HCA Reaffirms 2025 Guidance in Q1 Earnings Amid 'Very Fluid' Policy Environment

The for-profit giant posted solid first quarter results, though leadership highlighted uncertainty around policy reform.

HCA Healthcare remained on track with its earnings in the first quarter, but it's unclear how potential policy changes in Washington could impact the health system going forward.

Along with reporting revenue growth and strong profits for the first quarter, HCA reaffirmed its 2025 guidance range of $5.85 billion to $6.29 billion.

Leadership, meanwhile, stayed away from providing details on how policies like tariffs and Medicaid reform could affect finances in an earnings call with investors.

"We are in a very fluid situation," CEO Sam Hazen said on the call. "While we have a general sense for the new administration's stated priorities, we do not have any specifics. It is unclear how these efforts might be carried out and what effects they may have on our business."

For the first quarter, HCA recorded revenue of $18.32 billion and net income of $1.61 billion, improvements over the $17.34 billion and $1.59 billion, respectively, reported during the same period last year.

Revenue growth was driven by an increase in patient volume, with the health system seeing same facility admissions rise 2.6% year over year, same facility equivalent admissions jump 2.8%, and emergency room visits swell by 4%.

One area of volume that continued to decline was outpatient surgeries, which fell by 2.1% year over year. Hazen attributed to dip in part to 2024 being a leap year with an added day for services.

When asked by investors about policy developments, Hazen stated that HCA is engaged in advocacy efforts.

"Our general approach is to support reasonable reforms," Hazen said. "However, we do not support reforms that harm coverage for families or individuals, nor do we support policies that compromise the ability for hospitals across the country to care for people in their times of utmost need."

On the issue of tariffs, CFO Mike Marks called HCA's level of risk for the year "manageable." The health system has 70% of its supply expense contracted with firm pricing for 2025, and 75% of its supply expense coming from either the United States, Canada, or Mexico, or from products that currently have broad exemption from tariffs, according to Marks.

Still, Hazen again touted the wait-and-see approach he offered following the release of the health system's fourth quarter earnings.

"I know you would like us to size the potential impacts of health policy risks and now tariff risks, but we are not comfortable with providing estimates at this time," Hazen said. "We just do not have enough insight into what might happen."