HCA vs THC Stock Comparison: AI Score, Valuation, Performance and Upside
HCA Healthcare and Tenet Healthcare are both major for-profit hospital companies, but with different strategic emphases. HCA is the pure hospital system operator — the largest and best-run for-profit hospital company in the US. Tenet is pivoting away from hospitals toward ambulatory surgery centers through USPI, believing higher-margin same-day surgery is the future of procedure volume. HCA's scale and operational excellence make it the clear quality leader; Tenet's USPI ambulatory strategy is a different but potentially interesting bet on healthcare delivery migration.
HCA vs THC is the largest, best-operated for-profit hospital company with Sun Belt population tailwinds and industry-leading margins (HCA Healthcare) versus the hospital-to-ambulatory surgery center transition company with USPI ASC platform as the primary value driver (Tenet Healthcare) — scale and excellence in hospitals vs ambulatory surgery center growth pivot.
THC holds the edge across 5 of 5 key metrics in this comparison. THC leads on both 1-year return (+42.75%) and forward P/E quality (12.26x vs 13.01x for HCA), a relatively favorable combination of momentum and valuation. On fundamentals, HCA is growing revenue faster (8.70%), while THC maintains the higher operating margin (18.16%) — a classic growth-versus-profitability split. Analyst consensus implies similar upside for both: +8.06% for HCA and +10.28% for THC.
Human Wall Street analysts' price targets, typically implying a ~12-month view — a separate signal from this site's own AI Prediction Signal further down the page, which is a 5-/30-day machine-learning forecast based on price history alone.
- prefer the highest-quality for-profit hospital operator with industry-leading margins from scale, management, and Sun Belt population tailwinds
- value HCA's 180+ hospital network creating purchasing power and operational best-practice sharing unavailable to smaller systems
- want for-profit healthcare services exposure with the most proven management team and operational system in the industry
- are comfortable with labor cost inflation, CMS reimbursement rate pressure, and outpatient migration reducing inpatient hospital acuity
- prefer Tenet's strategic pivot toward higher-margin ambulatory surgery through USPI as a play on healthcare procedure migration from hospitals to outpatient settings
- value USPI as one of the largest ambulatory surgery center operators benefiting from same-day surgical volume growth
- want hospital sector exposure with the strategic thesis that ambulatory surgery centers will capture increasing procedure share from traditional hospitals
- are comfortable with Tenet's smaller hospital scale vs HCA, hospital divestiture revenue headwinds, and USPI competition from other ASC operators
| Metric | HCA | THC |
|---|---|---|
| AI scorei | 53.3 | 64.3 |
| AI ranki | #345 | #90 |
| Latest closei | $429.04 | $261.90 |
| 1M returni | +4.20% | -3.08% |
| 6M returni | -14.13% | +27.69% |
| 1Y returni | +7.42% | +42.75% |
How much would $10,000 be worth today if invested at the start of each period, with all dividends reinvested?
| Period | HCA | THC |
|---|---|---|
| 1Y ago | $10.7K (+7.0%) started 2025-09-18 | $13.76K (+37.6%) started 2025-09-18 |
| 5Y ago | $17.91K (+79.1%) started 2021-09-20 | $36.47K (+264.7%) started 2021-09-20 |
| 10Y ago | $64.92K (+549.2%) started 2016-09-19 | $113.67K (+1036.7%) started 2016-09-19 |
Hypothetical — past performance does not guarantee future results.
| Metric | HCA | THC |
|---|---|---|
| Market capi | $90.46B | $20.82B |
| Trailing P/Ei | 14.01 | 9.99 |
| Forward P/Ei | 13.01 | 12.26 |
| Price/Salesi | N/A | N/A |
| EV/Revenuei | 1.85 | 1.65 |
| Analyst targeti | $451.48 | $285.10 |
| Target upsidei | +8.06% | +10.28% |
| Metric | HCA | THC |
|---|---|---|
| Revenue growthi | 8.70% | 6.80% |
| Earnings growthi | 11.60% | 213.40% |
| EPS growthi | +11.60% | +213.40% |
| FCF margini | +4.79% | +10.31% |
| Operating margini | 15.16% | 18.16% |
| Profit margini | 8.77% | 10.27% |
| ROIC proxyi | 13631.68% | 37.34% |
| Return on equityi | 13631.68% | 37.34% |
| Dividend yieldi | 0.75% | N/A |
| Payout ratioi | 10.06% | 0.00% |
| Dividend growth streaki | No increase yet | N/A |
| Betai | 1.11 | 1.23 |
| Debt/equityi | N/A | 152.28 |
| Current ratioi | 0.99 | 1.41 |
| Quick ratioi | 0.78 | 1.15 |
Over the past year, HCA and THC have moved moderately in the same direction (correlation of 0.61), based on daily returns.
