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HCA trades against a final fair-value range of $496.77-$798.49, with the midpoint set by the accepted valuation synthesis rather than earlier draft model outputs. Fair value range: low $497, high $798, with mid-point at $647.
Stock analysis

HCA HCA fair value $497–$798

HCA
By StockMarketAgent.AI team· supervised by
Analyzed: 2026-05-13Next update: 2026-08-13Methodology v2.5Review: automatedArchetype: Mature compounder
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Last price
$426.37
▲ +220.89 (+51.81%)
Fair value
$647
$497–$798
Rating
Strong Buy
confidence 88/100
Upside
+51.8%
upside to fair value
Margin of Safety
$550.17
MoS level · 15%
Market Cap
$94.6B
P/E fwd 12.9

§1 Executive summary

  • Composite fair value $647 with high case $798.
  • Implied upside of 51.8% to fair value.
  • Moat 9/10 · confidence 88/100 · Mature compounder.
  • Trades below fair value with a meaningful cushion to the midpoint.
Fair value
$647
Margin of safety
+34.1%
Confidence
88/100
Moat
9/10

Educational analysis only — not financial advice. Always do your own due diligence.

$426.37Price
Low $496.77
Mid $647.26
High $798.49

HCA trades against a final fair-value range of $496.77-$798.49, with the midpoint set by the accepted valuation synthesis rather than earlier draft model outputs.

  • Local market density and scale
    Local market density and scale advantages driving industry-leading margins.
  • Demographic tailwinds with an aging
    Demographic tailwinds with an aging population ensuring consistent volume.
  • Bull thesis
    Market under-appreciates the durability of HCA's local market density and the resultant ROIC/WACC spread.

§2 Bear case

A prolonged period of elevated interest rates combined with flat commercial volumes and margin compression to 13% would severely stress HCA's free cash flowFree cash flowOperating cash flow minus capital expenditures. The cash a business generates after maintaining and growing its asset base — the closest accounting proxy for owner-economics., threatening the heavily leveraged capital structure and ending the share repurchase algorithm.

Ways this thesis can break

Severe Reimbursement Cuts

· Medium

Government payers drastically compress Medicare/Medicaid rates to manage ballooning deficits, crushing margins.

FV impact
Downside anchoring near Expected Value of $421
Trigger
12 to 24 months

Structural Labor Shortage

· High

Persistent clinical staff shortages force a permanent reliance on expensive contract labor, eroding operating margins below 14%.

FV impact
Valuation anchors to Forward Earnings mid $420
Trigger
6 to 18 months

Debt Cost Spiral

· Low

Refinancing the massive $48.7B net debt load at significantly higher rates extinguishes the aggressive buyback program.

FV impact
Severe reduction in Owner Earnings fair value and DCF upside
Trigger
24 to 36 months
Early-warning signals to monitor
MetricCurrentTrigger threshold
Operating margin falling below 14.0% in consecutive quarters.MonitorDeterioration versus the report thesis
Year-over-year reduction in diluted shares outstanding falling below 3%.MonitorDeterioration versus the report thesis
Sustained acceleration in contract labor costs.MonitorDeterioration versus the report thesis
Negative shift in payer mix toward government and uninsured.MonitorDeterioration versus the report thesis
Deterioration of free cash flow conversion below $7B annually.MonitorDeterioration versus the report thesis

§3 Financial history

Income statement — last six periods
Line itemT−0T−1T−2T−3T−4CAGR
Period2021-12-312022-12-312023-12-312024-12-312025-12-31Trend
Revenue$60.23B$64.97B$70.60B$75.60B+5.8%
Gross profit$23.18B$25.58B$28.68B$31.37B+7.9%
Operating income$9.05B$9.63B$10.55B$11.97B+7.2%
Net income$5.64B$5.24B$5.76B$6.78B+4.7%
EPS (diluted)$19.15$18.97$22.00$28.33+10.3%
EBITDA$13.29B$12.72B$13.90B$15.60B+4.1%
R&D
SG&A$26.78B$27.69B$29.49B$31.17B+3.9%

Quality scores

OCF / Net income
1.86×
>1 indicates high earnings quality
Accounting quality gate
Fail
Sector-adjusted gate
ROIC
22.4%
Return on invested capital
§3

Numbers analysis

Cash flow

Cash-flow quality is reflected in the OCFOperating cash flowCash generated from the company's core operations after working-capital changes but before capital expenditures. The first line of the cash-flow statement. / net incomeNet IncomeNet Income is an income-statement line item used to reconcile revenue to operating profit, pre-tax income, net income, or per-share earnings. It should be compared across periods and against peer disclosure conventions., accounting-quality, and ROICROICReturn on invested capital. Operating profit (after tax) divided by invested capital. The single best gauge of capital-efficiency. Spread over WACC = economic value created. rows above.

Capital allocation

Capital allocation should be evaluated against reinvestment needs, balance-sheet strength, and shareholder returns.

Individual subscribers — §4 onwards11 more sections

Read the full analysis — 11 more sections.

Competitive moat, industry cycle, peer comparison, intrinsic valuation, sensitivity, scenarios, earnings decision tree, position management, investor perspectives, scorecard, and final recommendation.

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FAQ

HCA — frequently asked questions

  1. Based on our latest analysis, HCA looks meaningfully undervalued. The current price is $426 versus a composite fair-value midpoint of $647 (range $497–$798), which implies roughly 51.8% upside to the midpoint.
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