HCA Healthcare, Inc. (HCA): Business Model Canvas [Dec-2025 Updated]

You're digging into the mechanics of one of the biggest players in US healthcare, and honestly, the sheer size of HCA Healthcare, Inc.'s operation is the first thing that hits you. With 2025 revenue guidance landing between $75.0 billion and $76.5 billion across its 191 hospitals and 2,500+ sites, this isn't just a business; it's an integrated system built on massive scale and tight cost control, especially managing that projected $5.0 billion to $5.2 billion capital investment. I've spent two decades mapping these giants, and what makes HCA tick-from its internal Group Purchasing Organization (GPO) to its favorable payer mix driving revenue per admission-is laid out in the nine building blocks below. Let's break down exactly how they generate that revenue and manage those costs.

HCA Healthcare, Inc. (HCA) - Canvas Business Model: Key Partnerships

You're looking at the core relationships HCA Healthcare, Inc. (HCA) relies on to keep its massive network running and profitable as of late 2025. These partnerships are about scale, cost control, and talent pipeline, so let's look at the hard numbers that define them.

HealthTrust (GPO) for Supply Chain Efficiency

HealthTrust Performance Group is central to HCA Healthcare, Inc.'s strategy for cost control through consolidated purchasing power. HealthTrust Purchasing Group LP supports over 1,800 hospitals and health systems, plus more than 43,000 other member locations, like ambulatory surgery centers. HealthTrust Workforce Solutions, a related entity, reported US staffing revenue of $1,051 million in 2024. This scale is what drives the price advantages on supplies and services, which is a key lever for managing expenses across HCA Healthcare, Inc.'s 191 hospitals. The group also provides consulting expertise in supply chain, workforce, and clinical integration.

Commercial and Government Payers for Patient Reimbursement

Reimbursement contracts with payers are the lifeblood of HCA Healthcare, Inc.'s revenue. The payer mix showed positive momentum through the third quarter of 2025. On a same-facility basis, commercial equivalent admissions increased by 3.7% year-over-year. This commercial growth was split, with admissions from exchanges rising 8% and other commercial admissions up 2.4%. Government payers also contributed, as Medicare equivalent admissions grew by 3.4%, and Medicaid grew by 1.4%, while self-pay declined by 6%. HCA Healthcare, Inc. has been disciplined on contracting, having finalized more than 90% of its 2025 contracts and about 75% of its 2026 contracts at favorable rates.

Academic Institutions for Talent Pipeline

Securing the future nursing workforce involves deep ties with educational partners. HCA Healthcare, Inc. made a significant investment in Pepperdine University, gifting $4.8 million to help launch its School of Nursing, which opened in the fall of 2025 with 68 students. These students gain clinical rotation opportunities at facilities like HCA Healthcare, Inc.'s Los Robles Regional Medical Center. HCA Healthcare, Inc. also owns Galen College of Nursing, which grew to 25 campuses nationwide as of late 2025, having opened 2 new campuses in 2024. Furthermore, in 2024 alone, HCA Healthcare, Inc. distributed $35 million to assist more than 11,500 colleagues in pursuing nursing degrees. HCA Healthcare, Inc. operates 56 teaching hospitals supporting graduate medical education programs.

Technology Partners for Digital Solutions

The partnership with Meditech is a cornerstone of HCA Healthcare, Inc.'s digital transformation. HCA Healthcare, Inc. named Meditech its preferred Electronic Health Record (EHR) provider in 2022. As of October 2025, the company completed the first wave of its large-scale deployment of the cloud-based Meditech Expanse platform, bringing the new system live across 32 hospitals in its network. This move is intended to seamlessly integrate data and accelerate the adoption of future digital and AI innovations.

Non-Profits for Community Health Initiatives

HCA Healthcare, Inc. supports community health through various non-profit collaborations, including initiatives with organizations like the American Heart Association and March of Dimes. The company reinforces its commitment to communities through foundation investments and colleague-driven giving, which contributed to its overall operational footprint across 20 US states and the United Kingdom.

