Cover and table of contents

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Cover and table of contents

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

Form 10-Q

(Mark One)

☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended June 30, 2026

☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from to

Commission file number 1-11239

HCA Healthcare, Inc.

(Exact name of registrant as specified in its charter)



Delaware	27-3865930
(State or other jurisdiction of incorporation or organization)	(I.R.S. Employer Identification No.)

One Park Plaza Nashville, Tennessee	37203
(Address of principal executive offices)	(Zip Code)

(615) 344-9551

(Registrant’s telephone number, including area code)

Not Applicable

(Former name, former address and former fiscal year, if changed since last report)

Securities registered pursuant to Section 12(b) of the Act:



Title of each class	Trading Symbol(s)	Name of each exchange on which registered
Voting common stock, $.01 par value	HCA	New York Stock Exchange

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☒ No ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.



Large accelerated filer	☒	Accelerated filer	☐

Non-accelerated filer	☐	Smaller reporting company	☐

Emerging growth company	☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒

Indicate the number of shares outstanding of each of the issuer’s classes of common stock as of the latest practicable date.


Class of Common Stock	Outstanding at July 24, 2026
Voting common stock, $.01 par value	216,501,500 shares

HCA HEALTHCARE, INC.

Form 10-Q

June 30, 2026



		Page of Form 10-Q
Part I.	Financial Information

Item 1.	Financial Statements (Unaudited):

	Condensed Consolidated Income Statements — for the quarters and six months ended June 30, 2026 and 2025	3

	Condensed Consolidated Comprehensive Income Statements — for the quarters and six months ended June 30, 2026 and 2025	4

	Condensed Consolidated Balance Sheets — June 30, 2026 and December 31, 2025	5

	Condensed Consolidated Statements of Stockholders’ Equity (Deficit) — for the quarters and six months ended June 30, 2026 and 2025	6

	Condensed Consolidated Statements of Cash Flows — for the six months ended June 30, 2026 and 2025	7

	Notes to Condensed Consolidated Financial Statements	8

Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	17

Item 3.	Quantitative and Qualitative Disclosures About Market Risk	31

Item 4.	Controls and Procedures	31

Part II.	Other Information

Item 1.	Legal Proceedings	31

Item 1A.	Risk Factors	31

Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	31

Item 5.	Other Information	32

Item 6.	Exhibits	32

Signatures		33

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED INCOME STATEMENTS

FOR THE QUARTERS AND SIX MONTHS ENDED JUNE 30, 2026 AND 2025

Unaudited

(Dollars in millions, except per share amounts)


	Quarter						Six Months
	2026			2025			2026			2025
Revenues	$	20,230		$	18,605		$	39,339		$	36,926

Salaries and benefits		8,290			8,138			16,573			16,135
Supplies		2,886			2,844			5,739			5,608
Other operating expenses		5,043			3,793			9,223			7,638
Equity in earnings of affiliates		(16	)		(19	)		(25	)		(37	)
Depreciation and amortization		944			863			1,874			1,723
Interest expense		599			568			1,183			1,115
Losses (gains) on sales of facilities		(10	)		3			(9	)		2
		17,736			16,190			34,558			32,184
Income before income taxes		2,494			2,415			4,781			4,742
Provision for income taxes		564			524			994			1,026
Net income		1,930			1,891			3,787			3,716
Net income attributable to noncontrolling interests		231			238			468			453
Net income attributable to HCA Healthcare, Inc.	$	1,699		$	1,653		$	3,319		$	3,263
Per share data:
Basic earnings	$	7.70		$	6.91		$	14.95		$	13.43
Diluted earnings	$	7.62		$	6.83		$	14.77		$	13.28
Shares used in earnings per share calculations (in millions):
Basic		220.538			239.173			222.055			243.033
Diluted		222.828			241.911			224.731			245.654

The accompanying notes are an integral part of the condensed consolidated financial statements.

