Effect of dilutive incremental shares 3,290 3,154 2,844 3,217
Shares used for diluted earnings per share 236,181 259,917 242,459 263,987
Basic earnings $ 7.05 $ 4.94 $ 20.47 $ 16.57
Diluted earnings $ 6.96 $ 4.88 $ 20.23 $ 16.37
v3.25.3
Investments of Insurance Subsidiaries - Schedule of Investments (Detail) - USD ($)
$ in Millions
Sep. 30, 2025
Dec. 31, 2024
Debt Securities, Available-for-sale [Line Items]    
Amounts classified as current assets $ (94) $ (88)
Investment carrying value 573 569
Money market funds and other, Amortized Cost 339 296
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 339 296
Investment Owned, at Cost, Total 682 684
Investment Gains 1 0
Investment Losses (16) (27)
Investment Fiar Value 667 657
Debt Securities [Member]    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 343 388
Unrealized Amounts, Gains 1 0
Unrealized Amounts, Losses (16) (27)
Fair Value $ 328 $ 361
v3.25.3
Investments of Insurance Subsidiaries - Schedule of Maturities of Investments (Detail)
$ in Millions
Sep. 30, 2025
USD ($)
Investments, Debt and Equity Securities [Abstract]  
Due in one year or less, Amortized Cost $ 18
Due after one year through five years, Amortized Cost 151
Due after five years through ten years, Amortized Cost 114
Due after ten years, Amortized Cost 60
Amortized Cost, Total 343
Due in one year or less, Fair Value 17
Due after one year through five years, Fair Value 147
Due after five years through ten years, Fair Value 107
Due after ten years, Fair Value 57
Fair Value, Total $ 328
v3.25.3
Investments of Insurance Subsidiaries - Additional Information (Detail)
 9 Months Ended
Sep. 30, 2025
Investments, Debt and Equity Securities [Abstract]  
Available for sale securities expected maturity of debt securities 4 years
Available for sale securities average scheduled maturity 8 years 1 month 6 days
v3.25.3
Assets and Liabilities Measured at Fair Value - Summary of Investments of Insurance Subsidiaries Measured at Fair Value on Recurring Basis (Detail) - USD ($)
$ in Millions
Sep. 30, 2025
Dec. 31, 2024
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]    
Money market funds and other $ 339 $ 296
Investments of insurance subsidiaries 667 657
Less amounts classified as current assets (94) (88)
Asset fair value 573 569
Debt Securities [Member]    
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]    
Debt securities 328 361
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 339 296
Investments of insurance subsidiaries 340 296
Less amounts classified as current assets (94) (88)
Asset fair value 246 208
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member] | Debt Securities [Member]    
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]    
Debt securities 1  
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 327 361
Asset fair value 327 361
Significant Other Observable Inputs (Level 2) [Member] | Debt Securities [Member]    
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]    
Debt securities $ 327 $ 361
v3.25.3
Assets and Liabilities Measured at Fair Value - Additional Information (Detail) - USD ($)
$ in Millions
Sep. 30, 2025
Dec. 31, 2024
Fair Value Disclosures [Abstract]    
Estimated fair value of long-term debt $ 43,898 $ 40,845
Carrying amounts of long-term debt $ 44,927 $ 43,400
v3.25.3
Debt - Schedule of Debt (Detail) - USD ($)
$ in Millions
Sep. 30, 2025
Feb. 28, 2025
Dec. 31, 2024
Debt Instrument [Line Items]      
Debt issuance costs and discounts $ (416)   $ (369)
Total long-term debt (average life of 11.7 years, rates averaging 5.1%) 42,601   43,031
Total debt 44,511   43,031
Less amounts due within one year 6,110   4,698
Long-term debt 38,401   38,333
Commercial Paper [Member]      
Debt Instrument [Line Items]      
Short-term borrowings 1,910   0
Senior Secured Term Loan Facility [Member]      
Debt Instrument [Line Items]      
Senior secured debt 0 $ 1,238 1,238
Other Senior Secured Debt [Member]      
Debt Instrument [Line Items]      
Other senior secured debt 1,067   1,046
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 $ 41,950   $ 41,116
v3.25.3
Debt - Schedule of Debt (Parenthetical) (Detail)
 9 Months Ended
Sep. 30, 2025
Debt Instrument [Line Items]  
Total long-term debt average term 11 years 8 months 12 days
Total long-term debt average rate 5.10%
Commercial Paper [Member]  
Debt Instrument [Line Items]  
Short term debt average term 17 days
Weighted average rate 4.70%
Other Senior Secured Debt [Member]  
Debt Instrument [Line Items]  
Effective interest rate 4.40%
Senior Unsecured Notes Payable Through 2095 [Member]  
Debt Instrument [Line Items]  
