HCA Healthcare (HCA) Cash Flow: Operating & Free Cash Flow

HCA Healthcare (HCA) Cash Flow Statement

In fiscal 2025 (fiscal year ended Dec 31, 2025), HCA Healthcare generated $12.64B of operating cash flow and spent $4.94B on capital expenditures. That left free cash flow of $7.69B, up 36.4% from $5.64B a year earlier, or 10.2% of revenue. It returned $10.75B to shareholders through $679.00M in dividends and $10.07B in share buybacks.

HCA Healthcare Cash Flow Statement Analysis

Values in billions USD

Income Statement Balance Sheet Cash Flow Ratios

Scale:

Scroll to see more

Cash flow statement showing operating, investing, and financing activities for HCA Healthcare, Inc. (HCA) - Annual data in billions USD
Breakdown	FY 2025	FY 2024	FY 2023	FY 2022	FY 2021	FY 2020	FY 2019	FY 2018	FY 2017
Period ending	Dec 2025	Dec 2024	Dec 2023	Dec 2022	Dec 2021	Dec 2020	Dec 2019	Dec 2018	Dec 2017
Operating Activities
Net Income	6.78	6.66	6.09	6.83	7.72	4.39	4.15	4.39	2.74
Depreciation & Amortization	3.52	3.31	3.08	2.97	2.85	2.72	2.60	2.28	2.13
Deferred Income Tax	0.00	0.02	0.23	0.57	-0.07	0.04	0.25	0.07	0.43
Stock Based Compensation	0.00	0.36	0.26	0.34	0.44	0.36	0.35	0.27	0.27
Change in Working Capital	0.73	-0.11	-0.46	-1.15	-0.50	1.28	-0.09	0.03	-0.30
Change in Accounts Receivable	-0.09	-0.80	-0.94	-0.80	-0.96	0.33	-0.33	-0.42	-4.64
Change in Inventory	-0.15	0.33	-0.13	-0.06	-0.54	-0.30	-0.16	-0.24	-0.07
Change in Accounts Payable	0.67	0.36	0.36	-0.30	1.00	1.26	0.40	0.70	0.37
Change in Other Working Capital	0.31	0.00	0.22	0.18	0.00	0.00	0.00	0.70	4.04
Other Operating Activities	1.60	0.27	0.22	-0.47	-1.55	0.44	0.35	-0.28	0.15
Net Cash from Operating Activities	12.64	10.51	9.43	8.52	8.96	9.23	7.60	6.76	5.43
Investing Activities
Capital Expenditures	-4.94	-4.88	-4.74	-4.40	-3.58	-2.84	-4.16	-3.57	-3.02
Acquisitions	-0.13	0.00	-0.64	-0.22	-1.11	-0.50	-1.62	-0.45	-1.21
Purchases of Investments	0.00	0.00	-0.11	0.01	-0.12	-0.02	-0.03	0.00	0.00
Sales/Maturities of Investments	0.07	0.00	0.00	0.01	0.12	0.02	0.03	0.06	0.00
Other Investing Activities	0.01	-0.06	-0.13	-0.01	-0.12	-0.06	0.06	0.06	-0.05
Net Cash from Investing Activities	-4.99	-4.93	-5.32	-3.39	-2.64	-3.39	-5.72	-3.90	-4.28
Financing Activities
Debt Repayment	3.21	3.21	-0.91	-2.83	-3.87	-3.22	0.57	-0.34	1.51
Common Stock Repurchased	-10.07	-6.04	-3.81	-7.00	-8.22	-0.44	-1.03	-1.53	-2.05
Dividends Paid	-0.68	-0.69	-0.66	-0.65	-0.62	-0.15	-0.55	-0.49	0.00
Other Financing Activities	-1.01	-1.06	-0.92	-1.29	-1.07	-0.87	-0.76	-0.71	-0.52
Net Cash from Financing Activities	-8.55	-4.58	-4.09	-5.66	-6.66	-4.68	-1.77	-3.08	-1.06
Summary
Effect of Forex Changes on Cash	0.01	0.00	0.01	-0.02	0.00	0.01	0.01	-0.02	0.00
Net Change in Cash	-0.89	1.00	0.03	-0.54	-0.34	1.17	0.12	-0.23	0.09
Cash at Beginning of Period	1.93	0.94	0.91	1.45	1.79	0.62	0.50	0.73	0.65
Cash at End of Period	1.04	1.93	0.94	0.91	1.45	1.79	0.62	0.50	0.73
Free Cash Flow	7.69	5.64	4.69	4.13	5.38	6.40	3.44	3.19	2.41
Supplemental Disclosures
Interest Paid	2.21	1.94	1.89	1.66	1.50	-	-	-	-
Income Taxes Paid	1.74	1.84	1.39	1.18	2.18	-	-	-	-

Source: Company financial statements from annual and quarterly filings. Data as of Jun 30, 2026. Data sources and methodology

Frequently Asked Questions About HCA Healthcare Cash Flow

What is HCA Healthcare's free cash flow?

HCA Healthcare generated free cash flow of $7.69B in fiscal 2025 (fiscal year ended Dec 31, 2025), operating cash flow of $12.64B minus $4.94B of capital expenditures. That was up 36.4% from $5.64B a year earlier. Free cash flow equaled 10.2% of revenue.

How much does HCA Healthcare spend on capital expenditures?

HCA Healthcare spent $4.94B on capital expenditures in fiscal 2025, compared with $4.88B a year earlier. That equals 39.1% of operating cash flow.

Does HCA Healthcare pay dividends or buy back shares?

Yes. In fiscal 2025 HCA Healthcare returned $679.00M in dividends and $10.07B in share buybacks to shareholders, according to its cash flow statement.

What is free cash flow?

Free cash flow is operating cash flow minus capital expenditures. It is the cash a company has left for dividends, buybacks, debt repayment or acquisitions after funding its operations and investment. Full definition