Dallas-based Tenet Healthcare reported $21.3 billion in revenue in 2025, up from $20.7 billion in 2024, as the system posted strong fourth-quarter results and outlined a positive outlook for 2026. For the fourth quarter, Tenet reported net operating revenue of $5.5 billion, compared to $5.1 billion during the same period in 2024.
“2025 extended Tenet’s track record of strong revenue growth, disciplined operations, improved margins and robust free cash flow generation,” Tenet Chair and CEO Saum Sutaria, MD, said in a Feb. 11 news release. “We see continued demand for acute care and ambulatory surgical services in our markets and are confident in our ability to execute on our strategy and achieve our full-year 2026 expectations.”
Eight things to know:
1. Net income was $1.4 billion (6.6% margin) in 2025, down from $3.2 billion (15.5% margin) in 2024, which included a pre-tax gain of $2.9 billion ($2.1 billion after tax) primarily associated with the hospital divestitures. Tenet sold 14 hospitals last year.
2. The for-profit system reported an operating income of $3.5 billion (16.5% margin) in 2025, down from $6 billion (28.8% margin) in 2024.
3. Tenet reported full-year adjusted EBITDA of $4.6 billion, compared to $4 billion in 2024. Adjusted EBITDA reached $1.2 billion in the fourth quarter, up 12.9% from $1.1 billion in the same quarter last year.
4. Tenet’s ambulatory care segment, which includes United Surgical Partners International, generated $580 million in adjusted EBITDA during the fourth quarter, a 9.4% increase over the prior-year period. As of Dec. 31, USPI held interests in 533 ambulatory surgery centers, including 401 consolidated facilities, and 26 surgical hospitals across 37 states.
5. Cash flow from operating activities totaled $3.54 billion in 2025, compared to $2.05 billion in 2024. Free cash flow reached $2.53 billion, up from $1.12 billion the prior year. The 2024 cash flow figures included $855 million in income tax payments associated with hospital sale gains.
6. On Jan. 27, Tenet entered into an agreement with Chicago-based CommonSpirit related to the company’s revenue cycle subsidiary Conifer Health Solutions. The deal includes $1.9 billion in payments from CommonSpirit to Tenet over three years and a $540 million payment from Conifer to CommonSpirit tied to the redemption of CommonSpirit’s 23.8% equity stake. Tenet expects to record approximately $1.65 billion in revenue from contract termination in 2026, along with about $500 million in tax expense associated with the transaction.
7. Tenet repurchased 8.8 million shares of common stock in 2025 for $1.39 billion, including 0.94 million shares for $198 million in the fourth quarter alone.
8. For 2026, Tenet expects:
- Revenue to be between $21.5 billion and $22.3 billion.
- Net income to range between $2.61 billion and $2.84 billion.
- Adjusted EBITDA to range between $4.49 billion and $4.79 billion.
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