ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS
17
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Second Quarter 2026 Operations Summary
Revenues increased to $20.230 billion in the second quarter of 2026 from $18.605 billion in the second quarter of 2025. Net income attributable to HCA Healthcare, Inc. totaled $1.699 billion, or $7.62 per diluted share, for the quarter ended June 30, 2026, compared to $1.653 billion, or $6.83 per diluted share, for the quarter ended June 30, 2025. Second quarter results for 2026 and 2025 include gains on sales of facilities of $10 million, or $0.03 per diluted share, and losses on sales of facilities of $3 million, or $0.01 per diluted share, respectively. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes. Shares used for diluted earnings per share were 222.828 million shares for the quarter ended June 30, 2026 and 241.911 million shares for the quarter ended June 30, 2025. During 2025 and the first six months of 2026, we repurchased 26.739 million shares and 7.909 million shares, respectively, of our common stock.
Revenues increased 8.7% on a consolidated basis and 9.3% on a same facility basis for the quarter ended June 30, 2026, compared to the quarter ended June 30, 2025. The increase in consolidated revenues can be primarily attributed to the combined impact of a 6.0% increase in revenue per equivalent admission and a 2.6% increase in equivalent admissions. The same facility revenues increase primarily resulted from the combined impact of a 6.4% increase in same facility revenue per equivalent admission and a 2.7% increase in same facility equivalent admissions. The second quarter of 2026 includes incremental revenues of $1.372 billion and other operating expenses of $829 million related to the Florida directed payment program for the time period October 1, 2024 through June 30, 2026, to reflect the impact of the state directed payment program approved during the quarter by the Centers for Medicare & Medicaid Services (“CMS”). Of those amounts, approximately $980 million of incremental revenues and $557 million of other operating expenses related to periods prior to 2026. During the second quarter of 2026, we recognized approximately $400 million of incremental net benefit from Medicaid supplemental payment programs, including the state of Florida program.
During the quarter ended June 30, 2026, consolidated admissions increased 2.4% and same facility admissions increased 2.5% compared to the quarter ended June 30, 2025. Inpatient surgical volumes declined 2.3% on both a consolidated basis and a same facility basis during the quarter ended June 30, 2026, compared to the quarter ended June 30, 2025. Outpatient surgical volumes declined 4.4% on a consolidated basis and 3.4% on a same facility basis during the quarter ended June 30, 2026, compared to the quarter ended June 30, 2025. Emergency department visits increased 3.5% on a consolidated basis and 3.6% on a same facility basis during the quarter ended June 30, 2026, compared to the quarter ended June 30, 2025. Consolidated and same facility uninsured admissions increased 23.3% and 23.4%, respectively, for the quarter ended June 30, 2026, compared to the quarter ended June 30, 2025. Uninsured admissions increased for the second quarter and first six months of 2026 reflecting impacts from the expiration of the EPTCs at the end of 2025 and administrative reforms, as well as a decline in Medicaid conversions. The second quarter increase in uninsured admissions includes the impact of attrition related to Exchange volumes from the first quarter that occurred during the second quarter.
Cash flows from operating activities declined $1.875 billion, from $4.210 billion for the second quarter of 2025 to $2.335 billion for the second quarter of 2026. The decline in cash provided by operating activities was primarily related to unfavorable working capital changes of $1.413 billion, including an increase in accounts receivable primarily related to Medicaid state directed and supplemental payment programs, as well as an increase in income taxes paid of $594 million related to the 2025 Internal Revenue Service (“IRS”) deferral of quarterly estimated income tax payments for Tennessee-based taxpayers until the fourth quarter of 2025, partially offset by a $28 million increase in net income, excluding the non-cash impact of losses and gains on sales of facilities.
18
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations
Revenue/Volume Trends
Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the Exchanges), and the transaction prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals.
Revenues increased 8.7% from $18.605 billion in the second quarter of 2025 to $20.230 billion in the second quarter of 2026. Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual adjustments under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured and other discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay revenues at the estimated amounts we expect to collect. Patients treated at our hospitals for non-elective care who have income at or below 400% of the federal poverty level are eligible for charity care. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in revenues. Our revenues by primary third-party payer classification and other (including uninsured patients) for the quarters and six months ended June 30, 2026 and 2025 are summarized in the following table (dollars in millions):
| Line item | Quarter2026 | QuarterRatio | Quarter2025 | QuarterRatio |
|---|---|---|---|---|
| Medicare | $2,927 | 14.5% | $2,803 | 15.1% |
| Managed Medicare | 3,424 | 16.9 | 3,352 | 18.0 |
| Medicaid | 2,789 | 13.8 | 1,440 | 7.7 |
| Managed Medicaid | 997 | 4.9 | 899 | 4.8 |
| Managed care and insurers | 9,013 | 44.6 | 9,124 | 49.1 |
| International (managed care and insurers) | 491 | 2.4 | 461 | 2.5 |
| Other | 589 | 2.9 | 526 | 2.8 |
| Revenues | $20,230 | 100.0% | $18,605 | 100.0% |
| Six Months | ||||
| 2026 | Ratio | 2025 | Ratio | |
| Medicare | $5,985 | 15.2% | $5,698 | 15.4% |
| Managed Medicare | 6,932 | 17.6 | 6,651 | 18.0 |
| Medicaid | 4,233 | 10.8 | 2,630 | 7.1 |
| Managed Medicaid | 1,936 | 4.9 | 1,778 | 4.8 |
| Managed care and insurers | 18,097 | 46.0 | 18,165 | 49.2 |
| International (managed care and insurers) | 990 | 2.5 | 906 | 2.5 |
| Other | 1,166 | 3.0 | 1,098 | 3.0 |
| Revenues | $39,339 | 100.0% | $36,926 | 100.0% |
19
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Revenue/Volume Trends (continued)
As expected, during the quarter and six months ended June 30, 2026, our revenues from managed care and insurers were unfavorably impacted by the expiration of the EPTCs at the end of 2025 and administrative reforms, both related to insurance purchased through the Exchanges. In addition, we recognized revenues for the quarter and six months ended June 30, 2026 related to Medicaid state directed and supplemental payment programs, primarily from the Florida directed payment program.