Here's a quick look at the scale of these key relationships:

Partner Category	Specific Partner/Program	Key Metric (Late 2025 or Latest Available)	Value/Amount
Supply Chain (GPO)	HealthTrust Purchasing Group LP Membership Scale	Hospitals and Health Systems Served	Over 1,800
Supply Chain (GPO)	HealthTrust Workforce Solutions 2024 Revenue	US Staffing Revenue	$1,051 million
Payers	Commercial Equivalent Admissions Growth (Q3 2025)	Year-over-Year Increase	3.7%
Payers	Exchange Admissions Growth (Q3 2025)	Year-over-Year Increase	8%
Payers	Medicare Equivalent Admissions Growth (Q3 2025)	Year-over-Year Increase	3.4%
Academic Institutions	Pepperdine University Nursing School Launch Gift	Donation Amount	$4.8 million
Academic Institutions	Galen College of Nursing Campuses	Total Nationwide Campuses (Late 2025)	25
Academic Institutions	Colleague Tuition Assistance (2024)	Colleagues Assisted	More than 11,500
Technology	Meditech Expanse EHR Deployment	Hospitals Live with Expanse (Oct 2025)	32

HCA Healthcare, Inc. leverages these external relationships to manage costs and secure its talent pipeline. The company's structure relies on these external entities for purchasing leverage and future clinical staffing.

• HealthTrust serves over 43,000 alternate care sites in addition to hospitals.
• HCA Healthcare, Inc. has finalized approximately 75% of its 2026 payer contracts.
• Pepperdine's School of Nursing opened with 68 students in Fall 2025.
• HCA Healthcare, Inc. operates across 20 US states and the United Kingdom.
• In 2024, HCA Healthcare, Inc. distributed $35 million for colleague nursing education.

Finance: draft 13-week cash view by Friday.

HCA Healthcare, Inc. (HCA) - Canvas Business Model: Key Activities

You're looking at the core engine of HCA Healthcare, Inc. (HCA)-the daily, hands-on work that keeps the whole operation running and growing. This isn't just about keeping the lights on; it's about disciplined execution across a massive footprint.

Delivering Acute Care Services

The primary activity is the delivery of acute care services, which happens across a vast network. As of late 2025 reports, HCA Healthcare operates approximately 190 hospitals, supported by over 2,500 ambulatory sites of care, spanning 20 states and the U.K.. This scale is critical for capturing market share and managing patient acuity. For instance, in Q3 2025, same-facility admissions rose 2.1% year over year, contributing to a 9.6% top-line growth for the quarter.

The sheer volume of care managed is staggering, which feeds directly into their data advantage. Consider the scale of patient encounters:

Metric	2024 Data Point	Context
Annual Patient Encounters	Approximately 44 million	Used to advance science and improve care
Emergency Room Visits	Over 9 million	Indicates high utilization of emergency services
Charity/Uncompensated Care Cost	Estimated at $4.4 billion	Cost of care provided without direct reimbursement

Organic System Development

HCA Healthcare, Inc. (HCA) actively pursues organic system development, meaning they build capacity from within rather than relying solely on acquisitions. This involves adding beds to existing hospitals and building new facilities, or de novos. Management is guiding capacity expansion by adding approximately 600 inpatient beds annually. This disciplined physical expansion supports their market share goals, aiming for 29% market share by 2029-2030, up from 27% a decade prior.

The focus isn't just inpatient; they are also expanding outpatient presence significantly. The plan includes developing about 20 outpatient sites per hospital over the next decade. This dual focus on inpatient and outpatient capacity is a core growth activity.

Strategic Capital Investment

To support both service delivery and expansion, HCA Healthcare, Inc. (HCA) commits substantial capital. For the 2025 fiscal year, the company is projecting capital investments to fall between $5.0 billion to $5.2 billion. This investment level represents about 45% to 55% of their operating cash flow for the year. This capital is strategically deployed across facility expansion and technology advancement.

The deployment of this capital is key to maintaining their high return profile. HCA's Return on Invested Capital (ROIC) is reported near 23.6% in 2025, which is well above the market average of 11.3%. That's a clear signal of effective capital allocation.

Managing Labor Costs

A critical, ongoing activity is the rigorous management of labor expenses, which are the largest cost component for any health system. HCA Healthcare, Inc. (HCA) has seen success in reducing reliance on expensive external staffing. Specifically, contract labor spend fell by 9.3% year-over-year in Q1 2025. This reduction brought contract labor down to 4.4% of total labor costs in Q1 2025, down from 5.1% in Q1 of the prior year.

