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HCA Healthcare cash flow, quarter by quarter

Latest: Q3 2026 · from the cash-flow statements filed with the SEC

Free cash flow$3.1B in Q3 2026 · $6.0B over twelve months

Operating cash flow$4.5B
Capital spending−$1.4B
Free cash flow+$3.1B
Cash / net income2.4×

Analysis

In Q3 2026, HCA Healthcare generated $4.5B of operating cash flow and spent $1.4B on capital projects, leaving free cash flow of $3.1B. That is $24.0M less than in Q3 2025 ($3.1B).

Over the twelve months to Sep 30, 2026, operating cash flow was $11.2B; the largest uses were buybacks ($9.2B), capital spending ($5.2B), other investing ($1.1B); besides operations, cash came from net borrowing (+) / repaid (−) ($5.8B), asset & business sales ($199M); the cash balance fell by $89.0M.

Operating cash flow was $4.5B against net income of $1.8B — 2.4× profit, cash ran ahead of reported earnings. The largest differences: depreciation & amortization +$954M, receivables +$782M, payables +$769M.

Free cash flow

HCA Healthcare: free cash flow by quarterHCA Healthcare: free cash flow by quarter$1.3BQ4 2024$660MQ1 2025$3.0BQ2 2025$3.1BQ3 2025$870MQ4 2025$895MQ1 2026$1.1BQ2 2026$3.1BQ3 2026
Operating cash flow less capital spending.
HCA Healthcare: operating cash flow against capital spendingHCA Healthcare: operating cash flow against capital spendingOperating cash flowCapital spending$2.6B$1.3BQ4 2024$1.7B$991MQ1 2025$4.2B$1.2BQ2 2025$4.4B$1.3BQ3 2025$2.4B$1.5BQ4 2025$2.0B$1.1BQ1 2026$2.3B$1.2BQ2 2026$4.5B$1.4BQ3 2026
Latest (Q3 2026): Operating cash flow $4.5B, Capital spending $1.4B.

Capital allocation, year by year

HCA Healthcare: where the cash came from (up) and went (down), by fiscal yearHCA Healthcare: where the cash came from (up) and went (down), by fiscal yearOperating cash flowNet borrowingAsset salesCapital spendingBuybacksDividendsFY2021: Operating cash flow $9.0BFY2021: Net borrowing $3.1BFY2021: Asset sales $2.2BFY2021: Capital spending −$3.6BFY2021: Buybacks −$8.2BFY2021: Dividends −$624M$14.3BFY2021FY2022: Operating cash flow $8.5BFY2022: Net borrowing $3.2BFY2022: Asset sales $1.2BFY2022: Capital spending −$4.4BFY2022: Buybacks −$7.0BFY2022: Dividends −$653M$12.9BFY2022FY2023: Operating cash flow $9.4BFY2023: Net borrowing $1.2BFY2023: Asset sales $193MFY2023: Capital spending −$4.7BFY2023: Buybacks −$3.8BFY2023: Dividends −$661M$10.8BFY2023FY2024: Operating cash flow $10.5BFY2024: Net borrowing $3.0BFY2024: Asset sales $328MFY2024: Capital spending −$4.9BFY2024: Buybacks −$6.0BFY2024: Dividends −$690M$13.9BFY2024FY2025: Operating cash flow $12.6BFY2025: Net borrowing $3.1BFY2025: Asset sales $269MFY2025: Capital spending −$4.9BFY2025: Buybacks −$10.1BFY2025: Dividends −$679M$16.0BFY2025
Over these 5 years operating cash flow totalled $50.1B; the largest uses were buybacks ($35.1B) and capital spending ($22.5B). Cash-flow statements as filed.

Cash runway and the debt wall

Cash & investments$908M
Debt$44.8B
Net debt$43.9B

HCA Healthcare funds itself: free cash flow was $6.0B over the last twelve months, and $908M of cash and investments stands against $44.8B of debt.

HCA Healthcare: debt maturities by year (FY2025)HCA Healthcare: debt maturities by year (FY2025)$2.5BYear 2$3.6BYear 3$3.6BYear 4$4.0BYear 5
Principal due in each year as disclosed in the annual report, against $908M of cash and investments now.

Where the cash came from and went

HCA Healthcare: sources (+) and uses (−) of cash, Q3 2026HCA Healthcare: sources (+) and uses (−) of cash, Q3 2026Operating cash flow$4.5BBuybacks−$3.0BCapital spending−$1.4BNet borrowing (+) / repaid (−)$723MOther investing−$645MPartners−$240MDividends−$165MCash drawn (+) / kept (−)$105MAsset & business sales$86.0MOther financing$3.0MExchange rates−$1.0M
HCA Healthcare: sources (+) and uses (−) of cash, TTM to Q3 2026HCA Healthcare: sources (+) and uses (−) of cash, TTM to Q3 2026Operating cash flow$11.2BBuybacks−$9.2BNet borrowing (+) / repaid (−)$5.8BCapital spending−$5.2BOther investing−$1.1BPartners−$770MDividends−$681MOther financing−$338MAsset & business sales$199MCash drawn (+) / kept (−)$89.0MExchange rates−$4.0M

From profit to cash

HCA Healthcare: net income to operating cash flow, Q3 2026HCA Healthcare: net income to operating cash flow, Q3 2026Net income$1.8BDepreciation & amortization$954MStock-based pay$133MDeferred taxes−$171MGains on disposals−$13.0MOther non-cash$39.0MReceivables$782MInventory$108MPayables$769MOperating cash flow$4.5B
Non-cash charges are added back; money tied up in receivables or inventory is subtracted.

Every quarter

QuarterOperating cash flowCapital spendingBuybacksDividendsNet borrowing (+) / repaid (−)Cash drawn (+) / kept (−)Free cash flow
Q3 2026$4.5B−$1.4B−$3.0B−$165M$723M$105M$3.1B
Q2 2026$2.3B−$1.2B−$2.1B−$171M$1.7B−$73.0M$1.1B
Q1 2026$2.0B−$1.1B−$1.6B−$183M$1.4B$100M$895M
Q4 2025$2.4B−$1.5B−$2.6B−$162M$2.0B−$43.0M$870M
Q3 2025$4.4B−$1.3B−$2.5B−$166M−$36.0M−$58.0M$3.1B
Q2 2025$4.2B−$1.2B−$2.5B−$171M−$217M$121M$3.0B
Q1 2025$1.7B−$991M−$2.5B−$180M$1.6B$873M$660M
Q4 2024$2.6B−$1.3B−$1.7B−$165M−$64.0M$955M$1.3B

HCA Healthcare: income statement and cash flow

HCA Healthcare, Q3 2026: revenue $19.8B (+4% year over year), operating margin 11.9%. The chart follows the revenue to costs, profit and cash.

HCA Healthcare: every quarter, Q/Q and Y/Y → Open in the app

Read automatically from the company’s XBRL cash-flow statements; quarterly figures for the fourth quarter are the year less the first three. Errors are possible. Not investment advice.