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED COMPREHENSIVE INCOME STATEMENTS

FOR THE QUARTERS AND SIX MONTHS ENDED JUNE 30, 2026 AND 2025

Unaudited

(Dollars in millions)


	Quarter					Six Months
	2026			2025		2026			2025
Net income	$	1,930		$	1,891	$	3,787		$	3,716
Other comprehensive income (loss) before taxes:
Foreign currency translation		(6	)		55		(30	)		85
Unrealized (losses) gains on available-for-sale securities		(1	)		3		(2	)		9
Other comprehensive (loss) income before taxes		(7	)		58		(32	)		94
Income taxes (benefits) related to other comprehensive income items		—			10		(3	)		16
Other comprehensive (loss) income		(7	)		48		(29	)		78
Comprehensive income		1,923			1,939		3,758			3,794
Comprehensive income attributable to noncontrolling interests		231			238		468			453
Comprehensive income attributable to HCA Healthcare, Inc.	$	1,692		$	1,701	$	3,290		$	3,341

The accompanying notes are an integral part of the condensed consolidated financial statements.

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

Unaudited

(Dollars in millions)


	June 30, 2026			December 31, 2025
ASSETS
Current assets:
Cash and cash equivalents	$	1,013		$	1,040
Accounts receivable		12,281			10,867
Inventories		1,662			1,652
Other		2,234			2,224
		17,190			15,783

Property and equipment, at cost		68,409			66,275
Accumulated depreciation		(36,593	)		(35,134	)
		31,816			31,141

Investments of insurance subsidiaries		402			485
Investments in and advances to affiliates		813			633
Goodwill and other intangible assets		10,662			10,293
Right-of-use operating lease assets		2,109			2,130
Other		258			255
	$	63,250		$	60,720
LIABILITIES AND STOCKHOLDERS’ (DEFICIT) EQUITY
Current liabilities:
Accounts payable	$	4,752		$	4,659
Accrued salaries		2,199			2,525
Other accrued expenses		4,097			4,277
Short-term borrowings and long-term debt due within one year		6,264			4,889
		17,312			16,350

Long-term debt, less debt issuance costs and discounts of $451 and $436		43,454			41,603
Professional liability risks		1,464			1,466
Right-of-use operating lease obligations		1,834			1,853
Income taxes and other liabilities		2,395			2,219

Stockholders’ (deficit) equity:
Common stock $0.01 par; authorized 1,800,000,000 shares; outstanding217,963,300 shares — 2026 and 224,605,100 shares — 2025		2			2
Accumulated other comprehensive loss		(334	)		(305	)
Retained deficit		(6,310	)		(5,724	)
Stockholders’ deficit attributable to HCA Healthcare, Inc.		(6,642	)		(6,027	)
Noncontrolling interests		3,433			3,256
		(3,209	)		(2,771	)
	$	63,250		$	60,720

The accompanying notes are an integral part of the condensed consolidated financial statements.

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY (DEFICIT)

FOR THE QUARTERS AND SIX MONTHS ENDED JUNE 30, 2026 AND 2025

Unaudited

(Dollars in millions)


