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.
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| IDN Name | Definitive ID | Net Patient Revenue | # of Hospitals | Avg. Daily Census | Explore 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.