greeksoup/ stock research

Universal Health Services Inc.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 26 February 2026: press release. Guidance figures: 11 new. The quarter’s numbers.

Key takeaways

  • Fourth-quarter net income rose: Fourth-quarter net income attributable to UHS was $445.9 million, or $7.06 per diluted share, against $332.4 million, or $4.96, a year earlier. Net revenues rose 9.1% to $4.486 billion, from $4.114 billion. Source
  • Generative AI stake gain in reported results: Reported results included an unrealized after-tax gain on a minority stake in a healthcare generative AI company, recorded in other (income) expense, net. Adjusted results exclude this gain. Source
  • Full-year net income and revenue: Full-year 2025 net income attributable to UHS was $1.489 billion, or $23.10 per diluted share, against $1.142 billion, or $16.82. Net revenues rose 9.7% to $17.365 billion. Source
  • Acute same-facility revenue up 8.5%: Same-facility acute care revenues rose 8.5% in 2025 and 6.9% in the fourth quarter. Adjusted admissions rose 1.6% for the year and were unchanged in the quarter; adjusted patient days rose 0.3% for the year and fell 0.7% in the quarter. Source
  • Acute pricing drove quarter growth: In the fourth quarter, same-facility acute revenue per adjusted admission rose 5.4% and per adjusted patient day rose 6.1%, while adjusted admissions were unchanged and adjusted patient days fell 0.7%. Source
  • Operating cash flow fell for 2025: Operating cash flow for 2025 was $1.864 billion, a $203 million decrease from 2024. Fourth-quarter operating cash flow was $574.7 million, against $658.4 million a year earlier. Source
  • Full-year buybacks reached $899 million: For 2025 the company repurchased 4.650 million shares for about $899.3 million, at an average of about $193 per share. 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

Guidance

AreaPeriodFigureAgainst last quarter
Net revenues SourceYear ending December 31, 2026$18.417 billion to $18.789 billionNew
Adjusted EBITDA net of NCI SourceYear ending December 31, 2026$2.641 billion to $2.789 billionNew
EPS-diluted SourceYear ending December 31, 2026$22.64 to $24.52 per shareNew
Capital expenditures SourceYear ending December 31, 2026$950 million to $1.1 billionNew
Net revenues growth (midpoint) SourceYear ending December 31, 2026 versus 20257.1% increase at midpointNew
Adjusted EBITDA net of NCI growth (midpoint) SourceYear ending December 31, 2026 versus 20254.8% increase at midpointNew
Adjusted EPS-diluted growth (midpoint) SourceYear ending December 31, 2026 versus 20258.5% increase at midpointNew
Net income attributable to UHS SourceYear ending December 31, 2026$1,366,561 thousand to $1,479,817 thousandNew
Depreciation and amortization and interest expense SourceYear ending December 31, 2026Depreciation and amortization 671,628 thousand; interest expense 181,140 thousandNew
Other (income) expense, net and income tax provision SourceYear ending December 31, 2026Other (income) expense, net (7,960) thousand; provision for income taxes 429,183 thousand to 464,751 thousandNew
Diluted share count SourceYear ending December 31, 202660,349 thousand sharesNew

What changed from last quarter

  • New guidance: The company issued its first 2026 operating forecast, covering net revenues, Adjusted EBITDA net of NCI, EPS-diluted and capital expenditures. Source
  • New: The 2026 forecast excludes changes in value of certain non-marketable securities tied to the minority stake in a generative AI company. The October 2025 forecast referred instead to equity securities. Source