	Equity (Deficit) Attributable to HCA Healthcare, Inc.
							Capital			Accumulated						Equity
	Common Stock						in Excess			Other						Attributable to
	Shares			Par			of Par			Comprehensive			Retained			Noncontrolling
	(in millions)			Value			Value			Loss			Deficit			Interests			Total
Balances, December 31, 2024		249.981		$	3		$	—		$	(387	)	$	(2,115	)	$	3,054		$	555
Comprehensive income											30			1,610			215			1,855
Repurchase of common stock		(7.762	)		(1	)		(57	)					(2,470	)					(2,528	)
Share-based benefit plans		0.736						57												57
Cash dividends declared ($0.72 per share)														(178	)					(178	)
Distributions																	(220	)		(220	)
Other														(11	)		32			21
Balances, March 31, 2025		242.955			2			—			(357	)		(3,164	)		3,081			(438	)
Comprehensive income											48			1,653			238			1,939
Repurchase of common stock		(7.031	)					(126	)					(2,404	)					(2,530	)
Share-based benefit plans		0.220						126												126
Cash dividends declared ($0.72 per share)														(173	)					(173	)
Distributions																	(174	)		(174	)
Other														1			11			12
Balances, June 30, 2025		236.144			2			—			(309	)		(4,087	)		3,156			(1,238	)
Comprehensive income											(8	)		1,643			260			1,895
Repurchase of common stock		(6.514	)					(123	)					(2,399	)					(2,522	)
Share-based benefit plans		0.215						123												123
Cash dividends declared ($0.72 per share)														(169	)					(169	)
Distributions																	(237	)		(237	)
Other														(8	)		(3	)		(11	)
Balances, September 30, 2025		229.845			2			—			(317	)		(5,020	)		3,176			(2,159	)
Comprehensive income (loss)											12			1,878			285			2,175
Repurchase of common stock		(5.432	)					(111	)					(2,419	)					(2,530	)
Share-based benefit plans		0.192						111												111
Cash dividends declared ($0.72 per share)														(164	)					(164	)
Distributions																	(196	)		(196	)
Other														1			(9	)		(8	)
Balances, December 31, 2025		224.605			2			—			(305	)		(5,724	)		3,256			(2,771	)
Comprehensive income											(22	)		1,620			237			1,835
Repurchase of common stock		(3.157	)											(1,581	)					(1,581	)
Share-based benefit plans		1.155												(116	)					(116	)
Cash dividends declared ($0.78 per share)														(176	)					(176	)
Distributions																	(191	)		(191	)
Other		(0.072	)											(1	)		23			22
Balances, March 31, 2026		222.531			2			—			(327	)		(5,978	)		3,325			(2,978	)
Comprehensive income											(7	)		1,699			231			1,923
Repurchase of common stock		(4.752	)					(12	)					(1,976	)					(1,988	)
Share-based benefit plans		0.184						12						116						128
Cash dividends declared ($0.78 per share)														(172	)					(172	)
Distributions																	(143	)		(143	)
Other														1			20			21
Balances, June 30, 2026		217.963		$	2		$	—		$	(334	)	$	(6,310	)	$	3,433		$	(3,209	)

The accompanying notes are an integral part of the condensed consolidated financial statements.

HCA HEALTHCARE, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

FOR THE SIX MONTHS ENDED JUNE 30, 2026 AND 2025

Unaudited

(Dollars in millions)


	2026			2025
Cash flows from operating activities:
Net income	$	3,787		$	3,716
Adjustments to reconcile net income to net cash provided by operating activities:
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable		(1,417	)		320
Inventories and other assets		(26	)		(427	)
Accounts payable and accrued expenses		(439	)		(676	)
Depreciation and amortization		1,874			1,723
Income taxes		269			880
Losses (gains) on sales of facilities		(9	)		2
Amortization of debt issuance costs and discounts		23			25
Share-based compensation		171			197
Other		116			101
Net cash provided by operating activities		4,349			5,861
Cash flows from investing activities:
Purchase of property and equipment		(2,350	)		(2,167	)
Acquisition of hospitals and health care entities		(386	)		(326	)
Sales of hospitals and health care entities		21			167
Change in investments		(120	)		41
Other		(4	)		2
Net cash used in investing activities		(2,839	)		(2,283	)
Cash flows from financing activities:
Issuance of long-term debt		2,994			5,233
Net change in short-term borrowings and revolving credit facility		2,679			1,768
Repayment of long-term debt		(2,608	)		(5,660	)
Distributions to noncontrolling interests		(334	)		(394	)
Payment of debt issuance costs		(17	)		(57	)
Payment of dividends		(354	)		(351	)
Repurchase of common stock		(3,635	)		(5,011	)
Other		(259	)		(112	)
Net cash used in financing activities		(1,534	)		(4,584	)
Effect of exchange rate changes on cash and cash equivalents		(3	)		12
Change in cash and cash equivalents		(27	)		(994	)
Cash and cash equivalents at beginning of period		1,040			1,933
Cash and cash equivalents at end of period	$	1,013		$	939
Interest payments	$	1,163		$	1,074
Income tax payments, net	$	725		$	146

The accompanying notes are an integral part of the condensed consolidated financial statements.

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

NOTE 1 — BASIS OF PR****ESENTATION 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 June 30, 2026, these affiliates owned and operated 190 hospitals, 118 freestanding surgery centers and 30 freestanding endoscopy centers and provided extensive outpatient and ancillary services. HCA Healthcare, Inc.’s facilities are located in 19 states and England. The terms “Company,” “HCA,” “we,” “our” or “us,” as used herein and unless otherwise stated or indicated by context, refer to HCA Healthcare, Inc. and its affiliates. The terms “facilities” or “hospitals” refer to entities owned and operated by affiliates of HCA and the term “employees” refers to employees of affiliates of HCA.

