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.
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.
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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.