Healthcare Insights

Top 50 healthcare systems by operating expenses

Healthcare systems, also known as integrated delivery networks (IDNs), operate multiple health facilities, including a variety of care settings and types of services. The largest of these organizations operate hundreds of facilities and incur high costs in providing patient care.

Understanding and managing expenses are more important than ever as hospitals face decreasing revenues, thin operating margins, and increasing medical supply and contract labor expenses.

The Definitive Healthcare HospitalView product tracks operating expenses for nearly 890 healthcare systems. The figure is aggregated from the most recent 12-month interval tracked in our database and updated from the October 2022 Medicare Cost Report release for the health system’s member hospitals.

The following table lists the top 50 healthcare systems in the U.S. by total operating expenses.

Top IDNs in the U.S. by total operating expenses

RankDefinitive IDHealthcare system nameLocationTotal operating expensesExplore dataset
14710HCA Healthcare (FKA Hospital Corporation of America)Nashville, TN$36,403,674,734 Explore
2981465CommonSpirit HealthChicago, IL$30,664,498,796 Explore
34695Ascension HealthSaint Louis, MO$21,354,568,514 Explore
44713Kaiser PermanenteOakland, CA$20,789,810,903 Explore
54712Trinity Health (FKA CHE Trinity Health)Livonia, MI$20,506,649,563 Explore
64716Providence St Joseph Health (AKA Providence)Renton, WA$18,685,433,892 Explore
71057655Advocate HealthCharlotte, NC$16,920,358,815 Explore
8560423University of California Health (AKA UC Health-CA)Oakland, CA$15,503,082,174 Explore
94698Dignity HealthSan Francisco, CA$14,627,328,108 Explore
104744Northwell Health (AKA North Shore Long Island Jewish Health System)New Hyde Park, NY$13,025,392,983 Explore
114685Tenet HealthcareDallas, TX$12,793,970,632 Explore
12845347Kaiser Permanente Northern CaliforniaOakland, CA$11,410,309,906 Explore
137001Mass General Brigham (FKA Partners HealthCare)Boston, MA$11,298,833,557 Explore
14274173Cleveland Clinic Health SystemCleveland, OH$11,199,583,582 Explore
154694AdventHealth (FKA Adventist Health System)Altamonte Springs, FL$11,044,255,818 Explore
167066NewYork-Presbyterian Healthcare SystemNew York, NY$10,218,916,403 Explore
176448University of Pittsburgh Medical Center (AKA UPMC)Pittsburgh, PA$9,664,165,775 Explore
187112NYC Health and Hospitals (FKA New York City Health and Hospitals Corporation)New York, NY$9,502,262,194 Explore
19542233Community Health Systems (AKA CHS)Franklin, TN$9,008,371,101 Explore
207055Universal Health ServicesKing Of Prussia, PA$8,781,522,623 Explore
21845346Kaiser Permanente Southern CaliforniaPasadena, CA$8,578,561,607 Explore
224717Sutter HealthSacramento, CA$8,441,515,741 Explore
23965729Advocate Aurora HealthDowners Grove, IL$8,383,491,535 Explore
24577357Baylor Scott & White HealthDallas, TX$7,988,132,198 Explore
25975303Bon Secours Mercy HealthCincinnati, OH$7,920,981,710 Explore
264727Intermountain HealthcareSalt Lake City, UT$7,874,337,601 Explore
277104Mayo ClinicRochester, MN$7,734,531,299 Explore
28938977Stanford MedicineStanford, CA$7,643,422,166 Explore
291044485Corewell Health (FKA BHSH System)Grand Rapids, MI$7,611,777,297 Explore
304732Banner HealthPhoenix, AZ$7,546,621,196 Explore
31274141University of Texas SystemAustin, TX$7,448,872,061 Explore
327033Penn Medicine (AKA University of Pennsylvania Health System)Philadelphia, PA$6,997,382,600 Explore
33579801NYU Langone Health (FKA NYU Langone Medical Center)New York, NY$6,841,228,308 Explore
34577655Mount Sinai Health System (FKA Mount Sinai Medical Center)New York, NY$6,659,977,399 Explore
357004LifePoint Health (FKA LifePoint Hospitals)Brentwood, TN$6,596,432,940 Explore
364729University Hospitals Health SystemCleveland, OH$6,477,609,295 Explore
37274282UNC Health (FKA UNC Health Care)Chapel Hill, NC$6,176,784,570 Explore
382754Montefiore Health System (AKA Montefiore Medical Center - Health System)Bronx, NY$6,168,161,490 Explore
39835851RWJBarnabas HealthWest Orange, NJ$6,129,224,285 Explore
407012Indiana University Health (AKA IU Health)Indianapolis, IN$5,830,363,142 Explore
41829066Hackensack Meridian HealthEdison, NJ$5,675,850,304 Explore
42550112Northwestern Medicine (AKA Northwestern Memorial Healthcare)Chicago, IL$5,625,996,921 Explore
43829072Stanford Health CareStanford, CA$5,609,678,997 Explore
44542209Vanderbilt Health (FKA Vanderbilt University Medical Center System)Nashville, TN$5,575,114,126 Explore
454702CHRISTUS HealthIrving, TX$5,525,213,560 Explore
464767Yale New Haven Health SystemNew Haven, CT$5,486,300,135 Explore
47846985Providence Health & Services - Southern California (FKA Providence Health & Services - California)Mission Hills, CA$5,481,985,634 Explore
487210Jefferson HealthPhiladelphia, PA$5,479,428,891 Explore
494868Ochsner Health SystemNew Orleans, LA$5,471,984,077 Explore
506446SSM HealthSaint Louis, MO$5,453,554,487 Explore

Fig. 1. Data is from the Definitive Healthcare HospitalView product. Healthcare system level data is aggregated from the most recent 12-month interval tracked in our database and updated from the October 2022 Medicare Cost Report release. Accessed January 2023.

Which healthcare system has the highest operating expenses?

HCA Healthcare has the highest total operating expense at more than $36 billion. HCA Healthcare is also the largest healthcare system in the U.S. and is a top IDN when measured by number of hospitals, total number of beds, and hospital net patient revenue.

Operating expenses for CommonSpirit Health are nearly $31 billion while Ascension Health has total costs of more than $21 billion.

Total operating expenses at each of the top 50 healthcare systems are over $5 billion.

Nine of the healthcare systems on the list are headquartered in California and six are based in New York.

What is the average healthcare system operating expense?

The average annual total operating expense for the 889 healthcare systems tracked in HospitalView is close to $1.6 billion.

The average total operating expenses for the top 50 healthcare systems on the list above is more than $10 billion.

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.

Explore our data