Basis of Presentation

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

The majority of our expenses are “costs of revenues” items. Costs that could be classified as general and administrative would include our corporate office costs, which were $148 million and $130 million for the quarters ended June 30, 2026 and 2025, respectively, and $281 million and $256 million for the six months ended June 30, 2026 and 2025, respectively. Operating results for the quarter and six months ended June 30, 2026 are not necessarily indicative of the results that may be expected for the year ending December 31, 2026. For further information, refer to the consolidated financial statements and footnotes thereto included in our annual report on Form 10-K for the year ended December 31, 2025.

Revenues

Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the federal and state-based health insurance exchanges (the “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.

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

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 six months ended June 30, 2026 and 2025 are summarized in the following table (dollars in millions):


	Quarter
	2026		Ratio			2025		Ratio
Medicare	$	2,927		14.5	%	$	2,803		15.1	%
Managed Medicare		3,424		16.9			3,352		18.0
Medicaid		2,789		13.8			1,440		7.7
Managed Medicaid		997		4.9			899		4.8
Managed care and insurers		9,013		44.6			9,124		49.1
International (managed care and insurers)		491		2.4			461		2.5
Other		589		2.9			526		2.8
Revenues	$	20,230		100.0	%	$	18,605		100.0	%

	Six Months
	2026		Ratio			2025		Ratio
Medicare	$	5,985		15.2	%	$	5,698		15.4	%
Managed Medicare		6,932		17.6			6,651		18.0
Medicaid		4,233		10.8			2,630		7.1
Managed Medicaid		1,936		4.9			1,778		4.8
Managed care and insurers		18,097		46.0			18,165		49.2
International (managed care and insurers)		990		2.5			906		2.5
Other		1,166		3.0			1,098		3.0
Revenues	$	39,339		100.0	%	$	36,926		100.0	%

As expected, during the quarter and six months ended June 30, 2026, our revenues from managed care and insurers were unfavorably impacted by the expiration of the enhanced premium tax credits at the end of 2025 and administrative reforms, both related to insurance purchased through the Exchanges. In addition, we recognized revenues for the quarter and six months ended June 30, 2026 related to Medicaid state directed and supplemental payment programs, primarily from the Florida directed payment program approved by the Centers for Medicare & Medicaid Services during the second quarter of 2026 for the program year beginning October 1, 2024 through September 30, 2025.

To quantify the total impact of the trends related to uninsured patient accounts, we believe it is beneficial to consider total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. Total uncompensated care was $15.076 billion and $11.625 billion, respectively, for the quarters ended June 30, 2026 and 2025, and the estimated cost of total uncompensated care was $1.445 billion and $1.116 billion, respectively, for the quarters ended June 30, 2026 and 2025. Total uncompensated care was $28.688 billion and $22.618 billion, respectively, for the six months ended June 30, 2026 and 2025, and the estimated cost of total uncompensated care was $2.697 billion and $2.171 billion, respectively, for the six months ended June 30, 2026 and 2025. The estimated cost of uncompensated care was based on a ratio of patient care costs (salaries and benefits, supplies, other operating expense and depreciation and amortization) to gross charges.

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

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

Revenues (continued)

The total uncompensated care amounts include charity care of $5.318 billion and $4.112 billion, respectively, for the quarters ended June 30, 2026 and 2025, and the related estimated costs of charity care were $511 million and $395 million, respectively, for the quarters ended June 30, 2026 and 2025. The total uncompensated care amounts include charity care of $10.831 billion and $7.756 billion, respectively, and the related estimated costs of charity care were $1.018 billion and $745 million, respectively, for the six months ended June 30, 2026 and 2025.

