Strong Top-Line and Profitability
Reported Q1 2026 net operating revenues of $5.4 billion and consolidated adjusted EBITDA of $1.162 billion, yielding an adjusted EBITDA margin of 21.6%.
USPI Outperformance and Growth
USPI delivered adjusted EBITDA of $484 million (6% YoY growth) with a 36.7% margin. Same-facility system-wide revenues rose 5.3%, net revenue per case increased 5.6%, and same-facility volumes were essentially stable (down 0.3%).
Hospital Segment Resilience
Hospital segment adjusted EBITDA of $678 million (16.7% margin), representing 27.5% of full-year adjusted EBITDA guidance; same-hospital inpatient adjusted admissions increased 0.6% YoY despite headwinds.
Strong Free Cash Flow and Liquidity
Generated $978 million of adjusted free cash flow in Q1, ended the quarter with $2.97 billion cash on hand, no borrowings on the revolver, and no significant debt maturities until late 2027.
Capital Return to Shareholders
Repurchased 1.35 million shares for $318 million in Q1 and signaled continued share repurchases given current valuations.
Active M&A and Capital Deployment for USPI
Invested $125 million in Q1 to acquire 7 ASCs and commenced patient care at 3 de novo centers (about half of the targeted full-year USPI M&A spend of $250 million), with a robust pipeline of potential assets.
Operational and Technology Productivity Gains
Execution of expense initiatives and technology/AI investments improved productivity and throughput—Conifer analytics productivity reportedly doubled or more; pilots include EMR integrations, ambient scribe, automated discharge summaries and autonomous professional fee coding.
Deleveraging and Financial Discipline
Reported leverage of 2.24x EBITDA (2.83x EBITDA less NCI), reaffirmed full-year guidance and stated normalized adjusted EBITDA growth expectation of ~10% at midpoint (excluding non-recurring items and premium tax credit expiration).