Becker’s Hospital Review
HCA Healthcare recorded the highest net income, while Tenet Healthcare posted the highest operating margin among the nation’s four largest publicly traded for-profit health systems in the first quarter of 2026.
HCA, Tenet, Community Health Systems and Universal Health Services each reported operating margins of 9.5% or higher in the three months ended March 31. All but CHS reported positive net income in the quarter.
Here’s how their first-quarter financial and operational metrics compare:
HCA Healthcare (Nashville, Tenn.)
Operating income: $2.29 billion (12% operating margin), down from $2.33 billion (12.7% margin) in the first quarter of 2025.
Operating revenue: $19.1 billion, up from $18.3 billion
Operating expenses: $16.8 billion, up from $16 billion
Net income: $1.62 billion, up from $1.61 billion
“The start of the year presented a dynamic environment for HCA Healthcare,” CEO Sam Hazen said. “I want to recognize our colleagues for continuing to demonstrate a remarkable ability to adapt to changing conditions and deliver for our patients, communities and stakeholders.”
Tenet Healthcare (Dallas)
Operating income: $1.3 billion (24.1% margin), up from $943 million (18.1% margin)
Operating revenue: $5.4 billion, up from $5.2 billion
Operating expenses: $4.1 billion, down from $4.3 billion
Net income: $702 million, up from $406 million
“We delivered strong results in both the ambulatory and hospital segments in the first quarter of 2026, characterized by disciplined operations and strong free cash flow,” Saum Sutaria, MD, chairman and CEO of Tenet, said. “We continue to support our physician partners to drive innovation in patient care as we execute on our high-acuity strategy and grow our businesses both organically and inorganically.”
Universal Health Services (King of Prussia, Pa.)
Operating income: $502.9 million (11.2% margin), up from $454.8 million (11.1% margin)
Operating revenue: $4.5 billion, up from $4.1 billion
Operating expenses: $4 billion, up from $3.6 billion
Net income: $348.7 million, up from $316.7 million
“These results highlight the adaptability and financial discipline of our leadership teams and the benefits of our efficiency initiatives, which are driven by technology adoption and operational excellence,” UHS President and CEO Marc Miller said.
Community Health Systems (Franklin, Tenn.)
Operating income: $281 million (9.5% margin), down from $284 million (9% margin)
Operating revenue: $3 billion, down from $3.2 billion
Operating expenses: $2.7 billion, down from $2.9 billion
Net loss: $58 million, compared to a $13 million net loss in Q1 2025
“We are pleased with the continued, tangible progress on our key priorities, demonstrated by improvements in quality scores, patient experience and physician satisfaction measures, and investments in growth opportunities,” CEO Kevin Hammons said. “In the face of a dynamic macroeconomic environment, we remain focused on the variables within our control and believe we are positioning the company for long-term success and value creation.”