To quantify the total impact of the trends related to uninsured patient accounts, we believe it is beneficial to consider total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. Total uncompensated care was $15.076 billion and $11.625 billion, respectively, for the quarters ended June 30, 2026 and 2025, and the estimated cost of total uncompensated care was $1.445 billion and $1.116 billion, respectively, for the quarters ended June 30, 2026 and 2025. Total uncompensated care was $28.688 billion and $22.618 billion, respectively, for the six months ended June 30, 2026 and 2025, and the estimated cost of total uncompensated care was $2.697 billion and $2.171 billion, respectively, for the six months ended June 30, 2026 and 2025. The estimated cost of uncompensated care was based on a ratio of patient care costs (salaries and benefits, supplies, other operating expense and depreciation and amortization) to gross charges.
Consolidated and same facility revenue per equivalent admission increased 6.0% and 6.4%, respectively, in the second quarter of 2026, compared to the second quarter of 2025. The increase in revenue per equivalent admission was impacted by the incremental revenue from the Florida directed payment program approved during the quarter. Consolidated and same facility equivalent admissions increased 2.6% and 2.7%, respectively, in the second quarter of 2026, compared to the second quarter of 2025. Consolidated and same facility outpatient surgeries declined 4.4% and 3.4%, respectively, in the second quarter of 2026, compared to the second quarter of 2025. Consolidated and same facility inpatient surgeries each declined 2.3% in the second quarter of 2026, compared to the second quarter of 2025. Consolidated and same facility emergency department visits increased 3.5% and 3.6%, respectively, in the second quarter of 2026, compared to the second quarter of 2025.
Same facility uninsured admissions increased 23.4% in the second quarter of 2026 compared to the second quarter of 2025. Same facility uninsured admissions increased 15.5% in the first quarter of 2026 compared to the first quarter of 2025. The increases in both periods reflect impacts from the expiration of the EPTCs at the end of 2025. Same facility uninsured admissions in 2025, compared to 2024, increased 7.1% in the fourth quarter, declined 2.0% in the third quarter, increased 0.4% in the second quarter and declined 0.7% in the first quarter.
The approximate percentages of our admissions related to Medicare, managed Medicare, Medicaid, managed Medicaid, managed care and insurers and the uninsured for the quarters and six months ended June 30, 2026 and 2025 are set forth in the following table.
| Line item | Quarter2026 | Quarter2025 | Six Months2026 | Six Months2025 |
|---|---|---|---|---|
| Medicare | 19% | 19% | 19% | 20% |
| Managed Medicare | 27 | 27 | 27 | 27 |
| Medicaid | 4 | 4 | 4 | 4 |
| Managed Medicaid | 11 | 11 | 11 | 11 |
| Managed care and insurers | 31 | 32 | 31 | 32 |
| Uninsured | 8 | 7 | 8 | 6 |
| 100% | 100% | 100% | 100% |
20
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Revenue/Volume Trends (continued)
The approximate percentages of our inpatient revenues related to Medicare, managed Medicare, Medicaid, managed Medicaid, managed care and insurers for the quarters and six months ended June 30, 2026 and 2025 are set forth in the following table.
| Line item | Quarter2026 | Quarter2025 | Six Months2026 | Six Months2025 |
|---|---|---|---|---|
| Medicare | 19% | 20% | 20% | 20% |
| Managed Medicare | 17 | 20 | 18 | 20 |
| Medicaid | 20 | 12 | 16 | 11 |
| Managed Medicaid | 5 | 5 | 5 | 5 |
| Managed care and insurers | 39 | 43 | 41 | 44 |
| 100% | 100% | 100% | 100% |
The changes in the percentages of our inpatient revenues for the quarter and six months ended June 30, 2026 are primarily related to the increase in inpatient revenues from state Medicaid directed and supplemental payment programs.
At June 30, 2026, we had 103 hospitals in the states of Texas and Florida. During the quarter ended June 30, 2026, 58% of our admissions and 55% of our revenues were generated by these hospitals. Uninsured admissions in Texas and Florida represented 73% of our uninsured admissions during the quarter ended June 30, 2026.
We receive a significant portion of our revenues from government health programs, principally Medicare and Medicaid, which are highly regulated and subject to frequent and substantial changes. Some states make additional payments to providers through the Medicaid program that are separate from base payments. These payments may be in the form of payments, such as upper payment limit payments, that are intended to address the difference between Medicaid fee-for-service payments and Medicare reimbursement rates, or payments under other programs that vary by state under waivers authorized by Section 1115 of the Social Security Act. In addition, many states have implemented SDP arrangements to direct certain Medicaid managed care plan expenditures. These payments are generally authorized by CMS and subject to periodic extension or reapproval.
As discussed in additional detail in Item 1, “Business — Sources of Revenue — Medicaid State Directed and Supplemental Payments” in our Annual Report on Form 10-K for the year ended December 31, 2025, the use and nature of SDP arrangements are subject to policy changes. For example, as mandated by the FBA, CMS has proposed revisions to regulations governing SDP arrangements, tying caps on payment rates paid by Medicaid managed care organizations to Medicare payment rates instead of average commercial rates. The changes proposed by CMS include applying similar limits to certain Medicaid fee-for-service targeted practitioner payments. The payment limitations for SDPs for services specified by the FBA will apply to SDP arrangements made for services furnished in the rating periods beginning on or after July 4, 2025. However, the FBA temporarily grandfathers certain SDP arrangements, including those for which an application was submitted to CMS prior to July 4, 2025, for the rating period occurring within 180 days of July 4, 2025. Certain states in which we operate have submitted applications to CMS and received approval to increase payments up to the average commercial rate before the step down begins in 2028. Those approvals or future approvals could result in the recognition of additional revenues, which may be significant. However, we are unable to predict the timing or extent of any additional approvals by CMS and the timing or amount of any resulting recognition of the related revenues. Beginning with the rating period on or after January 1, 2028, grandfathered SDP arrangements will be subject to a phase-down period consistent with the FBA payment rate caps.