Fourth-quarter and full-year results

  • Fourth-quarter net income rose: Fourth-quarter net income attributable to UHS was $445.9 million, or $7.06 per diluted share, against $332.4 million, or $4.96, a year earlier. Net revenues rose 9.1% to $4.486 billion, from $4.114 billion. Source
  • Adjusted fourth-quarter earnings per share: Adjusted net income was $371.4 million, or $5.88 per diluted share, against $329.9 million, or $4.92, a year earlier. Source
  • Generative AI stake gain in reported results: Reported results included an unrealized after-tax gain on a minority stake in a healthcare generative AI company, recorded in other (income) expense, net. Adjusted results exclude this gain. Source
  • Full-year net income and revenue: Full-year 2025 net income attributable to UHS was $1.489 billion, or $23.10 per diluted share, against $1.142 billion, or $16.82. Net revenues rose 9.7% to $17.365 billion. Source
  • Full-year adjusted EBITDA rose: Adjusted EBITDA net of NCI was $2.590 billion for 2025, against $2.246 billion. Reported EBITDA net of NCI was $2.725 billion, against $2.248 billion. Source

Acute and behavioral segments

  • Acute same-facility revenue up 8.5%: Same-facility acute care revenues rose 8.5% in 2025 and 6.9% in the fourth quarter. Adjusted admissions rose 1.6% for the year and were unchanged in the quarter; adjusted patient days rose 0.3% for the year and fell 0.7% in the quarter. Source
  • Behavioral same-facility revenue up 7.7%: Same-facility behavioral health revenues rose 7.7% in 2025 and 7.2% in the fourth quarter. Adjusted admissions rose 0.2% for the year and 1.8% in the quarter; adjusted patient days rose 0.9% and 1.5%. Source
  • All-facility revenue grew in both segments: Fourth-quarter net revenues for all acute care operations were $2.546 billion, up 9.4%. For all behavioral health operations they were $1.938 billion, up 8.6%. These totals include provider tax assessments and newer facilities. Source
  • Footprint changed on counting method: Year-end footprint: 29 acute hospitals, 346 behavioral health facilities and 168 outpatient facilities, against 345 behavioral and 156 outpatient in the October release. The company changed its outpatient behavioral counting method in Q3 2025, and most of the increase relates to that change. Source

“Our operating philosophy is as effective today as it was upon the Company's founding in 1979, enabling us to provide compassionate care to our patients and their loved ones.”

Universal Health Services Inc., press release

Patient volumes and pricing

  • Acute pricing drove quarter growth: In the fourth quarter, same-facility acute revenue per adjusted admission rose 5.4% and per adjusted patient day rose 6.1%, while adjusted admissions were unchanged and adjusted patient days fell 0.7%. Source
  • Full-year per-day acute pricing rose faster: For 2025, same-facility acute revenue per adjusted patient day rose 6.8%, faster than the 5.4% rise per adjusted admission. Source
  • Behavioral pricing rose in both periods: Fourth-quarter same-facility behavioral revenue per adjusted admission rose 5.3% and per adjusted patient day rose 5.6%. For 2025 the per-admission rate rose 7.5% and the per-day rate 6.8%. Source
  • Reported admissions and patient days rose: Reported fourth-quarter acute admissions were 87,277, up 2.1%, and behavioral admissions were 115,654, up 1.2%. Acute patient days were 414,230, up 1.2%, and behavioral patient days were 1,616,026, up 2.2%. Source

Costs, margins and provider taxes

  • Acute labor cost ratio fell: Same-facility acute salaries, wages and benefits were 39.9% of net revenues in the fourth quarter, against 40.6%, and 39.5% for 2025, against 41.0%. Source
  • Other operating costs rose as share: Same-facility acute other operating expenses were 29.2% of net revenues in the fourth quarter, up from 28.2%, and 28.6% for 2025, up from 27.8%. Source
  • Acute supply cost ratio eased: Same-facility acute supplies expense was 15.0% of net revenues in the fourth quarter, down from 15.7%, and 15.0% for 2025, down from 15.8%. Source
  • Behavioral labor cost ratio rose: Same-facility behavioral salaries, wages and benefits were 53.6% of net revenues in the fourth quarter, up from 52.8%, and 54.0% for 2025, up from 53.6%. Source
  • Adjusted EBITDA margin rose: Adjusted EBITDA net of NCI margin was 15.1% in the fourth quarter, against 14.9%, and 14.9% for 2025, against 14.2%. Source
  • Provider taxes raise revenue and costs: All-facility tables include provider tax assessments, which raise both net revenues and other operating expenses. Same-facility tables exclude them. Pre-tax income is not affected either way. Source

