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Tenet: strong margin, softer hospitals
Tenet reported $5.4 billion in revenue and $702 million in net income for the quarter. Operating income reached $1.3 billion, a 24.1% margin, but the headline was lifted by $413 million in revenue from the early end of Conifer’s revenue cycle contract with CommonSpirit Health. Underneath, same-hospital net patient revenue fell 1.5%, reflecting the loss of a prior-year Medicaid supplemental payment and fewer exchange admissions. Respiratory admissions were down 41% from a year earlier.
The ambulatory business carried growth. Revenue in that segment rose 10.6% to $1.3 billion, with double-digit growth in joint replacements. Tenet reaffirmed 2026 revenue guidance of $21.5 billion to $22.3 billion and still expects a $250 million hit this year from the expiration of enhanced ACA subsidies.
UHS: weaker winter, steady guidance
UHS posted $4.5 billion in revenue, up almost 10%, and net income of nearly $349 million. Acute care volumes fell 200 basis points, which executives attributed to a mild respiratory season and winter storms; same-facility adjusted admissions were flat. The company lost about $15 million from the end of enhanced subsidies and expects about $75 million for the year. Executives estimated the true decline in ACA admissions at 10% to 12% after grace-period enrollees are counted. UHS kept full-year revenue guidance of $18.4 billion to $18.8 billion and said behavioral health staffing investments are starting to pay off.
What nonprofit leaders can take from this
- Separate one-time gains from run rate. Tenet’s margin shows how a single contract event can mask flat core performance.
- Measure the subsidy cliff directly. Both companies are tracking exchange admissions and dollars lost. Few nonprofits report the figure this precisely.
- Outpatient capacity is the growth engine. Ambulatory surgery and outpatient capture offset inpatient softness for both.
- Weather and viral seasons matter. A mild flu season can cut admissions sharply, so budgets should include seasonal scenarios.
Archive entry for May 6, 2026, added Nov. 11, 2026.