Grade History
| Quarter | Disclosure Quality | Financial Quality |
|---|---|---|
| Q1'25 → | B+ | B |
| Q2'25 → | B+ | B+ |
| Q3'25 → | B+ | B+ |
| Q4'25 → | B+ | B |
| Q1'26 → | B+ | B |
Promise Ledger · All Quarters
| Marked | Promise | Status | |
|---|---|---|---|
| Q1'26 | ⏳ | Same-hospital admission growth of 1% to 2% for 2026 Q1 delivered 0.6% despite respiratory headwinds, on track | pending |
| Q1'26 | ✅ | We will continue to have a balanced approach to share repurchases $318M in Q1 buybacks, up from $198M in Q4 | delivered |
| Q1'26 | ✅ | Continued outstanding cash collection performance at Conifer Generated $978M adjusted free cash flow, well above expectations | delivered |
| Q1'26 | ✅ | We will continue to prioritize capital investments to grow USPI through M&A Acquired 7 ASCs plus 3 de novo centers in Q1, aggressive pace | delivered |
| Q1'26 | ⏳ | $250 million annual target for USPI M&A in 2026 Already deployed $125M in Q1 - 50% of annual target achieved | pending |
| Q1'26 | ✅ | We expect first-quarter 2026 consolidated adjusted EBITDA to be 24% of full-year at midpoint Q1 delivered $1.162B, implying 25%+ of midpoint annual guidance | exceeded |
| Q4'25 | ❌ | Respiratory season recovery from Q3 weakness Continued weakness through Q4, impacted volumes | missed |
| Q4'25 | ❌ | Hospital same-store volume growth momentum from Q3 Admissions went from +1.4% in Q3 to flat in Q4 | missed |
| Q4'25 | ✅ | Increased CapEx investments to $875-975M for 2025 Executed the $150M increase for growth initiatives | delivered |
| Q4'25 | ✅ | Continue adding additional centers in Q4 Added 35 facilities for full year, $350M invested | delivered |
| Q4'25 | ✅ | USPI same-facility revenue growth 'well above 3-6% long-term goal' 7.5% for full year, consistently outperformed | delivered |
| Q4'25 | ✅ | Free cash flow minus NCI of $1.495-1.695B for 2025 Delivered strong performance driven by Conifer collections | exceeded |
| Q4'25 | ✅ | Full year 2025 adjusted EBITDA guidance of $4.47-4.57B raised from $4.42-4.52B Hit $4.566B, at high end of raised range | delivered |
| Q3'25 | ✅ | Continue balanced approach to share repurchases Though Q3 buybacks lower at $93M vs $747M in Q2, YTD total of $1.2B remains substantial | delivered |
| Q3'25 | ✅ | Maintain disciplined cost controls and labor management SWB improved to 41.7% of revenues, contract labor only 1.9% of SWB expenses | delivered |
| Q3'25 | ✅ | Strong free cash flow conversion from EBITDA growth FCF guidance raised $250M at midpoint, demonstrating strong conversion capability | exceeded |
| Q3'25 | ✅ | Open Port St. Lucie hospital facility Opened in September with comprehensive emergency and specialty care as planned | delivered |
| Q3'25 | ✅ | Continue same-facility revenue growth above long-term expectations 8.3% same-facility growth vs 7.7% prior quarter, ahead of long-term 4-7% range | delivered |
| Q3'25 | ✅ | Exceed $250M baseline USPI M&A spend in 2025 Nearly $300M spent YTD, well ahead of target with Q4 activity still expected | exceeded |
| Q2'25 | ✅ | Commitment to deleveraged balance sheet Leverage at 2.45x, within target range and improving | delivered |
| Q2'25 | ✅ | No adjustments to full year 2025 outlook in Q1 Raised guidance by $395M at midpoint - major beat | exceeded |
| Q2'25 | ✅ | Focus on higher acuity service offerings in hospitals Case mix up 1%, revenue per admission up 5.2% - strategy working | delivered |
| Q2'25 | ✅ | Continue to prioritize capital investments to grow USPI Added 8 new centers in Q2, clear execution on growth strategy | delivered |
| Q2'25 | ✅ | Plan to be active repurchasers of our shares $747M in Q2 vs $348M in Q1 - dramatically accelerated pace | exceeded |
| Q2'25 | ✅ | Baseline of approximately $250 million towards USPI M&A each year Now expecting to exceed $250M in 2025 - delivered above commitment | exceeded |
| Q1'25 | ⏳ | 10 to 12 de novo centers in 2025 No specific update on de novo progress | pending |
| Q1'25 | ⏳ | Approximately $250 million each year towards M&A in ambulatory space Added six centers in Q1, on track | pending |
| Q1'25 | ✅ | Active share repurchasers in 2025 given attractive valuations $348M Q1 repurchases, $1.4B annual pace | delivered |
| Q1'25 | ⏳ | Free cash flows in the range of $1.8 to $2.05 billion for 2025 $642M Q1 suggests strong start toward guidance | pending |
| Q1'25 | ✅ | Same-hospital admissions growth of 2% to 3% in 2025 Q1 delivered 4.4%, well above high end of range | exceeded |
| Q1'25 | ✅ | Same-facility revenue growth of 3% to 6% for USPI in 2025 Q1 delivered 6.8%, above midpoint of range | exceeded |
Get the next THC call sheet the day it drops.
Subscribe to Call Sheet Daily →