Tenet Healthcare Corp's quarterly revenue fell for the first time in six years missing estimates, hurt by weak demand and the hospital operator forecast lower-than-expected full year earnings.
Tenet's shares fell 10 percent in extended trading on Monday.
The third largest for-profit U.S. hospital operator, which had long-term debt of about $15 billion as of Dec. 31, has been cutting costs and selling hospitals, focusing on raising its hospital unit margins to turn its business around.
Tenet said its adjusted admissions, which include both outpatients and people who stay in the hospital overnight, fell 0.5 percent in the fourth quarter from a year earlier.
Shares of hospital operators have regained some favor to start 2017, as investors set aside concerns about an immediate dismantling of Obamacare.
Up to Monday's close, Tenet shares rose 52.8 percent this year.
Hospital stocks were sold off after the Nov. 8 presidential election of Donald Trump, who vowed to repeal the Affordable Care Act (ACA), known as Obamacare.
But President Donald Trump and Republicans in the U.S. Congress have struggled with swift action.
Trump sought on Monday to bring the nation's largest insurance companies on board with his plans to overhaul Obamacare, saying their help was needed to deliver a smooth transition to Republicans' new plan.
Tenet's net operating revenue fell 3.3 percent to $4.86 billion, missing the average analysts' estimate of $4.96 billion, according to Thomson Reuters I/B/E/S .
Net loss attributable to Tenet shareholders narrowed to $79 million, or 79 cents per share, in the fourth quarter ended Dec. 31, from a loss of $97 million, or 98 cents per share, a year earlier.
Excluding items, the company earned 6 cents per share, sharply below estimates of 22 cents.
The company said it expects 2017 adjusted earnings from continuing operations of $1.05-$1.30 per share, below estimates of $1.97 per share.
Tenet expects 2017 revenue to be $19.7 billion-$20.1 billion compared with estimates of $19.98 billion.
(Reporting by Ankur Banerjee in Bengaluru; Editing by Shounak Dasgupta)