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Tenet Healthcare Corp.: Q2 FY2026 earnings call

What management said about Q2 FY2026, from the documents filed with the SEC on 23 July 2026: press release. Guidance figures: 15 raised, 1 lowered, 7 kept. The quarter’s numbers.

Key takeaways

  • Net income and diluted EPS rose: Second quarter net income available to common shareholders was $826 million, or $9.84 per diluted share, against $288 million, or $3.14, a year earlier. Source
  • Adjusted EBITDA rose 16.3%: Consolidated Adjusted EBITDA was $1.304 billion, up 16.3%, attributed to same facility revenue growth and disciplined expense management. Source
  • Hospital margin rose to 18.0%: Hospital Adjusted EBITDA was $762 million, up 22.3%, with margin of 18.0% against 15.6% a year earlier. Source
  • Six-month operating cash flow rose: Operating cash flow for the six months reached $2.226 billion, up from $1.751 billion in the prior-year period. Source
  • Quarter buybacks of $1.042 billion: The company repurchased 5.68 million shares for $1.042 billion in the second quarter. Source

“Strong same-store revenue growth and effective expense management drove our fundamental outperformance in the second quarter of 2026 compared to our original assumptions,”

Saum Sutaria, M.D., Chairman and Chief Executive Officer of Tenet

Guidance

AreaPeriodFigureAgainst last quarter
Net operating revenues SourceFY 2026$21,900 to $22,500 millionRaised from $21,500 to $22,300 million
Net income available to common shareholders SourceFY 2026$2,869 to $3,024 millionRaised from $2,605 to $2,840 million
Adjusted EBITDA SourceFY 2026$4,830 to $5,030 millionRaised from $4,485 to $4,785 million
Adjusted EBITDA margin SourceFY 202622.1% to 22.4%Raised from 20.9% to 21.5%
Diluted EPS SourceFY 2026$34.57 to $36.43Raised from $29.94 to $32.64
Adjusted net income SourceFY 2026$1,685 to $1,800 millionRaised from $1,425 to $1,625 million
Adjusted diluted EPS SourceFY 2026$20.30 to $21.69Raised from $16.38 to $18.68
Income tax expense SourceFY 2026$1,075 to $1,130 millionRaised from $985 to $1,060 million
Weighted average diluted common shares SourceFY 2026~83 millionLowered from ~87 million
Net cash provided by operating activities SourceFY 2026$3,840 to $4,290 millionRaised from $3,640 to $4,090 million
Adjusted net cash provided by operating activities SourceFY 2026$3,425 to $3,825 millionRaised from $3,200 to $3,600 million
Capital expenditures SourceFY 2026$700 to $800 millionKept
Free cash flow SourceFY 2026$3,140 to $3,490 millionRaised from $2,940 to $3,290 million
Adjusted free cash flow SourceFY 2026$2,725 to $3,025 millionRaised from $2,500 to $2,800 million
NCI cash distributions SourceFY 2026$900 to $970 millionKept
Ambulatory net operating revenues SourceFY 2026$5,500 to $5,700 millionKept
Ambulatory Adjusted EBITDA SourceFY 2026$2,160 to $2,220 million
Ambulatory same-facility system-wide revenues SourceFY 2026Up 3.0% to 6.0%Kept
Hospital net operating revenues SourceFY 2026$16,400 to $16,800 millionRaised from $16,000 to $16,600 million
Hospital Adjusted EBITDA SourceFY 2026$2,670 to $2,810 millionRaised from $2,355 to $2,555 million
Hospital inpatient and adjusted admissions SourceFY 2026Up 1.0% to 2.0%Kept
Impairment, restructuring, acquisition and litigation costs SourceFY 2026$(125) to $(75) millionRaised from $(100) to $(50) million
Revenue from contract termination SourceFY 2026$1,650 millionKept
Interest expense SourceFY 2026$800 to $810 millionKept

What changed from last quarter

  • Guidance raised: Full-year Adjusted EBITDA range raised at the midpoint. Source
  • Guidance raised: Full-year adjusted free cash flow range raised at the midpoint. Source
  • Guidance lowered: Full-year weighted average diluted share count assumption is lower than the prior assumption. Source
  • New: Board increased the share repurchase program authorization by $2.0 billion. Source

Results and growth drivers

  • Net income and diluted EPS rose: Second quarter net income available to common shareholders was $826 million, or $9.84 per diluted share, against $288 million, or $3.14, a year earlier. Source
  • Adjusted EBITDA rose 16.3%: Consolidated Adjusted EBITDA was $1.304 billion, up 16.3%, attributed to same facility revenue growth and disciplined expense management. Source
  • Adjusted diluted EPS up 52.2%: Adjusted diluted earnings per share was $6.12 against $4.02 a year earlier. The release reconciles it to GAAP net income in Table 1. Source

Segments and regions

  • Ambulatory revenue rose 9.3%: Ambulatory net operating revenues were $1,388 million, up 9.3%, driven by same-facility net patient revenue growth, facility acquisitions and added service lines. Source
  • USPI footprint at quarter end: USPI held interests in 538 ambulatory surgery centers (405 consolidated) and 26 surgical hospitals (eight consolidated) across 37 states. Source
  • Hospital margin rose to 18.0%: Hospital Adjusted EBITDA was $762 million, up 22.3%, with margin of 18.0% against 15.6% a year earlier. Source
  • Hospital revenue rose 6.0%: Hospital net operating revenues were $4,240 million, up 6.0%, from higher adjusted admissions and higher acuity. Source

“We are actively navigating current industry dynamics through excellent operational execution, investments in innovation, and a continued focus on higher acuity services to sustain growth, margins and significant free cash flow.”

