Healthcare Insights

Top 25 hospitals in North Carolina by net patient revenue 

Home to nearly 10.7 million people, North Carolina is the ninth-most populous state in the U.S. Residents have access to nearly 200 hospitals and 26 integrated delivery networks (IDNs), according to Definitive Healthcare data. The state has some of the most consolidated hospital markets in the country, meaning most hospitals belong to a large system.

Below, we’ve compiled a list of the top 25 hospitals in North Carolina based on 2021 net patient revenue (NPR) using HospitalView. NPR is the amount of money generated from patient services from sources such as commercial insurance, Medicaid, and Medicare. It is a standard for measuring the financial performance of healthcare organizations.

North Carolina hospitals with the highest net patient revenues in 2021

RankHospital nameCity2021 NPR# of discharges# of staffed bedsExplore dataset
1Duke University HospitalDurham$2,675,540,231 40,906960Explore
2Atrium Health Carolinas Medical CenterCharlotte$2,485,398,176 56,9351,119Explore
3UNC Medical Center (FKA University of North Carolina Hospitals - Memorial Hospital)Chapel Hill$2,361,574,427 32,909809Explore
4Wake Forest Baptist Medical CenterWinston Salem$1,986,016,553 39,025808Explore
5Novant Health Forsyth Medical Center (FKA Forsyth Memorial Hospital)Winston Salem$1,554,471,513 35,071912Explore
6Novant Health Presbyterian Medical Center (FKA Presbyterian Hospital)Charlotte$1,334,067,693 27,118602Explore
7Mission Hospital - Memorial CampusAsheville$1,267,230,070 43,795733Explore
8ECU Health Medical Center (FKA Vidant Medical Center)Greenville$1,238,027,840 39,794847Explore
9Cone Health Moses Cone Hospital (AKA Moses H Cone Memorial Hospital)Greensboro$1,220,416,231 42,593536Explore
10UNC Rex Hospital (FKA Rex Hospital)Raleigh$1,216,062,000 27,530439Explore
11Novant Health New Hanover Regional Medical CenterWilmington$1,206,003,088 33,901684Explore
12WakeMed Raleigh CampusRaleigh$1,098,020,941 31,167609Explore
13Cape Fear Valley Medical CenterFayetteville$828,787,409 31,795490Explore
14FirstHealth Moore Regional HospitalPinehurst$777,631,182 21,914412Explore
15Atrium Health Cabarrus (FKA Carolinas HealthCare System NorthEast)Concord$740,539,454 27,471447Explore
16Duke Raleigh HospitalRaleigh$564,845,828 9,833175Explore
17CaroMont Regional Medical Center (AKA CaroMont Health)Gastonia$562,521,028 22,641393Explore
18Atrium Health Pineville (FKA Carolinas HealthCare System Pineville)Charlotte$543,916,624 17,339154Explore
19CarolinaEast Health System (AKA CarolinaEast Medical Center)New Bern$467,405,340 12,754289Explore
20Duke Regional Hospital (FKA Durham Regional Hospital)Durham$411,872,941 14,800301Explore
21Wake Forest Baptist Health - High Point Medical CenterHigh Point$332,336,489 13,789288Explore
22Atrium Health Cleveland (FKA Carolinas HealthCare System Cleveland)Shelby$326,562,232 13,653308Explore
23Nash General HospitalRocky Mount$322,840,236 11,799322Explore
24WakeMed Cary HospitalCary$310,162,578 13,643178Explore
25Catawba Valley Medical CenterHickory$290,342,636 11,037200Explore

Fig. 1. Data is from Definitive Healthcare’s HospitalView product. Data is from the October 2022 Medicare Cost Report. Data is accurate as of December 2022. 

Which hospital had the highest net patient revenue?

Nonprofit Duke University Hospital, part of Duke Health, had the highest net patient revenue (NPR) among hospitals in North Carolina in 2021, with nearly $2.68 billion. The hospital competes in the Durham-Chapel Hill area with two major systems: UNC Health and WakeMed Health and Hospitals.

Duke University Hospital is the flagship teaching hospital of Duke University Health System. It conducts a large amount of medical research and has a reputation as a high-quality healthcare provider. In 2022, Duke University Hospital was ranked the top hospital in North Carolina by U.S. News & World Report.

In second place is Atrium Health Carolinas Medical Center – an academic medical center affiliated with Wake Forest School of Medicine – with $2.49 billion in NPR. The nonprofit hospital has the highest number of discharges (56,935) and staffed beds (1,119) in North Carolina.

Atrium Health Carolinas Medical Center is part of Advocate Health (formerly Atrium Health), one of the largest IDNs in the country and the dominant health system in the Charlotte market. Advocate Health emerged from the mega-merger between North Carolina-based Atrium Health and Advocate Aurora Health, which operates in Illinois and Wisconsin.

Rounding out the top three is the nonprofit UNC Medical Center, a nationally-ranked academic medical center in Chapel Hill. The hospital earned $2.36 billion in NPR for the hospital cost report period ending in June 2021. UNC Medical Center is affiliated with the University of North Carolina School of Medicine. It’s the second-best hospital in the state, according to U.S. News & World Report.

What is net patient revenue?

Net patient revenue (NPR) is the aggregate money generated from patient services collected from payors, including private insurance, Medicaid, and Medicare. Hospitals calculate their NPR to paint a clear picture of their financial strength, develop meaningful business strategies, and help ensure that all departments are adequately funded.

A hospital can calculate its net patient revenue by subtracting patient discounts from its total patient revenue. Metrics like contractual adjustments, charitable donations, foundation earnings, and bad debt are not included in these calculations.

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Healthcare Insights are developed with healthcare commercial intelligence from the Definitive Healthcare platform. Want even more insights? Start a free trial now and get access to the latest healthcare commercial intelligence on hospitals, physicians, and other healthcare providers.