Most states in which we receive payment have adopted statewide or local provider taxes to fund the non-federal share of Medicaid programs. As discussed in additional detail in Item 1, “Business — Sources of Revenue — Medicaid” in our Annual Report on Form 10-K for the year ended December 31, 2025, the FBA includes restrictions on provider tax arrangements, which are expected to reduce the federal matching funds received by state Medicaid programs. In July 2026, CMS issued a proposed rule to implement changes related to limits on the structure and applicability of provider taxes and the related safe harbor limits. Separately, in February 2026, CMS issued a final rule that implements limits on the structure and applicability of provider taxes. As a result of these changes, some taxes on managed care organizations and providers permitted prior to the enactment of the FBA must be reduced, or are no longer permissible, subject to transition periods. The changes to provider taxes could increase state budgetary pressures, reduce federal Medicaid funding, and negatively affect reimbursement rates and coverage, among other effects. We are unable to predict the ultimate impact of these changes on our business and financial results.
21
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Revenue/Volume Trends (continued)
The health care industry is subject to changing political, regulatory and other influences, including health care reform efforts at the federal and state levels. We are monitoring and engaged in advocacy efforts around potential health care policy changes and reform. See Item 1A, “Risk Factors” from our Annual Report on Form 10-K for the year ended December 31, 2025 for additional information.
Key Performance Indicators
We present certain metrics and statistical information that management uses when assessing our results of operations. We believe this information is useful to investors as it provides insight into how management evaluates operational performance and trends between reporting periods. Information on how these metrics and statistical information are defined is provided in the following tables summarizing operating results and operating data.
Operating Results Summary
The following is a comparative summary of results of operations for the quarters and six months ended June 30, 2026 and 2025 (dollars in millions):
| Line item | Quarter · 2026Amount | Quarter · 2026Ratio | Quarter · 2025Amount | Quarter · 2025Ratio |
|---|---|---|---|---|
| Revenues | $20,230 | 100.0 | $18,605 | 100.0 |
| Salaries and benefits | 8,290 | 41.0 | 8,138 | 43.7 |
| Supplies | 2,886 | 14.3 | 2,844 | 15.3 |
| Other operating expenses | 5,043 | 24.9 | 3,793 | 20.4 |
| Equity in earnings of affiliates | (16) | (0.1) | (19) | (0.1) |
| Depreciation and amortization | 944 | 4.6 | 863 | 4.7 |
| Interest expense | 599 | 3.0 | 568 | 3.0 |
| Losses (gains) on sales of facilities | (10) | — | 3 | — |
| 17,736 | 87.7 | 16,190 | 87.0 | |
| Income before income taxes | 2,494 | 12.3 | 2,415 | 13.0 |
| Provision for income taxes | 564 | 2.8 | 524 | 2.8 |
| Net income | 1,930 | 9.5 | 1,891 | 10.2 |
| Net income attributable to noncontrolling interests | 231 | 1.1 | 238 | 1.3 |
| Net income attributable to HCA Healthcare, Inc. | $1,699 | 8.4 | $1,653 | 8.9 |
| % changes from prior year: | ||||
| Revenues | 8.7% | 6.4% | ||
| Income before income taxes | 3.2 | 8.0 | ||
| Net income attributable to HCA Healthcare, Inc. | 2.8 | 13.1 | ||
| Admissions(a) | 2.4 | 2.1 | ||
| Equivalent admissions(b) | 2.6 | 2.3 | ||
| Revenue per equivalent admission | 6.0 | 3.9 | ||
| Same facility % changes from prior year(c): | ||||
| Revenues | 9.3 | 5.8 | ||
| Admissions(a) | 2.5 | 1.8 | ||
| Equivalent admissions(b) | 2.7 | 1.7 | ||
| Revenue per equivalent admission | 6.4 | 4.0 |
22
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Operating Results Summary (continued)
| Line item | Six Months · 2026Amount | Six Months · 2026Ratio | Six Months · 2025Amount | Six Months · 2025Ratio |
|---|---|---|---|---|
| Revenues | $39,339 | 100.0 | $36,926 | 100.0 |
| Salaries and benefits | 16,573 | 42.1 | 16,135 | 43.7 |
| Supplies | 5,739 | 14.6 | 5,608 | 15.2 |
| Other operating expenses | 9,223 | 23.5 | 7,638 | 20.7 |
| Equity in earnings of affiliates | (25) | (0.1) | (37) | (0.1) |
| Depreciation and amortization | 1,874 | 4.7 | 1,723 | 4.7 |
| Interest expense | 1,183 | 3.0 | 1,115 | 3.0 |
| Losses (gains) on sales of facilities | (9) | — | 2 | — |
| 34,558 | 87.8 | 32,184 | 87.2 | |
| Income before income taxes | 4,781 | 12.2 | 4,742 | 12.8 |
| Provision for income taxes | 994 | 2.6 | 1,026 | 2.7 |
| Net income | 3,787 | 9.6 | 3,716 | 10.1 |
| Net income attributable to noncontrolling interests | 468 | 1.2 | 453 | 1.3 |
| Net income attributable to HCA Healthcare, Inc. | $3,319 | 8.4 | $3,263 | 8.8 |
| % changes from prior year: | ||||
| Revenues | 6.5% | 6.0% | ||
| Income before income taxes | 0.8 | 5.8 | ||
| Net income attributable to HCA Healthcare, Inc. | 1.7 | 6.9 | ||
| Admissions(a) | 1.5 | 2.4 | ||
| Equivalent admissions(b) | 1.9 | 2.7 | ||
| Revenue per equivalent admission | 4.6 | 3.2 | ||
| Same facility % changes from prior year(c): | ||||
| Revenues | 6.9 | 5.9 | ||
| Admissions(a) | 1.7 | 2.3 | ||
| Equivalent admissions(b) | 2.0 | 2.3 | ||
| Revenue per equivalent admission | 4.8 | 3.6 |
(a)
Represents the total number of patients admitted to our hospitals and is used by management and certain investors as a general measure of inpatient volume.
