HCA stock forecast
HCA's weighted forecast is $469.67 in October 2027, $513.34 in October 2028 and $564.83 in October 2029; the base case receives 50% probability, the bear case 30%, and the bull case 20%. It hinges on whether coverage losses stabilize and cash generation funds capital spending and repurchases without materially higher debt.
Where could HCA's shares be by 2029?
The weighted price is $469.67 in October 2027, a 1% return including dividends. It rises to $513.34 in October 2028, an 11% return, then to $564.83 in October 2029, a 22% return.
The 2029 range is $317.18 to $881.00. Today’s price is $469.91. The base case receives 50% probability. The bear case receives 30%, and the bull case receives 20%.
| Case | Probability | October 2027 | October 2028 | October 2029 |
|---|---|---|---|---|
| Bear | 30 % | 353.94 (-24 %) | 337.63 (-27 %) | 317.18 (-30 %) |
| Base | 50 % | 489.95 (+5 %) | 536.51 (+16 %) | 586.95 (+27 %) |
| Bull | 20 % | 592.58 (+27 %) | 719.02 (+55 %) | 881.00 (+90 %) |
| Weighted | 100 % | 469.67 (+1 %) | 513.34 (+11 %) | 564.83 (+22 %) |
What has to go right or wrong for HCA?
The bear case keeps margins below the recent 9.0% level as uninsured care and payment pressure persist. Earnings fall from $5,966 million to $5,960 million across the forecast dates. The bull case reaches $8,372 million as volume, productivity and new capacity lift margins to 9.2%. The reduced 2026 outlook anchors the forecast, while the $423 million Florida catch-up contribution is excluded because it relates to earlier care.
How much cash does HCA really make?
Capital spending then consumed $4,944 million, leaving $7,692 million of common free cash flow. Stock compensation added back $401 million in accounting cash flow but gave employees an ownership claim; deducting it produces analytical “real free cash flow” of $7,291 million. Working capital also released $418 million in 2025, after tying up $106 million in 2024. That favorable timing may not repeat.
| 2025 | 2024 | 2023 | 2022 | 2021 | |
|---|---|---|---|---|---|
| Cash from operations | 12,636 | 10,514 | 9,431 | 8,522 | 8,959 |
| − Capital spending | 4,944 | 4,875 | 4,744 | 4,395 | 3,577 |
| = Free cash flow | 7,692 | 5,639 | 4,687 | 4,127 | 5,382 |
| − Stock pay | 401 | 360 | 262 | 341 | 440 |
| = Real free cash flow | 7,291 | 5,279 | 4,425 | 3,786 | 4,942 |
What this means. Stock pay uses no cash today, but it gives employees part of the company, so we subtract it to show what is truly left for shareholders.
What does an investor pay for HCA today?
At $469.91, HCA trades at 15.7 times trailing earnings. P/E, or price-to-earnings ratio, tells investors how many dollars they pay for each dollar of annual profit per share. Its 14.6 times forward P/E implies about $32.19 of earnings per share over the next twelve months, above the revised 2026 guidance of $28.70 to $30.50. Because that forward period reaches into 2027, the price assumes earnings recover beyond the weaker current-year outlook.
| Today (Oct 15, 2026) | |
|---|---|
| Share price | 469.91 |
| Enterprise value (calculated) | 150,441.22 |
| P/E, last 12 months (calculated) | 15.7x |
| P/E, next 12 months (calculated) | 14.6x |
What this means. The price-to-book number is not meaningful because the company owes more than it owns, so its book value is negative.