Consolidated Results of Operations, As Reported and As Adjusted  – Three-month periods ended December 31, 2024 and 2023:

KING OF PRUSSIA, Pa., Feb. 26, 2025 /PRNewswire/ -- Universal Health Services, Inc. (NYSE: UHS) announced today that its reported net income attributable to UHS was $332.4 million, or $4.96 per diluted share, during the fourth quarter of 2024, as compared to $216.4 million, or $3.16 per diluted share, during the fourth quarter of 2023. Net revenues increased by 11.1% to $4.114 billion during the fourth quarter of 2024, as compared to $3.704 billion during the fourth quarter of 2023.

As reflected on the Schedule of Non-GAAP Supplemental Information ("Supplemental Schedule"), our adjusted net income attributable to UHS during the fourth quarter of 2024 was $329.9 million, or $4.92 per diluted share, as compared to $214.9 million, or $3.13 per diluted share, during the fourth quarter of 2023. 

As reflected on the Supplemental Schedule, included in our reported results during the fourth quarter of 2024 were: (i) an unrealized after-tax gain of $2.1 million, or $.03 per diluted share ($2.7 million pre-tax), resulting from an increase in the market value of certain equity securities (included in "Other (income) expense, net"), and; (ii) a favorable net after-tax impact of $407,000, or $.01 per diluted share, resulting from the net tax benefit recorded pursuant to "ASU 2016-09", Compensation – Stock Compensation: Improvements to Employee Share-Based Payment Accounting.    

Included in our reported and adjusted net income attributable to UHS during the fourth quarter of 2023, were net incremental reimbursements (net of related provider taxes) of approximately $17.8 million, or $.20 per diluted share, recorded in connection with the Mississippi Hospital Access Program covering the period of July 1, 2023, through December 31, 2023.  In addition, as reflected on the Supplemental Schedule, included in our reported results during the fourth quarter of 2023, was an unrealized after-tax gain of $1.5 million, or $.03 per diluted share ($1.9 million pre-tax), resulting from an increase in the market value of certain equity securities.

As calculated on the attached Supplemental Schedule, our earnings before interest, taxes, depreciation & amortization ("EBITDA net of NCI", NCI is net income attributable to noncontrolling interests), was $620.2 million during the fourth quarter of 2024, as compared to $476.9 million during the fourth quarter of 2023. Our adjusted earnings before interest, taxes, depreciation & amortization ("Adjusted EBITDA net of NCI"), which excludes the impact of other (income) expense, net, was $614.6 million during the fourth quarter of 2024, as compared to $473.4 million during the fourth quarter of 2023.

Consolidated Results of Operations, As Reported and As Adjusted  – Twelve-month periods ended December 31, 2024 and 2023:

Reported net income attributable to UHS was $1.142 billion, or $16.82 per diluted share, during the full year 2024, as compared to $717.8 million, or $10.23 per diluted share, during 2023. Net revenues increased by 10.8% to $15.828 billion during the full year of 2024, as compared to $14.282 billion during 2023.

As reflected on the Supplemental Schedule, our adjusted net income attributable to UHS during the twelve-month period ended December 31, 2024, was $1.128 billion, or $16.61 per diluted share, as compared to $739.4 million, or $10.54 per diluted share, during the twelve-month period ended December 31, 2023. 

As reflected on the Supplemental Schedule, included in our reported results during the full year of 2024 were: (i) an unrealized after-tax loss of $2.0 million, or $.03 per diluted share ($2.6 million pre-tax), resulting from a decrease in the market value of certain equity securities (included in "Other (income) expense, net"), and; (ii) a favorable net after-tax impact of $15.9 million, or $.24 per diluted share, resulting from the above-mentioned net tax benefit recorded in connection with ASU 2016-09, net of the impact of executive compensation limitations pursuant to IRC section 162(m).     

As reflected on the Supplemental Schedule, included in our reported results during 2023 was an unrealized after-tax loss of $21.6 million, or $.31 per diluted share ($28.2 million pre-tax) resulting from a decrease in the market value of certain equity securities. 

As calculated on the attached Supplemental Schedule, our earnings before interest, taxes, depreciation & amortization ("EBITDA net of NCI"), was $2.248 billion during the full year of 2024, as compared to $1.714 billion during the full year of 2023. Our adjusted earnings before interest, taxes, depreciation & amortization ("Adjusted EBITDA net of NCI"), which excludes the impact of other (income) expense, net, was $2.246 billion during the full year of 2024, as compared to $1.742 billion during the full year of 2023.