(b)
Equivalent admissions are used by management and certain investors as a general measure of combined inpatient and outpatient volume. Equivalent admissions are computed by multiplying admissions (inpatient volume) by the sum of gross inpatient revenues and gross outpatient revenues and then dividing the resulting amount by gross inpatient revenues. The equivalent admissions computation “equates” outpatient revenues to the volume measure (admissions) used to measure inpatient volume, resulting in a general measure of combined inpatient and outpatient volume.
(c)
Same facility information excludes the operations of hospitals and their related facilities which were either acquired or divested during the current and prior period.
23
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Quarters Ended June 30, 2026 and 2025
Revenues increased to $20.230 billion in the second quarter of 2026 from $18.605 billion in the second quarter of 2025. Net income attributable to HCA Healthcare, Inc. totaled $1.699 billion, or $7.62 per diluted share, for the quarter ended June 30, 2026, compared to $1.653 billion, or $6.83 per diluted share, for the quarter ended June 30, 2025. Second quarter results for 2026 and 2025 include gains on sales of facilities of $10 million, or $0.03 per diluted share, and losses on sales of facilities of $3 million, or $0.01 per diluted share, respectively. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes. Shares used for diluted earnings per share were 222.828 million shares for the quarter ended June 30, 2026 and 241.911 million shares for the quarter ended June 30, 2025. During 2025 and the first six months of 2026, we repurchased 26.739 million shares and 7.909 million shares, respectively, of our common stock.
Revenues increased 8.7% on a consolidated basis and 9.3% on a same facility basis for the quarter ended June 30, 2026, compared to the quarter ended June 30, 2025. The increase in consolidated revenues can be primarily attributed to the combined impact of a 6.0% increase in revenue per equivalent admission and a 2.6% increase in equivalent admissions. The same facility revenues increase primarily resulted from the combined impact of a 6.4% increase in same facility revenue per equivalent admission and a 2.7% increase in same facility equivalent admissions.
As expected, during the quarter ended June 30, 2026, our revenues from managed care and insurers were unfavorably impacted by the expiration of the EPTCs at the end of 2025 and administrative reforms, both related to insurance purchased through the Exchanges. In addition, we recognized an increase in revenues for the quarter ended June 30, 2026 related to Medicaid state directed and supplemental payment programs, primarily from the Florida directed payment program.
Salaries and benefits, as a percentage of revenues, were 41.0% in the second quarter of 2026 and 43.7% in the second quarter of 2025. Salaries and benefits per equivalent admission declined 0.7% in the second quarter of 2026, compared to the second quarter of 2025. Same facility salaries and benefits per full-time equivalent increased 2.5% for the second quarter of 2026, compared to the second quarter of 2025.
Supplies, as a percentage of revenues, were 14.3% in the second quarter of 2026 and 15.3% in the second quarter of 2025. Supply costs per equivalent admission declined 1.0% in the second quarter of 2026, compared to the second quarter of 2025. Supply costs per equivalent admission increased 0.1% for medical devices and declined 5.0% for pharmacy supplies and 1.1% for general medical and surgical items in the second quarter of 2026, compared to the second quarter of 2025. The decline in supply costs per equivalent admission for pharmacy supplies is primarily related to a decrease in the utilization of certain drugs.
Other operating expenses, as a percentage of revenues, were 24.9% in the second quarter of 2026 and 20.4% in the second quarter of 2025. Other operating expenses are primarily comprised of contract services, professional fees, repairs and maintenance, rents and leases, utilities, insurance (including professional liability insurance) and non-income taxes. The 4.5% increase in other operating expenses, as a percentage of revenues, for the second quarter of 2026 compared to the second quarter of 2025 was primarily related to growth in Medicaid state directed and supplemental payment program expenses and professional fees. We have seen inflation have a negative impact on certain of these expenses and expect inflationary pressures will continue to impact operating expenses in the future.
Equity in earnings of affiliates was $16 million and $19 million in the second quarters of 2026 and 2025, respectively.
Depreciation and amortization increased $81 million, from $863 million in the second quarter of 2025 to $944 million in the second quarter of 2026. The increase in depreciation relates primarily to capital expenditures at our existing facilities.
Interest expense was $599 million in the second quarter of 2026 and $568 million in the second quarter of 2025. Our average debt balance was $49.228 billion for the second quarter of 2026, compared to $44.506 billion for the second quarter of 2025. The average effective interest rate for our debt was 4.9% and 5.1% for the quarters ended June 30, 2026 and 2025, respectively.
During the second quarters of 2026 and 2025, we recorded gains on sales of facilities of $10 million and losses on sales of facilities of $3 million, respectively.
The effective tax rates were 24.9% and 24.1% for the second quarters of 2026 and 2025, respectively. The effective tax rate computations exclude net income attributable to noncontrolling interests as it relates to consolidated partnerships. The increase in the effective tax rate for the quarter ended June 30, 2026 is related primarily to decreases in amounts of deductible share-based compensation for vested employee equity awards and other nontaxable items.