Cash flow and liquidity

  • Operating cash flow fell for 2025: Operating cash flow for 2025 was $1.864 billion, a $203 million decrease from 2024. Fourth-quarter operating cash flow was $574.7 million, against $658.4 million a year earlier. Source
  • Days sales outstanding rose to 55: Days sales outstanding were 55 at year end, against 50 a year earlier. Total debt was $4.753 billion, against $4.505 billion. Source
  • Revolver availability and leverage: $889 million was available under the $1.3 billion revolver at year end. Debt to EBITDA net of NCI was 1.74 times, against 2.00, on the latest four quarters. Source

Capital spending and investments

  • Capital spending rose in 2025: Capital expenditures were $1.015 billion for 2025, against $943.8 million. Fourth-quarter capital expenditures were $281.2 million, against $245.9 million. Source
  • Other investing items in 2025: 2025 investing items included $63.1 million from sales of marketable equity securities, $9.8 million invested in non-marketable securities, and $24.7 million of ERP application costs. Source
  • Acquisitions and asset sale proceeds: Acquisitions of businesses and property totaled $47.8 million in 2025, against $19.0 million. Proceeds from sales of assets and businesses were $15.9 million. Source

Share repurchases and dividends

  • Fourth-quarter buybacks of $333.5 million: In the fourth quarter the company repurchased 1.461 million shares for about $333.5 million, at an average of about $228 per share. Source
  • Full-year buybacks reached $899 million: For 2025 the company repurchased 4.650 million shares for about $899.3 million, at an average of about $193 per share. Source
  • Repurchase authorization remaining at year end: About $1.425 billion of repurchase authorization remained at December 31, 2025. Source
  • Cash returned through buybacks and dividends: The cash flow statement shows $967.951 million of common share repurchases and $51.267 million of dividends paid in 2025, against $670.754 million and $53.346 million in 2024. Source

Rankings, footprint and leadership

  • Fortune and Forbes rankings cited: The release cites a #271 rank on the Fortune 500 and a #355 rank among American companies on the Forbes Global 2000. Source
  • Workforce and footprint grew: Employee count is about 101,500, against about 99,300 in the October 2025 release. Operations span 40 states, against 39 previously, plus Washington, D.C., the United Kingdom and Puerto Rico. Source
  • No leadership change named: The documents name no change in executive leadership. The only person named is the investor relations contact. Source

Figures management reported

FigureReported
Same-facility revenue and volumes, acute care SourceRevenue +6.9% in Q4 and +8.5% for 2025; adjusted admissions 0.0% and 1.6%; adjusted patient days -0.7% and 0.3%
Same-facility revenue and volumes, behavioral health SourceRevenue +7.2% in Q4 and +7.7% for 2025; adjusted admissions 1.8% and 0.2%; adjusted patient days 1.5% and 0.9%
Occupancy-licensed beds, same facility, Q4 SourceAcute 63.5% (65.0% in Q4 2024); behavioral 72.0% (71.3% in Q4 2024)

Risks management discussed

  • Financial: Accounts receivable absorbed $385 million of cash in 2025, including a $145 million increase tied to Medicaid supplemental payment programs and a $50 million increase tied to two newer hospitals. Source
  • Financial: Self-insurance claim payments, net of commercial reimbursements, were $259.5 million in 2025, against $192.2 million in 2024, a $67 million larger cash outflow. Source

Earlier plans management reported on

  • Not stated: Management refers to the October 2025 authorization as previously announced. The documents give no status for it. 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.