The success in labor management is a major driver of margin performance. The Salaries and Benefits ratio improved to 43.6% of net revenue in Q1 2025. This efficiency helps drive operating leverage. Here are the key labor cost metrics:

• Contract labor spend reduction in Q1 2025: 9.3%
• Contract labor as a percentage of total labor cost (Q1 2025): 4.4%
• Salaries and benefits as a percent of net revenue (Q1 2025): 43.6%

Advancing Digital Transformation and AI

HCA Healthcare, Inc. (HCA) actively engages in advancing digital transformation and AI to streamline operations and enhance patient care delivery. The Digital Transformation and Innovation (DT&I) department leverages data capabilities to create value through these solutions. A concrete example is the AI-driven scheduling tool named Tiffany, which was in use at 50 hospitals and slated to expand to 80 hospitals the following month.

System-wide technology deployment is also a focus. The Meditech Expanse system implementation was projected to be 20% complete by the end of 2025. These technology investments are integral to achieving operational efficiency and supporting the company's overall margin expansion goals.

HCA Healthcare, Inc. (HCA) - Canvas Business Model: Key Resources

Extensive physical network of facilities forms the core infrastructure for HCA Healthcare, Inc. (HCA).

As of June 30, 2025, HCA Healthcare, Inc. operated 191 hospitals and approximately 2,500 ambulatory sites of care across 20 states and the United Kingdom.

The scale of the physical footprint is detailed below:

• Hospitals: 191
• Ambulatory Sites of Care: Approximately 2,500
• Freestanding Outpatient Surgery Centers: 124 (as of June 30, 2025)
• Urgent Care Clinics: 341 (as of 2024)

The large, trained workforce is another critical asset, essential for delivering care across this network.

HCA Healthcare, Inc. had approximately 316,000 colleagues as of December 31, 2024. This group includes over 99,000 registered nurses and more than 44,000 active and affiliated physicians.

HCA Healthcare, Inc. leverages its scale to generate proprietary clinical data.

The system analyzes data from more than 9 million emergency room patient encounters annually to develop enterprise-wide best practices.

The strong balance sheet and free cash flow generation support ongoing capital allocation and investment.

Here's a quick look at the balance sheet as of June 30, 2025:

Metric	Amount (as of June 30, 2025)
Cash and Cash Equivalents	$939 million
Total Assets	$59.536 billion
Total Debt	$44.483 billion
Cash Flows from Operating Activities (Q2 2025)	$4.210 billion

For the full fiscal year 2025, HCA Healthcare, Inc. increased its Adjusted EBITDA expectation to between $15.35 billion and $15.65 billion.

HealthTrust, the internal Group Purchasing Organization (GPO), is a massive resource for cost management.

HealthTrust partners with 1,800 hospitals and health systems. Its purchasing power is significant, with five members representing approximately $20B in supply spend. HealthTrust Workforce Solutions, an affiliate, reported $1,051 million in company US staffing revenue in 2024.

The GPO consolidates non-clinical and administrative functions to improve performance and reduce costs via total spend management solutions.

HCA Healthcare, Inc. (HCA) - Canvas Business Model: Value Propositions

You're looking at the core value HCA Healthcare, Inc. (HCA) delivers to its various stakeholders, which is deeply rooted in scale and clinical performance. It's not just about having facilities; it's about the density and quality across a massive footprint.

Broad access to care via an integrated, multi-state network

The sheer scale of HCA Healthcare, Inc. (HCA) is a primary value proposition. They operate as one of the largest healthcare providers nationally, which translates directly into geographic access for patients and referral networks for physicians. As of late 2025, HCA Healthcare, Inc. (HCA) manages 191 hospitals across 20 states and the United Kingdom. This integrated structure supports patient flow and service continuity.

The network capacity continues to expand, reflecting investment in the physical infrastructure supporting this access. The total number of beds across HCA facilities reached 50,577 in 2025. This network supports consistent volume, evidenced by the company reporting 16 consecutive quarters of volume growth as of July 2025.

High-quality clinical outcomes; 49 hospitals on the 2025 Healthgrades America's 250 Best list

Clinical excellence is quantified through external validation, which you see reflected in the Healthgrades awards. For 2025, 49 of HCA Healthcare, Inc. (HCA)'s hospitals made the America's 250 Best Hospitals list. That designation means these facilities are in the top 5% of hospitals nationwide based on patient outcomes. This focus on outcomes across multiple specialties is key to their market positioning.

