Shares of three of the largest publicly traded hospital operators have outpaced the broader market since June 30, even as the systems split on their outlooks for the rest of 2026.
The rally comes despite a hard year for payer mix: The expiration of enhanced ACA premium tax credits pushed many exchange patients into the uninsured column.
Four things to know:
1. Dallas-based Tenet Healthcare’s shares closed at $267.25 on Oct. 16, up 42.9% from their June 30 close of $187.08. King of Prussia, Pa.-based Universal Health Services’ shares closed at $185.10, up 24.5% from their June 30 close of $148.69. Shares of Nashville, Tenn.-based HCA Healthcare closed at $458.84, up 17.7% from their June 30 close of $389.89. The S&P 500 rose 2.1% over the same period.
2. The three systems moved their 2026 outlooks in different directions after the second quarter. Tenet raised its outlook July 23 and now projects $21.9 billion to $22.5 billion in net operating revenue, up from $21.5 billion to $22.3 billion, and $4.83 billion to $5.03 billion in adjusted EBITDA, up from $4.49 billion to $4.79 billion. UHS revised its forecast July 27, now projecting $2.61 billion to $2.717 billion in adjusted EBITDA, a 1.9% decrease from the midpoint of its original forecast. Its revenue projection rose slightly to $18.501 billion to $18.762 billion. HCA lowered its guidance July 14 after more patients lost ACA exchange coverage. The system now expects changes to the exchange environment to cost it $1 billion to $1.2 billion in 2026, up from an April estimate of $600 million to $900 million.
3. JPMorgan analysts said in an early October note that hospitals would be the “clearest beneficiaries” if lawmakers delay or reverse Medicaid reductions, CNBC reported Oct. 5. Under a Democratic sweep of Congress, the analysts expect Medicaid cuts to be softened or delayed, while a split Congress would largely block new cuts, according to an Oct. 6 report from Invezz. The outlet noted the key risk for hospital stocks is that Medicaid relief doesn’t materialize or is replaced by tougher hospital reimbursement rules.
4. Third-quarter earnings reports for the systems will be released next week. HCA and UHS are scheduled to report third-quarter results Oct. 27, and Tenet is set to report Oct. 29.
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
