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Universal Health Services Inc.: Q3 FY2025 earnings call

What management said about Q3 FY2025, from the documents filed with the SEC on 28 October 2025: press release. Guidance figures: 4 raised, 1 lowered. The quarter’s numbers.

Key takeaways

  • Reported diluted EPS rose to $5.86: Net income attributable to UHS was $373.0 million, or $5.86 per diluted share, against $258.7 million, or $3.80, a year earlier. Net revenues rose 13.4% to $4.495 billion. Source
  • Adjusted EBITDA margin reached 14.9%: Adjusted EBITDA net of NCI was $670.6 million, 14.9% of net revenues, against $526.5 million and 13.3%. Reported EBITDA net of NCI was $684.2 million. Source
  • Medicaid reimbursement added $90 million: Third-quarter results included $90 million of pre-tax reimbursements, net of provider taxes, covering October 2024 through September 2025, from a newly approved Medicaid program. These were not in the 2025 operating forecast. Source
  • Net revenue forecast midpoint up 1.0%: The revised 2025 net revenue midpoint is 1.0% above the previous midpoint. The Adjusted EBITDA net of NCI midpoint is 3.9% above, and the Adjusted EPS-diluted midpoint is 6.4% above. Source
  • Acute care income from operations rose: Same-facility acute care income from operations was $338.3 million, 13.9% of net revenues, against $206.3 million and 9.6%. Operating expenses fell to 86.1% of revenue from 90.4%. Source
  • Operating cash flow fell $119 million: Nine-month operating cash flow was $1.290 billion, against $1.409 billion. A $257 million favorable change from net income and non-cash items partly offset the decline. Source
  • Third-quarter buybacks totaled $234.3 million: Third-quarter repurchases were 1.315 million shares of Class B Common Stock, at an average of about $178 per share. Source

“Based upon the operating trends and financial results experienced during the first nine months of 2025, as well as the recent approval of a new Medicaid supplemental payment program in Washington, D.C.”

Universal Health Services Inc., press release

Guidance

AreaPeriodFigureAgainst last quarter
Net revenues SourceFull year 2025$17.306 billion to $17.445 billionRaised from $17.096 billion to $17.312 billion
Adjusted EBITDA, net of NCI SourceFull year 2025$2.569 billion to $2.619 billionRaised from $2.458 billion to $2.543 billion
Adjusted EPS, diluted SourceFull year 2025$21.50 to $22.10 per shareRaised from $20.00 to $21.00 per share
Net income attributable to UHS SourceFull year 2025$1,382,259 thousand to $1,420,335 thousandRaised from $1,298,461 thousand to $1,363,549 thousand
Diluted share count SourceFull year 202564,282 thousand sharesLowered from 64,922 thousand shares

What changed from last quarter

  • Guidance raised: Full-year 2025 forecast ranges for net revenues, Adjusted EBITDA net of NCI and Adjusted EPS-diluted were raised from the ranges disclosed on July 28, 2025. Source
  • New: The Board raised the stock repurchase authorization by $1.5 billion. The current aggregate available authorization is $1.759 billion, against $492.9 million at June 30, 2025. Source
  • New: Outpatient behavioral facility counts changed under a new counting method. The reported outpatient count is 156, against 61 in the July release. Source

Results and growth drivers

  • Reported diluted EPS rose to $5.86: Net income attributable to UHS was $373.0 million, or $5.86 per diluted share, against $258.7 million, or $3.80, a year earlier. Net revenues rose 13.4% to $4.495 billion. Source
  • Adjusted EPS of $5.69 excludes two items: Adjusted net income was $362.3 million, or $5.69 per diluted share, against $252.5 million, or $3.71. The gap to reported EPS is an unrealized $0.16 equity securities gain and a $0.01 ASU 2016-09 tax benefit. Source
  • Nine-month revenue grew 9.9%: Nine-month net revenues were $12.879 billion. Reported diluted EPS was $16.07, against $11.88, and adjusted diluted EPS was $15.87, against $11.71. Source
  • Adjusted EBITDA margin reached 14.9%: Adjusted EBITDA net of NCI was $670.6 million, 14.9% of net revenues, against $526.5 million and 13.3%. Reported EBITDA net of NCI was $684.2 million. Source
  • Medicaid reimbursement added $90 million: Third-quarter results included $90 million of pre-tax reimbursements, net of provider taxes, covering October 2024 through September 2025, from a newly approved Medicaid program. These were not in the 2025 operating forecast. Source

Forecast revision for 2025

  • Net revenue forecast midpoint up 1.0%: The revised 2025 net revenue midpoint is 1.0% above the previous midpoint. The Adjusted EBITDA net of NCI midpoint is 3.9% above, and the Adjusted EPS-diluted midpoint is 6.4% above. Source
  • Adjusted EBITDA margin range 14.8% to 15.0%: The revised forecast shows an Adjusted EBITDA net of NCI margin of 14.8% at the low end of the range and 15.0% at the high end. Source
  • Forecast excludes hard-to-forecast items: Revised ranges exclude items management cannot forecast with sufficient accuracy, such as equity securities value changes, ASU 2016-09 effects, impairments, reserves for various matters, asset sale gains or losses, and repurchases that differ from assumptions. Source

“Our strategy includes building or acquiring high quality hospitals in rapidly growing markets, investing in the people and equipment needed to allow each facility to thrive, and becoming the leading healthcare provider in each community we serve.”

