Despite headwinds from the One Big Beautiful Bill Act, which will slash Medicaid funding, four of the nation’s largest for-profit health systems — HCA Healthcare, Community Health Systems, Tenet Healthcare and Universal Health Services — delivered strong margins and operating incomes in the second quarter of 2025 and remain cautiously optimistic about future earnings
Here’s how each system performed in the second quarter:
HCA Healthcare (Nashville, Tenn.)
HCA reported a net income of $1.7 billion in the second quarter, up from $1.5 billion in the same quarter in 2024. Operating income rose to $2.4 billion with a 13% margin, compared to $2.2 billion and a 12.8% margin in the same quarter of 2024.
Total revenue grew 6.3% year over year to $18.6 billion. The system also raised its full-year outlook, projecting 2025 revenue between $74 billion and $76 billion, with net income expected to hit $6.11 billion to $6.48 billion.
Same-facility admissions increased 1.8% and emergency room visits rose 1.3%, while inpatient and outpatient surgeries saw slight declines. Revenue per equivalent admission was up 4%.
As of June 30, HCA had $59.5 billion in total assets and $39.4 billion in long-term debt.
“We are pleased to report strong financial results for the second quarter. They reflected solid revenue growth, improved margins, and better outcomes for our patients,” HCA CEO Sam Hazen said in a news release.
Tenet posted a $832 million operating income with a 15.6% margin in the second quarter, up from $761 million and a 14.9% margin in the same period last year. Net income was $288 million (5.5% margin), up from $259 million (5.1% margin).
Net operating revenue climbed from $5.1 billion to $5.3 billion in the second quarter of 2025. Salaries, wages and benefits decreased slightly, while supply costs rose 2.6% year over year. The hospital segment saw a modest 0.9% revenue increase, and the ambulatory segment posted 11.3% revenue growth.
The system raised its 2025 outlook, now projecting between $20.95 billion and $21.25 billion in net operating revenue and between $1.12 billion and $1.22 billion in adjusted net income.
As of June 30, Tenet had $28.7 billion in total assets and $13.1 billion in long-term debt.
“Our strong second quarter results extend our track record of attractive same store revenue growth, operational performance driven by fundamentals, and robust free cash flow generation,” Tenet Chair and CEO Saum Sutaria, MD, said.
Community Health Systems (Franklin, Tenn.)
CHS reported $512 million in operating income in the second quarter, with a 16.3% margin, more than doubling its 7.6% margin from the same period in 2024. Net income rose to $282 million (9% margin), up from a $13 million loss (-0.4% margin) in the prior-year quarter.
Despite a slight year-over-year dip in total net revenue to $3.1 billion, same-store revenues were up 6.5%. Admissions increased 0.3% while adjusted admissions dropped 0.7%. Operating expenses declined 10.3% to $2.6 billion.
The system saw $239 million in net non-cash income in the second quarter — largely from hospital divestitures — and it signed a $195 million deal with Labcorp to transfer ambulatory lab services in 13 states.
As of June 30, CHS had $13.6 billion in total assets and $10.8 billion in long-term debt.
“The company continues to make good progress with its high priority strategic initiatives such as investments into growth projects and physician recruitment,” CEO Tim Hingtgen said. “We remain confident that the organization is on the right trajectory for the long term.”
Universal Health Services (King of Prussia, Pa.)
UHS reported $500.3 million in operating income (11.7% margin) in the second quarter, up from $436.4 million (11.2% margin) the second quarter of 2024. Net income reached $353.2 million (8.2% margin), up from $289.2 million (7.4% margin).
Total revenue grew 9.6% year over year to $4.3 billion. Acute care hospitals generated $225.2 million in operating income (9.4% margin), while the behavioral health division contributed $396.5 million (21.1% margin).
Same-facility acute care admissions rose 2% year over year and patient days increased 1.1%, with revenue per adjusted admission and patient day up 3.8% and 4.7%, respectively. The behavioral segment also saw strong performance, with revenue per patient day increasing 7.8%.
As of June 30, UHS had total assets of $15 billion and long-term debt of $4.5 billion.
