HCA Healthcare falls slightly short in Q4 2024 but closes the year strong with optimism for 2025

Overview

HCA Healthcare concluded 2024 with important financial and operational results, reporting revenues of $70.6bn for the full year and $18.29bn for Q4. Full-year net income totaled $5.76bn, with diluted EPS of $22.00, reflecting robust performance across all sectors. Adjusted EBITDA reached $13.88bn, supported by increased admissions, higher revenue per patient, and operational efficiencies. The company also generated $10.5bn in cash flow from operating activities and invested significantly in capital expenditures and share repurchases to drive future growth.

CEO Sam Hazen highlighted HCA Healthcare’s consistent ability to deliver value to patients, employees, and shareholders, emphasizing the company’s operational resilience and financial strength: “We finished 2024 with strong business fundamentals that were consistent with previous quarters. The first half of the current decade, which ended in 2024, proved to be another period of long-term growth for the company and resulted in operational improvements across key performance indicators and greater value for our patients, employees and shareholders. These accomplishments are a testament to the incredible work of our teams, and position us well for the future.”

Q4 2024 vs. Q4 2023:

• Revenues totaled $18.29bn (+6% vs. 2023), driven by increased admissions, equivalent admissions, and higher revenue per admission.
• Net income decreased compared to the same period last year, to a value of $1.44bn (-10.5% YoY), while diluted EPS followed the same trend, reaching a value of $5.63 (-5% YoY), primarily related to the pending sale of a hospital facility in California.
• Adjusted EBITDA increased slightly compared to Q4 2023, reaching a value of $3.71bn (+3% YoY).
• Cash flows provided by operating activities was $2.56bn (-4% vs. 2023).
• During the fourth quarter of 2024, the company repurchased 4.739m shares of its common stock at a cost of $1.7bn.

Full-Year 2024 highlights:

• Revenues for the year ended have experienced significant growth, to a value of $70.6bn (+9% YoY).
• Even though the situation for Q4 was not favorable, at the annual level net income increased to a value of $5.76bn (+10% vs. 2023), while diluted EPS rose to $22.00 (+16% YoY), reflecting solid financial performance across all sectors.
• Adjusted EBITDA also had an increasing trend, up to a value of $13.88bn (+9% YoY), driven by operational improvements and revenue growth.
• Net cash provided by operating activities reached an important threshold of $10.5bn (+11.5% YoY).

HCA Healthcare forecasts revenues of $72.8–$75.8bn and adjusted EBITDA of $14.3–$15.1bn for 2025. Diluted EPS is expected to range between $24.05 and $25.85, supported by volume growth and a stable operating environment. Capital expenditures are projected at $5.0–$5.2bn to support continued infrastructure development.

Even though the full-year results showed significant increases, it seems that the slight declines in Q4 2024 made investors quite skeptical, with HCA’s share price falling by approximately 3.7% on the last trading day of this week.

Author: Andreea-Roxana Danci