24
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Quarters Ended June 30, 2026 and 2025 (continued)
Net income attributable to noncontrolling interests declined from $238 million for the second quarter of 2025 to $231 million for the second quarter of 2026. The decline in net income attributable to noncontrolling interests related primarily to the operations of two of our Texas markets.
Six Months Ended June 30, 2026 and 2025
Revenues increased to $39.339 billion in the first six months of 2026 from $36.926 billion in the first six months of 2025. Net income attributable to HCA Healthcare, Inc. totaled $3.319 billion, or $14.77 per diluted share, for the six months ended June 30, 2026, compared to $3.263 billion, or $13.28 per diluted share, for the six months ended June 30, 2025. Results for the first six months of 2026 and 2025 include gains on sales of facilities of $9 million, or $0.03 per diluted share, and losses on sales of facilities of $2 million, or $0.01 per diluted share, respectively. Our provision for income taxes for the first six months of 2026 and 2025 included tax benefits of $107 million, or $0.48 per diluted share, and $33 million, or $0.13 per diluted share, respectively, related to employee equity award settlements. All “per diluted share” disclosures are based upon amounts net of the applicable income taxes. Shares used for diluted earnings per share were 224.731 million shares for the six months ended June 30, 2026 and 245.654 million shares for the six months ended June 30, 2025. During 2025 and the first six months of 2026, we repurchased 26.739 million shares and 7.909 million shares, respectively, of our common stock.
Revenues increased 6.5% on a consolidated basis and 6.9% on a same facility basis for the six months ended June 30, 2026, compared to the six months ended June 30, 2025. The increase in consolidated revenues can be attributed to the combined impact of a 4.6% increase in revenue per equivalent admission and a 1.9% increase in equivalent admissions. The same facility revenues increase resulted primarily from the combined impact of a 4.8% increase in same facility revenue per equivalent admission and a 2.0% increase in same facility equivalent admissions.
As expected, during the six months ended June 30, 2026, our revenues from managed care and insurers were unfavorably impacted by the expiration of the EPTCs at the end of 2025 and administrative reforms, both related to insurance purchased through the Exchanges. In addition, we recognized an increase in revenues for the six months ended June 30, 2026 related to Medicaid state directed and supplemental payment programs, primarily from the Florida directed payment program.
Salaries and benefits, as a percentage of revenues, were 42.1% in the first six months of 2026 and 43.7% in the first six months of 2025. Salaries and benefits per equivalent admission increased 0.8% in the first six months of 2026, compared to the first six months of 2025. Same facility salaries and benefits per full-time equivalent increased 3.0% for the first six months of 2026, compared to the first six months of 2025.
Supplies, as a percentage of revenues, were 14.6% in the first six months of 2026 and 15.2% in the first six months of 2025. Supply costs per equivalent admission increased 0.5% in the first six months of 2026, compared to the first six months of 2025. Supply costs per equivalent admission increased 2.4% for medical devices and declined 5.0% for pharmacy supplies and 0.2% for general medical and surgical items in the first six months of 2026, compared to the first six months of 2025. The decline in supply costs per equivalent admission for pharmacy supplies is primarily related to a decrease in the utilization of certain drugs.
Other operating expenses, as a percentage of revenues, were 23.5% in the first six months of 2026 and 20.7% in the first six months of 2025. Other operating expenses are primarily comprised of contract services, professional fees, repairs and maintenance, rents and leases, utilities, insurance (including professional liability insurance) and non-income taxes. The 2.8% increase in other operating expenses, as a percentage of revenues, for the first six months of 2026 compared to the first six months of 2025 was primarily related to growth in Medicaid state directed and supplemental payment program expenses and professional fees. We have seen inflation have a negative impact on certain of these expenses and expect inflationary pressures will continue to impact operating expenses in the future.
Equity in earnings of affiliates was $25 million and $37 million in the first six months of 2026 and 2025, respectively.
Depreciation and amortization increased $151 million, from $1.723 billion in the first six months of 2025 to $1.874 billion in the first six months of 2026. The increase in depreciation relates primarily to capital expenditures at our existing facilities.
25
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Results of Operations (continued)
Six Months Ended June 30, 2026 and 2025 (continued)
Interest expense was $1.183 billion in the first six months of 2026 and $1.115 billion in the first six months of 2025. Our average debt balance was $48.256 billion for the first six months of 2026 compared to $44.061 billion for the first six months of 2025. The average effective interest rate for our debt was 4.9% and 5.1% for the six months ended June 30, 2026 and 2025, respectively.
During the first six months of 2026 and 2025, we recorded gains on sales of facilities of $9 million and losses on sales of facilities of $2 million, respectively.
The effective tax rates were 23.0% and 23.9% for the first six months of 2026 and 2025, respectively. The effective tax rate computations exclude net income attributable to noncontrolling interests as it relates to consolidated partnerships. Our provisions for income taxes for the first six months of 2026 and 2025 included tax benefits of $107 million and $33 million, respectively, related to employee equity award settlements.
Net income attributable to noncontrolling interests increased from $453 million for the first six months of 2025 to $468 million for the first six months of 2026. The increase in net income attributable to noncontrolling interests related primarily to the operations of our surgery centers, partially offset by one of our Texas markets.
Liquidity and Capital Resources
Cash provided by operating activities totaled $4.349 billion for the first six months of 2026 compared to $5.861 billion for the first six months of 2025. The $1.512 billion decline in cash provided by operating activities, for the first six months of 2026 compared to the first six months of 2025, related primarily to unfavorable changes in working capital items of
$1.099 billion, including an increase in accounts receivable primarily related to Medicaid state directed and supplemental payment programs, as well as an increase in income taxes paid of $579 million related to the 2025 IRS deferral of quarterly estimated income tax payments for Tennessee-based taxpayers until the fourth quarter of 2025, partially offset by a $62 million increase in net income, excluding the non-cash impact of losses and gains on sales of facilities. The combination of interest payments and net income tax payments in the first six months of 2026 and 2025 totaled $1.888 billion and $1.220 billion, respectively. We had negative working capital of $122 million and $567 million at June 30, 2026 and December 31, 2025, respectively. The negative working capital related primarily to the increase in short-term borrowings and long-term debt due within one year. We have the ability to refinance our outstanding commercial paper notes with our senior unsecured credit facility on a long-term basis. Excluding the impact of our outstanding commercial paper notes, our working capital at June 30, 2026 would have been $3.768 billion.
