Tenet, HCA post strong Q1 results, but caution looms over policy uncertainty, outpatient trends

Editor's Note

Tenet Healthcare and HCA Healthcare delivered robust first-quarter (Q1) earnings, bolstered by steady inpatient demand and operational discipline—but both hospital giants are treading carefully amid policy and market uncertainties, according to earnings reports covered by Healthcare Dive on April 28 and Trading View on April 29.

Tenet reported $406 million in net income available to shareholders, a sharp decline from the $2.15 billion it posted in Q1 2024 due to last year’s major divestiture gains, as reported by Trading View. However, adjusted diluted earnings per share rose 35.4% year-over-year to $4.36, and consolidated Adjusted EBITDA climbed 13.6% to $1.163 billion. Tenet credited strong same-hospital revenue growth and operational discipline for the performance. Its ambulatory care segment, anchored by United Surgical Partners International (USPI), saw a 15.7% boost in Adjusted EBITDA thanks to favorable revenue per case, strategic acquisitions, and service line growth. Hospital revenues declined due to prior divestitures, though same-facility admissions and revenue per admission increased. Tenet also repurchased $348 million in stock and benefited from $40 million in prior-year Medicaid supplemental revenues. It projects full-year 2025 Adjusted EBITDA between $3.975 billion and $4.175 billion.

HCA also exceeded expectations, posting $1.6 billion in Q1 net income on $18.3 billion in revenue, up from $17.3 billion in Q1 2024, according to Healthcare Dive. Executives cited rising demand for elective care and tight cost controls, including a 9.3% drop in contract labor expenses. Same-facility admissions rose 2.6% and emergency visits 4%, though outpatient surgical procedures declined 2.1%—partially due to last year’s leap day. Analysts noted this marks the fifth straight quarter of outpatient surgical volume decline, flagging it as a key trend to monitor. HCA reaffirmed its 2025 earnings forecast of $5.9 to $6.3 billion and announced plans to spend up to $5.2 billion on capital investments. However, leadership avoided detailing the financial implications of proposed Medicaid changes or tariffs, calling the situation too fluid.