The past several years have posed challenges to hospital finances. While some facilities have benefited from a smaller uninsured population, cuts to Medicare reimbursement, penalties tied to quality initiatives, and a shift towards outpatient treatment have forced some hospitals to cut expenses and focus on profitable services to remain financially solvent. However, some hospitals have thrived. The following list identifies the top 10 nonprofit and proprietary acute care and critical-access hospitals by median annual operating margin from 2011 to 2015, excluding facilities with less than 25 staffed beds.

Among both the top 10 most profitable nonprofit and proprietary hospitals there was a wide variety in hospital size and case mix, suggesting that neither in itself was clearly associated with overall operating margins. However, they did have substantially more favorable private payor mixes than most hospitals, with median values of 60.1 and 59.3 percent for nonprofit and proprietary facilities, respectively, compared to 49.5 percent for all hospitals. They also had accordingly lower median payor mixes for Medicare and Medicaid, which reimburse providers at lower rates than private insurers.

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