Healthcare Insights

Top 25 IDNs by Net Patient Revenue

Integrated delivery networks (IDNs), or health systems, are organizations responsible for managing one or more healthcare facilities within a defined geographic area. These networks can vary in both size and service offerings and, because of this, may be affiliated with many different inpatient and outpatient provider types.

Some IDNs have hundreds of member facilities within their networks, and can leverage their size to exert industry influence and increase their purchasing power. This allows them to negotiate supply chain costs in much the same way that a group purchasing organization (GPO) would.

Below, we’ve compiled a list of the top 25 largest IDNs by net patient revenue.

Largest IDNs in the U.S. 2020

With 214 member hospitals and a total net patient revenue of almost $42.6 billion as of April 2020, Nashville-based HCA Healthcare is the largest IDN in the United States. Kaiser Permanente and CommonSpirit Health are the second and third largest health systems by net patient revenue—with $29.1 billion and $28.3 billion in net patient revenue reported as of April 2020, respectively.

We might expect that health systems with a greater number of member hospitals would report higher net patient revenues. However, 20 of the top 25 IDNs—or 80 percent—have fewer than 100 member hospitals. Fifteen of the top IDNs, or 60 percent, have fewer than 50 member facilities.

Based on this fact, it seems that there is little correlation between number of member hospitals and net patient revenue. It is more likely that the performance of these member hospitals is a stronger contributing factor to the financial success of the top 25 IDNs.

Top 25 IDNs by net patient revenue

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Rank Definitive ID IDN Name State Number of Member Hospitals Number of Discharges Net Patient Revenue Explore This Dataset
1. 4710 HCA Healthcare TN 214 1,923,773 $42,673,974,296 Explore This Profile
2. 4713 Kaiser Permanente CA 43 444,072 $29,176,611,660 Explore This Profile
3. 981465 CommonSpirit Health IL 197 959,084 $28,358,722,418 Explore This Profile
4. 4695 Ascension Health MO 117 679,089 $18,788,901,219 Explore This Profile
5. 4716 Providence St Joseph Health WA 56 463,500 $16,286,062,476 Explore This Profile
6. 845347 Kaiser Permanente Northern California CA 21 209,916 $14,359,957,345 Explore This Profile
7. 4685 Tenet Healthcare TX 87 652,017 $14,140,396,155 Explore This Profile
8. 845346 Kaiser Permanente Southern California CA 15 185,367 $14,011,636,037 Explore This Profile
9. 4712 Trinity Health MI 59 574,749 $13,737,577,562 Explore This Profile
10. 560423 University of California Health CA 21 178,254 $13,032,563,332 Explore This Profile
11. 4698 Dignity Health CA 48 384,556 $11,656,703,049 Explore This Profile
12. 542233 Community Health Systems TN 100 496,596 $10,823,928,332 Explore This Profile
13. 7055 Universal Health Services PA 170 719,554 $9,471,725,806 Explore This Profile
14. 4744 Northwell Health NY 21 287,889 $8,970,564,399 Explore This Profile
15. 6448 University of Pittsburgh Medical Center PA 36 274,760 $8,796,223,659 Explore This Profile
16. 274173 Cleveland Clinic Health System OH 18 218,142 $8,666,646,603 Explore This Profile
17. 7066 NewYork-Presbyterian Healthcare System NY 13 204,905 $8,355,307,233 Explore This Profile
18. 7004 LifePoint Health TN 86 312,900 $8,269,550,749 Explore This Profile
19. 7001 Mass General Brigham MA 17 158,399 $8,089,311,911 Explore This Profile
20. 965729 Advocate Aurora Health IL 29 263,632 $8,052,905,383 Explore This Profile
21. 4694 AdventHealth FL 39 325,832 $8,016,967,163 Explore This Profile
22. 975303 Bon Secours Mercy Health OH 41 309,455 $7,741,285,587 Explore This Profile
23. 4717 Sutter Health CA 30 159,758 $7,639,862,131 Explore This Profile
24. 938977 Stanford Medicine CA 3 47,288 $7,158,753,641 Explore This Profile
25. 577357 Baylor Scott & White Health TX 53 259,997 $7,101,837,595 Explore This Profile

Fig 1. Data is from Definitive Healthcare’s Hospitals & IDNs database. Net patient revenue is an aggregate of member hospital financial information from the July 2020 Medicare Cost Report release. The next scheduled Medicare Cost Report release is October 2020. Accessed July 2020.

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