Top healthcare systems by hospital beds

Health systems, or integrated delivery networks (IDNs), are a key component of care delivery in the U.S. These entities bring together distinct healthcare facilities under one management system by coordinating patient care, retaining revenue, and controlling costs.

In the Definitive Healthcare HospitalView product, we track more than 800 IDNs and 7,300 hospitals across the country. Below, we break down the 10 largest health systems in the U.S. by beds. Bed size is based on the total member hospitals’ staffed beds for the healthcare system. By reviewing this information, we can get a better understanding of each health system’s financial presence, place among competitors, and operating power.

Largest health systems in the U.S. by bed count

Fig. 1 Data is from the Definitive Healthcare HospitalView product and derived from a range of sources, including the Medicare Cost Report and proprietary research. Accessed June 2025.

Which healthcare system has the most beds?

HCA Healthcare hospitals have more than 41,000 beds in total making it the largest health system in the U.S. by bed size. It is also the largest health system by total number of hospitals and net patient revenue.

The U.S. Department of Veterans Affairs is the second largest healthcare system in the country with more than 25,200 beds across its hospitals. Universal Health Services (UHS) ranks third, with more than 21,400 beds.

Collectively, these organizations represent a substantial portion of the nation’s hospital bed capacity and reflect diverse ownership models and regional coverage.

Below are key facts and figures on the top five largest IDNs in the U.S., ranked by bed count in descending order:

5. Kaiser Permanente

Kaiser Permanente, based in southern California, is a leading integrated managed care consortium, with over 13,000 hospital beds across its network. Known for its vertically integrated model, Kaiser combines insurance, hospital care, and physician services under one organization. It operates across eight states and the District of Columbia using a closed network system.

Fast facts:

• 13,098 staffed beds
• 63 hospitals
• 617 facilities
• 602,773 discharges
• $29.1 billion net patient revenue

4. CommonSpirit Health

Catholic Health Initiatives and Dignity Health merged in 2019 to form CommonSpirit Health, now the fourth largest healthcare system by bed size. Some of the states with the most CommonSpirit Health hospitals are located in the western U.S. including California, Colorado, Arizona, and Washington.

Fast facts:

• 18,980 staffed beds
• 155 hospitals
• 649 facilities
• 854,572 discharges
• $29.4 billion net patient revenue

3. Universal Health Services

Universal Health Services ranks third for total hospital beds among U.S. healthcare systems, with more than 21,000 staffed beds. The health system is headquartered in King of Prussia, Pennsylvania and its facilities are found in 40 states including Texas, Florida, and Nevada.

Fast facts:

• 21,419 staffed beds
• 185 hospitals
• 329 facilities
• 730,495 discharges
• $11.2 billion net patient revenue

2. Department of Veterans Affairs (VA)

VA hospitals provide healthcare services to more than nine million veterans that served in the U.S. military. It is the second largest healthcare system in the U.S. by hospital bed count with more than 25,000 beds and 161 hospitals. VA hospitals cover all 50 states, Washington D.C. and Puerto Rico. VA hospitals are government run and do not report financial figures.

Fast facts:

• 25,260 staffed beds
• 161 hospitals
• 482 facilities
• 2.1 million ER visits
• 18 Veterans Integrated Services Networks (VISNs)

1. HCA Healthcare

Ranked as the largest U.S. healthcare system by total member hospital beds is HCA Healthcare with over 41,000 staffed beds. Headquartered in Nashville, Tennessee, its facilities cover 18 states, with the most hospitals in Texas, Florida, Tennessee, and Virginia.

Fast facts:

• 41,215 staffed beds
• 223 hospitals
• 1,221 facilities
• 2,038,318 discharges
• $56.4 billion net patient revenue

HCA Healthcare has remained the largest IDN in the country for a number of years and has continued to grow. Compared to historical HospitalView data, HCA’s bed count increased by 10% from 2019 to 2024.

Learn more

IDNs provide an array of healthcare services, from outpatient surgical centers and imaging facilities to specialized cancer centers and children’s hospitals. They grow their coverage by adding to their service offerings, building new healthcare facilities, and through mergers and acquisitions. Large health systems aim to retain as many patients as possible in network while providing quality care.

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