HCA Healthcare, Inc. (NYSE: HCA)

Sector: Healthcare Industry: Medical Care Facilities CIK: 0000860730
Market Cap 126.41 Bn
P/B -20.97
P/E 18.63
P/S 1.67
ROIC (Qtr) 22.59
Div Yield % 0.54
Rev 1y % (Qtr) 6.72
Total Debt (Qtr) 48.35 Bn
Debt/Equity (Qtr) -8.02
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About

Investment thesis

Bull case

  • Operating cash flow of 12.64B provides strong 31.51x coverage of stock compensation 401M, indicating sustainable incentive practices.
  • Robust free cash flow of 7.69B exceeds capital expenditure of 4.94B by 1.56x, indicating strong organic growth funding capability.
  • Operating cash flow of 12.64B provides solid 0.77x coverage of current liabilities 16.35B, showing strong operational health.
  • Operating cash flow of 12.64B fully covers other non-current liabilities 3.69B by 3.43x, showing strong long-term stability.
  • Tangible assets of 50.43B provide robust 7.41x coverage of other current liabilities 6.80B, indicating strong asset backing.

Bear case

  • Operating cash flow of 12.64B barely covers its investment activities of (4.99B), with a coverage ratio of -2.53, indicating heavy reliance on external financing for growth which may not be sustainable in a tighter credit environment.
  • Operating cash flow of 12.64B provides thin coverage of dividend payments of (679M) with a -18.61 ratio, suggesting potential dividend sustainability issues if operational performance deteriorates.
  • Cash reserves of 1.04B provide limited coverage of acquisition spending of (128M), which is -8.12x, suggesting aggressive expansion might strain liquidity if market conditions deteriorate.
  • High receivables of 10.87B relative to inventory of 1.65B (6.58 ratio) suggests aggressive credit terms or collection difficulties, potentially masking revenue quality issues.
  • High financing cash flow of (8.55B) relative to working capital of (567M), which is 15.08x suggests concerning dependence on external funding for operational needs.

Consolidation Items Breakdown of Revenue (2025)

Peer comparison

Companies in the Medical Care Facilities
S.No. Ticker Company Market Cap P/E P/S Total Debt (Qtr)
1 HCA HCA Healthcare, Inc. 126.41 Bn 18.63 1.67 48.35 Bn
2 UHS Universal Health Services Inc 23.26 Bn 34.22 2.61 5.11 Bn
3 THC Tenet Healthcare Corp 21.11 Bn 15.01 0.99 13.17 Bn
4 FMS Fresenius Medical Care AG 14.42 Bn 17.06 0.62 14.98 Bn
5 EHC Encompass Health Corp 13.38 Bn 30.01 2.91 2.66 Bn
6 ENSG Ensign Group, Inc 12.18 Bn 35.41 2.41 2.21 Bn
7 DVA Davita Inc. 11.17 Bn 14.95 0.82 12.87 Bn
8 CHE Chemed Corp 8.11 Bn 81.70 5.57 0.14 Bn

Industry comparisons

Current Valuation Value Ind Avg Percentile
EV to Assets EV to Assets 2.83 1.24
EV to Cash from Ops. EV/CFO 13.59 15.08
EV to Debt EV to Debt 3.55 11.01
EV to EBIT EV/EBIT 15.50 15.96
EV to EBITDA EV/EBITDA 11.09 11.44
EV to Free Cash Flow [EV/FCF] EV/FCF 22.33 21.76
EV to Market Cap EV to Market Cap 1.36 619.57
EV to Revenue EV/Rev 2.27 2.71
Price to Book Value [P/B] P/B -20.97 -6.00
Price to Earnings [P/E] P/E 18.63 12.61
Dividend Metrics Value Ind Avg Percentile
Dividend Coverage Ratio Div Coverage (Qtr) 9.99 0.14
Dividend Payout Ratio % Div Payout % (Qtr) 10.00 -13.46
Dividend per Basic Share Div per Share (Qtr) 2.88 0.27
FCF Dividend Payout Ratio % FCF Div Payout % (Qtr) 8.85 5.42
Interest Coverage Int. cover (Qtr) 4.93 -94.29
Growth Metrics Value Ind Avg Percentile
Capex Growth (1y) % Capex 1y % (Qtr) -1.42 -116.62
Cash and Equivalents Growth (1y) % Cash & Equiv 1y % (Qtr) -46.20 46.03
Dividend Growth (1y) % Div 1y % (Qtr) 9.09 0.98
EBIAT Growth (1y) % EBIAT 1y % (Qtr) 16.31 -42.57
EBITDA Growth (1y) % EBITDA 1y % (Qtr) 11.75 91.55
EBIT Growth (1y) % EBIT 1y % (Qtr) 14.40 -56.79
EBT Growth (1y) % EBT 1y % (Qtr) 15.84 -111.80
EPS Growth (1y) % EPS 1y % (Qtr) 28.87 -19.28
FCF Growth (1y) % FCF 1y % (Qtr) 36.41 188.37
Gross Profit Growth (1y) % Gross Profit 1y % (Qtr) 9.40 20.14
Liquidity Ratios Value Ind Avg Percentile
Asset Utilization Ratio Asset Util Ratio (Qtr) 1.25 1.02
Cash Payout Ratio Cash Payout (Qtr) 0.04 0.04
Cash Ratio Cash Ratio (Qtr) 0.06 0.40
Current Ratio Curr Ratio (Qtr) 0.97 1.36
Debt to Equity Ratio Debt/Equity (Qtr) -8.02 -13.23
Interest Cover Ratio Int Coverage (Qtr) 4.93 -94.29
Times Interest Earned Times Interest Earned (Qtr) 4.93 -94.29
Profitability Value Ind Avg Percentile
EBITDA Margin % EBITDA Margin % (Qtr) 19.30 -75.46
EBIT Margin % EBIT Margin % (Qtr) 14.66 -74.60
EBT Margin % EBT Margin % (Qtr) 11.69 -85.12
Gross Margin % Gross Margin % (Qtr) 41.50 23.17
Net Profit Margin % Net Margin % (Qtr) 9.00 -85.79