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Integrated Delivery Networks (IDNs) offer both healthcare services and health insurance coverage to patients within a geographic area. Each IDN is unique in its function and offerings, but generally they provide primary care, acute care, specialty care (including clinics), long-term care, and home health care. IDNs often leverage their size to increase purchasing power, negotiating lower prices with medical device suppliers for their member facilities.

The following table lists the top 50 IDNs in the U.S. according to net patient revenue. The IDN with the greatest net revenue on our list, HCA Healthcare, leads by a significant margin, generating over $10 billion more per year than CommonSpirit Health in second place. Only five of the top 50 IDNs reported more than 100 in-network hospitals, with three of those in the top five.

On average, the top 50 IDNs brought in more than $7.9 billion in net patient revenue during the most recent reporting period. This is about one-fifth of the net patient revenue earned by HCA Healthcare, the largest IDN. Additionally, the top 50 IDNs contain an average of 39 in-network hospitals, though the IDN with the highest net patient revenue contains more than 5 times that number.

Top 50 IDNs by Net Patient Revenue

  IDN Name Net Patient Revenue Number of Hospitals Number of Discharges

1.

HCA Healthcare (TN)

$39,776,570,364

211

1,873,943

2.

CommonSpirit Health (IL)

$28,420,823,528

202

1,001,278

3.

Ascension Health (MO)

$17,090,314,410

124

705,559

4.

Providence St Joseph Health (WA)

$15,235,703,657

57

470,818

5.

Trinity Health (MI)

$13,894,648,951

61

568,624

6.

Tenet Healthcare (TX)

$13,598,155,515

84

655,371

7.

Dignity Health (CA)

$11,813,375,044

48

386,764

8.

University of California Health (CA)

$12,037,715,447

20

176,720

9.

Northwell Health (NY)

$8,993,294,199

23

310,432

10.

Community Health Systems (TN)

$10,861,711,462

111

538,915

11.

Cleveland Clinic Health System (OH)

$8,377,012,312

19

225,473

12.

Partners HealthCare (MA)

$7,546,947,766

15

158,727

13.

New York-Presbyterian Healthcare

System (NY)

$8,639,415,105

13

213,470

14.

Universal Health Services (PA)

$8,828,174,645

173

670,671

15.

University of Pittsburgh Medical

Center (PA)

$8,056,954,680

36

271,565

16.

Atrium Health (NC)

$7,626,467,360

39

268,003

17.

Baylor Scott & White Health (TX)

$7,170,574,656

51

268,993

18.

LifePoint Health (TN)

$7,897,128,960

86

312,173

19.

Advocate Aurora Health (IL)

$7,884,934,714

30

270,102

20.

Bon Secours Mercy Health (OH)

$7,598,915,710

39

305,897

21.

AdventHealth (FL)

$7,374,244,045

38

314,600

22.

Sutter Health (CA)

$6,722,495,150

30

165,370

23.

NYU Langone Health (NY)

$6,367,558,092

7

114,962

24.

Mayo Clinic Health System (MN)

$6,373,701,687

23

121,657

25.

University of Texas System (TX)

$5,384,305,964

10

97,087

26.

NYC Health and Hospitals (NY)

$5,626,899,758

12

144,305

27.

Indiana University Health (IN)

$4,520,214,139

18

111,419

28.

Penn Medicine (PA)

$5,659,696,584

10

139,362

29.

Stanford Medicine (CA)

$5,857,963,567

4

47,859

30.

Banner Health (AZ)

$5,774,913,766

31

236,107

31.

Mount Sinai Health System (NY)

$4,942,490,226

9

135,323

32.

Mercy (MO)

$4,962,551,792

37

195,480

33.

Johns Hopkins Health System (MD)

$4,406,170,200

6

112,177

34.

Montefiore Health System (NY)

$3,972,696,844

10

136,978

35.

SSM Health (MO)

$4,622,169,999

30

181,174

36.

Hackensack Meridian Health (NJ)

$4,364,314,858

16

155,224

37.

BJC HealthCare (MO)

$4,588,808,483

16

148,377

38.

Northwestern Medicine (IL)

$4,288,496,959

11

105,687

39.

Beth Israel Lahey Health (MA)

$4,131,809,903

13

142,175

40.

Stanford Health Care (CA)

$4,396,563,098

3

34,354

41.

Adventist Health (CA)

$3,962,096,929

20

135,454

42.

Memorial Hermann Health System (TX)

$4,416,797,459

21

186,472

43.

RWJ Barnabas Health (NJ)

$4,344,909,726

16

174,877

44.

Intermountain Healthcare (UT)

$4,420,608,890

25

127,578

45.

Advocate Health Care (IL)

$4,480,091,341

15

166,171

46.

Steward Health Care System (TX)

$4,448,187,497

39

200,151

47.

University of California San

Francisco Health System (CA)

$4,223,673,020

7

46,430

48.

MedStar Health (MD)

$4,331,003,459

10

122,938

49.

University of North Carolina Health Care (NC)

$4,094,567,144

18

117,673

50.

Yale New Haven Health System (CT)

$4,059,324,359

9

111,328

Fig 1. Data from Definitive Healthcare based on combined net patient revenue reported by IDN member hospitals from fiscal year 2016, the most recent data available. Number of discharges based on compilation of reports from IDN member hospitals.