Hospital management company Universal Health Services (NYSE: UHS) missed Wall Street’s revenue expectations in Q4 CY2025, but sales rose 9.1% year on year to $4.49 billion. On the other hand, the company’s full-year revenue guidance of $18.6 billion at the midpoint came in 2% above analysts’ estimates. Its non-GAAP profit of $5.88 per share was 0.5% below analysts’ consensus estimates.

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Company Overview

With a network spanning 39 states and three countries, Universal Health Services (NYSE: UHS) operates acute care hospitals and behavioral health facilities across the United States, United Kingdom, and Puerto Rico.

Revenue Growth

Reviewing a company’s long-term sales performance reveals insights into its quality. Any business can put up a good quarter or two, but many enduring ones grow for years. Luckily, Universal Health Services’s sales grew at a decent 8.5% compounded annual growth rate over the last five years. Its growth was slightly above the average healthcare company and shows its offerings resonate with customers.

We at StockStory place the most emphasis on long-term growth, but within healthcare, a half-decade historical view may miss recent innovations or disruptive industry trends. Universal Health Services’s annualized revenue growth of 10.3% over the last two years is above its five-year trend, suggesting some bright spots.

We can better understand the company’s revenue dynamics by analyzing its same-store sales, which show how much revenue its established locations generate. Over the last two years, Universal Health Services’s same-store sales averaged 3.1% year-on-year growth. Because this number is lower than its revenue growth, we can see the opening of new locations is boosting the company’s top-line performance.

This quarter, Universal Health Services’s revenue grew by 9.1% year on year to $4.49 billion, missing Wall Street’s estimates.

Looking ahead, sell-side analysts expect revenue to grow 5.1% over the next 12 months, a deceleration versus the last two years. We still think its growth trajectory is satisfactory given its scale and indicates the market is forecasting success for its products and services.

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Operating Margin

Operating margin is an important measure of profitability as it shows the portion of revenue left after accounting for all core expenses – everything from the cost of goods sold to advertising and wages. It’s also useful for comparing profitability across companies with different levels of debt and tax rates because it excludes interest and taxes.

Universal Health Services’s operating margin might fluctuated slightly over the last 12 months but has remained more or less the same, averaging 9.8% over the last five years. This profitability was mediocre for a healthcare business and caused by its suboptimal cost structure.

Analyzing the trend in its profitability, Universal Health Services’s operating margin of 11.5% for the trailing 12 months may be around the same as five years ago, but it has increased by 3.3 percentage points over the last two years. This dynamic unfolded because its sales growth gave it operating leverage and shows it has some momentum on its side.

In Q4, Universal Health Services generated an operating margin profit margin of 11.5%, in line with the same quarter last year. This indicates the company’s overall cost structure has been relatively stable.

Earnings Per Share

Revenue trends explain a company’s historical growth, but the long-term change in earnings per share (EPS) points to the profitability of that growth – for example, a company could inflate its sales through excessive spending on advertising and promotions.

Universal Health Services’s EPS grew at a spectacular 14.3% compounded annual growth rate over the last five years, higher than its 8.5% annualized revenue growth. However, this alone doesn’t tell us much about its business quality because its operating margin didn’t improve.

Diving into Universal Health Services’s quality of earnings can give us a better understanding of its performance. A five-year view shows that Universal Health Services has repurchased its stock, shrinking its share count by 26.2%. This tells us its EPS outperformed its revenue not because of increased operational efficiency but financial engineering, as buybacks boost per share earnings.

In Q4, Universal Health Services reported adjusted EPS of $5.88, up from $4.92 in the same quarter last year. This print was close to analysts’ estimates. Over the next 12 months, Wall Street expects Universal Health Services’s full-year EPS of $21.76 to grow 7.4%.

Key Takeaways from Universal Health Services’s Q4 Results

It was great to see Universal Health Services’s full-year revenue guidance top analysts’ expectations. We were also happy its full-year EPS guidance narrowly outperformed Wall Street’s estimates. On the other hand, its revenue slightly missed and its EPS fell a bit short of Wall Street’s estimates. Overall, this print was mixed but still had some key positives. Investors were likely hoping for more, and shares traded down 1.6% to $227.40 immediately after reporting.

Is Universal Health Services an attractive investment opportunity at the current price? We think that the latest quarter is only one piece of the longer-term business quality puzzle. Quality, when combined with valuation, can help determine if the stock is a buy. We cover that in our actionable full research report which you can read here (it’s free).