Acute Care Services – Three and twelve-month periods ended December 31, 2024 and 2023:

During the fourth quarter of 2024, at our acute care hospitals owned during both periods ("same facility basis"), adjusted admissions (adjusted for outpatient activity) increased by 2.2% while adjusted patient days increased by 0.1%, as compared to the fourth quarter of 2023. At these facilities, during the fourth quarter of 2024, net revenue per adjusted admission increased by 5.3% while net revenue per adjusted patient day increased by 7.5%, as compared to the fourth quarter of 2023. Net revenues generated from our acute care services, on a same facility basis, increased by 8.7% during the fourth quarter of 2024, as compared to the fourth quarter of 2023.

 During the twelve-month period ended December 31, 2024, at our acute care hospitals on a same facility basis, adjusted admissions increased by 2.9% while adjusted patient days increased by 1.8%, as compared to the year ended December 31, 2023. At these facilities, during the full year of 2024, net revenue per adjusted admission increased by 5.1% while net revenue per adjusted patient day increased by 6.3%, as compared to 2023. Net revenues generated from our acute care services, on a same facility basis, increased by 8.5% during the full year of 2024, as compared to 2023.

Behavioral Health Care Services – Three and twelve-month periods ended December 31, 2024 and 2023:

During the fourth quarter of 2024, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by 2.0% while adjusted patient days increased by 1.6%, as compared to the fourth quarter of 2023. At these facilities, during the fourth quarter of 2024, net revenue per adjusted admission increased by 8.7% and net revenue per adjusted patient day increased by 9.1%, as compared to the fourth quarter of 2023. Net revenues generated from our behavioral health care services, on a same facility basis, increased by 11.1% during the fourth quarter of 2024, as compared to the fourth quarter of 2023.

During the twelve-month period ended December 31, 2024, at our behavioral health care facilities on a same facility basis, adjusted admissions increased by 0.7% while adjusted patient days increased by 1.7%, as compared to the comparable period of 2023. At these facilities, during the full year of 2024, net revenue per adjusted admission increased by 9.8% and net revenue per adjusted patient day increased by 8.8%, as compared to 2023. Net revenues generated from our behavioral health care services, on a same facility basis, increased by 10.7% during 2024, as compared to 2023.

Net Cash Provided by Operating Activities and Liquidity:

Net Cash Provided by Operating Activities:

During the twelve-month period ended December 31, 2024, our net cash provided by operating activities was $2.067 billion as compared to $1.268 billion during the full year of 2023. The $799 million net increase in our net cash provided by operating activities consisted of: (i) a favorable change of $472 million resulting from an increase in net income plus/minus depreciation and amortization expense, stock-based compensation expense, gains on sales of assets and businesses and costs related to the extinguishment of debt; (ii) a favorable change of $250 million in accounts receivable due, in part, to a decrease in our days sales outstanding to 50 days at December 31, 2024, as compared to 57 days at December 31, 2023; (iii) a favorable change of $94 million in other working capital accounts due primarily to the timing of disbursements for certain accrued liabilities; (iv) an unfavorable change of $61 million in other assets and deferred charges; (v) a favorable change of $56 million in accrued and deferred income taxes, and; (vi) $12 million of other combined net unfavorable changes.     

Liquidity:

As of December 31, 2024, we had $1.17 billion of aggregate available borrowing capacity pursuant to our $1.3 billion revolving credit facility, net of outstanding borrowings and letters of credit.       

Stock Repurchase Program:

In connection with our stock repurchase program, shares of our Class B Common Stock may be repurchased, from time to time as conditions allow, on the open market or in negotiated private transactions. 

Pursuant to this program, during the fourth quarter of 2024, we have repurchased approximately 1.25 million shares at an aggregate cost of approximately $249.6 million (average price of approximately $199 per share). During the full year of 2024, we have repurchased approximately 2.98 million shares at an aggregate cost of approximately $598.5 million (average price of approximately $201 per share).

As of December 31, 2024, we had an aggregate available repurchase authorization of approximately $824.4 million pursuant to our stock repurchase program.

