Universal Health Services, Inc. (UHS) reported fourth‑quarter 2025 results that fell short of analyst consensus on both revenue and earnings per share. Net income attributable to UHS rose to $445.9 million, or $7.06 per diluted share, up 33% from $332.4 million ($4.96 per share) in the same quarter a year earlier. Revenue reached $4.49 billion, a 9.1% year‑over‑year increase, but missed the consensus estimate of $4.51 billion to $4.55 billion by roughly $20 million to $60 million. The miss was largely attributed to softness in the Las Vegas market, where lower respiratory case levels reduced acute‑care volumes.
Adjusted earnings attributable to UHS were $371.4 million, or $5.88 per diluted share, compared with $329.9 million ($4.92 per share) in Q4 2024. Adjusted EPS of $5.88 fell short of the consensus estimate of $5.92 to $5.96 by $0.04 to $0.08, a miss of less than 1.5%. The slight shortfall was driven by higher operating costs and a modest decline in the mix of high‑margin acute‑care services, offset by a $101 million contribution from new hospital openings.
Adjusted EBITDA net of non‑controlling interests climbed to $678.7 million, up 10% from $614.6 million a year earlier, reflecting continued operational leverage and a margin expansion to 15.1% from 14.9% in the prior‑year quarter. The margin growth was supported by disciplined cost management and a favorable mix shift toward higher‑margin behavioral‑health services, which grew 8.6% to over $1.9 billion.
UHS also reported a favorable tax benefit and an after‑tax unrealized gain of $71.5 million, or $1.11 per diluted share, from its minority ownership in a healthcare generative‑AI company. This gain contributed to the reported earnings and underscored the company’s strategic investment in emerging technologies.
Management guided for full‑year 2026 revenue of $18.4 billion to $18.8 billion, adjusted EBITDA net of NCI of $2.64 billion to $2.79 billion, and adjusted net income per diluted share of $22.64 to $24.52. The guidance represents a new outlook, not a revision of prior guidance, and signals confidence in sustaining growth amid regulatory and staffing headwinds. CEO Marc Miller noted that “softness in the Las Vegas market due to lower respiratory case levels slightly impacted acute care volumes,” highlighting the specific market pressure that contributed to the revenue miss.
Investors reacted to the earnings miss by focusing on the shortfall against consensus estimates. The market’s response was driven by the revenue miss and the EPS shortfall, which, although modest, indicated that UHS may face challenges in meeting analyst expectations in the near term. The company’s ability to maintain margin expansion and its strategic investments in AI and new facilities suggest a resilient long‑term trajectory, but the immediate miss underscores the importance of managing headwinds in key markets.
Overall, UHS’s Q4 2025 results demonstrate solid year‑over‑year growth in net income and adjusted earnings, but the revenue and EPS misses highlight ongoing market softness and the need for continued cost discipline. The company’s guidance for 2026 reflects confidence in its growth strategy, while the market’s focus on consensus misses signals a cautious outlook for the near term.
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