Tenet Healthcare posted the highest operating margin, and HCA Healthcare had the highest net income among the U.S.’s largest publicly traded for-profit health systems in the third quarter of 2026.
HCA, Tenet, Community Health Systems and Universal Health Services have reported third-quarter results. Three of the four systems posted positive net income, while CHS swung to a net loss. Tenet was the only one to widen its operating margin year over year, and HCA, CHS and UHS all saw margins narrow.
Here’s how their third-quarter financial and operational metrics compare:
HCA Healthcare (Nashville, Tenn.)
Operating income: $2.4 billion (11.9% operating margin), roughly flat with $2.4 billion (12.6% margin) in the third quarter of 2025
Operating revenue: $19.8 billion, up from $19.2 billion
Operating expenses: $17.5 billion, up from $16.7 billion
Net income: $1.58 billion, down from $1.64 billion a year earlier
“I have often mentioned that HCA has strong staying power because of our scale, the important role we play in providing critical services to communities, and our disciplined culture,” HCA CEO Sam Hazen said in the system’s Oct. 27 financial report. “Despite the challenges brought about by federal policy changes this year, our colleagues have continued to provide high-quality care to patients, and we believe HCA Healthcare is positioned to end the year positively.”
Operating income: $1.8 billion (31.1% margin), up from $889 million (16.8% margin)
Operating revenue: $5.6 billion, up from $5.3 billion. The quarter also included $646 million in revenue from the early end of Conifer’s revenue-cycle contract with CommonSpirit Health.
Operating expenses: $4.6 billion, up from $4.5 billion
Net income: $1 billion, up from $342 million
“Our outperformance in the third quarter of 2026 was driven by sustained strength in same-store revenue growth and effective expense management,” Tenet Chairman and CEO Saum Sutaria, MD, said in the Oct. 29 financial report.
Community Health Systems (Franklin, Tenn.)
Operating income: $146 million (5.3% margin), down from $243 million (7.9% margin)
Operating revenue: $2.8 billion, down from $3.1 billion
Operating expenses: $2.6 billion, down from $2.8 billion
Net loss: $86 million (-3.1% margin), compared with net income of $130 million (4.2% margin)
“We are pleased to make continued progress on our strategic initiatives around quality outcomes, patient satisfaction, physician experience, and employee satisfaction and remain confident these investments will lead to improved financial performance,” CHS CEO Kevin Hammons said in an Oct. 28 news release. “While volume trends and cash flow improved sequentially in the third quarter, payor mix and acuity did not develop as expected due to the challenging macro environment, negatively impacting financial results for the third quarter and our expectations for the remainder of the year.”
Universal Health Services (King of Prussia, Pa.)
Operating income: $454 million (9.6% margin), down from $522 million (11.6% margin) in the third quarter of 2025
Operating revenue: $4.7 billion, up from $4.5 billion
Operating expenses: $4.3 billion, up from $4 billion
Net income: $309 million, down from $373 million
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