Tenet’s ACA exchange revenue falls 17% as uninsured volumes rise

 Dallas-based Tenet Healthcare saw a 17% year-over-year decrease in ACA exchange-related revenue in the second quarter of 2026 and a 13.5% decrease in exchange admissions, executives said on the for-profit system’s July 24 earnings call. 

Tenet CFO Sun Park said both figures were roughly in line with the system’s expectations for the quarter. He also expects the overall market trends Tenet saw in the quarter to continue through the rest of the year. 

Exchange business made up about 5.5% of Tenet’s consolidated net operating revenue in the quarter and created a $65 million revenue headwind, Mr. Park said. The decline was steepest in Florida, Arizona, Michigan, South Carolina and Texas.

“I think we are roughly seeing a pretty consistent conversion from exchange patient volume into uninsured on a pretty much one-to-one basis,” he said. “So we did see a proportionately equal increase in uninsured volumes in Q2 as well, and we expect that to continue in the second half.”

Tenet Chairman and CEO Saum Sutaria, MD, said, “In light of the challenges that the decline in exchange enrollment presents, we are flexing our cost base and building an appropriate baseline on which to grow in the future, with a focus on continued margin strength.”

“Our consistent results are driven by a transformed portfolio of businesses, continued strategic focus on higher acuity specialty services, strong leadership at the local level, and an ability to effectively manage through the current dynamic environment,” Dr. Sutaria said. 

Tenet reported an operating income of $1.5 billion (26.7% operating margin) for the three months ended June 30, up from $823 million (15.6% margin) during the same period last year. 

The system also raised its 2026 earnings outlook. Tenet is now projecting net operating revenue between $21.9 billion and $22.5 billion for full-year 2026. Tenet previously projected full-year revenue between $21.5 billion and $22.3 billion. The system is projecting net income between $2.87 billion and $3.02 billion, up from its previous projection between $2.61 billion and $2.84 billion. Tenet is now projecting an EBITDA between $4.83 billion and $5.03 billion, up from its previous projection between $4.49 billion and $4.79 billion. 

https://www.beckershospitalreview.com/finance/tenets-aca-exchange-revenue-falls-17-as-uninsured-volumes-rise/