Tenet Raises 2025 Guidance Again as Strong Third Quarter Extends Momentum

The health system’s third-quarter performance reflects disciplined operations, ambulatory growth, and rising hospital volumes.

Tenet Healthcare delivered another quarter of solid earnings, raising its full-year outlook for the second time this year as growth across both its hospital and ambulatory businesses continued to drive results.

For the three months ended September 30, the Dallas-based health system reported net operating revenues of $5.29 billion, up from $5.13 billion in the same period last year. Operating income was $889 million, a dip from the $1.1 billion recorded in the third quarter of 2024, but still good for a 16.8% operating margin thanks to sustained volume growth, favorable service mix, and disciplined expense management.

“We continue to deliver consistent growth and have disciplined operations, which has translated into outstanding financial results,” CEO Saum Sutaria told investors during an earnings call. “We are confident in our ability to deliver on our increased outlook for 2025 as we continue to provide high-quality care for our patients.”

Tenet’s ambulatory business, United Surgical Partners International (USPI), remains a cornerstone of the company’s growth strategy and contributed $492 million in adjusted EBITDA for the quarter, up 12% from the prior year, with same-facility revenue rising more than 8%.

Sutaria said the organization’s ambulatory network is positioned to meet increasing patient demand as surgical care continues to shift away from hospitals. “The simplest way to look at it is we’re not worried about our capacity to take on the demand that we would see in the typical end of the fourth quarter at USPI,” he said.

The health system has continued to expand its footprint in the outpatient market through acquisitions and partnerships. Earlier in 2025, Tenet announced new ambulatory surgery centers and joint ventures to strengthen its reach in high-growth markets.

While the ambulatory business remains Tenet’s growth engine, its hospital segment continues to show steady improvement. Same-hospital admissions rose about 1.4% year-over-year, and revenue per adjusted admission was up 5.9%, reflecting stronger patient acuity and payer mix.

Sutaria attributed those gains to Tenet’s focus on complex care and investments in key clinical service lines. “Our strategy, which is more focused on higher acuity services, has delivered a track record of improved margins and strong earnings growth over the past few years,” he said.

To sustain that growth, the company has ramped up capital investments by $150 million and now expects to invest $875 to $975 million for 2025. Sutaria characterized the increased capital expenditure “as more investment in both program or clinical program infrastructure, service line support, and various other growth strategies in the hospitals.”

On the strength of its third-quarter results, Tenet raised its full-year guidance for adjusted EBITDA to a range of $4.47 billion to $4.57 billion, and its revenue projection to between $21.15 billion and $21.35 billion. The company also reaffirmed its commitment to maintaining a disciplined capital allocation approach while pursuing targeted growth opportunities.

Sutaria emphasized that health system’s performance reflects a long-term strategy that balances operational execution with sustainable growth. “Our strategy continues to deliver consistent results, and we believe we’re well positioned to build on this momentum,” he said.

Even with the strong financial showing, Sutaria acknowledged that policy and regulatory uncertainties could create headwinds next year, particularly around insurance coverage and reimbursement trends. “Uncertainty about the enhanced premium tax subsidies and the impact on reimbursement and enrollment in the exchanges still exists,” he said.

Those factors, along with evolving Medicare payment rules and state-level funding programs, remain key variables that Tenet, as well as other health systems, will monitor heading into 2026.