HCA
HCA Healthcare, Inc.$544.41
Sell
Target $452.33
Report: Mar 11, 2026Healthcare • Medical - Care Facilities • Asset-Based OperatorSnapshot
Decision-first overview with recommendation, valuation anchor, and current setup.
Company Overview
Research Snapshot
Price History
Pelican View
Current$544.41-16.9%
Rec: SellConviction: High
Entry Target
N/A
N/A
Fair Value
$452.33
(17% below current)
Stop Loss
N/A
N/A
Position Size
None
Time Horizon
N/A
Key Metrics
Live Snapshot
Market Data
52 Week High$556.52
52 Week Low$314.43
Avg. 3 Month Volume1.11M
Efficiency
LTM Gross Margin41.5%
LTM EBITDA Margin19.3%
LTM EBIT Margin14.7%
LTM Operating Margin15.8%
LTM ROA11.3%
LTM ROE-140.8%
LTM ROIC13.9%
LTM ROCE25.1%
Capital Structure
Market Cap (MM)$105.8B
Enterprise Value (MM)$153.1B
Shares Outstanding226.81M
Total Debt (MM)$48.34B
Cash & Equivalents (MM)$1.04B
LTM Net Debt (MM)$47.30B
LTM Net Debt/EBITDA3.2x
Growth
TTM Rev. Growth7.1%
Last 3-Yr Rev. CAGR7.9%
Last 3-Yr EBITDA CAGR6.5%
Last 3-Yr EPS CAGR13.9%
Valuation
Street Target Price$523.92
LTM EV/Revenue2.0x
LTM EV/Gross Profit4.9x
LTM EV/EBIT13.8x
LTM EV/EBITDA10.5x
LTM P/E15.6x
LTM EV/FCF19.9x
LTM P/FCF13.8x
LTM P/TB2.1x
LTM P/B-17.6x
Dividend Yield0.6%
Payout Ratio10.0%
Executive SummarySituation: Current price is $544.41 versus fair value $452.33 (-16.9% expected return), and valuation confidence is stable. Debate: Bull case depends on Expiration of Enhanced ACA Premium Tax Credits This event is expected to cause a 15-20% drop in exchange volumes, directly impacting HCA's high-margin payer mix. Bear case centers on Regulatory Scrutiny of Consolidation and Fees The FTC is increasingly scrutinizing healthcare deals and 'facility fees,' which could impair HCA's ability to maintain its 2.9% revenue-per-admission growth. Conclusion: Recommendation is Sell with no position, pending a materially better risk/reward setup.
Bull Case
Successful execution of the $400M resiliency program offsets regulatory headwinds; outpatient expansion (100 units/year) drives utilization above 75% occupancy; AI-driven revenue cycle improvements continue to reduce accounts receivable days.
Bear Case
ACA subsidy expiration creates a $600M-$900M EBITDA headwind; ROIC of 8.5% continues to lag the 9.7% WACC, destroying intrinsic value; high leverage (79.6% debt-to-assets) limits flexibility during a potential economic or regulatory downturn.
Key Catalysts
Near-Term (0-6 months)Impact: High
Expiration of Enhanced ACA Premium Tax Credits This event is expected to cause a 15-20% drop in exchange volumes, directly impacting HCA's h...
Mid-Term (6-18 months)Impact: Moderate
Resiliency Program Savings Realization Failure to achieve the $400M savings target would expose the company to further margin compression fr...
Long-Term (18+ months)Impact: Moderate
HCA is at a critical juncture following record 2025 results, with the Frist family's 13D filing and the CEO's $21.5M stock sale signaling a...
Primary Risks
Concern: High
Regulatory Scrutiny of Consolidation and Fees The FTC is increasingly scrutinizing healthcare deals and 'facility fees,' which could impair...
Concern: Medium
Leverage and Solvency Risk With debt-to-assets at 79.6% and negative tangible equity, any significant revenue shock could trigger a breach o...
Concern: Medium
The governance structure is dominated by the Frist family, creating a 'Status Quo' outcome tree where the current high-leverage, high-buybac...
Recent Activity
2026-02-11SEC Filing (SC 13D)
+5.89%Frist family files Schedule 13D for HCA Healthcare ownership
2026-01-27SEC Filing (8-K)
+7.08%HCA Healthcare reports record Q4 2025 results with 6.7% revenue growth and raises 2026 guidance.
2025-01-25SEC Filing (8-K)
+6.05%HCA Healthcare reports strong Q4 2024 results with 3% same-facility admissions growth and provides 2025 guidance.
2024-10-25SEC Filing (8-K)
-8.86%HCA Healthcare reports Q3 2024 financial results
2024-06-28Analyst Target
-6.41%Firm: Deutsche Bank Analyst: Pito Chickering Price Target: $375.00 Price When Posted: $335.04 Implied Upside: +11.9%
Valuation Table
9.8/10Decision Grade
Scenario Range
$405
Bear
$590
Base
$722
Bull
$544