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

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IDN NameDefinitive IDNet Patient Revenue# of HospitalsAvg. Daily CensusExplore This Dataset
1. HCA Healthcare 4710 $42,213,477,560 211 24,333.50 Explore This Profile
2. Universal Health Services 7055 $9,212,756,052 172 13,394.70 Explore This Profile
3. CommonSpirit Health 981465 $28,543,327,983 203 11,822.50 Explore This Profile
4. Ascension Health 4695 $17,858,985,891 125 8,799.40 Explore This Profile
5. Tenet Healthcare 4685 $13,721,002,396 84 7,559.20 Explore This Profile
6. Trinity Health 4712 $13,117,384,362 58 6,486.60 Explore This Profile
7. Community Health Systems 542233 $10,780,259,686 109 6,267.80 Explore This Profile
8. Encompass Health Corporation 7277 $3,182,735,641 135 6,066.30 Explore This Profile
9. Providence St Joseph Health 4716 $15,696,161,401 57 5,920.40 Explore This Profile
10. Kaiser Permanente 4713 $13,261,153,753 43 4,543.80 Explore This Profile
11. Dignity Health 4698 $11,817,607,947 48 4,289.30 Explore This Profile
12. Northwell Health 4744 $9,410,545,687 23 4,201.40 Explore This Profile
13. Select Medical Corporation 7013 $2,284,089,486 115 4,187.50 Explore This Profile
14. AdventHealth 4694 $7,759,295,166 38 4,013.30 Explore This Profile
15. University of Pittsburgh Medical Center 6448 $8,056,954,680 36 3,993.50 Explore This Profile
16. Kindred Healthcare 7048 $2,118,980,726 80 3,972.40 Explore This Profile
17. Atrium Health 4697 $7,930,837,733 39 3,519.70 Explore This Profile
18. Bon Secours Mercy Health 975303 $7,665,638,269 39 3,458.10 Explore This Profile
19. LifePoint Health 7004 $8,059,322,200 86 3,389.60 Explore This Profile
20. Advocate Aurora Health 965729 $7,919,307,404 30 3,315.10 Explore This Profile
21. Cleveland Clinic Health System 274173 $8,763,122,200 19 3,145.70 Explore This Profile
22. NewYork-Presbyterian Healthcare System 7066 $7,698,677,961 12 3,041.90 Explore This Profile
23. New York State Office of Mental Health 552464 $47,760,344 *Net Medicare Revenue 24 3,036.00 Explore This Profile
24. Banner Health 4732 $5,978,246,087 31 3,027.10 Explore This Profile
25. University of California (UC) Health 560423 $12,063,083,551 20 2,940.30 Explore This Profile
26. Baylor Scott & White Health 577357 $7,121,201,390 51 2,913.80 Explore This Profile
27. Partners HealthCare 7001 $7,599,868,208 15 2,709.70 Explore This Profile
28. Prime Healthcare Services 542003 $4,376,608,561 46 2,699.30 Explore This Profile
29. Acadia Healthcare 7230 $826,419,744 38 2,585.50 Explore This Profile
30. Mercy (MO) 7027 $4,963,556,308 37 2,535.40 Explore This Profile
31. Steward Health Care System 4684 $4,358,628,896 39 2,521.50 Explore This Profile
32. RWJBarnabas Health 835851 $4,788,607,968 16 2,491.00 Explore This Profile
33. NYC Health and Hospitals 7112 $5,626,899,758 12 2,489.80 Explore This Profile
34. HCA East Florida Division 780654 $3,354,022,598 14 2,383.10 Explore This Profile
35. CHRISTUS Health 4702 $4,422,891,997 35 2,378.90 Explore This Profile
36. SSM Health 6446 $4,763,284,753 30 2,263.90 Explore This Profile
37. Memorial Hermann Health System 7017 $4,459,894,281 21 2,239.60 Explore This Profile
38. Hackensack Meridian Health 829066 $4,502,658,114 16 2,183.30 Explore This Profile
39. HCA Gulf Coast Division 780655 $2,911,673,551 16 2,170.20 Explore This Profile
40. Montefiore Health System 2754 $3,972,696,844 10 2,153.80 Explore This Profile
41. BJC HealthCare 7076 $4,900,898,464 16 2,130.10 Explore This Profile
42. Sutter Health 4717 $6,676,610,412 30 2,105.20 Explore This Profile
43. Beaumont Health System 4746 $4,212,484,651 8 2,101.40 Explore This Profile
44. Advocate Health Care 4740 $4,514,464,031 15 2,084.70 Explore This Profile
45. HCA West Florida Division 780653 $2,774,637,519 17 2,082.20 Explore This Profile
46. Kaiser Permanente Northern California 845347 $7,224,288,886 21 2,080.20 Explore This Profile
47. Texas Health Resources 6447 $4,209,720,101 29 2,064.20 Explore This Profile
48. BayCare Health System 7067 $3,339,878,904 17 2,064.20 Explore This Profile
49. Mercy Health 4715 $3,989,902,894 23 2,047.40 Explore This Profile
50. Mount Sinai Health System 577655 $5,166,329,392 9 2,034.60 Explore This Profile

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.