Top 25 IDNs by net patient revenue
Integrated delivery networks (IDNs), sometimes called 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 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. Our list is based on the most recent 12-month interval tracked in our database.
25 largest IDNs in the U.S. by NPR in 2022
|Rank||IDN name||City||State||# of hospitals||NPR||# of staffed beds||# of discharges||Explore dataset|
|1||HCA Healthcare (FKA Hospital Corporation of America)||Nashville||TN||209||$47,440,144,679||42,300||1,883,616||Explore|
|3||Ascension Health||Saint Louis||MO||129||$21,994,513,119||18,007||730,161||Explore|
|5||Trinity Health (FKA CHE Trinity Health)||Livonia||MI||105||$20,146,316,427||14,550||674,658||Explore|
|7||Providence St Joseph Health (AKA Providence)||Renton||WA||57||$17,318,812,826||10,530||410,831||Explore|
|8||University of California Health (AKA UC Health-CA)||Oakland||CA||23||$15,158,951,541||4,716||165,725||Explore|
|9||Dignity Health||San Francisco||CA||52||$14,235,984,061||7,648||388,262||Explore|
|11||AdventHealth (FKA Adventist Health System)||Altamonte Springs||FL||47||$11,698,304,391||8,395||367,164||Explore|
|12||Kaiser Permanente Northern California||Oakland||CA||21||$11,306,310,062||4,186||213,148||Explore|
|13||Cleveland Clinic Health System||Cleveland||OH||22||$10,811,857,015||5,100||237,761||Explore|
|14||Community Health Systems (AKA CHS)||Franklin||TN||87||$10,660,925,865||10,537||414,426||Explore|
|15||Northwell Health (AKA North Shore Long Island Jewish Health System)||New Hyde Park||NY||20||$10,029,546,979||5,204||247,995||Explore|
|16||Universal Health Services||King Of Prussia||PA||178||$9,804,358,744||21,354||695,371||Explore|
|17||University of Pittsburgh Medical Center (AKA UPMC)||Pittsburgh||PA||36||$9,658,186,034||7,251||257,959||Explore|
|18||Kaiser Permanente Southern California||Pasadena||CA||15||$9,499,179,595||4,622||181,013||Explore|
|19||Mass General Brigham (FKA Partners HealthCare)||Boston||MA||16||$9,033,149,499||3,360||151,016||Explore|
|21||Mount Sinai Health System (FKA Mount Sinai Medical Center)||New York||NY||10||$8,766,335,585||3,293||120,049||Explore|
|22||Baylor Scott & White Health||Dallas||TX||50||$8,760,492,530||4,792||210,171||Explore|
|23||NewYork-Presbyterian Healthcare System||New York||NY||13||$8,197,110,141||3,794||186,232||Explore|
|24||NYC Health and Hospitals (FKA New York City Health and Hospitals Corporation)||New York||NY||12||$7,340,950,411||3,463||122,877||Explore|
|25||University of Texas System||Austin||TX||12||$7,096,266,707||3,344||106,168||Explore|
Which IDNs have the highest net patient revenue?
With 209 member hospitals and a total net patient revenue of $47.4 billion, Nashville-based HCA Healthcare is the largest IDN in the United States. CommonSpirit Health and Ascension Health are the second and third largest health systems by net patient revenue—with $31.0 billion and $22.0 billion in net patient revenue reported as of the October 2022 Medicare Cost Report.
We might expect that health systems with more member hospitals would report higher net patient revenues. However, 20 of the top 25 IDNs—or 80%—have fewer than 100 member hospitals. Thirteen of the top IDNs, or 52%, have fewer than 50 member facilities.
There is little correlation between the 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.
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