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Trade Ideas

Global Trade Idea: HCA Healthcare Inc. (HCA US) - BUY

 

By Peet Serfontein & Khumbulani Kunene

We initiate a long position with a target price of $376.00 and a stop-loss of $316.00 (Risk/reward ratio 1:2.5).

HCA Healthcare Inc. (HCA) is a leading healthcare services company in the United States (US) that operates ~185 hospitals, with mostly acute care centres as well as six behavioural hospitals and two rehabilitation hospitals. The company also runs ~125 ambulatory surgery centres, as well as urgent care, rehab, and other outpatient centres that form healthcare networks in many of the communities it serves.

The hospitals operated by HCA provide diagnosis, treatments, consultancy, nursing, surgeries, and other services, as well as medical education, physician resource centre, and training programmes. The company's footprint spans across the US and the United Kingdom (UK), and its hospitals house 49 500 beds, serving millions of patients annually.

Technically, a price in a bullish uptrend presents a promising investment opportunity (see the narrative on the main chart). A developing patten of higher lows and higher highs is a strong technical indicator of an uptrend, supporting our bullish stance. Higher lows indicates that buyers are stepping in at increasingly higher price levels and higher highs suggest growing bullish momentum, particularly as the stock continues to break through previous resistance levels. This highlights investor confidence and suggests that the stock is experiencing sustained accumulation.

A price in the accumulation phase of the Wyckoff price cycle also supports a bullish case for the stock. The stock typically moves sideways (within a range) during this phase. A breakout above the resistance confirms that the accumulation is complete, leading to a markup phase where prices trend higher.

The start of upside price momentum per the MACD indicator, as well as the recent uptick trajectory of the on-balance volume (OBV) indicator, supports our bullish view.

Share Information
Share Code HCA
Industry Health Care, Equipment & Service
Market Capital (USD) 82.72 billion
One Year Total Return 7.17%
Return Year-to-Date 10.97%
Current Price (USD) 333
52 Week High (USD) 417
52 Week Low (USD) 290
Financial Year End December
The stock price is trading below its 200-day, but above its 200-week simple moving average (SMA), which represents a long-term trend and is often seen as a strong support level.

Consensus
Expectations
(Bloomberg)
FY24 FY25E FY26E FY27E
Headline Earnings per Share (USD) 21.96 24.91 27.83 30.82
Growth (%) 13.41 11.74 10.75
Dividend Per Share (USD) 2.64 2.85 2.96 3.17
Growth (%) 7.80 3.87 7.24
Forward PE (times) 13.37 11.97 10.81
Forward Dividend Yield (%) 0.85 0.89 0.95
Earnings are expected to see double-digit growth in the short-to-medium term.

Buy/Sell Rationale:

Technical Analysis:

    • A typical bullish price swing supports a bullish trend (see the insert). The last green bar indicates a potential bullish continuation. The occurrence of numerous green bars throughout the period suggests that buyers have stepped in at key levels, supporting upward momentum. The latest green bar follows a period of mixed signals and is therefore encouraging as it indicates renewed strength in the stock. An increase in volume or further confirmation from other indicators could signal further price appreciation.
    • The lower panel shows the occurrence of the Relative Strength Index (RSI) backcross signals An RSI backcross signal from oversold territory occurs when the RSI rises back above the 30 level after previously being in oversold conditions and suggests a potential shift in momentum. The sharper the rebound, the more conviction there is behind the price recovery.
    • Our recommended entry range is $324.00 to $342.00, or as close as possible to $333.07 - a drop below this range would indicate a substantial change in price dynamics, giving reason to negate the trade idea.
    • Our target price is $376.00, representing ~12.9% upside from current levels.
    • Based on the forward calculation of the Relative Strength Index (RSI) indicator, the stock will be overbought at ~ $420.00, making our profit target realistic.
    • Our proposed time to exit is mid-April 2025, but investors can adjust for an either longer or shorter time horizon, depending on price behaviour.
    • A drop below $316.00, -5.1% below current levels, would suggest weakening technicals and a stop-loss is recommended at this level.
    • We expect moderate fluctuations in the price and therefore suggest a medium at-risk allocation for this trade. Increase exposure for a break above $342.00.

