MMarketMath

HCA

StalwartQuality: Medium (55/100)2 red flags

HCA Healthcare · Health Care · Health Care Facilities

$429.24

52w 353.99 – 556.52

20y monthly, adjusted

Mkt cap

$95.2B

P/E

13.5

P/FCF

11.9

FCF yield

8.4%

ROE

-112.6%

Shldr yield

11.8%

div 0.7% + bb 11.0%

What today's price assumes

At $95.2B, the market is pricing in 0.6% annual free-cash-flow growth for the next decade (10% discount rate, 2.5% terminal growth). Over the last ten years, FCF actually grew 11.5% per year — expectations look undemanding relative to history.

Simple DCF per-share range: $528 · $915 · $1,141 (4% / base / optimistic growth). An estimate, not a target.

Adjust the assumptions yourself →

Historical multiple lens

At its own median P/OCF of 7.5× across 10 years, HCA would trade near $427/share (25th–75th percentile: $349–$487); it trades at 7.5× today.

Assumes the historical multiple regime persists — re-ratings can be permanent.

Growth record

Compound annual growth rates from as-filed 10-K data, split-adjusted

Rev 3y

+7.9%

Rev 5y

+8.0%

Rev 10y

+6.9%

EPS 5y

+21.0%

EPS 10y

+16.3%

FCF 5y

+3.8%

FCF 10y

+11.5%

Fundamentals

Fiscal 2016–2025, from SEC filings

Revenue

2016: $41.5B
2017: $43.6B
2018: $46.7B
2019: $51.3B
2020: $51.5B
2021: $58.8B
2022: $60.2B
2023: $65.0B
2024: $70.6B
2025: $75.6B
$0$20.0B$40.0B$60.0B
16
18
20
22
24

Net income

2016: $2.9B
2017: $2.2B
2018: $3.8B
2019: $3.5B
2020: $3.8B
2021: $7.0B
2022: $5.6B
2023: $5.2B
2024: $5.8B
2025: $6.8B
$0$2.0B$4.0B$6.0B
16
18
20
22
24

Free cash flow

2016: $2.9B
2017: $2.4B
2018: $3.2B
2019: $3.4B
2020: $6.4B
2021: $5.4B
2022: $4.1B
2023: $4.7B
2024: $5.6B
2025: $7.7B
$0$2.0B$4.0B$6.0B
16
18
20
22
24

Diluted shares (lower is better)

2016: 395.9M
2017: 372.2M
2018: 355.3M
2019: 348.2M
2020: 343.6M
2021: 328.8M
2022: 294.7M
2023: 276.4M
2024: 261.8M
2025: 239.5M
0100.0M200.0M300.0M
16
18
20
22
24

Margins

5%8%10%13%1618202224
Net marginFCF margin

Capital returned (dividends + buybacks)

2016: $2.8B
2017: $2.1B
2018: $2.0B
2019: $1.6B
2020: $594.0M
2021: $8.8B
2022: $7.7B
2023: $4.5B
2024: $6.7B
2025: $10.7B
$0$5.0B$10.0B
16
18
20
22
24

Cash vs long-term debt

$0$20.0B$40.0B1618202224
CashLT debt

Quarterly

Discrete quarters from 10-Q filings; Q4 derived as fiscal year minus Q1–Q3. OCF is unwound from the year-to-date figures 10-Qs report. Compare to the same quarter a year ago — most businesses are seasonal.

Revenue by quarter

Q1'23: $15.6B
Q2'23: $15.9B
Q3'23: $16.2B
Q4'23: $17.3B
Q1'24: $17.3B
Q2'24: $17.5B
Q3'24: $17.5B
Q4'24: $18.3B
Q1'25: $18.3B
Q2'25: $18.6B
Q3'25: $19.2B
Q4'25: $19.5B
Q1'26: $19.1B
$0$5.0B$10.0B$15.0B
23
23
24
25
26

Net income by quarter

Q1'23: $1.4B
Q2'23: $1.2B
Q3'23: $1.1B
Q4'23: $1.6B
Q1'24: $1.6B
Q2'24: $1.5B
Q3'24: $1.3B
Q4'24: $1.4B
Q1'25: $1.6B
Q2'25: $1.7B
Q3'25: $1.6B
Q4'25: $1.9B
Q1'26: $1.6B
$0$500.0M$1.0B$1.5B
23
23
24
25
26
QuarterRevenueYoYNet incomeYoYEPSOCF
Q1'26$19.1B+4.3%$1.6B+0.6%7.15$2.0B
Q4'25 *$19.5B+6.7%$1.9B+30.6%8.09$2.4B
Q3'25$19.2B+9.6%$1.6B+29.4%6.96$4.4B
Q2'25$18.6B+6.4%$1.7B+13.1%6.83$4.2B
Q1'25$18.3B+5.7%$1.6B+1.2%6.45$1.7B
Q4'24 *$18.3B+5.7%$1.4B−10.5%5.66$2.6B
Q3'24$17.5B+7.9%$1.3B+17.7%4.88$3.5B
Q2'24$17.5B+10.3%$1.5B+22.5%5.53$2.0B
Q1'24$17.3B+11.2%$1.6B+16.7%5.93$2.5B
Q4'23 *$17.3B+11.7%$1.6B−22.8%5.92$2.7B
Q3'23$16.2B+8.3%$1.1B−4.9%3.91$2.5B
Q2'23$15.9B+7.0%$1.2B+3.3%4.29$2.5B
Q1'23$15.6B+4.3%$1.4B+7.1%4.85$1.8B

Track record

Compound annual growth by period. For debt and share count, negative is the good direction.

