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 our HospitalView product, we track more than 900 active IDNs and 7,300 hospitals across the country. Breaking down the ten largest U.S. healthcare systems by total member hospitals’ staffed beds, we can get a better understanding of their financial presence, place among competitors, and operating power.

Top 10 largest healthcare systems in the U.S. by member hospital beds

Fig. 1 Data is from the Definitive Healthcare HospitalView product. IDN and hospital data is sourced from the Medicare Cost Report and updated based on proprietary research. Data accessed September 2022.

Which healthcare system has the most beds?

HCA Healthcare hospitals have more than 41,400 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 25,880 beds across its hospitals.

The top 10 healthcare systems cover 1,223 hospitals and 186,232 hospital beds.

Here are some quick facts and figures about the top 5 largest U.S. IDNs in descending order:

5. Ascension Health

Ascension Health, based in St. Louis, Missouri is the fifth largest U.S. healthcare system with 18,032 staffed member hospital beds. The faith-based organization has facilities in 12 states, concentrated in the Midwest, Southeast, and South.

Fast facts:

• 18,032 staffed beds
• 130 hospitals
• 763 facilities
• 729,793 discharges
• $22.0 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. The organization has 19,573 staffed beds and 164 hospitals across 18 states.

Fast facts:

• 19,573 staffed beds
• 164 hospitals
• 832 facilities
• 822,571 discharges
• $30.7 billion net patient revenue

3. Universal Health Services

Universal Health Services ranks third for total member beds among U.S. healthcare systems, with more than 21,000 staffed beds. Its facilities are found in 40 states including Texas, Florida, and California.

Fast facts:

• 21,320 staffed beds
• 179 hospitals
• 290 facilities
• 694,528 discharges
• $9.7 billion net patient revenue

2. Department of Veterans Affairs (VA)

VA hospitals provide healthcare services to the nine million veterans that served in the U.S. military. It is the second largest healthcare system in the U.S. by hospital beds with 25,884 hospitals and 161 active inpatient hospitals. VA hospitals cover all 50 states, Washington D.C. and Puerto Rico.

Fast facts:

• 25,884 staffed beds
• 161 hospitals
• 2.2 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 37,00 staffed beds. Headquartered in Nashville, Tennessee, its facilities cover 19 states, with the most hospitals in Texas, Florida, Tennessee, and Virginia.

Fast facts:

• 41,411 staffed beds
• 211 hospitals
• 1,140 facilities
• 1,860,118 discharges
• $44.9 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 2022.

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 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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