By Sahil Pandey and Kamal Choudhury
Oct 27 (Reuters) – US hospital operator HCA Healthcare signaled flat earnings for 2027 on Tuesday, as lower Medicaid payments and a rise in uninsured patients threaten to offset steady patient demand, sending its shares down over 5%.
On a post-earnings conference call with analysts, CEO Sam Hazen said “we anticipate our earnings in 2027 will be generally consistent with 2026,” noting that the policy environment remains fluid. HCA will provide a full 2027 outlook in January.
“The market appeared disappointed by management’s flat 2027 outlook,” said Morningstar analyst Julie Utterback, noting that the outlook would put next year’s earnings per share below estimates.
Analysts on average expect 2027 earnings of $32.14 per share, according to data compiled by LSEG.
The company said it expects 2026 financial results to track in the upper half of the forecast range of annual profit between $28.70 and $30.50 per share on revenue of $77.0 billion to $79.5 billion.
HCA expects volume growth of 2% to 3% next year.
“While the firm expects solid volume growth still in 2027, headwinds related to rising uninsured rates, from further contraction on the individual exchanges and from new policy implementation in Medicaid, plus lower direct supplemental payments in Medicaid look likely to constrain profits in 2027 and beyond,” Utterback added.
Peers Tenet Healthcare and Universal Health Services were also down 2% and 6%, respectively.
MEDICAID AND UNINSURED HEADWINDS
HCA expects $550 million to $650 million less in Medicaid supplemental payment net benefits next year compared with 2026. Some state programs approved in 2026 reimbursed the company for services provided in prior years.
Hazen added that while fewer patients may drop coverage next year, the company still expects a “meaningful impact on payer mix” as individuals lose coverage on Affordable Care Act exchanges.
Earlier in the day, HCA reported a third-quarter adjusted profit of $7.22 per share on revenue of $19.85 billion, both beating Wall Street expectations.
HCA said a rise in uninsured patients, primarily people who lost coverage through health insurance exchanges, cut its pretax income by about $400 million in the third quarter.
(Reporting by Sahil Pandey and Kamal Choudhury in Bengaluru; Editing by Maju Samuel)
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