Reclassifications

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

NOTE 2 — ACQUISITIONS AND DISPOSITIONS

During the six months ended June 30, 2026, we paid $386 million to acquire nonhospital health care entities. During the six months ended June 30, 2025, we paid $190 million to acquire two hospital facilities in New Hampshire and Florida and $136 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 six months ended June 30, 2026, we received proceeds of $21 million and recognized pretax gains of $9 million related to sales of real estate and other health care entity investments. During the six months ended June 30, 2025, we received proceeds of $156 million related to the sale of a hospital facility in California and $11 million related to sales of real estate and other health care entity investments. We recognized pretax losses of $2 million for these transactions.

NOTE 3 — INCOME TAXES

Our provisions for income taxes for the quarters ended June 30, 2026 and 2025 were $564 million and $524 million, respectively, and the effective tax rates were 22.6% and 21.7% (24.9% and 24.1% excluding net income attributable to noncontrolling interests as it relates to consolidated partnerships), respectively. Our provisions for income taxes for the six months ended June 30, 2026 and 2025 were $994 million and $1.026 billion, respectively, and the effective tax rates were 20.8% and 21.6% (23.0% and 23.9% excluding net income attributable to noncontrolling interests as it relates to consolidated partnerships), respectively. Our provisions for income taxes included tax benefits related to settlements of employee equity awards of $107 million and $33 million for the six months ended June 30, 2026 and 2025, respectively.

Our gross unrecognized tax benefits were $553 million, excluding accrued interest and penalties of $98 million, as of June 30, 2026 ($519 million and $78 million, respectively, as of December 31, 2025). Unrecognized tax benefits of $304 million ($274 million as of December 31, 2025) would affect the effective rate, if recognized.

At June 30, 2026, the Internal Revenue Service (“IRS”) was examining the 2019 income tax return of an affiliate of the Company. We are subject to examination by the IRS for tax years after 2023, as well as by state and foreign taxing authorities.

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.

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 4 — EARNINGS PER SHARE (continued)

The following table sets forth the computation of basic and diluted earnings per share for the quarters and six months ended June 30, 2026 and 2025 (dollars and shares in millions, except per share amounts):


	Quarter				Six Months
	2026		2025		2026		2025
Net income attributable to HCA Healthcare, Inc.	$	1,699	$	1,653	$	3,319	$	3,263

Weighted average common shares outstanding		220.538		239.173		222.055		243.033
Effect of dilutive incremental shares		2.290		2.738		2.676		2.621
Shares used for diluted earnings per share		222.828		241.911		224.731		245.654
Earnings per share:
Basic earnings	$	7.70	$	6.91	$	14.95	$	13.43
Diluted earnings	$	7.62	$	6.83	$	14.77	$	13.28

NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES

A summary of our insurance subsidiaries’ investments at June 30, 2026 and December 31, 2025 follows (dollars in millions):


	June 30, 2026
			Unrealized Amounts
	Amortized Cost		Gains		Losses			Fair Value
Debt securities	$	346	$	1	$	(17	)	$	330
Money market funds and other		189		—		—			189
	$	535	$	1	$	(17	)		519
Amounts classified as current assets									(117	)
Investment carrying value								$	402


	December 31, 2025
			Unrealized Amounts
	Amortized Cost		Gains		Losses			Fair Value
Debt securities	$	342	$	1	$	(15	)	$	328
Money market funds and other		260		—		—			260
	$	602	$	1	$	(15	)		588
Amounts classified as current assets									(103	)
Investment carrying value								$	485

At June 30, 2026 and December 31, 2025, the investments in debt securities of our insurance subsidiaries were classified as “available-for-sale.” Changes in unrealized gains and losses that are not credit-related are recorded as adjustments to other comprehensive income or loss.

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 5 — INVESTMENTS OF INSURANCE SUBSIDIARIES (continued)

Scheduled maturities of investments in debt securities at June 30, 2026 were as follows (dollars in millions):


	Amortized Cost		Fair Value
Due in one year or less	$	38	$	38
Due after one year through five years		130		124
Due after five years through ten years		113		106
Due after ten years		65		62
	$	346	$	330

The average expected maturity of the investments in debt securities at June 30, 2026 was 5.6 years, compared to the average scheduled maturity of 8.0 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.

