Total Revenue

+3% " " " " "

Total revenue increased from $5,103 million in Q2 2024 to $5,271 million in Q2 2025. This modest improvement builds on earlier organic growth and strategic acquisitions, with earlier trends in both hospital and ambulatory segments helping create a broader revenue base despite prior divestitures affecting previous periods. " " " " "

Hospital Operations Revenue

+1% " " " " "

Hospital operations revenue grew from $3,962 million to $4,001 million. The slight uptick reflects modest gains from a favorable payer mix and increased patient admissions, though the revenue base remains tempered by the lingering effects of earlier hospital divestitures, which had a material impact on previous periods. " " " " "

Ambulatory Care Revenue

+11% " " " " "

Ambulatory care revenue increased from $1,141 million to $1,270 million, driven by continued contributions from acquisitions and same-facility growth. This trend aligns with prior period improvements seen in the segment, supported by expanded service lines and higher net revenue per case. " " " " "

Ambulatory Care Net Patient Service Revenue

+88% " " " "

Net patient service revenues within ambulatory care surged from $1,100 million to $2,067 million. This exceptional increase suggests a significant impact from the integration of acquired facilities and de novo centers, along with enhanced same-facility revenue capture—continuing trends noted in previous periods. " " " "

Full Year 2025 Adjusted EBITDA

FY 2025

no prior guidance

$4,400,000,000 to $4,540,000,000 " "

no prior guidance

Full Year 2025 Consolidated Net Operating Revenues

FY 2025

no prior guidance

$20,950,000,000 to $21,250,000,000 "

no prior guidance

USPI 2025 Adjusted EBITDA

FY 2025

no prior guidance

$1,990,000,000 to $2,050,000,000 "

no prior guidance

Same Facility USPI Revenue Growth

FY 2025

no prior guidance

4% to 7% (increase of 100 basis points) "

no prior guidance

Hospital Segment 2025 Adjusted EBITDA

FY 2025

no prior guidance

$2,410,000,000 to $2,490,000,000 "

no prior guidance

Hospital Adjusted Admissions Growth

FY 2025

no prior guidance

1.5% to 2.5% "

no prior guidance

2025 Free Cash Flows

FY 2025

no prior guidance

$2,025,000,000 to $2,275,000,000 "

no prior guidance

Distributions to Non-Controlling Interest

FY 2025

$750,000,000 to $800,000,000 "

$780,000,000 to $830,000,000 "

raised

Free Cash Flow After NCI

FY 2025

$1.05 billion to $1.25 billion "

$245,000,000 to $1,445,000,000 (increase of $195,000,000 at midpoint) "

raised

Third Quarter 2025 Consolidated Adjusted EBITDA

Q3 2025

no prior guidance

22.5% to 23.5% of full year adjusted EBITDA "

no prior guidance

Third Quarter 2025 USPI EBITDA

Q3 2025

no prior guidance

23.5% to 24.5% of full year USPI adjusted EBITDA "

no prior guidance

Regulatory and Policy Environment

Q1 discussed policy uncertainties and proactive engagement in shaping legislative proposals. " " Q4 highlighted both tailwinds (Medicaid supplemental payments, redetermination) and uncertainties (Medicaid cuts, broader regulatory change). " " " Q3 had indirect mentions via Medicaid supplemental programs. " "

Q2 focused on ACA exchanges, Medicaid redetermination, new legislative proposals with uncertainty, and emphasized exchange subsidies. " "

The focus remains consistent on regulatory frameworks and policy uncertainties—with ongoing attention to Medicaid and exchange subsidies and a slightly heightened concern over legislative uncertainty. " "

Operational Performance, Margin Expansion, and Free Cash Flow Generation

Q1, Q4, and Q3 consistently reported strong same‐store revenue growth, improved margins, and robust free cash flow generation. " " " " " "

Q2 reported a 19% increase in adjusted EBITDA, significant margin expansion, and ample free cash flow generation. " "