Fundamental view

    • While HCA Healthcare operates in one line of business, the company generates its revenue through its International Unit and through two groups based in Tennessee, namely:
      • National Group accounting for ~50% of revenue, which includes ~95 hospitals.
      • American Group (~45% of revenue), which comprises of 80 hospitals.
      • The International Unit runs seven facilities in the UK.
    • HCA services several clients, including the federal government through the Medicare programme, state government through their respective Medicaid programmes, managed care plans, private insurers and individual patients.
    • The company has invested heavily in healthcare technology and innovation. Management has invested in AI and Machine Learning through the introduction of Predictive Analytics (an AI model used to predict patient deterioration, enabling early intervention) and Operational Efficiency (a machine learning algorithm that helps optimise staffing, resource allocation, and patient flow in hospitals). The business continues to invest in research and development to improve clinical outcomes and operational efficiency.
    • As part of management's growth strategy, HCA Healthcare recently acquired Brookdale Health Care Services, which will enhance HCA's capabilities in post-acute care, enabling the company to offer more precise care services to patients. In 2022, the company expanded its footprint into London and other parts of the UK.
    • In 4Q24, revenue increased 5.7% to $18.3 billion. This outcome was supported by a 3% increase in admissions, a 2.4% increase in emergency room visits, and a 2.8% increase in inpatient surgeries. Revenue for FY24 increased 8.7% to $70.6 billion.
    • Management remains focused on achieving long-term growth and increasing shareholder value. The CEO highlighted that the last five years proved to be a period of long-term growth for the company, which resulted in operational improvements across key performance indicators and greater value for patients, employees and shareholders. Management aims to maintain this momentum and guided for revenue in FY25 to range between $72.8 billion to $75.8 billion, up 5.2% at the midpoint.
    • From a risk perspective, the company remains exposed to regulatory and compliance risks as this is a highly-regulated market and changes to healthcare laws such as the Affordable Care Act or reimbursement rates can significantly impact revenue. Public health can strain healthcare resources, increase costs, and disrupt normal operations.

Share Name and Position FE US - Buy
(Continue to hold)
MPWR US - Buy
(Continue to hold)
CHTR US - Buy
(Continue to hold)
Entry 40.63 617.57 340.26
Current 43.50 651.32 358.73
Movement +7.1% +5.5% +5.4%
A developing symmetrical triangle pattern remains of interest. Crossed above its 200-day simple moving average. The start of upside price momentum is supportive.

Our profit target remains at $45.00 with a trailing stop-loss at $42.15. Exit the trade by 30 April 2025.
A gap in the price remains of interest. Remains sandwiched between its 200-week and 200-day simple moving averages. Upside price momentum that halted is a concern.

Our profit target remains at $788.00 with a trailing stop-loss at $586.00. Exit the trade by 2 April 2025.
A price in a developing symmetrical triangle pattern remains of interest. Remains just above its 200-day simple moving average. Fading downside price momentum is supportive.

Our profit target remains at $390.00 with a trailing stop-loss at $335.50. Exit the trade by 30 May 2025.

Share Name and Position STE US (Buy)
(Continue to hold)
DOV US (Buy)
(Continue to hold)
DELL US (Buy)
(Continue to hold)
Entry 217.20 194.48 111.44
Current 223.79 198.36 110.65
Movement +3.0% +2.0% -0.7%
An Elliott wave price that is forming a trough remains of interest. Testing its 200-day simple moving average. Upside price momentum supports the trade strategy.

Our profit target remains at $239.00 with a trailing stop-loss at $215.00. Exit the trade by 18 April 2025.
Seasonal trends in the price of the stock remains of interest. Remains above its 200-day simple moving average. The start of downside price momentum is a concern.

Our profit target remains at $214.00 with a trailing stop-loss at $190.00. Exit the trade by 9 May 2025.
The stock appears to be undervalued compared to its peers. Remains just below its 200-day simple moving average. Fading downside price momentum is supportive.

Our profit target remains at $138.00 with a trailing stop-loss at $101.00. Exit the trade by 30 April 2025.

FNB Stockbroking and Portfolio Management (Pty) Ltd, a subsidiary of FirstRand Bank Limited, an authorised Financial Services Provider and authorised user of the JSE limited (Reg no: 1996/011732/07). This Publication note is issued by FNB Stockbroking and Portfolio Management (Pty) Ltd for the information of clients only and should not be produced in whole or part without prior permission. Although FNB Stockbroking and Portfolio Management (Pty) Ltd is an Authorised Financial Services Provider, any opinions and/or analysis contained in this Publication are for informational purposes only and should not be considered advice, including but not limited to financial, legal or tax advice, or a recommendation to invest in any security or to adopt any investment strategy. The information contained herein has been obtained from sources/persons which we believe to be reliable but is not guaranteed for correctness, completeness or otherwise and we do not assume liability for loss arising from errors in the information or that may be suffered from using or relying on the information contained herein irrespective of whether there has been any negligence by us, our affiliates or any other employees of us, and whether such losses be direct or consequential. As market and economic conditions are subject to rapid change, any comments, opinions, and analysis is rendered as of the date of publishing and may change without notice. Such changes may have a material impact on the outcome of any investment. Securities involve a degree of risk and are volatile instruments. Past performance is not indicative of future performances. Securities or financial instruments mentioned in the Publication note may not be suitable for all investors and FNB Stockbroking and Portfolio Management (Pty) Ltd has bares no responsibility whatsoever arising from or as a consequence hereof. The material is not intended as a complete analysis of every material fact regarding any share, instrument, sector, region, market, country, investment, or strategy. The recipient of this Publication must make their own investment decision and is advised to contact his relationship manager for a personal financial analysis prior to making any investment decisions. Copyright 2018 by FNB Stockbroking and Portfolio Management (Pty) Ltd.

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