Is HCA Healthcare Stock Underperforming the S&P 500?

With a market cap of $82.3 billion, HCA Healthcare, Inc. (HCA) is a leading healthcare services company in the United States that provides a broad range of medical services through its subsidiaries. The company owns, manages, and operates hospitals, ambulatory surgery centers, emergency care facilities, urgent care centers, clinics, and various outpatient healthcare services. 

Companies valued at $10 billion or more are generally considered “large-cap” stocks, and HCA Healthcare fits this criterion perfectly. Its hospitals offer comprehensive inpatient and outpatient care, including surgical, diagnostic, cardiac, emergency, and rehabilitation services.

Shares of the Nashville, Tennessee-based company have fallen 33.3% from its 52-week high of $556.52. HCA Healthcare’s shares have decreased nearly 30% over the past three months, underperforming the broader S&P 500 Index’s ($SPX) 10.4% gain over the same time frame. 

HCA stock is down 20.5% on a YTD basis, lagging behind SPX’s 11.1% rise. In the longer term, shares of the company have declined 2.7% over the past 52 weeks, compared to the 28% return of the SPX over the same time frame.

Despite a few fluctuations, HCA stock has been trading below its 50-day moving average since last year. Also, it has fallen below its 200-day moving average since late March.

Shares of HCA Healthcare tumbled 8.8% on Apr. 24 after the company reported weaker-than-expected Q1 2026 adjusted EBITDA of $3.80 billion, despite revenue rising 4% year-over-year to $19.1 billion. Investor sentiment was hurt by the company’s disclosure that it did not experience the usual seasonal volume increase, as respiratory-related admissions and emergency room visits fell 42% and 32% year-over-year, respectively, while January winter storms further reduced patient volumes in certain markets. 

Additionally, HCA reaffirmed its full-year adjusted EBITDA guidance of $15.55 billion to $16.45 billion, which came in below analyst expectations.

In comparison, rival Tenet Healthcare Corporation (THC) has outpaced HCA stock. THC stock has dipped 14.4% on a YTD basis and risen marginally over the past 52 weeks.

Despite the stock’s weak performance, analysts remain moderately optimistic on HCA. The stock has a consensus rating of “Moderate Buy” from the 25 analysts in coverage, and the mean price target of $513.62 is a premium of 38.5% to current levels.