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 June 30, 2026 and December 31, 2025, aggregated by the level in the fair value hierarchy within which those measurements fall (dollars in millions):


	June 30, 2026
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active Markets for Identical Assets (Level 1)			Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Debt securities	$	330		$	1		$	329	$	—
Money market funds and other		189			189			—		—
Investments of insurance subsidiaries		519			190			329		—
Less amounts classified as current assets		(117	)		(117	)		—		—
	$	402		$	73		$	329	$	—

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

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


	December 31, 2025
				Fair Value Measurements Using
	Fair Value			Quoted Prices in Active Markets for Identical Assets (Level 1)			Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Debt securities	$	328		$	1		$	327	$	—
Money market funds and other		260			260			—		—
Investments of insurance subsidiaries		588			261			327		—
Less amounts classified as current assets		(103	)		(103	)		—		—
	$	485		$	158		$	327	$	—

The estimated fair value of our debt was $48.640 billion and $45.911 billion at June 30, 2026 and December 31, 2025, respectively, compared to carrying amounts, excluding debt issuance costs and discounts, aggregating $50.169 billion and $46.928 billion, respectively. The estimates of fair value are generally based on Level 2 inputs, including quoted market prices or quoted market prices for similar issues of debt with the same maturities.

NOTE 7 — DEBT

A summary of our debt at June 30, 2026 and December 31, 2025, including related interest rates at June 30, 2026, follows (dollars in millions):


	June 30, 2026			December 31, 2025
Short-term borrowings:
Commercial paper (average life of 38 days, weighted average rate of 4.3%)	$	3,890		$	2,207
Long-term debt:
Other debt (effective interest rate of 4.9%)		1,069			1,021
Senior unsecured credit facility (effective interest rate of 4.8%)		1,010			—
Senior unsecured notes payable through 2095 (effective interest rate of 5.1%)		44,200			43,700
Debt issuance costs and discounts		(451	)		(436	)
Total long-term debt (average life of 11.7 years, rates averaging 5.1%)		45,828			44,285
Total debt		49,718			46,492
Less amounts due within one year		6,264			4,889
	$	43,454		$	41,603

During April 2026, we issued $3.000 billion aggregate principal amount of senior notes comprised of (i) $1.000 billion aggregate principal amount of 4.700% senior notes due 2031, (ii) $750 million aggregate principal amount of 5.000% senior notes due 2033 and (iii) $1.250 billion aggregate principal amount of 5.300% senior notes due 2036. We used the net proceeds to repay borrowings under the commercial paper program and for general corporate purposes.

During May 2026, we redeemed all $1.500 billion aggregate principal amount of 5.250% senior notes due 2026 and all $1.000 billion aggregate principal amount of 5.375% senior notes due 2026.

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

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.

NOTE 9 — SHARE REPURCHASE TRANSACTIONS AND OTHER COMPREHENSIVE LOSS

During each of January 2026 and January 2025, our Board of Directors authorized share repurchase programs, both of which were for up to $10 billion of our outstanding common stock. During the six months ended June 30, 2026, we repurchased 7.909 million shares of our common stock at an average price of $447.53 per share through market purchases pursuant to the January 2025 authorization (which was fully utilized during the first quarter of 2026) and the January 2026 authorization. At June 30, 2026, we had $7.210 billion of repurchase authorization available under the January 2026 authorization.

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


	Unrealized Losses on Available-for-Sale Securities			Foreign Currency Translation Adjustments			Defined Benefit Plans		Total
Balances at December 31, 2025	$	(11	)	$	(299	)	$	5	$	(305	)
Unrealized losses on available-for-sale securities		(2	)							(2	)
Foreign currency translation adjustments, net of $3 income tax benefits					(27	)				(27	)
Balances at June 30, 2026	$	(13	)	$	(326	)	$	5	$	(334	)

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 June 30, 2026, the National Group included 53 hospitals located in Alaska, California, Idaho, Kentucky, Nevada, New Hampshire, North Carolina, Tennessee, Utah and Virginia; the Atlantic Group included 64 hospitals located in Florida, Georgia, Northern Kansas, Missouri and South Carolina; and the American Group included 66 hospitals located in Colorado, Central Kansas, Louisiana and Texas. The seven hospitals we operate in England are included in the Corporate and other group.

