Ardent Forecasts Profit Retreat in ’26 But Sees Cost Pressures Stabilizing

The leaders of Ardent Health Inc. think the health system operator’s profits could fall 10 percent or more this year versus 2025 as they continue to wrestle with rising costs due to professional fees and insurers’ claims denials. But President and CEO Marty Bonick told investors and analysts on March 5 that he’s “encouraged” that those pressure points stabilized late last year and said the company’s cost-cutting program has grown by $15 million since the fall.

Nashville-based Ardent reported fourth-quarter net income of $74.2 million (with about $29 million of that coming from noncontrolling interests), which was down by nearly half from late 2024’s $141 million. Revenues were basically flat year over year at a little more than $1.6 billion.

On the operating front, the company’s 30 hospitals and associated facilities in six states saw adjusted admissions climb 2 percent to nearly 88,600 during the fourth quarter while a small drop in outpatient surgeries kept overall surgery volumes flat from late 2024.

Looking to 2026, Bonick and his team expect adjusted admissions to again rise roughly 2 percent, which should help revenues grow between 1 percent and 6 percent from last year’s $6.32 billion. But adjusted EBITDA is forecast to fall to between $485 million and $535 million versus last year’s $545 million—a forecast that includes an expected $35 million hit due to lower patient volumes from health insurance exchanges.

Executives’ primary focus remains on absorbing the higher professional fees and claims denials that in November caused them to cut their 2025 profit forecasts in half. In response to those cost pressures, Ardent leaders launched a plan that initially sought to cut about $40 million annually, including by laying off some workers. Bonick told investors March 5 that that figure has since grown to $55 million, which will help set the stage for EBITDA to grow again in 2027 and beyond.

Ardent isn’t alone in feeling the sting of rising professional fees. Speaking at the 47th Annual Raymond James Institutional Investor Conference this week, HCA Healthcare Inc. CFO Mike Marks said the hospital sector’s largest private operator is still dealing with “some pressures coming into ‘26” and pointed specifically to anesthesiology and radiology, the same specialties Ardent’s leaders singled out in November.

“We’re working really hard as a company, both in anesthesiology and radiology, and we’re making investments,” Marks told Raymond James attendees. “But we are not as far along in terms of getting through that change curve as we are in the emergency room and in hospital medicine.”

Technology is playing a key role in Ardent’s cost-containment efforts, Bonick said on Ardent’s 4 earnings conference call. Central to those are artificial-intelligence tools being put to use both behind the scenes and in patient-facing settings.

“We’ve had a very labor-dependent business across this industry and I think AI is going to be a liberator,” Bonick said. “There’s a lot of focus in this area to actually transform the way in which we deliver care, make it more accessible, make it more affordable and transform the cost structure for the business.”

Shares of Ardent (Ticker: ARDT) were down nearly 2 percent to $9.47 on the afternoon of March 5. Over the past six months, they have lost nearly 30 percent of their value, which has trimmed the company’s market capitalization to about $1.3 billion.