How much of HCA revenue comes from medicaid?
Based on HCA Healthcare’s most recent full-year SEC filings for 2025, approximately 12.7% of their net patient service revenues come from Medicaid.
Because HCA is the largest for-profit hospital operator in the United States, that relatively small percentage translates to a massive dollar amount:
- Total 2025 Revenue: HCA generated $75.6 billion in revenue in 2025.
- Medicaid Dollar Amount: At 12.7%, Medicaid accounts for roughly $9.6 billion of their annual top-line revenue.
The Full Payor Mix
HCA breaks its government payer mix down into traditional fee-for-service and managed care. Here is how their patient revenue is distributed according to their 2025 10-K filing:
| Payor Source | Percentage of Patient Revenue |
|---|---|
| Commercial / Managed Care | ~48.0% |
| Medicare (Traditional + Managed) | 32.7% (14.9% Traditional, 17.8% Managed) |
| Medicaid (Traditional + Managed) | 12.7% (7.8% Traditional, 4.9% Managed) |
| Other (Self-pay, International, etc.) | ~6.6% |
Key Insight: HCA’s overall Medicaid exposure (12.7%) is slightly lower than Universal Health Services (15%). This is primarily because HCA focuses heavily on acute care and high-margin surgical centers in economically growing suburban markets, whereas UHS has a massive behavioral health division, which inherently relies more on Medicaid.
However, even at 12.7%, Medicaid is critical to HCA's profitability. In their recent 2025 and early 2026 earnings calls, HCA executives specifically highlighted hundreds of millions of dollars in adjusted earnings driven directly by finalized Medicaid state supplemental payment programs—particularly in massive markets like Texas and Florida. Because these supplemental payments often drop straight to the bottom line, the new federal caps on State Directed Payments are still a major headwind for the company.