Nashville, Tenn.-based HCA Healthcare posted revenues of $19.8 billion in the third quarter of 2026, up from $19.2 billion a year earlier, even as a payer mix shift toward uninsured patients cut about $400 million from its pretax income.
HCA said the shift was driven primarily by patients who lost coverage on the ACA exchanges. The for-profit system said in its quarterly filing that its managed care and insurer revenue was hurt in the quarter by the expiration of enhanced premium tax credits at the end of 2025 and administrative reforms affecting exchange coverage, a trend it said was expected and consistent with the second quarter. HCA’s estimated cost of total uncompensated care rose to $1.5 billion in the quarter, up from $1.2 billion a year earlier, and hospitals in Texas and Florida accounted for 73% of its uninsured admissions, according to the filing.
Here is HCA’s payer mix by revenues for the quarters ended Sept. 30 in 2026 and 2025, according to an Oct. 29 regulatory filing:
Q3 2026
- Managed care and insurers: $9.6 billion (48.3%)
- Managed Medicare: $3.5 billion (17.8%)
- Medicare: $2.9 billion (14.7%)
- Medicaid: $1.8 billion (8.9%)
- Managed Medicaid: $961 million (4.8%)
- Other: $602 million (3%)
- International: $492 million (2.5%)
Q3 2025
- Managed care and insurers: $9.3 billion (48.4%)
- Managed Medicare: $3.3 billion (17.3%)
- Medicare: $2.7 billion (14.2%)
- Medicaid: $1.8 billion (9.3%)
- Managed Medicaid: $949 million (4.9%)
- Other: $644 million (3.4%)
- International: $484 million (2.5%)
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