HCA, Tenet Raise 2026 Outlooks While CHS, UHS Pull Back
After third-quarter earnings, the four largest for-profit hospital operators diverged on 2026 expectations. HCA kept its guidance range but now expects to land in the upper half, while Tenet raised its EBITDA and free cash flow outlook for the second straight quarter on strong same-store revenue growth. Community Health Systems cut guidance again, citing weaker payer mix and acuity amid a challenging macro environment, and Universal Health Services reiterated its range but now expects results toward the lower end due to slower de novo hospital ramp-up. Several operators, including HCA and Tenet, cited an unfavorable payer mix tied to patients losing exchange coverage and rising uninsured volume, while HCA also noted a modest increase in net benefit from Medicaid supplemental payment programs.