stockrowWhat it does
Tenet Healthcare is a healthcare services company headquartered in Dallas, Texas. Saum Sutaria is its chairman and chief executive officer. Tenet operates hospitals and outpatient facilities and provides business services to other healthcare organizations.
Its Hospital Operations segment treats patients at acute care and specialty hospitals, physician practices and outpatient sites. Hospital services range from emergency care and routine diagnostic work to procedures such as cardiac and spinal surgery. The outpatient sites include urgent care centers, imaging centers and emergency departments away from hospital campuses.
Tenet also operates ambulatory surgery facilities through USPI. These facilities perform procedures that generally do not require a conventional hospital stay, including orthopedic, gastrointestinal, eye and urology procedures. USPI typically owns its facilities with physicians or health system partners and manages their daily operations.
Through Conifer Health Solutions, Tenet provides services to hospitals, physician practices, employers and other clients. These include checking patients’ insurance coverage, medical coding, billing and collections. Conifer also helps clients manage the financial and clinical aspects of arrangements designed around the cost and quality of care.
Tenet operates through subsidiaries, partnerships and joint ventures. Its Philippine Global Business Center supports administrative functions across the company. Tenet returned to full ownership of Conifer effective January 1, 2026.
How it makes money
Tenet earns patient-service revenue when its hospitals and outpatient facilities provide care. The main payers for Hospital Operations are managed care organizations and Medicare; state Medicaid programs, other insurers and uninsured patients also pay for services. Managed care contracts set terms under which patients are encouraged to use particular facilities in exchange for discounts from established charges.
Hospital Operations revenue was $16.1 billion in FY2025. Ambulatory Care revenue was $5.2 billion in FY2025. Tenet reported $5.6 billion in net operating revenues for the third quarter of 2026.
USPI earns money as both an owner and a manager of surgery facilities. Its management and administrative fees are usually calculated as a percentage of each facility’s net revenue. USPI also receives its ownership share of each facility’s profit or loss. The facilities generate revenue as patients undergo procedures; management contracts and ownership interests can provide continuing income as those facilities operate.
Accounting differs depending on whether Tenet controls a facility. For consolidated facilities, Tenet includes the facility’s revenue and expenses in its financial statements and identifies the profit attributable to other owners separately. For facilities it does not control, it records its share of earnings and the fees it earns for managing them rather than the facility’s full revenue.
Conifer earns revenue by providing services such as insurance verification, coding and collections to Tenet and outside clients. Its agreement to provide end-to-end revenue cycle services to certain CommonSpirit Health facilities is scheduled to terminate effective December 31, 2026. Tenet expects transition activities at Conifer to contribute $450 million of adjusted EBITDA in 2026, but not to recur in 2027.
| Segment | Revenue, FY2025 | Share | Change on the year |
|---|---|---|---|
| Hospital Operations | $16.1 billion | 75.7% | −0.02% |
| Ambulatory Care | $5.2 billion | 24.3% | 14.1% |
Customers and how it sells
Tenet’s care customers are patients using its hospitals, outpatient facilities and surgery centers. Payment comes through managed care plans, government programs, other insurers and patients themselves. Physicians also direct patients to facilities through their admitting and scheduling practices; many practice at more than one facility and can send patients elsewhere.
At December 31, 2025, Tenet operated 50 acute care and specialty hospitals, primarily serving urban and suburban communities in eight states. Its Hospital Operations segment also included 132 outpatient facilities. USPI held ownership interests in 533 ambulatory surgery centers and 26 surgical hospitals across 37 states at the same date.
Conifer’s customers include hospitals, health systems, physician practices, employers and other organizations. At December 31, 2025, it provided business process services to approximately 600 Tenet and non-Tenet hospitals and other clients nationwide. Tenet and CommonSpirit Health facilities represented approximately 44% of those clients; the remainder included unaffiliated organizations.
Tenet uses subsidiaries and joint ventures to reach patients and operates many ambulatory facilities with local physicians or health systems. Its headquarters are in Dallas, and its Global Business Center in the Philippines supports administrative work across the network.
| Segment | Revenue, FY2025 | Share | Change on the year |
|---|---|---|---|
| Hospital Operations | $16.1 billion | 75.7% | −0.02% |
| Ambulatory Care | $5.2 billion | 24.3% | 14.1% |
Suppliers and costs
Tenet depends on nurses, physicians, therapists, pharmacists, laboratory technicians and other personnel to operate its care facilities. It had 99,000 employees at December 31, 2025. Most physicians who practice at its hospitals and outpatient centers do not have a contractual relationship with Tenet, although the company owns physician practices and employs or affiliates with physicians.
Staffing is a recurring operating cost. Limited availability of experienced medical support personnel can increase wages and benefits, and Tenet may need to pay premiums or hire temporary or contract workers. California’s minimum nurse-to-patient ratios also affect labor costs and can require the company to limit admissions when enough nurses are unavailable.
Tenet leases most of its outpatient facilities, and physician practices lease medical office space. It also invests in facilities, equipment and technology. Inflation affects salaries and other expenses, while medical supply price inflation remained high during 2025. Tariffs and other trade restrictions may also influence supply-chain pricing and availability.
- Revenue$21.3B
- Cost of revenue−$12.5B
- Other operating costs−$5.3B
- Operating income$3.5B
Competitive position
Tenet’s hospitals and outpatient centers compete locally and regionally for patients, physicians, staff and managed care contracts. Competition depends on factors including location, access, quality, range of services, reputation, facilities and medical staff. No competing company is named in the available business descriptions.
Some competing facilities are government-owned or not-for-profit. Those organizations may have access to funding, tax exemptions, tax-exempt financing or discounted prescription drug prices that Tenet’s facilities do not. Tenet also faces freestanding surgery centers, specialty hospitals, emergency departments, imaging centers and urgent care centers, some owned by physicians. The market for Conifer’s revenue cycle services is competitive as well.
Our reading: Tenet’s concentrations of facilities can support its local negotiating and operating position, but that advantage varies by market and does not prevent payers from forming narrow networks that exclude it. The company seeks to include hospitals, outpatient centers and physician practices in relevant managed care contracts. (item1)
Our reading: USPI’s physician and health system partnerships and its role managing facilities give it relationships that may help it develop and acquire centers, though physicians can also use competing facilities. Tenet said most of its third-quarter 2026 acquisitions came exclusively to USPI rather than through competitive processes. (item1, call_qa)
Growth opportunities
Tenet plans to expand Ambulatory Care through acquisitions, new outpatient centers, physician relationships, new service lines and partnerships. It expects the volume and complexity of surgery performed in outpatient settings to increase over time, helped by advances in surgical techniques, medical technology and anesthesia.
During 2025, Tenet acquired controlling interests in 27 ambulatory surgery centers and one surgical hospital, acquired a noncontrolling interest in another center, and opened six new centers. It also increased its interests in nine centers enough to consolidate them. In the third quarter of 2026, USPI’s same-facility systemwide revenues increased 4.5%, while same-facility case volumes declined 1.5% as the business focused on more complex care.
Tenet is pursuing growth in ambulatory specialties including urology, general surgery, robotics, spine and cardiac care. It also plans hospital investment in specialist networks, higher-demand services and access for patients and physicians.
Tenet expects overall adjusted EBITDA growth in 2027 after excluding Conifer transition activities, assuming current known regulatory frameworks. It expects USPI to expand its facility portfolio and increase same-store revenue, while assessing potential exchange headwinds and the impact of Medicaid work requirements. Conifer transition contributions expected in 2026 are not expected to recur in 2027.
- $19.5BFY2021
- $19.2BFY2022
- $20.6BFY2023
- $20.7BFY2024
- $21.3BFY2025
- $22.1BFY2026 guidance
Structural risks
- Payer contracts and collections: Tenet’s results could be affected if it cannot secure or renew managed care contracts on competitive terms, receives lower contracted rates or has difficulty collecting from payers. Exchange admissions and revenues declined 18% in the third quarter of 2026 from the prior-year quarter.
- Government funding and coverage: Changes in healthcare laws, reimbursement practices or insurance coverage can affect revenue and expenses. Tenet expects the One Big Beautiful Bill Act’s requirements to materially affect Medicaid funding and enrollment, as well as the health insurance marketplace; state implementation remains uncertain.
- Staffing and physician access: Tenet depends on medical personnel and affiliated physicians. Shortages can raise labor costs, while physicians who practice at its facilities may admit patients to competitors. California staffing requirements can also restrict admissions.
- Joint ventures and acquisitions: Acquisitions bring risks and uncertainties, and joint ventures can lead to disputes or decision-making impasses where Tenet does not have sole authority.
- Debt and liquidity: Debt may limit Tenet’s ability to raise capital or respond to changing conditions. Long-term liquidity for debt service depends on operating cash flow and, subject to market conditions, future borrowing and refinancing.
Bottom line
Our reading
Our reading: Tenet combines hospital care with a surgery-center ownership and management business, supported by relationships with physicians, payers and facility partners. (item1, item7) Its ability to expand outpatient care is balanced by exposure to payer negotiations, government reimbursement, staffing costs and debt, while the Conifer contract transition makes some 2026 earnings nonrecurring. (item1a, item7, call_prepared)