Effective interest rate 5.10%
Payable year 2095
v3.25.3
Debt - Additional Information (Detail) - USD ($)
$ in Thousands
 1 Months Ended 9 Months Ended
Sep. 30, 2025
Jun. 30, 2025
Apr. 30, 2025
Feb. 28, 2025
Oct. 30, 2025
Sep. 30, 2025
Sep. 30, 2024
Dec. 31, 2024
Debt Instrument [Line Items]                
Repayments of debt           $ 5,834,000 $ 2,346,000  
Commercial Paper [Member]                
Debt Instrument [Line Items]                
Debt instrument, principal amount   $ 4,000,000            
Commercial paper outstanding $ 1,910,000         1,910,000   $ 0
Commercial Paper [Member] | Maximum [Member]                
Debt Instrument [Line Items]                
Debt maturities, term   397 days            
Senior Notes [Member]                
Debt Instrument [Line Items]                
Debt instrument, principal amount       $ 5,250,000        
Senior Notes [Member] | Senior Secured Notes Due 2028 [Member]                
Debt Instrument [Line Items]                
Debt instrument, principal amount       $ 700,000        
Debt instrument, stated interest       5.00%        
Senior Notes [Member] | Senior Secured Notes Due 2030 [Member]                
Debt Instrument [Line Items]                
Debt instrument, principal amount       $ 750,000,000        
Debt instrument, stated interest       5.25%        
Senior Notes [Member] | Senior Secured Notes Due 2032 [Member]                
Debt Instrument [Line Items]                
Debt instrument, principal amount       $ 750,000,000        
Debt instrument, stated interest       5.50%        
Senior Notes [Member] | Senior Secured Notes Due 2035 [Member]                
Debt Instrument [Line Items]                
Debt instrument, principal amount       $ 1,500,000        
Debt instrument, stated interest       5.75%        
Senior Notes [Member] | Senior Secured Notes Due 2055 [Member]                
Debt Instrument [Line Items]                
Debt instrument, principal amount       $ 1,250,000        
Debt instrument, stated interest       6.20%        
Senior Notes [Member] | Senior Notes Due 2025 [Member]                
Debt Instrument [Line Items]                
Debt instrument, stated interest       5.375%        
Repayments of debt       $ 2,600,000        
Floating Rate Senior Notes [Member] | Senior Secured Notes Due 2028 [Member]                
Debt Instrument [Line Items]                
Debt instrument, principal amount       300,000,000        
Senior Secured Asset-Based Revolving Credit Facility [Member]                
Debt Instrument [Line Items]                
Long-term line of credit       4,500,000        
Senior Secured Term Loan Facilities [Member]                
Debt Instrument [Line Items]                
Senior secured debt $ 0     1,238,000   0   $ 1,238,000
Senior Secured Revolving Credit Facility [Member]                
Debt Instrument [Line Items]                
Long-term line of credit       3,500,000        
Senior Unsecured Revolving Credit Facility [Member]                
Debt Instrument [Line Items]                
Debt instrument, stated interest   7.69% 5.25%          
Repayments of debt   $ 291,000 $ 1,400,000          
Senior unsecured       $ 8,000,000        
Senior unsecured revolving credit commitments term       5 years        
Total committed capacity of senior unsecured credit facility   $ 8,000            
Borrowings outstanding           $ 0    
Senior Unsecured Revolving Credit Facility [Member] | Subsequent Event [Member]                
Debt Instrument [Line Items]                
Basis spread on variable interest rate (as percent)         1.25%      
Debt Instrument, Variable Interest Rate, Type [Extensible Enumeration]         Secured Overnight Financing Rate (SOFR) [Member]      
Credit spread adjustment         0.10%      
Investment, Variable Interest Rate, Type [Extensible Enumeration]         Secured Overnight Financing Rate (SOFR) [Member]      
Medium Unsecured Revolving Credit Facility [Member]                
Debt Instrument [Line Items]                
Debt instrument, stated interest 7.58%         7.58%    
Repayments of debt $ 125,000              
v3.25.3
Share Repurchase Transactions and Other Comprehensive Loss - Additional Information (Detail) - USD ($)
$ / shares in Units, shares in Thousands, $ in Millions
 9 Months Ended
Sep. 30, 2025
Jan. 31, 2025
Jan. 31, 2024
Repurchase of common stock, shares 21,307    
Repurchase price of common stock, per share $ 352.4    
Board of Directors Chairman [Member]      
Share repurchase program authorized amount $ 3,256 $ 10,000 $ 6,000
v3.25.3
