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Universal Health Services Inc.: Q2 FY2026 earnings call

What management said about Q2 FY2026, from the documents filed with the SEC on 28 July 2026: press release. Guidance figures: 1 raised, 2 lowered, 1 kept. The quarter’s numbers.

Key takeaways

  • Revenue rose 8.3% in the quarter: Six-month net revenues were $9.133 billion, up 8.9% from $8.384 billion in the first half of 2025. Source
  • Adjusted EBITDA rose; margin fell: Adjusted EBITDA net of NCI was $677.9 million, or 14.6% of revenue, against $642.9 million, or 15.0%. EBITDA net of NCI was $680.2 million. Source
  • Florida Medicaid item added $100 million: The quarter included a $100 million net pre-tax benefit for the Florida program covering October 2024 through September 2025. Source
  • Liability reserve reduced results $28 million: The company increased its reserve for self-insured professional and general liability claims. The increase was a $28 million pre-tax charge, netting against the Florida benefit to about $72 million. Source
  • Acute admissions and days grew: Same-facility acute adjusted admissions rose 2.9% and adjusted patient days rose 3.1% in the quarter. First-half increases were 1.4% and 1.9%. Source
  • Second-quarter buybacks of $320 million: The company repurchased 1.890 million shares in the quarter at about $169 per share. First-half repurchases totaled 2.565 million shares for $447.5 million. Source

“Based upon the operating trends, changes in reimbursements related to certain Medicaid supplemental payment programs and financial results experienced during the first six months of 2026”

Universal Health Services Inc., press release

Guidance

AreaPeriodFigureAgainst last quarter
Net revenues Sourcefull year 2026$18.501 billion to $18.762 billionRaised from $18.417 billion to $18.789 billion (original forecast, February 25, 2026)
Adjusted EBITDA net of NCI Sourcefull year 2026$2.610 billion to $2.717 billionLowered from $2.641 billion to $2.789 billion (original forecast, February 25, 2026)
Adjusted EPS, diluted Sourcefull year 2026$22.28 to $23.65 per shareLowered from $22.64 to $24.52 per share (original forecast, February 25, 2026)
Capital expenditures Sourcefull year 2026approximately $950 million to $1.1 billionKept

What changed from last quarter

  • Guidance raised: Full-year net revenue forecast midpoint raised 0.2% relative to the original forecast. Source
  • Guidance lowered: Full-year Adjusted EBITDA net of NCI forecast midpoint lowered 1.9% relative to the original forecast. Source
  • Guidance lowered: Full-year Adjusted EPS-diluted forecast midpoint lowered 2.6% relative to the original forecast. Source
  • Guidance kept: Capital expenditure range of $950 million to $1.1 billion is described as previously disclosed, with no revision stated. Source
  • New: A CMS preprint approval in April 2026 increased the size of the Florida Medicaid managed care directed payment program and changed its provider tax structure. Source
  • New: In July 2026 the company amended its credit agreement to add a $700 million delayed draw term loan A. Source

Second-quarter results and drivers

  • Revenue rose 8.3% in the quarter: Six-month net revenues were $9.133 billion, up 8.9% from $8.384 billion in the first half of 2025. Source
  • Reported diluted EPS was $5.98: Net income attributable to UHS was $358.4 million, against $353.2 million a year earlier. Year-earlier Adjusted EPS-diluted was $5.35; the current quarter had no adjustments. Source
  • Adjusted EBITDA rose; margin fell: Adjusted EBITDA net of NCI was $677.9 million, or 14.6% of revenue, against $642.9 million, or 15.0%. EBITDA net of NCI was $680.2 million. Source
  • Florida Medicaid item added $100 million: The quarter included a $100 million net pre-tax benefit for the Florida program covering October 2024 through September 2025. Source
  • Liability reserve reduced results $28 million: The company increased its reserve for self-insured professional and general liability claims. The increase was a $28 million pre-tax charge, netting against the Florida benefit to about $72 million. Source
  • Prior-year quarter had its own items: The second quarter of 2025 included about $101 million of net reimbursements and a $25 million pre-tax loss at a newly opened 142-bed Washington, D.C. hospital. Source

Acute and behavioral segment results

  • Same-facility acute revenue up 8.2%: Same-facility acute care net revenue was $2.508 billion in the quarter, against $2.319 billion a year earlier. The first-half increase was also 8.2%. Source
  • Same-facility behavioral revenue up 7.4%: Same-facility behavioral health net revenue was $1.929 billion, against $1.796 billion. The first-half increase was also 7.4%. Source
  • All-acute operating margin declined: Across all acute hospitals, income from operations was 8.7% of revenue against 9.4%. Same-facility acute income from operations stayed at 9.8%. Source
  • Behavioral same-facility margin rose: Same-facility behavioral income from operations was 22.2% of revenue against 21.8%. All-behavioral income from operations was 20.3% against 21.1%. Source

“The impact of these items was not included in our original 2026 operating results forecast, as previously disclosed on February 25, 2026.”