Cash used in investing activities was $2.839 billion in the first six months of 2026 compared to $2.283 billion in the first six months of 2025. Excluding acquisitions, capital expenditures were $2.350 billion in the first six months of 2026 and $2.167 billion in the first six months of 2025. Planned capital expenditures are expected to be approximately between $5.0 billion and $5.5 billion in 2026, excluding acquisitions. At June 30, 2026, there were projects under construction which had estimated additional costs to complete and equip over the next five years of approximately $8.6 billion. We expect to finance capital expenditures with internally generated and borrowed funds.
Cash used in financing activities totaled $1.534 billion in the first six months of 2026, compared to $4.584 billion in the first six months of 2025. During the first six months of 2026, net cash flows used in financing activities included a net increase of $3.065 billion in our indebtedness, payment of dividends of $354 million, repurchase of common stock of $3.635 billion and distributions to noncontrolling interests of $334 million. During the first six months of 2025, net cash flows used in financing activities included a net increase of $1.341 billion in our indebtedness, payment of dividends of $351 million, repurchase of common stock of $5.011 billion and distributions to noncontrolling interests of $394 million.
During April 2026, we issued $3.000 billion aggregate principal amount of senior notes comprised of (i) $1.000 billion aggregate principal amount of 4.700% senior notes due 2031, (ii) $750 million aggregate principal amount of 5.000% senior notes due 2033 and (iii) $1.250 billion aggregate principal amount of 5.300% senior notes due 2036. We used the net proceeds to repay borrowings under the commercial paper program and for general corporate purposes.
During May 2026, we repaid all $1.500 billion aggregate principal amount of 5.250% senior notes due 2026 and all $1.000 billion aggregate principal amount of 5.375% senior notes due 2026.
We have significant debt service requirements. Our debt totaled $49.718 billion at June 30, 2026. Our interest expense was $1.183 billion for the first six months of 2026 and $1.115 billion for the first six months of 2025.
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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Liquidity and Capital Resources (continued)
In addition to cash flows from operations, available sources of capital include amounts available under our senior unsecured credit facility ($3.086 billion and $3.816 billion available as of June 30, 2026 and July 24, 2026, respectively, after giving effect to all issued and outstanding letters of credit and our intention to maintain a minimum available borrowing capacity equal to the aggregate amount outstanding under the commercial paper program ($3.890 billion and $4.000 billion as of June 30, 2026 and July 24, 2026, respectively)) and anticipated access to public and private debt markets.
Investments of our insurance subsidiaries, held to maintain statutory equity levels and to provide liquidity to pay claims, totaled $519 million and $588 million at June 30, 2026 and December 31, 2025, respectively. An insurance subsidiary maintained net reserves for professional liability risks of $104 million and $91 million at June 30, 2026 and December 31, 2025, respectively. Our facilities are insured by our insurance subsidiary for losses up to $120 million per occurrence; however, this coverage is subject, in most cases, to a $15 million per occurrence self-insured retention. Additionally, the insurance subsidiary has entered into reinsurance contracts providing reimbursement for a certain portion of losses in excess of self-insured retentions. Net reserves for the self-insured professional liability risks retained were $1.892 billion and $1.906 billion at June 30, 2026 and December 31, 2025, respectively. Claims payments, net of reinsurance recoveries, during the next 12 months are expected to approximate $573 million. We estimate that approximately $532 million of the expected net claim payments during the next 12 months will relate to claims subject to the self-insured retention.
Management believes that cash flows from operations, amounts available under our senior unsecured credit facility and our anticipated access to public and private debt markets will be sufficient to meet expected liquidity needs for the foreseeable future.
Market Risk
We are exposed to market risk related to changes in market values of securities. The investment securities held by our insurance subsidiaries were recorded at $519 million at June 30, 2026. These investments are carried at fair value, with changes in unrealized gains and losses that are not credit-related being recorded as adjustments to other comprehensive income. At June 30, 2026, we had net unrealized losses of $16 million on the insurance subsidiaries’ investments.
We are exposed to market risk related to market illiquidity. Investments in debt and equity securities held by our insurance subsidiaries could be impaired by the inability to access the capital markets. Should the insurance subsidiaries require significant amounts of cash in excess of normal cash requirements to pay claims and other expenses on short notice, we may have difficulty selling these investments in a timely manner or be forced to sell them at a price less than what we might otherwise have been able to in a normal market environment. We may be required to recognize credit-related impairments on our investment securities in future periods should issuers default on interest payments or should the fair market valuations of the securities deteriorate due to ratings downgrades or other issue-specific factors.
We are also exposed to market risk related to changes in interest rates. With respect to our interest-bearing liabilities, approximately $5.200 billion of our debt at June 30, 2026 was subject to variable rates of interest, while the remaining debt balance of $44.518 billion at June 30, 2026 was subject to fixed rates of interest. Both the general level of interest rates and, for the senior unsecured credit facility, our leverage affect our variable interest rates. Our variable debt is comprised of outstanding commercial paper notes, the senior unsecured credit facility and the floating rate senior notes due 2028. The average effective interest rate for our debt was 4.9% and 5.1% for the six months ended June 30, 2026 and 2025, respectively.