Here's a quick look at some of the scale and quality metrics:

Metric	Value	Source/Context
Hospitals on 2025 Healthgrades America's 250 Best List	49	Top 5% for clinical excellence
Q1 2025 Same Facility Admissions Growth	2.6%	Year-over-year comparison
Q1 2025 Same Facility Equivalent Admissions Growth	2.8%	Year-over-year comparison

Operational efficiency and cost management, driving a high operating margin

The value proposition here is financial discipline supporting sustainable operations. HCA Healthcare, Inc. (HCA) has been focused on driving margins through operational leverage and cost controls, such as mitigating contract labor expenses. For 2025, the company was targeting an Adjusted EBITDA of $14.7B, which translates to an expected EBITDA margin of 19.8%. This focus on efficiency is what allows them to reinvest in the network.

To be fair, the net profit margin has seen slight compression, sitting at 8.2% currently, down from 8.4% last year, but analysts still project operating margin improvement through continued cost management. The company generated $10.5B in cash flow from operations in 2024 and expected around $11B for 2025.

Specialized service lines like cardiology, neuro, and orthopedics driving volume growth

Beyond general access, HCA Healthcare, Inc. (HCA) delivers value through depth in specific, high-acuity service lines. These specialty areas are critical drivers of volume and case mix improvement. Inpatient growth callouts for 2025 included specific strength in:

• Neuro
• Ortho
• General surgery
• Vascular
• Rehab
• Obstetrics
• Cardiac procedures

The growth in these areas helps offset softness in other areas, like the decline in outpatient surgeries in Q1 2025. The company has also seen strong growth in ACA/exchange volume, which represented about 8% of equivalent admissions and 10% of revenues in one quarter of 2025.

Commitment to patient safety, with 51 hospitals earning an 'A' grade from Leapfrog in Fall 2025

Patient safety is a non-negotiable component of the value offering, measured by the Leapfrog Group's Hospital Safety Grade. In the Fall 2025 grading cycle, HCA Healthcare, Inc. (HCA) topped the national list for health systems, with 51 of its hospitals achieving an 'A' grade. Furthermore, 18 of those facilities earned the 'Straight A' recognition, meaning they achieved an 'A' for at least two consecutive years. This demonstrates a systemic, rather than isolated, commitment to protecting patients from harm. It's defintely a strong talking point for any stakeholder.

Finance: draft 13-week cash view by Friday.

HCA Healthcare, Inc. (HCA) - Canvas Business Model: Customer Relationships

You're looking at how HCA Healthcare, Inc. (HCA) manages its relationships with key stakeholders-physicians, patients, and the community-as of late 2025. It's about the direct touchpoints and the systems supporting them.

Physician engagement is clearly a focus area, given the data coming out of the annual survey. In 2025, more than 14,000 employed and affiliate physicians participated in the survey, reporting an 84% engagement rate. That figure is noted as being 13 points above the industry physician benchmark.

The service-oriented care model leans heavily on digital support to streamline interactions. For instance, the automated scheduling and staffing platform, known as Timpani, is a key tool. Since its 2023 launch across nine sites, it has saved nursing leaders hundreds of hours. Currently, about 7,000 colleagues use the platform daily, with plans for implementation at nearly 90 additional locations by the end of 2025.

Community investment is quantified through uncompensated care figures. For the full year 2024, HCA Healthcare provided charity care, uninsured discounts, and other uncompensated care at an estimated cost of approximately $4.4 billion. This commitment is supported by specific policies:

• Charity Care Policy: Provides a 100% write-off for emergency services for qualifying patients, generally those with household incomes less than 200% of the Federal Poverty Level (FPL).
• Expanded Charity Care Policy: Offers financial relief for emergency services to families with household incomes between 200% and 400% of FPL.
• Uninsured Discount Policy: Offers a discount, approximately 92% of the total bill at most facilities, for uninsured patients receiving emergency services.

Securing long-term caregiver quality is tied directly to workforce development, particularly through the Galen College of Nursing partnership. This relationship forms the largest Academic Practice Partnership in U.S. healthcare. Here's a look at the scale of that pipeline effort:

Metric	Data Point
Total Galen Students Enrolled (2024)	More than 17,600
HCA Healthcare Colleagues Enrolled at Galen (2024)	Over 4,700
Galen Campuses (as of 2024)	22
Tuition Assistance Benefit	Zero out-of-pocket tuition for eligible colleagues in the online RN to BSN program

Rapid disaster response is managed through the Enterprise Emergency Operations Program (EEOP). This program trains corporate, division, and hospital-based clinicians and leaders annually on responding to events impacting patient care or colleague wellness. Hundreds of HCA Healthcare colleagues are prepared to deploy as Incident Response Teams. The Enterprise Emergency Operations Center (EEOC) in Nashville monitors threats. Furthermore, HCA Healthcare's disaster support includes financial partnership metrics:

• Annual Contribution to American Red Cross (ADGP)
• Total Financial Support to Red Cross for disaster relief (last eight years): Nearly $8 million

Finance: draft 13-week cash view by Friday.