Universal Health Services Inc., press release

Patient volumes and pricing

  • Acute admissions and days grew: Same-facility acute adjusted admissions rose 2.9% and adjusted patient days rose 3.1% in the quarter. First-half increases were 1.4% and 1.9%. Source
  • Acute revenue per unit rose: Net revenue per adjusted admission rose 3.0% and per adjusted patient day rose 2.8% at same-facility acute hospitals. First-half rates were 4.6% and 4.2%. Source
  • Behavioral admissions flat, days up: Same-facility behavioral adjusted admissions rose 0.5% and adjusted patient days rose 1.4%. First-half increases were 0.9% and 1.5%. Source
  • Behavioral revenue per unit up: Net revenue per adjusted admission rose 7.1% and per adjusted patient day rose 6.1% at same-facility behavioral facilities in the quarter. Source

Costs and operating ratios

  • Acute salaries ratio improved: Same-facility acute salaries, wages and benefits were 39.5% of revenue, against 40.5%. Supplies expense fell to 14.4% of revenue from 15.6%. Source
  • Acute other operating expenses rose: Same-facility acute other operating expenses were 31.1% of revenue against 29.0%. Across all acute hospitals the ratio was 33.9% against 31.5%. Source
  • Behavioral salaries ratio improved: Same-facility behavioral salaries, wages and benefits were 52.8% of revenue against 53.4%. Other operating expenses rose to 18.4% from 18.1%. Source
  • Adjusted EBITDA margin declined: Adjusted EBITDA margin net of NCI was 14.6% for the quarter against 15.0%, and 14.5% for the first half against 14.8%. Source

Forecast revision and exclusions

  • Ranges revised on first-half trends: Management revised the full-year ranges for net revenues, Adjusted EBITDA net of NCI and Adjusted EPS-diluted, citing first-half operating trends and Medicaid supplemental reimbursement changes. Source
  • Certain items excluded from forecast: Forecast ranges exclude items management cannot forecast with sufficient accuracy, including changes in value of a minority stake in a healthcare generative AI company. Source
  • No further Florida benefit forecast: The forecast includes no incremental Florida benefit beyond second-quarter amounts, because CMS has not approved the larger program for periods after September 30, 2025. Source

Cash flow and borrowing

  • First-half operating cash fell: Net cash from operations was $845 million in the first half against $909 million. Payables timing was a $207 million reduction, partly offset by a $86 million tax-related change. Source
  • Quarterly operating cash lower: Cash from operations was $443.3 million in the quarter, against $549.0 million. Days sales outstanding rose to 56 from 50. Source
  • Debt rose; leverage ratio lower: Total debt was $4.85 billion, up from $4.58 billion. Debt to Adjusted EBITDA net of NCI was 1.81 times against 1.92; debt to total capitalization was 39.2%. Source
  • Revolver had $1.27 billion available: $1.272 billion remained available under the $1.5 billion revolver after $225 million of borrowings and letters of credit. A $400 million delayed draw loan is reserved for Talkspace. Source

Share repurchases and capital spending

  • Second-quarter buybacks of $320 million: The company repurchased 1.890 million shares in the quarter at about $169 per share. First-half repurchases totaled 2.565 million shares for $447.5 million. Source
  • Repurchase authorization reduced: About $977.6 million remained under the repurchase authorization at June 30, down from about $1.298 billion at March 31. Source
  • Capital spending lower year on year: Property and equipment additions were $227.6 million in the quarter against $266.0 million, and $444.8 million for the first half against $505.0 million. Source
  • Full-year capital plan retained: Planned 2026 capital spending of about $950 million to $1.1 billion covers capital equipment, new facility construction, and renovations and expansions. Source

Workforce and footprint

  • Workforce exceeds 102,000: The company reported more than 102,000 employees, up from about 101,500 in the first-quarter release. Source
  • Outpatient count about 170: Outpatient and other facilities number about 170, against 168 in the first-quarter release. Behavioral facilities number 346. Source
  • Owned acute hospitals rose to 30: Acute hospitals owned and leased rose to 30 from 28 a year earlier, and behavioral facilities rose to 346 from 338. Source

Coming up, as management said on 28 July 2026

  • Talkspace acquisition expected to close: The Talkspace acquisition is expected to be finalized in the third quarter of 2026, with the $400 million delayed draw term loan drawn at closing. Source
  • Possible $700 million term loan draw: If elected, the new $700 million term loan would be funded by September 30, 2026, and could repay the $700 million notes due September 1, 2026. Source

Figures management reported

FigureReported
Same-facility acute care net revenues Source+8.2% (Q2 2026)
Same-facility behavioral health net revenues Source+7.4% (Q2 2026)
Same-facility acute adjusted admissions Source+2.9% (Q2 2026)
Same-facility acute adjusted patient days Source+3.1% (Q2 2026)
Same-facility behavioral adjusted admissions Source+0.5% (Q2 2026)
Same-facility behavioral adjusted patient days Source+1.4% (Q2 2026)

Risks management discussed

  • Financial: A higher reserve for self-insured professional and general liability claims added a $28 million pre-tax charge in the second quarter. Source
  • Regulatory: The larger Florida Medicaid program has not been approved by CMS for periods after September 30, 2025, so no further benefit is in the forecast. Source

Earlier plans management reported on

  • Not stated: Management refers to the capital spending range as previously disclosed, without stating progress against it. Source
  • Not stated: Management says the credit agreement amendment was previously disclosed on Form 8-K, and does not state progress on drawing the facility. 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.