Share Repurchase Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Detail)
$ in Millions
 9 Months Ended
Sep. 30, 2025
USD ($)
Equity [Abstract]  
Unrealized gains (losses) on available-for-sale securities, beginning balances $ (21)
Unrealized gains (losses) on available-for-sale securities, net of income taxes 9
Unrealized gains (losses) on available-for-sale securities, ending balances (12)
Foreign currency translation adjustments, beginning balances (353)
Foreign currency translation adjustments, net of income taxes 61
Foreign currency translation adjustments, ending balances (292)
Defined benefit plans, beginning balances (13)
Defined benefit plans, ending balances (13)
Accumulated other comprehensive loss, net of tax, beginning balances (387)
Unrealized losses on available-for-sale securities 9
Foreign currency translation adjustments, net of income tax benefit 61
Accumulated other comprehensive loss, net of tax, ending balances $ (317)
v3.25.3
Share Repurchase Transactions and Other Comprehensive Loss - Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail)
$ in Millions
 9 Months Ended
Sep. 30, 2025
USD ($)
Equity [Abstract]  
Unrealized losses on available-for-sale securities, net of income taxes $ 3
Foreign currency translation adjustments, net of income taxes $ 10
v3.25.3
Segment and Geographic Information - Additional Information (Detail)
 9 Months Ended
Sep. 30, 2025
Hospital
Segment Reporting Information [Line Items]  
Number of geographically organized groups 3
Number of owned and operated hospitals 191
Reorganization Group [Member] | National Group [Member]  
Segment Reporting Information [Line Items]  
Number of owned and operated hospitals 54
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 8
v3.25.3
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 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Dec. 31, 2024
Segment Reporting Information [Line Items]          
Revenues $ 19,161 $ 17,487 $ 56,087 $ 52,318  
Salaries and benefits 8,364 7,861 24,499 23,253  
Supplies 2,782 2,657 8,390 7,962  
Other operating expenses 4,161 3,717 11,799 10,946  
Equity in (earnings) losses of affiliates (16) (15) (53) (13)  
Depreciation and amortization 889 842 2,612 2,456  
Interest expense 561 515 1,676 1,533  
Losses (gains) on sales of facilities 2 4 4 (209)  
Income before income taxes 2,418 1,906 7,160 6,390  
Assets 59,747   59,747   $ 59,513
Operating Segments [Member]          
Segment Reporting Information [Line Items]          
Adjusted segment EBITDA 4,267 3,567 12,480 10,996  
Eliminations and Reconciling Items [Member]          
Segment Reporting Information [Line Items]          
Corporate and Other 397 300 1,028 826  
Depreciation and amortization 889 842 2,612 2,456  
Interest expense 561 515 1,676 1,533  
Losses (gains) on sales of facilities 2 4 4 (209)  
Income before income taxes 2,418 1,906 7,160 6,390  
National Group [Member] | Operating Segments [Member]          
Segment Reporting Information [Line Items]          
Revenues 5,525 4,931 15,790 14,622  
Salaries and benefits 1,970 1,897 5,848 5,656  
Supplies 742 696 2,238 2,094  
Other operating expenses 1,466 1,270 3,954 3,668  
Equity in (earnings) losses of affiliates (1) 0 (1) 2  
Operating expenses 4,177 3,863 12,039 11,420  
Adjusted segment EBITDA 1,348 1,068 3,751 3,202  
Depreciation and amortization 226 214 675 637  
Assets 13,274   13,274   12,855
Atlantic Group [Member] | Operating Segments [Member]          
Segment Reporting Information [Line Items]          
Revenues 6,142 5,738 18,431 17,429  
Salaries and benefits 2,288 2,190 6,750 6,500  
Supplies 889 858 2,738 2,651  
Other operating expenses 1,627 1,555 4,793 4,581  
Equity in (earnings) losses of affiliates (1) 0 (3) (2)  
Operating expenses 4,803 4,603 14,278 13,730  
Adjusted segment EBITDA 1,339 1,135 4,153 3,699  
Depreciation and amortization 281 271 830 790  
Assets 17,573   17,573   17,168
American Group [Member] | Operating Segments [Member]          
Segment Reporting Information [Line Items]          
Revenues 6,688 6,078 19,512 18,105  
Salaries and benefits 2,275 2,176 6,687 6,405  
Supplies 1,053 1,007 3,140 2,965  
Other operating expenses 1,796 1,549 5,156 4,689  
Equity in (earnings) losses of affiliates (16) (18) (47) (49)  
Operating expenses 5,108 4,714 14,936 14,010  
Adjusted segment EBITDA 1,580 1,364 4,576 4,095  
Depreciation and amortization 283 277 839 799  
Assets 20,889   20,889   20,714
Corporate and Other [Member]          
Segment Reporting Information [Line Items]          
Revenues 806 740 2,354 2,162  
Depreciation and amortization 99 $ 80 268 $ 230  
Assets $ 8,011   $ 8,011   $ 8,776