The Ledger

6.12 dollars: that is the adjusted per share profit Tenet Healthcare posted for the second quarter, nearly 1.86 dollars above what Wall Street expected, and investors sent the stock up double digits within hours. Tenet Healthcare reported second quarter 2026 results July 23, 2026, with revenue of 5.63 billion dollars, up 6.8 percent year over year and above analyst estimates of roughly 5.43 billion dollars; net income attributable to shareholders was 826 million dollars, or 9.84 dollars a share on a GAAP basis, up from 288 million dollars, or 3.14 dollars a share, a year earlier, while adjusted earnings per share of 6.12 dollars beat the roughly 4.26 dollar consensus estimate. The hospital operator raised its full year 2026 guidance to earnings per share of 20.30 to 21.69 dollars, up from a prior outlook near 17.81 dollars, and to revenue of 21.9 to 22.5 billion dollars, citing same store revenue growth and expense control; shares jumped as much as 15 percent, helped along by what investors called an improving credit story tied to recent deleveraging. Confidence: High, since the figures come directly from the company’s own earnings release. Source: Tenet Reports Strong Second Quarter 2026 Results, Raises 2026 Financial Outlook, Tenet Healthcare newsroom.

400 million dollars: that is the size of two nearly equal and opposite forces that hit HCA Healthcare’s bottom line last quarter, one a hit from patients who lost Affordable Care Act exchange coverage, the other a boost from Florida’s Medicaid program. HCA Healthcare, the country’s largest for profit hospital operator, reported second quarter 2026 revenue of 20.230 billion dollars, up 8.7 percent from a year earlier, net income attributable to the company of 1.699 billion dollars, up 2.8 percent, diluted earnings per share of 7.62 dollars, up 11.6 percent, and adjusted EBITDA of 4.027 billion dollars, up 4.6 percent; same facility admissions rose 2.5 percent and emergency room visits rose 3.6 percent, while inpatient surgeries fell 2.3 percent and outpatient surgeries fell 3.4 percent. The company said an increase in uninsured volume, primarily patients who lost coverage on the health insurance exchanges, had an unfavorable impact on income before income taxes of approximately 400 million dollars in the quarter, an impact it said was almost entirely offset by approximately 400 million dollars of incremental net benefit from Medicaid Supplemental Payment Programs, primarily the state of Florida’s program, the same category of provider tax funded payments a newly proposed federal rule is now moving to restrict. Confidence: High on the figures, since they come from the company’s own earnings release; Medium on how durable the offsetting Medicaid benefit is, given federal scrutiny of the underlying financing mechanism. Sources: HCA Healthcare Reports Second Quarter 2026 Results, HCA Healthcare investor relations, HCA Healthcare’s Form 8-K, second quarter 2026 earnings exhibit, U.S. Securities and Exchange Commission.

A+ from A: that is the ratings upgrade a top insurance rating agency handed Delta Dental of California this week, a signal of balance sheet strength in a dental insurance market drawing growing private equity attention. AM Best announced July 23, 2026 that it upgraded the Financial Strength Rating of Delta Dental of California and its affiliates to A+ (Excellent) from A (Excellent), and the Long-Term Issuer Credit Ratings to “aa-” from “a+”, with a stable outlook, citing the company’s balance sheet strength, operating performance, business profile and enterprise risk management. The upgrade lands as private equity backed dental service organizations continue rolling up practices nationally, a contrast this issue has tracked before: a stronger balance sheet at one of the country’s largest nonprofit dental insurers, even as the delivery side of the market consolidates under PE ownership. Confidence: High, since the rating action comes directly from AM Best’s own release. Source: AM Best Upgrades Credit Ratings for Delta Dental of California and Its Affiliates, AM Best.

19.1 percent: that is how much Quest Diagnostics grew per share profit last quarter, and the country’s largest independent lab operator raised its full year outlook for the second time this year on the back of it. Quest Diagnostics reported second quarter 2026 revenue of 3.04 billion dollars, up 10.2 percent year over year on 10.0 percent organic growth, reported diluted earnings per share of 2.84 dollars, up 15.0 percent, and adjusted diluted earnings per share of 3.12 dollars, up 19.1 percent; the company raised full year 2026 guidance to revenue of 11.95 to 12.05 billion dollars, reported diluted earnings per share of 9.97 to 10.17 dollars, and adjusted diluted earnings per share of 11.05 to 11.25 dollars, citing growth across its physician, hospital and consumer testing channels. For hospital operators reporting alongside it this week, it is a reminder that outside lab volume keeps growing even as some systems’ own surgical volumes soften. Confidence: High, since the figures come directly from the company’s own earnings release. Source: Quest Diagnostics Reports Second Quarter 2026 Financial Results; Raises Revenue and EPS Guidance for Full Year 2026, Quest Diagnostics newsroom.