Lower drawdown and smaller single-period drops generally indicate a smoother ride, though they do not guarantee lower future risk.
| Period | Metric | HCA | THC |
|---|---|---|---|
| 1Y | Growthi | +6.98% | +37.63% |
| CAGRi | +6.98% | +37.68% | |
| Volatilityi | 30.68% | 43.28% | |
| Sharpe ratioi | 0.23 | 0.85 | |
| Sortino ratioi | 0.33 | 1.52 | |
| Max drawdowni | 33.72% | 34.08% | |
| Current drawdowni | 21.30% | 6.72% | |
| Avg drawdowni | 13.24% | 11.37% | |
| Ulcer Indexi | 17.34% | 14.96% | |
| Max daily dropi | 8.77% | 5.71% | |
| Max wkly dropi | 14.06% | 13.37% | |
| 5Y | Growthi | +73.59% | +264.66% |
| CAGRi | +11.67% | +29.58% | |
| Volatilityi | 30.04% | 45.20% | |
| Sharpe ratioi | 0.37 | 0.71 | |
| Sortino ratioi | 0.51 | 1.02 | |
| Max drawdowni | 39.49% | 58.88% | |
| Current drawdowni | 21.30% | 6.72% | |
| Avg drawdowni | 11.66% | 16.63% | |
| Ulcer Indexi | 15.29% | 22.20% | |
| Max daily dropi | 21.82% | 30.96% | |
| Max wkly dropi | 22.87% | 28.74% | |
| 10Y | Growthi | +505.34% | +1036.72% |
| CAGRi | +19.74% | +27.53% | |
| Volatilityi | 32.99% | 56.56% | |
| Sharpe ratioi | 0.58 | 0.63 | |
| Sortino ratioi | 0.83 | 0.95 | |
| Max drawdowni | 54.74% | 71.68% | |
| Current drawdowni | 21.30% | 6.72% | |
| Avg drawdowni | 10.01% | 20.87% | |
| Ulcer Indexi | 13.86% | 26.55% | |
| Max daily dropi | 21.82% | 30.96% | |
| Max wkly dropi | 39.49% | 44.92% |
| Category | HCA | THC |
|---|---|---|
| Company | HCA Healthcare, Inc. | Tenet Healthcare Corporation |
| Sector | Healthcare | Healthcare |
| Industry | Medical Care Facilities | Medical Care Facilities |
| Core business | HCA Healthcare is the largest for-profit hospital operator in the United States, operating 180+ hospitals and 2,300+ care sites in 20 US states and the UK. HCA's scale provides unmatched purchasing power with medical suppliers and payers, staffing efficiency, and best-practice sharing across its network. HCA's hospitals are concentrated in high-growth US markets — Florida, Texas, Nashville, and Colorado — where population growth drives hospital utilization. HCA's management and operational systems are consistently among the best in the industry. | Tenet Healthcare operates hospital systems primarily in Texas and Florida plus USPI (United Surgical Partners International) — a leading ambulatory surgery center (ASC) company that is Tenet's fastest-growing and highest-margin business segment. Tenet's ASC strategy through USPI differentiates it from HCA's hospital focus — ambulatory surgery centers perform same-day surgical procedures outside hospitals at lower cost. Tenet has been divesting hospitals to focus capital on the higher-margin USPI ambulatory surgery business. |
| Investor focus | Investors track same-store volume growth (admissions and outpatient visits), revenue per equivalent admission, labor costs (the largest expense), and adjusted EBITDA margin. | Investors track USPI ASC revenue and margins (the primary value driver), hospital segment performance, and Tenet's hospital divestiture progress and capital allocation toward higher-margin ambulatory business. |
- Scale advantage: 180+ hospitals create purchasing power with suppliers, staffing agencies, and insurance payers that smaller systems cannot match
- Geographic concentration in high-growth Sun Belt markets — Florida, Texas, and Nashville provide population tailwinds that translate to growing hospital utilization
- Management excellence: HCA has consistently generated industry-leading operating margins through disciplined cost management and clinical quality focus
- USPI is one of the largest ASC operators in the US — the ambulatory surgery center market is growing as procedure migration from hospitals to ASCs accelerates
- Texas and Florida hospital concentration aligns with HCA's high-growth Sun Belt market thesis
- Hospital divestiture strategy focuses capital on USPI's higher-margin ambulatory surgery — improving Tenet's overall margin profile as the mix shifts toward ASCs
- Labor cost inflation — nursing shortages and travel nurse premiums have pressured hospital labor costs significantly; normalizing but still elevated
- Reimbursement rate pressure from CMS and commercial payers reduces revenue per procedure over time
- Hospital sector faces ongoing pressure from outpatient care migration — procedures moving to ambulatory surgery centers and outpatient settings reduce hospital acuity and revenue
- Smaller hospital system scale means Tenet has less purchasing power than HCA — supplier and payer negotiations are less favorable at smaller scale
- Hospital divestitures reduce revenue scale while USPI takes time to grow to offset losses — transitional period creates revenue headwinds
- Ambulatory surgery center competition from HCA's own ASC strategy, United Surgical Partners, and independent surgery centers
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