The estimated fair value of our long-term debt was $48.640 billion at June 30, 2026. The estimates of fair value are based upon the quoted market prices for the same or similar issues of long-term debt with the same maturities. Based on a hypothetical 1% increase in interest rates, the potential annualized reduction to future pretax earnings would be approximately $52 million. To mitigate the impact of fluctuations in interest rates, we generally target a majority of our debt portfolio to be maintained at fixed rates.
We are exposed to currency translation risk related to our foreign operations. We currently do not consider the market risk related to foreign currency translation to be material to our consolidated financial statements or our liquidity.
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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Tax Examinations
At June 30, 2026, the IRS was examining the 2019 income tax return of an affiliate of the Company. We are subject to examination by the IRS for tax years after 2023, as well as by state and foreign taxing authorities. Management believes HCA Healthcare, Inc., its subsidiaries and affiliates properly reported taxable income and paid taxes in accordance with applicable laws and agreements established with the IRS, state and foreign taxing authorities, and final resolution of any disputes will not have a material, adverse effect on our results of operations or financial position. However, if payments due upon final resolution of any issues exceed our recorded estimates, such resolutions could have a material, adverse effect on our results of operations or financial position.
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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
Operating Data
| Line item | 2026 | 2025 |
|---|---|---|
| Number of hospitals in operation at: | ||
| March 31 | 189 | 192 |
| June 30 | 190 | 191 |
| September 30 | 191 | |
| December 31 | 190 | |
| Number of freestanding outpatient surgical centers in operation at: | ||
| March 31 | 119 | 125 |
| June 30 | 118 | 124 |
| September 30 | 123 | |
| December 31 | 121 | |
| Licensed hospital beds at(a): | ||
| March 31 | 50,459 | 50,571 |
| June 30 | 50,550 | 50,485 |
| September 30 | 50,577 | |
| December 31 | 50,436 | |
| Weighted average beds in service(b): | ||
| Quarter: | ||
| First | 42,848 | 42,862 |
| Second | 42,905 | 42,858 |
| Third | 42,896 | |
| Fourth | 42,985 | |
| Year | 42,901 | |
| Average daily census(c): | ||
| Quarter: | ||
| First | 30,829 | 31,518 |
| Second | 29,571 | 29,399 |
| Third | 29,266 | |
| Fourth | 29,442 | |
| Year | 29,899 | |
| Admissions(d): | ||
| Quarter: | ||
| First | 580,258 | 576,361 |
| Second | 579,562 | 566,061 |
| Third | 577,804 | |
| Fourth | 576,839 | |
| Year | 2,297,065 | |
| Equivalent admissions(e): | ||
| Quarter: | ||
| First | 1,023,575 | 1,012,090 |
| Second | 1,044,384 | 1,017,994 |
| Third | 1,038,799 | |
| Fourth | 1,038,269 | |
| Year | 4,107,152 | |
| Average length of stay (days)(f): | ||
| Quarter: | ||
| First | 4.8 | 4.9 |
| Second | 4.6 | 4.7 |
| Third | 4.7 | |
| Fourth | 4.7 | |
| Year | 4.8 |
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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS (Continued)
| Emergency room visits(g):Quarter: | 2026 | 2025 |
|---|---|---|
| First | 2,509,083 | 2,518,716 |
| Second | 2,526,147 | 2,439,763 |
| Third | 2,477,474 | |
| Fourth | 2,511,009 | |
| Year | 9,946,962 | |
| Outpatient surgeries(h): | ||
| Quarter: | ||
| First | 240,061 | 246,620 |
| Second | 246,947 | 258,365 |
| Third | 253,426 | |
| Fourth | 264,401 | |
| Year | 1,022,812 | |
| Inpatient surgeries(i): | ||
| Quarter: | ||
| First | 133,262 | 133,759 |
| Second | 133,041 | 136,122 |
| Third | 138,563 | |
| Fourth | 136,961 | |
| Year | 545,405 | |
| Days revenues in accounts receivable(j): | ||
| Quarter: | ||
| First | 53 | 54 |
| Second | 55 | 51 |
| Third | 50 | |
| Fourth | 51 | |
| Outpatient revenues as a % of patient revenues(k): | ||
| Quarter: | ||
| First | 37% | 37% |
| Second | 34% | 38% |
| Third | 38% | |
| Fourth | 40% | |
| Year | 38% |
(a)
Licensed beds are those beds for which a facility has been granted approval to operate from the applicable state licensing agency.
(b)
Represents the average number of beds in service, weighted based on periods owned.
(c)
Represents the average number of patients in our hospital beds each day.
(d)
Represents the total number of patients admitted to our hospitals and is used by management and certain investors as a general measure of inpatient volume.
(e)
Equivalent admissions are used by management and certain investors as a general measure of combined inpatient and outpatient volume. Equivalent admissions are computed by multiplying admissions (inpatient volume) by the sum of gross inpatient revenues and gross outpatient revenues and then dividing the resulting amount by gross inpatient revenues. The equivalent admissions computation “equates” outpatient revenues to the volume measure (admissions) used to measure inpatient volume resulting in a general measure of combined inpatient and outpatient volume.
(f)
Represents the average number of days admitted patients stay in our hospitals.
(g)
Represents the number of patients treated in our emergency rooms.
(h)
Represents the number of surgeries performed on patients who were not admitted to our hospitals. Pain management and endoscopy procedures are not included in outpatient surgeries.
(i)
Represents the number of surgeries performed on patients who have been admitted to our hospitals. Pain management and endoscopy procedures are not included in inpatient surgeries.
(j)
Revenues per day is calculated by dividing revenues for the quarter by the days in the quarter. Days revenues in accounts receivable is then calculated as accounts receivable at the end of the quarter divided by revenues per day.
(k)
Represents the percentage of patient revenues related to patients who are not admitted to our hospitals. The decline in the second quarter of 2026 is primarily related to the impact of incremental inpatient revenues related to the Florida state directed payment program.
