Top hospitals by total operating expense

Which hospitals have the highest operating expense?

The top hospital by total operating expense is New York-Presbyterian Weill Cornell Medical Center with more than $10 billion in reported 2024 operating costs. Located in New York City, this major academic medical center serves a densely populated urban area and offers a broad range of specialized services and advanced treatments. Its large patient volume, extensive research activity, and high cost of operations in NYC all contribute to its significant expenses. The hospital consistently appears near the top of other expense categories, such as salary, operating room, and medical supply costs.

In second place is Tisch Hospital, also based in New York City, with more than $9.8 billion in operating expenses. As a nonprofit academic hospital, Tisch delivers a high volume of complex care and invests heavily in research, clinical innovation, and medical education. These factors, combined with NYC’s high cost of labor and services, likely drive its overall expense level.

Rounding out the top three is the nonprofit, academic medical center Cleveland Clinic Main Campus, reporting $9.1 billion in 2024 operating expenses. As one of the largest hospital-based research programs in the U.S., Cleveland Clinic is widely recognized as one of the top hospitals in the United States and globally, and supports a high number of patient procedures, beds, and operating rooms. The system’s integrated care model and emphasis on specialty services likely contribute to its high resource utilization and operating costs.

How does non-profit hospital status influence operating expenses?

The three top hospitals by operating expense listed above are all non-profit hospitals affiliated with major academic medical centers, which invest heavily in medical research and education. They are also located in urban areas. Urban hospitals, whether non-profit or for-profit, generally face higher costs related to staffing, real estate, and facilities maintenance. This is particularly true in cities like New York, where the cost of living is significantly higher. Non-profit hospitals’ focus on community service, research, and education can also contribute to their overall higher operating expenses compared to many for-profit hospitals.

Additionally, these top three hospitals rank as the top three non-profit hospitals by net patient revenue (NPR). Based on the high NPR for these hospitals, it is reasonable to conclude that they see a higher volume of patients, requiring that they have more providers, staff, equipment, and facility space.

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