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)

Adjusted segment EBITDA is defined as income before depreciation and amortization, interest expense, losses and gains on sales of facilities, losses on retirement of debt, income taxes and net income attributable to noncontrolling interests. We use adjusted segment EBITDA as an analytical indicator for purposes of allocating resources to geographic areas and assessing their performance. Adjusted segment EBITDA is commonly used as an analytical indicator within the health care industry and also serves as a measure of leverage capacity and debt service ability. Adjusted segment EBITDA should not be considered as a measure of financial performance under generally accepted accounting principles, and the items excluded from adjusted segment EBITDA are significant components in understanding and assessing financial performance. Because adjusted segment EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, adjusted segment EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. The geographic distributions of our revenues, salaries and benefits, supplies, other operating expenses, equity in earnings of affiliates, adjusted segment EBITDA, depreciation and amortization and assets that are provided to the Chief Operating Decision Maker, which is the Chief Executive Officer, are summarized in the following tables (dollars in millions) and represent the operating segments for the quarters and six months ended June 30, 2026 and 2025 and assets at June 30, 2026 and December 31, 2025:


	Quarter									Six Months
	2026
	National Group			Atlantic Group			American Group			National Group			Atlantic Group			American Group
Revenues	$	5,251		$	7,573		$	6,582		$	10,572		$	13,936		$	13,148

Salaries and benefits		1,965			2,293			2,287			3,931			4,579			4,564
Supplies		773			934			1,084			1,536			1,878			2,143
Other operating expenses		1,330			2,520			1,859			2,664			4,215			3,690
Equity in earnings of affiliates		(1	)		(1	)		(17	)		(1	)		(2	)		(32	)
		4,067			5,746			5,213			8,130			10,670			10,365
Adjusted segment EBITDA	$	1,184		$	1,827		$	1,369		$	2,442		$	3,266		$	2,783


	Quarter								Six Months
	2025
	National Group		Atlantic Group			American Group			National Group		Atlantic Group			American Group
Revenues	$	5,200	$	6,122		$	6,493		$	10,265	$	12,289		$	12,824

Salaries and benefits		1,919		2,246			2,216			3,878		4,462			4,412
Supplies		755		935			1,067			1,496		1,849			2,087
Other operating expenses		1,255		1,590			1,649			2,488		3,166			3,360
Equity in earnings of affiliates		-		(1	)		(17	)		-		(2	)		(31	)
		3,929		4,770			4,915			7,862		9,475			9,828
Adjusted segment EBITDA	$	1,271	$	1,352		$	1,578		$	2,403	$	2,814		$	2,996

HCA HEALTHCARE, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Continued)

NOTE 10 — SEGMENT AND GEOGRAPHIC INFORMATION (continued)


	Quarter					Six Months
	2026			2025		2026			2025
Adjusted segment EBITDA:
National Group	$	1,184		$	1,271	$	2,442		$	2,403
Atlantic Group		1,827			1,352		3,266			2,814
American Group		1,369			1,578		2,783			2,996
		4,380			4,201		8,491			8,213
Adjustments to reconcile Total Adjusted segment EBITDA to consolidated Income before income taxes:
Corporate and Other		353			352		662			631
Depreciation and amortization		944			863		1,874			1,723
Interest expense		599			568		1,183			1,115
Losses (gains) on sales of facilities		(10	)		3		(9	)		2
Income before income taxes	$	2,494		$	2,415	$	4,781		$	4,742


	Quarter				Six Months
	2026		2025		2026		2025
Revenues:
National Group	$	5,251	$	5,200	$	10,572	$	10,265
Atlantic Group		7,573		6,122		13,936		12,289
American Group		6,582		6,493		13,148		12,824
Corporate and other		824		790		1,683		1,548
	$	20,230	$	18,605	$	39,339	$	36,926
Depreciation and amortization:
National Group	$	238	$	223	$	474	$	449
Atlantic Group		298		275		596		549
American Group		296		277		591		556
Corporate and other		112		88		213		169
	$	944	$	863	$	1,874	$	1,723


	June 30, 2026		December 31, 2025
Assets:
National Group	$	13,589	$	13,596
Atlantic Group		19,374		17,945
American Group		21,385		21,217
Corporate and other		8,902		7,962
	$	63,250	$	60,720

Next: Item 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF