The worst result, after buying shares in a company (assuming no leverage), would be if you lose all the money you put in. But on the bright side, you can make far more than 100% on a really good stock. Long term HCA Healthcare, Inc. (NYSE:HCA) shareholders would be well aware of this, since the stock is up 237% in five years. It’s also good to see the share price up 26% over the last quarter.
After a strong gain in the past week, it’s worth seeing if longer term returns have been driven by improving fundamentals.
To quote Buffett, ‘Ships will sail around the world but the Flat Earth Society will flourish. There will continue to be wide discrepancies between price and value in the marketplace…’ By comparing earnings per share (EPS) and share price changes over time, we can get a feel for how investor attitudes to a company have morphed over time.
Over half a decade, HCA Healthcare managed to grow its earnings per share at 23% a year. This EPS growth is reasonably close to the 28% average annual increase in the share price. This indicates that investor sentiment towards the company has not changed a great deal. Rather, the share price has approximately tracked EPS growth.
The company’s earnings per share (over time) is depicted in the image below (click to see the exact numbers).
NYSE:HCA Earnings Per Share Growth November 27th 2025
We know that HCA Healthcare has improved its bottom line lately, but is it going to grow revenue? Check if analysts think HCA Healthcare will grow revenue in the future.
When looking at investment returns, it is important to consider the difference between total shareholder return (TSR) and share price return. The TSR incorporates the value of any spin-offs or discounted capital raisings, along with any dividends, based on the assumption that the dividends are reinvested. It’s fair to say that the TSR gives a more complete picture for stocks that pay a dividend. As it happens, HCA Healthcare’s TSR for the last 5 years was 252%, which exceeds the share price return mentioned earlier. This is largely a result of its dividend payments!
It’s nice to see that HCA Healthcare shareholders have received a total shareholder return of 59% over the last year. Of course, that includes the dividend. That’s better than the annualised return of 29% over half a decade, implying that the company is doing better recently. Someone with an optimistic perspective could view the recent improvement in TSR as indicating that the business itself is getting better with time. While it is well worth considering the different impacts that market conditions can have on the share price, there are other factors that are even more important. Even so, be aware that HCA Healthcare is showing 2 warning signs in our investment analysis , and 1 of those makes us a bit uncomfortable…