Universal Health Services Inc., press release

Segments and same-facility volumes

  • Acute care income from operations rose: Same-facility acute care income from operations was $338.3 million, 13.9% of net revenues, against $206.3 million and 9.6%. Operating expenses fell to 86.1% of revenue from 90.4%. Source
  • Nine-month behavioral admissions fell 0.2%: Same-facility behavioral adjusted admissions were down over nine months, while adjusted patient days rose 0.7% and revenue per adjusted patient day rose 7.2%. Source
  • Reported admissions rose in both segments: As reported for the quarter, acute admissions were 86,984 against 83,149, and behavioral admissions were 120,655 against 120,003. Patient days rose 2.7% at acute and 1.1% at behavioral facilities. Source
  • Behavioral income from operations rose to 19.3%: Same-facility behavioral income from operations was $350.0 million, 19.3% of net revenues, against $312.3 million and 18.8%. Source

Costs, margins and pricing

  • Revenue per adjusted admission rose 9.8%: Same-facility acute revenue per adjusted admission rose 9.8% and per adjusted patient day rose 11.5%. Behavioral revenue per adjusted admission rose 8.8% and per adjusted patient day rose 7.9%. Source
  • Consolidated salaries rose to $2.072 billion: Consolidated salaries, wages and benefits were $2.072 billion against $1.912 billion. Other operating expenses were $1.295 billion against $1.090 billion. Source
  • Acute supplies fell to 14.2% of revenue: Same-facility acute supplies expense was 14.2% of net revenues, against 15.4%. Salaries, wages and benefits were 38.6%, against 41.7%. Source
  • Behavioral salaries were 54.6% of revenue: Same-facility behavioral salaries, wages and benefits were 54.6% of net revenues, against 54.8%. Other operating expenses were 19.2%, against 19.1%. Source
  • Provider taxes offset in revenue and costs: Same-facility tables exclude provider tax assessments, which raise net revenues and other operating expenses by equal amounts and leave pre-tax income unchanged. Source

Cash flow, liquidity and debt

  • Operating cash flow fell $119 million: Nine-month operating cash flow was $1.290 billion, against $1.409 billion. A $257 million favorable change from net income and non-cash items partly offset the decline. Source
  • Self-insurance settlements cut operating cash: Payments made in settlement of self-insurance claims, net of commercial insurance reimbursements, were a $41 million unfavorable change within nine-month operating cash flow. Source
  • Revolver availability stood at $965 million: Available capacity under the revolving credit facility was $965 million at September 30, 2025, against $1.08 billion at June 30, 2025. Source
  • Debt to EBITDA ratio fell to 1.83: Debt was $4.691 billion, against $4.656 billion a year earlier. Debt to EBITDA net of NCI for the latest four quarters was 1.83, against 2.21. Source

Share repurchases and dividends

  • Third-quarter buybacks totaled $234.3 million: Third-quarter repurchases were 1.315 million shares of Class B Common Stock, at an average of about $178 per share. Source
  • Nine-month buybacks reached $565.8 million: Nine-month repurchases totaled 3.190 million shares, about $565.8 million, at an average of about $177 per share. Source
  • Cash flow showed repurchases and dividends: Repurchases of common shares were $615.9 million and dividends paid were $38.9 million in the nine months, against $420.6 million and $40.3 million a year earlier. Source

Footprint, employees and investment

  • 29 acute hospitals and 345 behavioral facilities: Hospitals owned and leased were 29 acute, against 27, and 345 behavioral, against 334, as reported for the quarter. Source
  • About 99,300 employees across the company: The company reports about 99,300 employees, the same figure given in the July release. Source
  • Third-quarter capital spending fell: Third-quarter capital expenditures were $228.9 million, against $247.9 million. Nine-month capital expenditures were $733.9 million, against $697.9 million. Source

Coming up, as management said on 28 October 2025

  • Washington, D.C. reimbursement cash expected in Q4: The $90 million net reimbursement recorded in the third quarter is expected to be received in cash during the fourth quarter of 2025. Source

Figures management reported

FigureReported
Same-facility acute care net revenues Source+12.8% (third quarter); +9.1% (nine months)
Same-facility behavioral health net revenues Source+9.3% (third quarter); +7.9% (nine months)
Acute adjusted admissions, same facility Source+2.0%
Acute adjusted patient days, same facility Source+0.4%
Behavioral adjusted admissions, same facility Source+0.5%
Behavioral adjusted patient days, same facility Source+1.3%

Risks management discussed

  • Operational: Reserves for self-insured professional and general liabilities were increased by a $35 million pre-tax charge on unfavorable claims trends, an item not in the 2025 operating forecast. Source
  • Financial: Accounts receivable were an unfavorable $306 million change within nine-month operating cash flow, and days sales outstanding rose to 55 from 52. Source

Earlier plans management reported on

  • Not stated: Management refers back to the July 28, 2025 disclosure for the treatment of items excluded from the 2025 operating results forecast. Source
  • Not stated: The revised forecast tables show the previously revised 2025 ranges disclosed on July 28, 2025 alongside the current ranges. 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.