The Ledger

Universal Health Services filled more beds and earned less per patient last quarter. The hospital and behavioral health operator reported third-quarter results October 27 after the market close. Net revenues rose 5.3% to $4.733 billion from $4.495 billion, but net income attributable to the company fell to $308.7 million from $373.0 million, and diluted earnings per share fell to $5.22 from $5.86, per its 8-K earnings release. Adjusted EBITDA (earnings before interest, taxes, depreciation and amortization), net of noncontrolling interests, was $624.6 million against $670.6 million, and the margin slipped to 13.2% from 14.9%. In acute care, same-facility adjusted admissions rose 4.9% while revenue per adjusted admission fell 1.7%. Behavioral health admissions rose 2.5%, with revenue per adjusted admission up 1.7% and net revenues up 4.0%. The company repurchased about 1.35 million shares for about $242 million in the quarter. Who it hits: hospital operators and lenders pricing acute care payer mix into 2027. So what: volume is not the problem; price per patient is, and behavioral health is again the steadier of the two businesses, which answers the question we raised yesterday. The release cites Medicaid supplemental payment programs, mainly in Washington, D.C. and California, as a favorable item and warns of risk if they are not renewed. It says a tentative litigation settlement was reached in the quarter and that a substantial portion of it is covered. We found no new full-year guidance figures in the release, which refers back to the July 27 forecast. Confidence: High on the figures (company filing); Low on any guidance read, because we did not retrieve the call.

Tenet reports Thursday, with the widest guidance gap in the sector to defend. Tenet’s second-quarter 8-K raised 2026 adjusted EBITDA guidance to $4.83 billion to $5.03 billion, while HCA’s second-quarter release cut its range to $15.4 billion to $16.1 billion on exchange losses. HCA’s third-quarter 8-K then put the exchange hit at about $400 million of pretax income in the quarter. Who it hits: acute-care operators with exchange-heavy markets, and the lenders and vendors that price them. So what: UHS now shows admissions up and price per admission down; Tenet’s surgery center and hospital mix is the next test of whether that pattern holds. This is a preview, and we make no claim about what Tenet will report. Confidence: High on July figures (primary filings); Med on the date, which we have not confirmed on Tenet’s investor site.

UPDATE: the Horizon Blue Cross Blue Shield of New Jersey and Summit Health deal appears to have been announced October 21, not October 26 or 27. Yesterday we reported the purchase with the announcement date unconfirmed. New Jersey business press now dates the agreement October 21 and describes the target as the Berkeley Heights, New Jersey multispecialty physician group, per ROI-NJ (supplemental), and LevinPro lists it October 27. Value is reported above $1 billion; financial terms were not disclosed and the deal is subject to regulatory approval. Who it hits: New Jersey commercial payers and independent physician groups that negotiate with Horizon. So what: the date matters because it means this is a week-old deal now entering review, not a fresh one. We still have not retrieved a company release or regulatory filing. Confidence: Low to Med. Trade press only; the value is reported, not disclosed.

THE DEAL SHEET

No new transactions spotted in the last 24 hours.

Scan covered SEC filings, company releases and trade press for October 27 and 28. No new health system bankruptcy, rating action, closure, or FTC or DOJ healthcare merger action dated in the window could be confirmed from a primary source. Earlier deals, listed for reference and not new: Horizon and Summit Health New Jersey (October 21, reported above $1 billion); HealthSpan Partners and Surgery Partners (October 26, about $5.7 billion, per the 8-K exhibit); Cencora and American Oncology Network (October 21). Frontier scan this run: home health and hospice; only undated or mid-2026 items surfaced (Aveanna’s planned $175.5 million Family First Homecare purchase, per its August call summary), so no story ran.