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HCA Healthcare owns and runs hospitals and surgery centers that treat patients and get paid mainly by insurance companies and the government.
HCA Healthcare is one of the biggest hospital companies in America. It runs roughly 180 hospitals and about 2,500 other care sites, like surgery centers and urgent care clinics, across the US and the UK. When you get surgery, have a baby, or land in the emergency room at one of its facilities, someone has to pay for that room, the nurses, the doctors, and the machines. That someone is usually an insurance company, a government program like Medicare or Medicaid, or the patient directly. HCA collects that money and keeps whatever is left after paying its costs. Think of it as a giant landlord for medical care: it owns the buildings, employs the staff, and rents out the beds to people who need them, but the rent check comes from insurers and taxpayers, not the patient.
The business splits into two main pieces. The biggest one is inpatient care — overnight stays in hospitals, which bring in the majority of revenue, mostly from Medicare and private insurers. The second piece is outpatient care — same-day surgeries, emergency visits, and clinics, which is the faster-growing part because more procedures are moving out of hospitals and into cheaper standalone centers. HCA also runs a small UK operation. In recent years the company has been buying up surgery centers and urgent care clinics, and it has been pushing hard into outpatient surgery, where margins tend to be better. Revenue was about $70 billion in 2024, growing at a steady mid-single-digit pace.
HCA was founded in 1968 by a father and son, Thomas Frist Sr. and Thomas Frist Jr., along with Jack Massey, and it helped invent the idea of a for-profit hospital chain. The company went private in a big leveraged buyout in 2006, then went public again in 2011. Because hospitals are capital-hungry, HCA spends a lot of its cash on building and upgrading facilities. It also pays a small dividend and buys back stock — roughly 2% to 3% of shares a year in recent periods — and carries a meaningful debt load from all those buildings and acquisitions. The big risks are simple: government reimbursement rates, insurance company pushback on prices, labor shortages driving up nurse wages, and any rule change in Washington that shrinks what Medicare pays.
Saved answer · last researched 11 Oct 2026