- Company name
- Tenet Healthcare
- Sector
- Hospitals and ambulatory surgery centers
- About
- Tenet Healthcare Corporation (Tenet) is a healthcare services company based in Dallas, Texas. Its Hospital Operations segment ran 51 hospitals in eight states and 135 outpatient facilities at September 30, 2026. Its Ambulatory Care segment is United Surgical Partners International (USPI), which held interests in 535 surgery centers, 406 of them consolidated, and 25 surgical hospitals in 37 states. Net operating revenues were $5,631 million in Q3 2026 and $16,627 million for nine months. Saum Sutaria, M.D., is Chairman and Chief Executive Officer. The common stock trades on the NYSE in US dollars. Tenet files 10-K and 10-Q reports.
- Thesis
- The price of Tenet reflects fast earnings growth in 2026, and it depends on whether 2027 earnings can hold as payment rules change. Adjusted EBITDA rose 23.3% to $1,355 million in Q3 2026, and management raised its 2026 outlook for adjusted EBITDA to $5.05 billion to $5.20 billion. USPI, the surgery center business, grew adjusted EBITDA 9.1% to $537 million. Tenet bought back 7.99 million shares for $1.615 billion in nine months. Q3 included a net favorable $147 million from the early end of the revenue cycle contract with CommonSpirit Health. For the price to hold or rise, four things must be true. Same-facility revenue must keep growing as exchange admissions fall. USPI must keep growing as surgical cases are flat to lower. Medicaid payment limits that start in 2027 must cost less than Tenet's cost savings. Tenet must keep buying back shares while net debt stays near 2 times adjusted EBITDA. The Q4 2026 report, expected in February 2027, and the 2027 outlook are the next tests.
- Risks
- Payment rules are changing. The 10-Q says that the One Big Beautiful Bill Act brings Medicaid work requirements, caps on state-directed payments and limits on provider taxes from 2027. Tenet cannot yet estimate the effect.
Exchange volumes are falling. Enhanced premium tax credits for marketplace coverage ended at the end of 2025. Tenet reports lower exchange admissions and an unfavorable payer mix.
Debt is large. Long-term debt was $13,079 million at September 30, 2026, and interest expense is guided to $815 million to $825 million for 2026. Net debt was 2.11 times adjusted EBITDA.
Q3 results include timing items. The CommonSpirit transition added a net $147 million to Q3 adjusted EBITDA. The release says that the timing part does not change the full year, so Q4 will not show the same gain.
Surgical cases are not growing. Same-facility system-wide surgical cases at USPI fell 1.5% in Q3 2026. Price per case rose 6.1%, but a longer fall in cases would slow growth.
- Balance sheet
- Cash: $2.7B
Debt: $13.2B
Net debt: $10.6B
Debt due within 12 months: $164M
At September 30, 2026, Tenet had cash and cash equivalents of $2,674 million. Long-term debt was $13,079 million, and the current part was $164 million. The release gives a ratio of net debt to adjusted EBITDA of 2.11, against 2.25 at December 31, 2025. The senior secured revolving credit facility allows borrowings of up to $1.900 billion. In September 2026, Tenet issued $2.0 billion of 6.250% senior notes due 2034 and redeemed the 5.125% notes due 2027 and part of the 6.125% notes due 2028. Adjusted free cash flow was $2,524 million for nine months. Tenet repurchased 7.99 million shares for $1.615 billion in nine months.
As of Sep 30, 2026.
- Checkpoints
- Feb 10, 2027 (estimate): Q4 2026 results and 2027 outlook. Pending. Watch: Adjusted EBITDA for 2026 is in the raised range of $5.05 billion to $5.20 billion and the 2027 outlook shows earnings above 2026, and this passes; a lower outlook fails.
2027 (estimate): Medicaid payment limits start. Pending. Watch: Tenet shows that the cost of the new Medicaid rules is smaller than its savings and growth, and this passes; a large cut in supplemental payments fails.
- Recent events
- Oct 30, 2026: Tenet said that the transition of its revenue cycle management services for CommonSpirit Health will be substantially complete by this date, earlier than the end of 2026. In Q3 2026 it booked catch-up revenue from contract termination of $233 million and a net favorable $147 million to adjusted EBITDA.
Oct 29, 2026: Tenet reported Q3 2026 results. Net income available to common shareholders was $1.000 billion, or $12.41 per diluted share. Adjusted diluted earnings per share rose 79.5% to $6.64. It raised its 2026 outlook for adjusted EBITDA to $5.05 billion to $5.20 billion and for adjusted free cash flow to $2.825 billion to $3.125 billion.
Sep 22, 2026: Tenet filed an 8-K for its private placement of $2.0 billion of 6.250% senior notes due 2034. It used the proceeds and cash to redeem all $1.5 billion of its 5.125% senior secured first lien notes due 2027 and $500 million of its 6.125% senior notes due 2028.
Jan 1, 2026: Tenet redeemed the minority interest of Catholic Health Initiatives, now CommonSpirit Health, in Conifer. This cut its redeemable noncontrolling interests by $846 million and raised additional paid-in capital by $306 million.