HCA Healthcare, Inc. (HCA) - Canvas Business Model: Channels

HCA Healthcare, Inc. deploys a multi-faceted channel strategy to reach patients, focusing on both high-acuity physical locations and expanding digital access points, supplemented by a significant educational pipeline.

The core physical channel remains the acute-care hospital network, providing inpatient services across its footprint. This is complemented by a growing network of sites designed for lower-acuity or specialized outpatient care, which helps manage patient flow and capture services outside the main hospital setting.

The company's scale allows for centralized support functions to enhance these channels, including supply-chain management and data analytics, which are critical for efficiency across the disparate physical locations.

The Graduate Medical Education (GME) programs function as a vital, long-term channel, not just for service delivery but as a direct pipeline for physician talent, helping to mitigate national physician shortages.

Digital platforms are increasingly integrated to serve as the initial point of access and ongoing engagement for patients, supporting the physical infrastructure.

Here's the quick math on the scale of these primary channels as of mid-2025:

Channel Category	Specific Facility/Program	Count (as of late 2025/most recent data)
Inpatient Services	Acute-care Hospitals	191
Outpatient Services	Freestanding Outpatient Surgery Centers (ASCs)	124
Outpatient Services	Total Ambulatory Sites of Care (including ASCs, ERs, Urgent Care, Physician Clinics)	Approximately 2,500
Talent Pipeline	GME Teaching Hospitals	79
Talent Pipeline	GME Residents and Fellows	More than 5,400

The physical reach extends through various specialized facilities that serve as immediate access points:

• Freestanding outpatient surgery centers (ASCs).
• Urgent care clinics.
• Physician offices.
• Freestanding emergency rooms.
• Diagnostic/imaging centers.

For digital access, HCA Healthcare, Inc. is embedding technology to meet patients where they are. While industry data suggests that approximately 78.6% of U.S. hospitals connect with patients through telehealth services, HCA is actively investing in its own digital health initiatives to drive patient engagement.

The GME channel is substantial, positioning HCA Healthcare, Inc. as the largest sponsor of U.S. graduate medical-education programs. As of early 2025, this included:

• Over 340 Accreditation Council for Graduate Medical Education (ACGME) accredited programs.
• Training more than 5,400 residents and fellows.
• Utilizing 79 teaching hospitals across 16 states.

The company welcomed 1,846 new residents and fellows for the 2024-2025 academic year to feed this pipeline.

HCA Healthcare, Inc. (HCA) - Canvas Business Model: Customer Segments

You're looking at the patient base for HCA Healthcare, Inc. (HCA) as of late 2025. This is a massive, diversified set of customers spanning the entire acuity spectrum, from routine outpatient procedures to the most complex critical care.

Commercial insurance patients represent a significant and growing portion of the paying base, driven by favorable contracting and increased enrollment in Affordable Care Act (ACA) exchange plans.

• Same facility commercial equivalent admissions rose by 3.7% in the third quarter of 2025 compared to the prior year period.
• This commercial growth was split, with exchange volume up 8% and all other commercial volume up 2.4% on a same-facility basis in 3Q 2025.
• For the six months ended June 30, 2025, total revenues reached $36,926 million.

Medicare and Medicaid patients form the foundation of government-funded volume, with Medicare Advantage plans being a key component of the Medicare segment.

• Same facility Medicare equivalent admissions increased by 3.4% in the third quarter of 2025.
• Same facility Medicaid equivalent admissions grew by 1.4% in the third quarter of 2025.
• Self-pay volume saw a decline of 6% on a same-facility basis in 3Q 2025.

