HCA Healthcare Inc. (HCA): 2Q First Take: Earnings Call Q&A Focus: Topics: 2H26 Payer Mix / Surgical Vols / Medicaid SDPs

Research evidence excerpt

HCA Healthcare Inc. (HCA): 2Q First Take: Earnings Call Q&A Focus: Topics: 2H26 Payer Mix / Surgical Vols / Medicaid SDPs

Equity Research

24 July 2026 | 9:52AM EDT

HCA Healthcare Inc. (HCA): 2Q First Take: Earnings Call Q&A Focus

Topics: 2H26 Payer Mix / Surgical Vols / Medicaid SDPs

On 7/24/26, HCA reported 2Q26 revenue of $20.230 billion and adjusted EBITDA of Scott Fidel

+1(212)902-7304 | scott.fidel@gs.com

$4.027 billion. These results were in line with preliminary 2Q26 results announced Goldman Sachs & Co. LLC

7/14/26. Sarah Conrad

+1(212)357-2448 |

sarah.conrad@gs.com

During 2Q, HCA experienced an unfavorable payer mix shift driven by increased Goldman Sachs & Co. LLC

uninsured volumes following coverage losses on the ACA exchanges (HIX), which Valentine Vlasov

reduced pre-tax earnings by an estimated -$400 million, including -$75 million +1(212)934-0210valentine.vlasov@gs.com|

related to a refinement of the prior estimate of 1Q26 impacts. HCA also experienced Goldman Sachs & Co. LLC

a service mix shift related to a decline in surgical volumes, similar to trends flagged

by ARDT and from the panelists at our Hospital Diligence Day, who also discussed

similar changing payer mix dynamics, including rising self-pay / uninsured volume

trends.

Offsetting these pressures, HCA recognized approximately $400 million of

incremental net Medicaid supplemental payment benefit, primarily related to Florida

SDP approvals, and improving expense trends.

We look for HCA’s guidance assumptions for 2H26 on payer mix trends, surgical

volumes, and Medicaid SDP payments to lead a robust agenda of topics to discuss on

today’s 2Q earnings call.

See below for more details on underlying performance drivers:

(1) Revenue: HCA reported 2Q26 revenue of $20.230 billion, consistent with the 2Q