Healthcare Insights
Top IDNs by net patient revenue
Net patient revenue (NPR) is a metric used to identify financially successful healthcare organizations. To gain a bigger picture of how financially strong a network of facilities is, the NPR of an integrated delivery network (IDN), or health system, can be a key indicator.
What is an IDN in healthcare?
An integrated delivery network (IDN), also referred to as a health system, is an organization that owns and operates a network of healthcare facilities. An IDN may include facilities such as hospitals, physician groups, clinics, ambulatory surgery centers, and imaging centers, to name a few.
Using the Definitive Healthcare HospitalView product, we have created a list of the top IDNs in the U.S. by their net patient revenue. The data is aggregated from affiliated facilities based on data from the Medicare Cost Report and is according to the most recent 12-month interval tracked in our database.
| Rank | Definitive ID | IDN name | City | State | Net patient revenue | Explore dataset |
|---|---|---|---|---|---|---|
| 1 | 4710 | HCA Healthcare (FKA Hospital Corporation of America) | Nashville | TN | $48,179,695,081 | Explore |
| 2 | 981465 | CommonSpirit Health | Chicago | IL | $30,957,192,494 | Explore |
| 3 | 4695 | Ascension Health | Saint Louis | MO | $22,146,200,529 | Explore |
| 4 | 4713 | Kaiser Permanente | Oakland | CA | $21,466,800,788 | Explore |
| 5 | 4712 | Trinity Health (FKA CHE Trinity Health) | Livonia | MI | $20,688,489,330 | Explore |
| 6 | 1057655 | Advocate Health | Charlotte | NC | $19,026,724,669 | Explore |
| 7 | 4716 | Providence St Joseph Health (AKA Providence) | Renton | WA | $17,388,860,227 | Explore |
| 8 | 560423 | University of California Health (AKA UC Health-CA) | Oakland | CA | $16,683,722,920 | Explore |
| 9 | 4685 | Tenet Healthcare | Dallas | TX | $14,320,649,530 | Explore |
| 10 | 4698 | Dignity Health | San Francisco | CA | $14,187,995,174 | Explore |
| 11 | 845347 | Kaiser Permanente Northern California | Oakland | CA | $11,306,310,062 | Explore |
| 12 | 542233 | Community Health Systems (AKA CHS) | Franklin | TN | $10,815,134,425 | Explore |
| 13 | 274173 | Cleveland Clinic Health System | Cleveland | OH | $10,811,857,015 | Explore |
| 14 | 4694 | AdventHealth (FKA Adventist Health System) | Altamonte Springs | FL | $10,673,024,175 | Explore |
| 15 | 4744 | Northwell Health (AKA North Shore Long Island Jewish Health System) | New Hyde Park | NY | $10,322,251,261 | Explore |
| 16 | 6448 | University of Pittsburgh Medical Center (AKA UPMC) | Pittsburgh | PA | $9,793,022,925 | Explore |
| 17 | 7055 | Universal Health Services | King Of Prussia | PA | $9,629,719,858 | Explore |
| 18 | 845346 | Kaiser Permanente Southern California | Pasadena | CA | $9,499,179,595 | Explore |
| 19 | 7001 | Mass General Brigham (FKA Partners HealthCare) | Boston | MA | $9,401,472,112 | Explore |
| 20 | 7066 | NewYork-Presbyterian Healthcare System | New York | NY | $9,343,667,708 | Explore |
| 21 | 7104 | Mayo Clinic | Rochester | MN | $8,957,642,234 | Explore |
| 22 | 577357 | Baylor Scott & White Health | Dallas | TX | $8,898,041,633 | Explore |
| 23 | 4727 | Intermountain Health (FKA Intermountain Healthcare) | Salt Lake City | UT | $8,551,024,876 | Explore |
| 24 | 4717 | Sutter Health | Sacramento | CA | $8,501,170,541 | Explore |
| 25 | 975303 | Bon Secours Mercy Health | Cincinnati | OH | $8,463,451,952 | Explore |
Fig. 1 Data is from the Definitive Healthcare HospitalView product. Data is aggregated from affiliated facilities based on data from the Medicare Cost Report and is displayed according to the most recent 12-month interval tracked in our database. Data accessed July 2023.
What is the largest health system in the U.S. by net patient revenue?
The top IDN in the U.S. by net patient revenue is HCA Healthcare. This health system is also both the largest IDN in the U.S. by the number of member hospitals and by the number of staffed beds. With the most hospitals and bed capacity across the country, we might expect that this health system sees more patients leading to a high net patient revenue.
Commonspirit Health comes in second place in the list of top IDNs by NPR. Like HCA Healthcare, this health system also makes the list of largest health systems in the U.S. by number of member hospitals (third place) and by number of staffed beds (fourth place). Additionally, Commonspirit Health tops the list of IDNs with the greatest number of affiliations. Having more affiliated facilities may allow this IDN to reach more patients, which would contribute to a higher NPR.
In third place is Ascension Health. Similar to the other top IDNs by net patient revenue, this IDN shares characteristics of being one of the largest health systems by the number of member hospitals (sixth place) and by the number of staffed beds (fifth place).
These three IDNs also rank in the top three spots in the list of top healthcare systems by operating expenses, as well.
What is the average net patient revenue for IDNs?
The average net patient revenue for all IDNs in the U.S. is $1.6 billion. The average NPR for the top 25 IDNs listed above is much greater at $14.8 billion.
The combined NPR for these 25 IDNs accounts for 26% of the nationwide IDN net patient revenue.
Keys to marketing and selling to IDNs
By marketing to a health system, you can reach decision-makers that are responsible for leading care at a wider network of facilities, which could allow for greater distribution of your product or therapy.
While net patient revenue is a key indicator of the financial strength of these IDNs there are other metrics to consider prior to sales conversations. Other key IDN metrics include prescription patterns, integration level, affiliations, referrals, and relationships.
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