Shares of Tenet Healthcare outpaced hospital operator peer HCA Healthcare as the companies presented two very different pictures to Wall Street on Friday, sending Tenet stock sharply higher while HCA posted a more modest gain.

Tenet spiked 23% after the company hiked its full-year earnings outlook. The company now expects adjusted earnings of $20.30 to $21.69 a share on net operating revenue of $21.9 billion to $22.5 billion. Tenet had previously guided for per-share earnings of $16.38 to $18.68 and revenue in the range of $21.5 billion to $22.3 billion.

At the midpoint of each new range, the figures are sharply ahead of analysts' calls for $17.94 a share and $21.97 billion, respectively.

Tenet's second-quarter numbers also blew past expectations. The company posted adjusted earnings of $6.12 a share, handily beating analysts' calls for $4.26. Operating revenue rose 6.8% to $5.63 billion, ahead of the $5.43 billion Wall Street had forecast.

While Tenet shares jumped by double digits -- pacing toward their biggest single-day gain since February -- HCA's response was muted by comparison. That's largely because HCA pre-announced its results last week, leaving investors with few surprises.

On July 14, HCA posted better-than-expected numbers for the second quarter while cautioning that a rise in uninsured patients and a decline in surgical volumes had dented income.

The company reiterated those results on Friday, posting adjusted earnings of $7.59 a share, ahead of the $7.56 analysts had expected. Revenue rose 9% to $20.23 billion, beating out calls for $19.76 billion.

HCA shares rose 3.7% on Friday. The benchmark S&P 500 index declined slightly.

Although the numbers cleared forecasts, a $400 million net benefit from Medicaid supplemental payments did much of the heavy lifting. Strip that away, and the financial picture becomes more complicated: More patients lost exchange-based coverage in the quarter, adding to HCA's uninsured population. The company estimates this change cost it roughly $400 million in pre-tax income.

HCA is now targeting full-year earnings between $28.70 to $30.50 a share, down from a prior range of $29.10 to $31.50. Management also tightened its revenue outlook to a range of $77 billion to $79.5 billion, compared with $76.5 billion to $80 billion previously.

Both HCA Healthcare and Tenet Healthcare oversee networks of hospitals, outpatient surgery centers, and specialized clinics across the U.S. While they function as market peers, HCA generates the bulk of its revenue through large-scale regional hospital networks, while Tenet focuses more heavily on its network of ambulatory surgery centers.

Write to Mackenzie Tatananni at mackenzie.tatananni@barrons.com

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July 24, 2026 09:59 ET (13:59 GMT)

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