2025 Operating Results Forecast:

Reflected below is our 2025 forecasted range for consolidated net revenues, earnings before interest, taxes, depreciation & amortization, and the impacts of other income/expense and net income attributable to noncontrolling interests ("Adjusted EBITDA net of NCI"), net income attributable to UHS per diluted share ("EPS-diluted") and capital expenditures. 

Our 2025 forecasted range of net income attributable to UHS, and EPS-diluted, exclude certain items as described below because we do not believe we can forecast those items with sufficient accuracy. Adjusted EBITDA net of NCI, is a non-GAAP financial measure and should not be considered a measure of financial performance under GAAP. We believe Adjusted EBITDA net of NCI is helpful to our investors as a measure of our operating performance. Please see the Supplemental Non-GAAP Disclosures - 2025 Operating Results Forecast schedule as included herein for additional information and a reconciliation of our 2025 forecasted range of net income attributable to UHS to our 2025 forecasted range of Adjusted EBITDA net of NCI. 

Our 2025 operating results forecast contains a number of assumptions including, but not limited to, the following:

• The 2025 forecasted amounts exclude the impact of future items, if applicable, that are nonrecurring or non-operational in nature including items such as changes in the market value of shares of certain equity securities, the impact of ASU 2016-09, net of the impact of executive compensation limitations pursuant to IRC section 162(m), and other potential material items that are nonrecurring or non-operational in nature including, but not limited to, impairments of goodwill, long-lived and intangible assets, reserves for various matters including settlements, legal judgments and lawsuits, costs related to extinguishment of debt, gains/losses on sales of assets and businesses, potential impacts of non-ordinary acquisitions, divestitures, joint ventures or other strategic transactions, other amounts that may be reflected in the current or prior year financial statements that relate to prior periods, and the impact of share repurchases that differ from our forecasted assumptions. It is also subject to certain conditions including those as set forth below in General Information, Forward-Looking Statements and Risk Factors and Non-GAAP Financial Measures.
• Our net revenues are estimated to be approximately $17.020 billion to $17.364 billion representing an increase of 7.5% to 9.7% over our 2024 net revenues of $15.828 billion.
• Our Adjusted EBITDA net of NCI is estimated to be approximately $2.357 billion to $2.484 billion representing an increase of 4.9% to 10.6% over our 2024 Adjusted EBITDA net of NCI of $2.246 billion.
• Our EPS-diluted range is estimated to be $18.45 per diluted share to $19.95 per diluted share, representing an increase of 11.1% to 20.1% over our adjusted net income attributable to UHS of $16.61 per diluted share for the year ended December 31, 2024, as calculated on the attached Supplemental Schedule.

Conference call information:

We will hold a conference call for investors and analysts at 10:00 a.m. eastern time on February 27, 2025. A live webcast of the call will be available on our website at www.uhs.com. To participate via telephone, please register in advance at this link. Upon registration, all telephone participants will receive a confirmation email detailing how to join the conference call, including the dial-in number along with a unique passcode and registrant ID that can be used to access the call. A replay of the call will be available for one full year following the live call.

General Information, Forward-Looking Statements and Risk Factors and Non-GAAP Financial Measures:

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (the "Company") has built an impressive record of achievement and performance. Growing steadily since our inception into an esteemed Fortune 500 corporation, our annual revenues during 2024 were $15.828 billion. UHS ranked #299 on the Fortune 500; and #399 on Forbes' list of America's Largest Public Companies. In 2025, UHS was again recognized as one of the World's Most Admired Companies by Fortune.  

Our operating philosophy is as effective today as it was upon the Company's founding in 1979, enabling us to provide compassionate care to our patients and their loved ones.  Our strategy includes building or acquiring high quality hospitals in rapidly growing markets, investing in the people and equipment needed to allow each facility to thrive, and becoming the leading healthcare provider in each community we serve.

Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and, through its subsidiaries, operates 28 inpatient acute care hospitals, 331 inpatient behavioral health facilities, 60 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 39 states, Washington, D.C., the United Kingdom and Puerto Rico. It acts as the advisor to Universal Health Realty Income Trust, a real estate investment trust (NYSE:UHT).  For additional information visit www.uhs.com.

