Healthcare Insights

Top IDNs by average daily census

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 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 average daily census. The IDN with the highest average daily census on our list, HCA Healthcare, leads by a significant margin. With an average daily census of 24,333, the gap between the first and second spot on our list exceeds 10,000 patients. HCA consists of 211 in-network hospitals. The average number of in-network hospitals for IDNs in the top 50 comes in at just over 48.

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 less than one-fifth of the net patient revenue earned by HCA Healthcare, the largest IDN.

Top 50 IDNs by average daily census

IDN NameDefinitive IDNet Patient Revenue# of HospitalsAvg. Daily CensusExplore Dataset
1HCA Healthcare 4710$42,213,477,560 21124,333.50Explore
2Universal Health Services 7055$9,212,756,052 17213,394.70Explore
3CommonSpirit Health 981465$28,543,327,983 20311,822.50Explore
4Ascension Health 4695$17,858,985,891 1258,799.40Explore
5Tenet Healthcare 4685$13,721,002,396 847,559.20Explore
6Trinity Health 4712$13,117,384,362 586,486.60Explore
7Community Health Systems 542233$10,780,259,686 1096,267.80Explore
8Encompass Health Corporation 7277$3,182,735,641 1356,066.30Explore
9Providence St Joseph Health 4716$15,696,161,401 575,920.40Explore
10Kaiser Permanente 4713$13,261,153,753 434,543.80Explore
11Dignity Health 4698$11,817,607,947 484,289.30Explore
12Northwell Health 4744$9,410,545,687 234,201.40Explore
13Select Medical Corporation 7013$2,284,089,486 1154,187.50Explore
14AdventHealth 4694$7,759,295,166 384,013.30Explore
15University of Pittsburgh Medical Center 6448$8,056,954,680 363,993.50Explore
16Kindred Healthcare 7048$2,118,980,726 803,972.40Explore
17Atrium Health 4697$7,930,837,733 393,519.70Explore
18Bon Secours Mercy Health 975303$7,665,638,269 393,458.10Explore
19LifePoint Health 7004$8,059,322,200 863,389.60Explore
20Advocate Aurora Health 965729$7,919,307,404 303,315.10Explore
21Cleveland Clinic Health System 274173$8,763,122,200 193,145.70Explore
22NewYork-Presbyterian Healthcare System 7066$7,698,677,961 123,041.90Explore
23New York State Office of Mental Health 552464$47,760,344 *Net Medicare Revenue 243,036.00Explore
24Banner Health 4732$5,978,246,087 313,027.10Explore
25University of California (UC) Health 560423$12,063,083,551 202,940.30Explore
26Baylor Scott & White Health 577357$7,121,201,390 512,913.80Explore
27Partners HealthCare 7001$7,599,868,208 152,709.70Explore
28Prime Healthcare Services 542003$4,376,608,561 462,699.30Explore
29Acadia Healthcare 7230$826,419,744 382,585.50Explore
30Mercy (MO) 7027$4,963,556,308 372,535.40Explore
31Steward Health Care System 4684$4,358,628,896 392,521.50Explore
32RWJBarnabas Health 835851$4,788,607,968 162,491.00Explore
33NYC Health and Hospitals 7112$5,626,899,758 122,489.80Explore
34HCA East Florida Division 780654$3,354,022,598 142,383.10Explore
35CHRISTUS Health 4702$4,422,891,997 352,378.90Explore
36SSM Health 6446$4,763,284,753 302,263.90Explore
37Memorial Hermann Health System 7017$4,459,894,281 212,239.60Explore
38Hackensack Meridian Health 829066$4,502,658,114 162,183.30Explore
39HCA Gulf Coast Division 780655$2,911,673,551 162,170.20Explore
40Montefiore Health System 2754$3,972,696,844 102,153.80Explore
41BJC HealthCare 7076$4,900,898,464 162,130.10Explore
42Sutter Health 4717$6,676,610,412 302,105.20Explore
43Beaumont Health System 4746$4,212,484,651 82,101.40Explore
44Advocate Health Care 4740$4,514,464,031 152,084.70Explore
45HCA West Florida Division 780653$2,774,637,519 172,082.20Explore
46Kaiser Permanente Northern California 845347$7,224,288,886 212,080.20Explore
47Texas Health Resources 6447$4,209,720,101 292,064.20Explore
48BayCare Health System 7067$3,339,878,904 172,064.20Explore
49Mercy Health 4715$3,989,902,894 232,047.40Explore
50Mount Sinai Health System 577655$5,166,329,392 92,034.60Explore

Fig 1. Data from Definitive Healthcare based on combined net patient revenue reported by IDN member hospitals from fiscal year 2018, the most recent data available. Average Daily Census based on compilation of reports from IDN member hospitals. Aggregate of Member Hospital Financial Information from CMS Medicare Cost Report.

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