Series3y5y10y15y
Revenue+7.9%+8.0%
Operating cash flow+14.0%+6.5%
Free cash flow+23.1%+3.8%
EPS (diluted)+13.9%+21.0%
Equity
LT debt+3.3%+6.2%
Diluted shares−6.7%−7.0%
Stock price+16.6%+12.1%+19.9%+25.1%

$100, 3 years ago

$158vs $176 in SPY

16.6% vs 20.7%/yr

$100, 5 years ago

$177vs $181 in SPY

12.1% vs 12.6%/yr

$100, 10 years ago

$613vs $412 in SPY

19.9% vs 15.2%/yr

$100, 15 years ago

$2,887vs $813 in SPY

25.1% vs 15.0%/yr

The $1 test — market value created per $1 of earnings retained (Buffett's hurdle: at least $1)

Last 5 years

$2.34

$63.3B created / $27.1B retained

Quality & capital discipline

Cash-based returns and how management deploys capital

Cash ROIC

35.5%

OCF ÷ (equity + debt)

OCF / EV yield

9.6%

MC vs 10× OCF

0.72

≤1 = priced under 10× OCF

Debt / FCF

5.4y

SBC / FCF

5.2%

Owner earnings

$7.3B

OCF − capex − SBC

OE yield

8.0%

Share count 5y

−5.4%

per year; negative = buybacks

Growth engine (5y): reinvested 9.9% of operating cash flow at an incremental return of 68.6% — an organically fundable growth rate of about 6.8% per year (growth ≈ reinvestment rate × incremental ROIC).

Checklist

17 of 24 checks pass · 71%. Checks with structurally missing inputs are excluded.

Growth & Consistency

5/7

  • Revenue growth

    8.0% · 5y CAGR ≥ 5%

    pass
  • EPS growth

    21.0% · 5y CAGR ≥ 5%

    pass
  • FCF growth

    3.8% · 5y CAGR ≥ 5%

    fail
  • Revenue rises consistently

    9 of 9 · up in ≥ 7 of last 10 years

    pass
  • FCF consistently positive

    10 of 10 · positive in ≥ 8 of last 10 years

    pass
  • Profitable every year

    10 of 10 · net income > 0 in ≥ 8 of last 10

    pass
  • Cash flow keeps up with sales

    6.5% vs 8.0% · OCF CAGR ≥ 0.9× revenue CAGR

    fail

Profitability

4/5

  • Net margin

    9.0% · ≥ 8%

    pass
  • Operating margin

    · ≥ 10%

    na
  • Gross margin stable or rising

    · no drop > 2 pts over 3y

    na
  • Return on equity

    -112.6% · ≥ 12%

    fail
  • Cash ROIC

    35.5% · ≥ 12%

    pass
  • FCF margin

    10.2% · ≥ 5%

    pass
  • Earnings back their cash

    OCF $12.6B vs NI $6.8B · OCF ≥ net income (latest FY)

    pass

Balance Sheet

1/4

  • Debt payable from cash flow

    5.4y · LT debt ≤ 3× FCF

    fail
  • Cash cushion

    2% · cash ≥ 50% of LT debt

    fail
  • Leverage

    -6.90 · LT debt ≤ 1.5× equity

    pass
  • Equity positive and compounding

    −$6.0B · equity > 0 and grew over ~5y

    fail
  • Interest burden

    · interest ≤ 15% of operating income

    na

Capital Allocation

3/4

  • Share count flat or shrinking

    -5.4% · ≤ +0.5%/yr over ~5y

    pass
  • Stock comp restrained

    5% · SBC ≤ 15% of FCF

    pass
  • Distributions funded by FCF

    140% · dividends + buybacks ≤ 100% of FCF

    fail
  • Repurchases are a habit

    10 of 10 · buybacks in ≥ 5 of last 10 years

    pass

Valuation Discipline

4/4

  • FCF yield

    8.4% · ≥ 3%

    pass
  • Earnings multiple

    13.5 · P/E ≤ 25

    pass
  • Price asks less than history delivered

    0.6% vs 11.5% · implied FCF growth ≤ historical FCF CAGR

    pass
  • Shareholder yield

    11.8% · dividends + buybacks ≥ 2% of market cap

    pass

Red flags

Mechanical checks — a flag is a question to investigate, not a verdict

Heavy debt load

Long-term debt exceeds 5 years of free cash flow.

Distributions exceed FCF

Dividends plus buybacks exceeded free cash flow in the latest fiscal year.

Financial data

As filed in 10-Ks; per-share figures split-adjusted. $ in millions.

FYRevenueGross profitOp incomeNet incomeEPSOCFCapExFCFDividendsBuybacksSBCCashLT debtEquityShares
202575,6006,78428.3312,6364,9447,69267910,0674011,04041,603-6,027239
202470,6035,76022.0010,5144,8755,6396906,0423601,93338,333-2,499262
202364,9685,24218.979,4314,7444,6876613,81126293537,169-1,774276
202260,2335,64319.158,5224,3954,1276537,00034190837,714-2,767295
202158,7526,95621.168,9593,5775,3826248,2154401,45134,342-933329
202051,5333,75410.939,2322,8356,3971534413621,79330,795572344
201951,3363,50510.077,6024,1583,4445501,03134762133,577-2,808348
201846,6773,78710.666,7613,5733,1884871,53026850232,033-4,950355
201743,6142,2165.955,4263,0152,41102,05127073232,858-6,806372
201641,4902,8907.305,6532,7602,8932,75125164631,160-7,302396

Some concepts are structurally absent for certain industries (banks report no gross profit or capex). Missing ≠ zero.