            This press release contains forward-looking statements based on current management expectations.  Numerous factors, including those disclosed herein, those related to healthcare industry trends and those detailed in our filings with the Securities and Exchange Commission (as set forth in Item 1A-Risk Factors, and Item 7-Forward-Looking Statements and Risk Factors, in our Form 10-K for the year ended December 31, 2024), may cause the results to differ materially from those anticipated in the forward-looking statements.  These statements are subject to risks and uncertainties and therefore actual results may differ materially.  Readers should not place undue reliance on such forward-looking statements which reflect management's view only as of the date hereof.  We undertake no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise. 

Many of the factors that could affect our future results are beyond our control or ability to predict, including, but not limited to:  

• A significant portion of our revenues are derived from federal and state government programs including the Medicare and Medicaid programs. Payments from these programs are subject to statutory and regulatory changes, administrative rulings, interpretations and determinations, requirements for utilization review, and federal and state funding restrictions. Changes to these programs, if adopted, could materially affect program payments which could materially impact our results of operations. In addition, we receive substantial reimbursement from multiple states in connection with various supplemental Medicaid payment programs. Failure to renew these programs beyond their scheduled termination dates, failure of the public hospitals to provide the necessary Inter-Governmental Transfers for the states' share of the Medicaid disproportionate share hospital programs, failure of our hospitals that currently receive supplemental Medicaid revenues to qualify for future funds under these programs, the adoption of certain proposed reductions of federal funding for Medicaid, or reductions in other reimbursements, could cause our actual results of operations for the year ended December 31, 2025 to differ materially from our 2025 operating results forecast.
• The increase in interest rates during the past few years has increased our interest expense significantly thereby reducing our free cash flow. As such, although interest rates have moderated more recently, the effects of increased borrowing rates have adversely impacted our results of operations, financial condition and cash flows. We cannot predict future changes to interest rates, however, significant increases in our borrowing rates could have a material unfavorable impact on our future results of operations and our ability to access the capital markets on favorable terms;
• The outcome of known and unknown litigation, liabilities and other claims asserted against us and/or our subsidiaries, including, but not limited to, the matters related to Cumberland Hospital for Children and Adolescents, located in New Kent, Virginia, as previously disclosed on Form 8-K on September 30, 2024, Form 10-Q for the quarterly period ended September 30, 2024 and Form 10-K for the year ended December 31, 2024; and the matter related to the Pavilion Behavioral Health System, located in Champaign, Illinois, as previously disclosed on Forms 8-K on April 1, 2024, September 30, 2024 and October 11, 2024, Forms 10-Q for the quarterly periods ended March 31, 2024, June 30, 2024 and September 30, 2024 and Form 10-K for the year ended December 31, 2024. Although we can make no assurances regarding the ultimate outcome of these matters, or what damages will ultimately be awarded, the final resolution of these matters could have a material adverse effect on the Company.

We believe that adjusted net income attributable to UHS, adjusted net income attributable to UHS per diluted share, EBITDA net of NCI and Adjusted EBITDA net of NCI, which are non-GAAP financial measures ("GAAP" is Generally Accepted Accounting Principles in the United States of America), are helpful to our investors as measures of our operating performance. In addition, we believe that, when applicable, comparing and discussing our financial results based on these measures, as calculated, is helpful to our investors since it neutralizes the effect of material items impacting our net income attributable to UHS, such as, changes in the market value of shares of certain equity securities, the impact of ASU 2016-09, net of the impact of executive compensation limitations pursuant to IRC section 162(m), and other potential material items that are nonrecurring or non-operational in nature including, but not limited to, impairments of goodwill, long-lived and intangible assets, reserves for various matters including settlements, legal judgments and lawsuits, costs related to extinguishment of debt, gains/losses on sales of assets and businesses, potential impacts of non-ordinary acquisitions, divestitures, joint ventures or other strategic transactions, and other amounts that may be reflected in the current or prior year financial statements that relate to prior periods. To obtain a complete understanding of our financial performance these measures should be examined in connection with net income attributable to UHS, as determined in accordance with GAAP, and as presented in the condensed consolidated financial statements and notes thereto in this report or in our other filings with the Securities and Exchange Commission including our Report on Form 10-K for the year ended December 31, 2024. Since the items included or excluded from these measures are significant components in understanding and assessing financial performance under GAAP, these measures should not be considered to be alternatives to net income as a measure of our operating performance or profitability. Since these measures, as presented, are not determined in accordance with GAAP and are thus susceptible to varying calculations, they may not be comparable to other similarly titled measures of other companies. Investors are encouraged to use GAAP measures when evaluating our financial performance.