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ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
The information called for by this item is provided under the caption “Market Risk” under Item 2, “Management’s Discussion and Analysis of Financial Condition and Results of Operations.”
ITEM 4. CONTROLS AND PROCEDURES
Evaluation of Disclosure Controls and Procedures
HCA’s management, with the participation of HCA’s chief executive officer and chief financial officer, has evaluated the effectiveness of HCA’s disclosure controls and procedures as of June 30, 2026. Based on that evaluation, HCA’s chief executive officer and chief financial officer concluded that HCA’s disclosure controls and procedures were effective as of June 30, 2026.
Changes in Internal Control Over Financial Reporting
During the period covered by this report, there have been no changes in our internal control over financial reporting that have materially affected or are reasonably likely to materially affect our internal control over financial reporting.
PART II. OTHER INFORMATION
ITEM 1. LEGAL PROCEEDINGS
The information set forth in “Note 8 – Contingencies” in the notes to the condensed consolidated financial statements is incorporated herein by reference.
ITEM 1A. RISK FACTORS
Reference is made to the factors set forth under the caption “Forward-Looking Statements” in Part I, Item 2 of this quarterly report on Form 10-Q and other risk factors described in our annual report on Form 10-K for the year ended December 31, 2025, which are incorporated herein by reference. There have not been any material changes to the risk factors previously disclosed in our annual report on Form 10-K for the year ended December 31, 2025.
ITEM 2. UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS
During January 2026, our Board of Directors authorized a share repurchase program for up to $10 billion of our outstanding common stock. During the quarter ended June 30, 2026, we repurchased 4,752,930 shares of our common stock at an average price of $414.25 per share through market purchases pursuant to the January 2026 authorization. At June 30, 2026, we had $7.210 billion of repurchase authorization available under the January 2026 authorization.
The following table provides certain information with respect to our repurchases of common stock from April 1, 2026 through June 30, 2026 (dollars in billions, except per share amounts).
| Period | Total Numberof Shares Purchased | Average Price Paid per Share | Total Numberof Shares Purchased as Part of Publicly Announced Plans or Programs | Approximate Dollar Value of Shares That May Yet Be Purchased Under Publicly Announced Plansor Programs |
|---|---|---|---|---|
| April 1, 2026 - April 30, 2026 | 928,213 | $475.23 | 928,213 | $8.738 |
| May 1, 2026 - May 31, 2026 | 1,951,116 | $418.99 | 1,951,116 | 7.921 |
| June 1, 2026 - June 30, 2026 | 1,873,601 | $379.12 | 1,873,601 | $7.210 |
| Total for second quarter 2026 | 4,752,930 | $414.25 | 4,752,930 |
On July 23, 2026, our Board of Directors declared a quarterly dividend of $0.78 per share on our common stock payable on September 30, 2026 to stockholders of record at the close of business on September 16, 2026. Future declarations of quarterly dividends and the establishment of future record and payment dates are subject to the final determination of our Board of Directors.
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ITEM 5. OTHER INFORMATION
(c) During the three months ended June 30, 2026, no director or officer (as defined in Rule 16a-1(f) of the Securities Exchange Act of 1934 (the “Exchange Act”)) of the Company adopted or terminated a “Rule 10b5-1 trading arrangement” or “non-Rule 10b5-1 trading arrangement,” as each term is defined in Item 408(a) of Regulation S-K.
ITEM 6. EXHIBITS
(a) List of Exhibits:
| | | |
4.1 — Supplemental Indenture No. 54, dated as of April 30, 2026, among HCA Inc., HCA Healthcare, Inc., CSC Delaware Trust Company, as trustee, and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent (filed as Exhibit 4.2 to the Company’s Current Report on Form 8-K filed on April 30, 2026, and incorporated herein by reference). 4.2 — Supplemental Indenture No. 55, dated as of April 30, 2026, among HCA Inc., HCA Healthcare, Inc., CSC Delaware Trust Company, as trustee, and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent (filed as Exhibit 4.3 to the Company’s Current Report on Form 8-K filed on April 30, 2026, and incorporated herein by reference). 4.3 — Supplemental Indenture No. 56, dated as of April 30, 2026, among HCA Inc., HCA Healthcare, Inc., CSC Delaware Trust Company, as trustee, and Deutsche Bank Trust Company Americas, as paying agent, registrar and transfer agent (filed as Exhibit 4.4 to the Company’s Current Report on Form 8-K filed on April 30, 2026, and incorporated herein by reference). 4.4 — Form of 4.700% Senior Notes due 2031 (included in Exhibit 4.1). 4.5 — Form of 5.000% Senior Notes due 2033 (included in Exhibit 4.2). 4.6 — Form of 5.300% Senior Notes due 2036 (included in Exhibit 4.3). (22) — List of Subsidiary Guarantors and Pledged Securities. 31.1 — Certification of Chief Executive Officer Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. 31.2 — Certification of Chief Financial Officer Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. (32) — Certification Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. (101) — The following financial information from our quarterly report on Form 10-Q for the quarter ended June 30, 2026 filed with the SEC on July 28, 2026, formatted in Inline Extensible Business Reporting Language: (i) the condensed consolidated balance sheets at June 30, 2026 and December 31, 2025, (ii) the condensed consolidated income statements for the quarters and six months ended June 30, 2026 and 2025, (iii) the condensed consolidated comprehensive income statements for the quarters and six months ended June 30, 2026 and 2025, (iv) the condensed consolidated statements of stockholders’ equity (deficit) for the quarters and six months ended June 30, 2026 and 2025, (v) the condensed consolidated statements of cash flows for the six months ended June 30, 2026 and 2025 and (vi) the notes to condensed consolidated financial statements. The instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document. (104) — The cover page from the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2026, formatted in Inline XBRL (included in Exhibit 101).
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