230: that is how many jobs the University of California’s San Diego hospital system is cutting, and on July 22 hundreds of its workers walked out for a single day in protest. Workers represented by the American Federation of State, County and Municipal Employees (AFSCME) Local 3299 staged a one day unfair labor practice strike July 22, 2026 at UC San Diego Health over the system’s plan to eliminate approximately 230 positions, about 1.5 percent of its workforce, including hospital nursing assistants, senior nurse’s aides and lab technicians; the union said 103 of the affected employees are its members and has filed charges alleging the university failed to bargain over the layoffs and their effects, while the health system has pointed to financial pressure including reimbursement trends. Separately, Novant Health, the Winston-Salem, North Carolina system that operates 21 hospitals across the Carolinas, confirmed July 22, 2026 it is eliminating 31 revenue cycle positions system-wide, including roles at its New Hanover Regional Medical Center in Wilmington, as part of an effort to reduce redundancy and modernize revenue cycle operations. Confidence: Medium on the precise headcounts, since the figures rest on union statements and trade press reporting rather than each system’s own numeric disclosure. Sources: Hundreds strike UC hospitals over ‘unnecessary’ job cuts, Becker’s Hospital Review, UC San Diego Health lays off 230 workers, Healthcare Dive, Novant Health cutting 31 revenue cycle roles, Becker’s Hospital Review.

FRONTIER SCAN: 500: that is how many US healthcare facilities a new report found operating inside joint ventures between private equity firms and nonprofit hospitals, a structure researchers say may let private equity sidestep the wave of new state laws built to screen it out. The Private Equity Stakeholder Project, a nonprofit research and advocacy group that tracks private equity’s footprint in health care, reported July 6, 2026 that more than 500 healthcare facilities, spanning hospitals, rehabilitation facilities, ambulatory surgery centers, hospice, home health and behavioral health, now operate through joint ventures between private equity owned companies and nonprofit health systems, against a backdrop of more than 1 trillion dollars in private equity investment in US health care over the past decade; the group found 21.4 percent of private equity owned hospitals use joint venture structures with nonprofit partners, and singled out Apollo Global Management owned LifePoint Health, which the report says runs 61 percent of its hospitals through such arrangements. Much of the federal guidance governing nonprofit and for profit joint ventures dates to 1998 through 2004, well before private equity’s current scale in health care, and the report’s authors argue existing oversight frameworks may not fully account for these structures; a live test is already underway, per Stateline, the nonprofit news service, which reported July 13, 2026 that a hospice joint venture between Compassus and Providence has drawn state merger review scrutiny in California, Oregon and Washington, three states that have each passed new laws in the past two years meant to screen private equity transactions in health care. For corporate development teams and state regulators alike, the open question is whether joint venture structures, as opposed to outright acquisitions, trigger the new review laws at all. Confidence: High on the report’s headline figures, since they come from the research group’s own published report; Medium on how the framing extends to any single jurisdiction’s transaction review law, since this is advocacy research rather than a regulatory or judicial finding. Sources: Private Equity’s Joint Venture Takeover of Nonprofit Healthcare, Private Equity Stakeholder Project, Private equity might dodge state laws by partnering with healthcare nonprofits, Stateline.

THE DEAL SHEET

Target	Acquirer/Investor	Vertical	Value	Source
Transcripta Bio	Mayo Clinic, Omnimed, JAZZ Venture Partners, BlueYard Capital	AI drug discovery, neurological and neuromuscular disease	$24 million seed round	Pro Rata, Axios
Prosper Medical	FUSE (led)	Digital health, AI driven concierge primary care	$16 million seed round	Prosper Medical banks $16M to scale AI-driven concierge care platform, Fierce Healthcare

No private equity buyout, strategic merger, or bankruptcy transaction was confirmed against a primary source in the last 24 to 48 hours; the two venture financings above were the only healthcare deals we could verify in the window.

Tenet Healthcare and HCA Healthcare both reported today. Universal Health Services reports July 27, Centene around July 28, Boston Scientific July 29, Humana and Privia Health both around July 29 to August 6, and Cigna July 30.