Start of Main Content

Healthcare Insights

Top IDNs by net patient revenue

Net patient revenue (NPR) is a metric used to identify financially successful healthcare organizations. To gain a bigger picture of how financially strong a network of facilities is, the NPR of an integrated delivery network (IDN), or health system, can be a key indicator.

What is an IDN in healthcare?

An integrated delivery network (IDN), also referred to as a health system, is an organization that owns and operates a network of healthcare facilities. An IDN may include facilities such as hospitals, physician groups, clinics, ambulatory surgery centers, and imaging centers, to name a few.

Using the Definitive Healthcare HospitalView product, we have created a list of the top IDNs in the U.S. by their net patient revenue. The data is aggregated from affiliated facilities based on data from the Medicare Cost Report and is according to the most recent 12-month interval tracked in our database.

Top 25 largest IDNs in the U.S. by net patient revenue

Rank IDN nameDefinitive IDStateNet patient revenueExplore dataset
1HCA Healthcare (FKA Hospital Corporation of America)4710TN$51,384,221,832 Explore
2CommonSpirit Health981465IL$30,619,819,853 Explore
3Ascension Health4695MO$22,299,893,095 Explore
4Kaiser Permanente4713CA$22,109,572,373 Explore
5Trinity Health (FKA CHE Trinity Health)4712MI$21,373,343,612 Explore
6Advocate Health1057655NC$20,146,366,247 Explore
7University of California Health (AKA UC Health-CA)560423CA$19,321,094,207 Explore
8Providence St Joseph Health (AKA Providence)4716WA$17,607,865,714 Explore
9Dignity Health4698CA$14,967,486,129 Explore
10AdventHealth (FKA Adventist Health System)4694FL$13,383,421,372 Explore
11Tenet Healthcare4685TX$12,818,577,941 Explore
12Kaiser Permanente Northern California845347CA$12,088,937,583 Explore
13Cleveland Clinic Health System274173OH$11,712,463,759 Explore
14Northwell Health (AKA North Shore Long Island Jewish Health System)4744NY$10,920,269,929 Explore
15Community Health Systems (AKA CHS)542233TN$10,660,441,725 Explore
16Universal Health Services7055PA$10,428,923,269 Explore
17St Lukes University Health Network6449PA$10,354,167,683 Explore
18Mass General Brigham (FKA Partners HealthCare)7001MA$10,243,196,913 Explore
19NewYork-Presbyterian Healthcare System7066NY$10,228,262,503 Explore
20University of Pittsburgh Medical Center (AKA UPMC)6448PA$10,137,426,933 Explore
21Banner Health4732AZ$10,054,203,618 Explore
22Stanford Medicine938977CA$9,621,542,663 Explore
23Baylor Scott & White Health577357TX$9,537,700,608 Explore
24Mayo Clinic7104MN$9,377,911,804 Explore
25Kaiser Permanente Southern California845346CA$9,279,357,000 Explore

Fig. 1 Data is from the Definitive Healthcare HospitalView product. Data is aggregated from affiliated facilities based on data from the Medicare Cost Report and is displayed according to the most recent 12-month interval tracked in our database. Data accessed May 2024.

What is the largest health system in the U.S. by net patient revenue?

The top IDN in the U.S. by net patient revenue is HCA Healthcare with an NPR of more than $51 billion. This health system is also the largest IDN in the U.S. by the number of member hospitals and by the number of staffed beds. With the most hospitals and bed capacity across the country, we might expect that this health system sees more patients leading to a high net patient revenue.

Commonspirit Health ranks second with an NPR of about $30 billion. Like HCA Healthcare, this health system also makes the list of largest health systems in the U.S. by number of member hospitals (third place) and staffed beds (fourth place). Additionally, Commonspirit Health is near the top of the list of IDNs with the greatest number of affiliations. More affiliated facilities may allow this IDN to reach more patients, contributing to a higher NPR.

In third place is Ascension Health with an NPR of more than $22 billion. Like the other top IDNs by net patient revenue, this IDN shares characteristics of being one of the largest health systems by the number of member hospitals (sixth place) and by the number of staffed beds (fifth place).

These three IDNs also rank in the top three spots in the list of top healthcare systems by operating expenses.

What is the average net patient revenue for IDNs?

The average net patient revenue for all IDNs in the U.S. is $1.7 billion. The average NPR for the top 25 IDNs listed above is much greater at $15.6 billion.

The combined NPR for these 25 IDNs accounts for about 26% of the nationwide IDN net patient revenue.

Keys to marketing and selling to IDNs

By marketing or selling to a health system, you can reach decision-makers responsible for leading care at a wider network of facilities, allowing for a greater distribution of your product or therapy.

While net patient revenue is a key indicator of the financial strength of these IDNs there are other metrics to consider for informed sales conversations. Other key IDN metrics include prescription patterns, integration level, affiliations, referrals, relationships, average daily census, and more.

Learn more

Healthcare Insights are developed with healthcare commercial intelligence from the Definitive Healthcare platform. Want even more insights? Start a free trial now and get access to the latest healthcare commercial intelligence on hospitals, physicians, and other healthcare providers.