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