HCA Healthcare's shares were under pressure after the for-profit operator of healthcare facilities scaled back financial guidance for the year following payer mix shifts due to health insurance exchanges.

In premarket trading, the shares were 9.4% lower at $354. As of Monday's close, the stock had already retreated 22% over the last three months.

HCA said that based on preliminary operating results for the latest quarter it has lowered its forecast for 2026 earnings to between $28.70 and $30.50 a share and narrowed its revenue target to $77 billion to $79.5 billion from a prior $76.5 billion to $80 billion range. Adjusted earnings before interest, taxes, depreciation and amortization are targeted at between $15.4 billion and $16.1 billion, where HCA previously anticipated $15.55 billion to $16.45 billion.

The company said it anticipates adjusted Ebitda for the second quarter of roughly $4.03 billion, and revenue for the three months of about $20.23 billion. That compared with $3.85 billion and $18.61 billion a year earlier, and is below the $4.47 billion and $19.47 billion in revenue that analysts polled by FactSet had penciled in.

HCA said it experienced a payer mix shift in the quarter, driven by an increase in uninsured volume, primarily due to patients who had lost coverage on health insurance exchanges. It estimated that this payer mix shift had an unfavorable impact on income before income taxes of about $400 million during the second quarter.

The company said it did see positive factors during the quarter, including growth in admissions, equivalent admissions and emergency room visits, increased benefit from Medicaid Supplemental Payment Programs and improved expense trends.

Write to Robb M. Stewart at robb.stewart@wsj.com

(END) Dow Jones Newswires

July 14, 2026 08:52 ET (12:52 GMT)

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