The end of the earnings season is always a good time to take a step back and see who shined (and who not so much). Let’s take a look at how hospital chains stocks fared in Q4, starting with Acadia Healthcare (NASDAQ: ACHC).
Hospital chains operate scale-driven businesses that rely on patient volumes, efficient operations, and favorable payer contracts to drive revenue and profitability. These organizations benefit from the essential nature of their services, which ensures consistent demand, particularly as populations age and chronic diseases become more prevalent. However, profitability can be pressured by rising labor costs, regulatory requirements, and the challenges of balancing care quality with cost efficiency. Dependence on government and private insurance reimbursements also introduces financial uncertainty. Looking ahead, hospital chains stand to benefit from tailwinds such as increasing healthcare utilization driven by an aging population that generally has higher incidents of disease. AI can also be a tailwind in areas such as predictive analytics for more personalized treatment and efficiency (intake, staffing, resourcing allocation). However, the sector faces potential headwinds such as labor shortages that could push up wages as well as substantial investments needs for digital infrastructure to support telehealth and electronic health records. Regulatory scrutiny, and reimbursement cuts are also looming topics that could further strain margins.
The 4 hospital chains stocks we track reported a mixed Q4. As a group, revenues along with next quarter’s revenue guidance were in line with analysts’ consensus estimates.
Amidst this news, share prices of the companies have had a rough stretch. On average, they are down 12.7% since the latest earnings results.
Weakest Q4: Acadia Healthcare (NASDAQ: ACHC)
With a network of over 250 facilities serving patients in 38 states and Puerto Rico, Acadia Healthcare (NASDAQ: ACHC) operates facilities providing mental health and substance use disorder treatment services across the United States.
Acadia Healthcare reported revenues of $774.2 million, up 4.2% year on year. This print fell short of analysts’ expectations by 0.6%. Overall, it was a softer quarter for the company with a significant miss of analysts’ EPS estimates and EBITDA guidance for next quarter missing analysts’ expectations.

The stock is down 39.1% since reporting and currently trades at $24.52.
Read our full report on Acadia Healthcare here, it’s free.
Best Q4: Universal Health Services (NYSE: UHS)
With a network spanning 39 states and three countries, Universal Health Services (NYSE: UHS) operates acute care hospitals and behavioral health facilities across the United States, United Kingdom, and Puerto Rico.
Universal Health Services reported revenues of $4.11 billion, up 11.1% year on year, outperforming analysts’ expectations by 2.6%. The business had a very strong quarter with an impressive beat of analysts’ full-year EPS guidance estimates.

Universal Health Services achieved the biggest analyst estimates beat, fastest revenue growth, and highest full-year guidance raise among its peers. The stock is down 1.8% since reporting. It currently trades at $176.
Is now the time to buy Universal Health Services? Access our full analysis of the earnings results here, it’s free.
Tenet Healthcare (NYSE: THC)
With a network spanning nine states and serving primarily urban and suburban communities, Tenet Healthcare (NYSE: THC) operates a nationwide network of hospitals, ambulatory surgery centers, and outpatient facilities providing acute care and specialty healthcare services.
Tenet Healthcare reported revenues of $5.07 billion, down 5.7% year on year, falling short of analysts’ expectations by 2%. It was a mixed quarter as it posted a solid beat of analysts’ full-year EPS guidance estimates but full-year revenue guidance missing analysts’ expectations.
Tenet Healthcare delivered the weakest performance against analyst estimates, slowest revenue growth, and weakest full-year guidance update in the group. As expected, the stock is down 12.1% since the results and currently trades at $122.
Read our full analysis of Tenet Healthcare’s results here.
HCA Healthcare (NYSE: HCA)
With roots dating back to 1968 and a network spanning 20 states, HCA Healthcare (NYSE: HCA) operates a network of 190 hospitals and 150+ outpatient facilities providing a full range of medical services across the US and England.
HCA Healthcare reported revenues of $18.29 billion, up 5.7% year on year. This result beat analysts’ expectations by 0.7%. More broadly, it was a mixed quarter as it also produced a narrow beat of analysts’ EPS estimates but same-store sales in line with analysts’ estimates.
The stock is up 2.1% since reporting and currently trades at $332.01.
Read our full, actionable report on HCA Healthcare here, it’s free.
Market Update
In response to the Fed’s rate hikes in 2022 and 2023, inflation has been gradually trending down from its post-pandemic peak, trending closer to the Fed’s 2% target. Despite higher borrowing costs, the economy has avoided flashing recessionary signals. This is the much-desired soft landing that many investors hoped for. The recent rate cuts (0.5% in September and 0.25% in November 2024) have bolstered the stock market, making 2024 a strong year for equities. Donald Trump’s presidential win in November sparked additional market gains, sending indices to record highs in the days following his victory. However, debates continue over possible tariffs and corporate tax adjustments, raising questions about economic stability in 2025.
Want to invest in winners with rock-solid fundamentals? Check out our 9 Best Market-Beating Stocks and add them to your watchlist. These companies are poised for growth regardless of the political or macroeconomic climate.
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