Here's a look at the payer mix based on the most recent comprehensive revenue breakdown available from Q2 2024, alongside the latest reported growth trends from Q3 2025:

Payer Category	Q2 2024 Net Patient Service Revenue	Q2 2024 Percentage of Revenue	3Q 2025 Same-Facility Equivalent Admission Growth
Commercial	$8.5 billion	48.8%	3.7% Increase
Medicare (Traditional)	$2.6 billion	15.0%	3.4% Increase
Managed Medicare	$2.9 billion	16.7%	Included in Medicare segment growth
Medicaid (Non-Managed)	$1.1 billion	6.3%	1.4% Increase

Patients requiring complex, high-acuity inpatient care are critical for revenue per equivalent admission, as acuity trends remain favorable.

• The company's overall occupancy rate stood at 74% in the first nine months of 2025.
• Same facility inpatient surgeries increased by 1.4% in the third quarter of 2025 over the prior year period.
• The total number of licensed beds across HCA Healthcare facilities increased to over 50,500 at the end of 3Q25.
• Case mix improved modestly, driven by critical care admissions holding steady.

Patients seeking convenient, lower-acuity outpatient and ambulatory services represent a key area of network expansion.

• HCA Healthcare operated approximately 2,500 ambulatory sites of care as of September 30, 2025.
• These sites include surgery centers, freestanding Emergency Rooms (EDs), urgent care centers, and physician clinics.
• Same facility outpatient surgeries increased by 1.1% in the third quarter of 2025 compared to the same period of 2024.
• Same facility emergency room visits increased by 1.3% in the third quarter of 2025.

Affiliated and employed physicians and clinicians are essential internal customers, supported by one of the largest physician development infrastructures in the nation.

• HCA Healthcare provides support to more than 44,000 active and affiliated physicians.
• For the 2024-2025 academic year, the company welcomed 1,846 new residents and fellows to its Graduate Medical Education (GME) programs.
• HCA Healthcare is the largest sponsor of GME in the nation.

HCA Healthcare, Inc. (HCA) - Canvas Business Model: Cost Structure

You're looking at the expense side of HCA Healthcare, Inc. (HCA) operations as of late 2025. This is where the revenue goes, and honestly, it's a massive undertaking managing costs across hundreds of facilities.

Salaries and benefits (labor costs) are the largest expense category. This is the reality for any major health system; people are the primary resource. For the first six months of 2025, HCA Healthcare reported salaries and benefits totaling $16,135 million. Looking at the second quarter of 2025 specifically, this cost component was $8,138 million. This compares to the full year 2024 figure of $31,170 million, which represented 44.1% of that year's total revenue. The company has seen success mitigating high-cost contract labor, which was reported at 4.3% of total salaries and benefits in a recent period, a slight decrease from 4.6% in Q2 2024.

Supplies and pharmaceuticals expense, managed via HealthTrust GPO. HCA Healthcare uses its group purchasing organization, HealthTrust, to manage the procurement of necessary medical supplies and drugs. For the second quarter of 2025, supplies expense was reported at $2,844 million. This follows the full year 2024 expense of $10,755 million, which was 15.2% of 2024 revenue. HealthTrust has been actively de-risking the supply chain, with 70% of 2025 purchases locked in under fixed pricing.

The key cost drivers for HCA Healthcare's Cost Structure are detailed below, using the latest available figures:

Cost Category	Latest Quarterly Figure (2025)	Latest Period Reported	Full Year Figure (2024)
Salaries and Benefits	$8,138 million	Q2 2025	$31,170 million
Supplies Expense	$2,844 million	Q2 2025	$10,755 million
Interest Expense	$561 million	Q3 2025	$2,061 million
Capital Expenditures (Excl. Acquisitions)	$1,288 million	Q3 2025	$4.9 billion (2024 Total)

Capital expenditures for facility upgrades and new construction, projected at $5.0 billion+. HCA Healthcare is maintaining a significant investment cadence. The 2025 guidance for capital expenditures, excluding acquisitions, is set around $5.0 billion. For the third quarter of 2025, actual capital expenditures totaled $1.288 billion. Over the first six months of 2025, this spend amounted to $2.167 billion, excluding acquisitions. This investment is roughly allocated with 70% toward inpatient capacity buildout, including de-novo facilities.

Professional fees, which remain a significant cost driver. Professional fees are a major component within the broader Other Operating Expenses line item. For the full year 2024, professional fees accounted for 24% of Other Operating Expenses. In the first quarter of 2025, this specific cost inflator rose 11% year-over-year, largely driven by physician subsidies tied to volume, though costs were flat sequentially from the fourth quarter of 2024.

You've got to keep an eye on the debt load, too.