Saum Sutaria, M.D., Chairman and Chief Executive Officer of Tenet

Products, customers and service mix

  • Revenue per surgical case rose: Ambulatory net patient revenue per surgical case rose in the quarter, which management attributed to higher acuity and favorable service mix. Source
  • Medicaid supplemental revenue added: The Hospital segment recognized a $92 million favorable pre-tax impact from additional Medicaid supplemental revenues tied to prior years, against $70 million a year earlier. Source
  • Commercial employer revenue lifted rate: Net patient service revenue per adjusted admission rose 3.3%, mainly from commercial employer net patient revenues, with Medicaid supplemental revenues also increasing. Source

Costs and expense control

  • Salaries share of revenue fell: Salaries, wages and benefits were $2,231 million, or 39.6% of net operating revenues, against 41.0% a year earlier. Source
  • Supplies costs rose in dollars: Supplies expense was $984 million, or 17.5% of revenues, against 17.7% a year earlier, and was up 5.6% in dollars. Source
  • Other operating expenses share fell: Other operating expenses, net were $1,174 million, or 20.9% of net operating revenues, against 21.3% a year earlier. Source

Cash flow and balance sheet

  • Six-month operating cash flow rose: Operating cash flow for the six months reached $2.226 billion, up from $1.751 billion in the prior-year period. Source
  • Six-month adjusted free cash flow: Adjusted free cash flow was $1.422 billion for the six months, against $1.466 billion in the prior-year period, as the company defines the measure. Source
  • Net debt ratio rose to 2.33x: Net debt to Adjusted EBITDA was 2.33x at June 30, against 2.24x at March 31 and 2.25x at December 31, 2025. Source
  • Quarter free cash flow reported: Second quarter free cash flow was $417 million and adjusted free cash flow was $444 million, per the reconciliation table. Source

Share repurchases and capital returns

  • Quarter buybacks of $1.042 billion: The company repurchased 5.68 million shares for $1.042 billion in the second quarter. Source
  • Authorization remaining at July 23: After the increase, the company reported $2.13 billion remaining under its repurchase authorizations as of July 23, 2026. Source
  • Six-month repurchases of $1.36 billion: Six-month repurchases were 7.02 million shares for $1.360 billion, against $1.095 billion of repurchases in the prior-year six months. Source

Strategy and investment

  • Quarter capital spending lower: Capital expenditures were $168 million in the quarter, against $193 million, with Hospital spending at $130 million against $166 million. Source
  • Acquisition spending in six months: Purchases of businesses or joint venture interests were $130 million for the six months, against $147 million a year earlier. Source

Conifer and CommonSpirit contract

  • Contract termination revenue of $413M: Revenue from the early CommonSpirit contract conclusion was $413 million in the quarter and sits outside net operating revenues. Source
  • Six-month termination revenue of $826M: Six-month revenue from contract termination was $826 million, shown as a separate line in the consolidated statement of operations. Source
  • Cash received for contract termination: Cash received for the contract termination was $540 million in the six months, and the adjusted cash flow measures exclude it. Source
  • Consideration basis of termination revenue: Termination revenue represents the present value of $1.9 billion of consideration for early termination of the Conifer agreement, net of amortization of a contract asset. Source

Coming up, as management said on 23 July 2026

  • Supplemental materials available July 23: The slide presentation, the earnings release and a supplemental financial disclosures document are to be available on the investor relations website on July 23, 2026. Source
  • Buybacks at management's discretion: Repurchases will be made from time to time in the open market or in privately negotiated transactions, subject to market conditions. Source

Figures management reported

FigureReported
Same-facility system-wide net patient service revenues, Ambulatory (Q2 2026 vs Q2 2025) Source5.0%
Same-facility system-wide surgical cases, Ambulatory Source(1.2)%
Same-hospital admissions, Hospital Source2.3%
Same-hospital adjusted admissions, Hospital Source2.6%
Same-hospital outpatient visits, including outpatient ER, Hospital Source0.1%
Same-hospital emergency room visits, Hospital Source2.0%
Same-hospital surgeries, Hospital Source(0.7)%
Same-hospital net patient service revenues, Hospital Source$3,648 million

Risks management discussed

  • Demand: Management cites unfavorable payer mix from lower exchange admissions as a headwind that partly offsets revenue and Adjusted EBITDA growth. Source

Earlier plans management reported on

  • Ahead: The release says Adjusted EBITDA well exceeded the high end of the earlier second-quarter range of 24-25%, while also reporting a 23.2% Adjusted EBITDA margin. Source

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.