There is a consistent strong performance with continued margin improvement and enhanced free cash flow, reinforcing a positive operational outlook. " "

High-Acuity Procedures and ASC Expansion

Q1, Q4, and Q3 emphasized a strategic shift toward higher-acuity procedures and aggressive ASC expansion—highlighting increases in joint replacements and de novo developments. " " " " " " "

Q2 underscored a continued strategic focus on high-acuity service lines and ASC expansion, specifically mentioning the addition of eight new centers and active pursuit of M&A opportunities. " " " "

The commitment to high-acuity procedures and ASC expansion remains steady, with increased investments and new center additions reinforcing the growth strategy. " "

Volume, Mix, and Elective Surgery Demand

Q1 reported robust volume growth and strong payer mix; Q4 noted that the volume environment remained solid despite some seasonal adjustments; Q3 stressed a favorable mix and a shift toward higher acuity. " " " " "

Q2 noted strong volumes with the right mix, though there was mention of a deceleration attributed to seasonality. "

Demand remains robust with a favorable payer mix; however, minor seasonal adjustments are now more apparent, indicating stability with slight volume moderation. "

Labor and Cost Management

Q1 focused on reducing contract labor, maintaining a stable wage environment, and boosting retention. " " " Q4 highlighted initiatives such as the global business center and cost efficiencies, while Q3 detailed improvements in labor cost ratios and efficiency strategies. " " "

Q2 demonstrated improved labor metrics and cost control through a data-driven approach and the integration of AI-enabled technologies for faster dispute resolution. " " "

The emphasis on disciplined labor management and cost efficiency is maintained, with added technological enhancements further strengthening cost control measures. " "

Payer Negotiation, Reimbursement, and Managed Care Challenges

Q1 maintained a stable managed care contracting approach and strong payer mix. " " Q4 addressed commercial rate updates, low denial rates, and revenue cycle efficiency, while Q3 highlighted ongoing challenges with administrative burdens and the benefits of process investments. " " "

Q2 reiterated the focus on multi-year agreements and proactively managing denials and disputes through technology and automation. " "

The approach remains stable, with an increasing reliance on automated technologies to streamline payer negotiations and dispute management, affirming continuity in strategy. " "

Capital Deployment, Share Repurchases, and Guidance Confidence

Q1 emphasized strategic capital deployment—including M&A in ambulatory settings and active share repurchases. " " " Q4 detailed a balanced approach to capital allocation with strong share repurchase activity, and Q3 stressed flexibility in capital allocation with steady guidance. " " " "

Q2 raised full-year guidance, underscored significant share repurchases (e.g., 4.6 million shares for $747 million), and maintained proactive capital deployment priorities. " " "

There is increased optimism and raised full-year guidance, reflecting a stronger confidence in operational fundamentals and an aggressive stance on capital deployment and shareholder returns. " "

Divestitures and Revenue Impact

Q1 mentioned that divestitures led to adjustments in reported uncompensated care and contributed to a one-off impact on EBITDA. " " Q4 detailed the 14-hospital divestitures, their $5 billion proceeds, and non-recurring adjusted EBITDA impacts; Q3 discussed the revenue shortfall from the sale of assets. " " " "

Q2 did not include specific remarks on divestitures, with no detailed discussion on related revenue impacts. " "

The current period shows a diminished focus on divestitures, suggesting that this topic is less prominent or that recent divestiture activity is not impacting current discussions. " "

External Operational Disruptions (Seasonality and Weather-related Impacts)

Q4 addressed both seasonality and weather-related impacts (including weather events affecting elective procedures). " Q3 discussed the impact of hurricanes on operations (with 148 centers affected) while still meeting guidance. " " "

Q2 mentioned only seasonality affecting volumes, with no explicit reference to weather-related disruptions. "

There is a reduced emphasis on weather-related operational disruptions in the current period, with only seasonality cited as an influencing factor, suggesting a more stabilized external environment. "