Interest expense on substantial long-term debt. The cost of servicing HCA Healthcare's debt is a fixed drain on earnings. Interest expense for the third quarter of 2025 was $561 million. This follows the full-year 2024 interest expense of $2,061 million, which was up from $1.938 billion in 2023 due to an increase in the average debt balance. As of September 30, 2025, total debt stood at $44.511 billion.

Here are the key expense-related metrics for context:

• Q1 2025 Revenue: $18.321 billion
• Q3 2025 Revenue: $19.161 billion
• 2025 Full Year Revenue Guidance (Updated): $75 billion to $76.5 billion
• Professional Liability Risk Provisions (2024): $627 million

Finance: draft 13-week cash view by Friday.

HCA Healthcare, Inc. (HCA) - Canvas Business Model: Revenue Streams

You're looking at the core engine of HCA Healthcare, Inc.'s financial performance, which is overwhelmingly driven by patient services. The sheer scale of their operations means even modest percentage gains translate into massive dollar amounts. For the twelve months ending September 30, 2025, HCA Healthcare, Inc. reported total revenue of approximately $74.372 billion. This reflects the ongoing strength in demand for their inpatient and outpatient services across their 191 hospitals and extensive network of care sites.

The primary revenue source is patient service revenue, which you see broken down into inpatient admissions and outpatient procedures. While same-facility inpatient surgeries increased $1.4\%$ year-over-year in the third quarter of 2025, same-facility outpatient surgeries grew by $1.1\%$ in that same period. Remember, the revenue generated isn't just about the number of procedures; it's heavily influenced by the complexity and the payer. For the first nine months of 2025, total revenues reached $56.087 billion.

Here's a quick look at how the top-line revenue is tracking for the full year, based on the latest guidance you have access to as of late 2025:

Metric	Period/Basis	Value/Range
Full Year 2025 Revenue Guidance	Full Year Estimate	$75 billion to $76.5 billion
Revenue (TTM)	Twelve Months Ending September 30, 2025	$74.372 billion
Q3 2025 Revenue	Quarter Ended September 30, 2025	$19.161 billion
Revenue Growth (YoY)	Q3 2025	9.6 percent

The metric that really tells the story of pricing power and case selection is revenue per equivalent admission. This figure is definitely growing, which is a huge tailwind. In the third quarter of 2025, same-facility revenue per equivalent admission climbed 6.6% year-over-year. That's a significant jump, especially when you compare it to the first quarter of 2025, where the same metric rose by $2.9\%$ to $3.0\%$. This growth is being driven by a more favorable payer mix and an increase in patient acuity, meaning sicker patients requiring more intensive, higher-reimbursing care, like critical care admissions.

Payments from commercial insurance payers are showing strong growth, which is exactly what you want to see given their generally higher reimbursement rates compared to government programs. On a same-facility basis for Q3 2025, commercial equivalent admissions grew by 3.7% compared to the prior year. This growth is a blend:

• Exchange admissions jumped 22.4% in the first quarter of 2025, with exchange volume representing about 10% of revenues in that quarter.
• All other commercial equivalent admissions grew by 2.4% in Q3 2025.

This commercial strength helps offset some of the pressures from government payers. It's defintely a key part of their margin story.

Reimbursement from government programs remains a substantial, though sometimes less lucrative, piece of the revenue pie. You need to watch the trends here closely. For the third quarter of 2025, same-facility Medicare equivalent admissions rose by 3.4% year-over-year. Medicaid admissions showed modest growth at 1.4% in Q3 2025, which contrasts with the $1.4\%$ decline seen in Q1 2025, likely due to the completion of Medicaid redeterminations. Conversely, self-pay equivalent admissions declined by 6% in Q3 2025. Furthermore, Medicaid state supplemental payment revenues were a major factor, contributing to about half of the year-over-year jump in inpatient revenue per equivalent admission in Q3, with an estimated $240 million net benefit to adjusted EBITDA from these programs.

For other operating revenues, the data is less granular in the latest reports, but we know that growth in Ambulatory Surgery Centers (ASCs) has been a focus. In 2024, ASC revenues grew between 5% and 6%. While specific management fee or rental income figures aren't explicitly itemized as a major revenue stream in the latest earnings summaries, the overall revenue growth is supported by expanding their footprint, including acquisitions of two hospitals in 2025.

Finance: draft 13-week cash view by Friday.