Top healthcare systems by operating expenses

Which healthcare systems have the highest operating expenses?

The top health system in the U.S. by operating expense is HCA Healthcare. This health system also ranks first for the largest healthcare systems in the U.S. by number of hospitals and is among the top health systems by total facility area. With 210 hospitals across 19 states, operating expenses are expected to be high, which is likely why HCA Healthcare tops this list of IDNs with the highest operating expenses.

The second health system with the highest operating expense is CommonSpirit Health. This health system also ranks in the top IDNs by number of hospitals and by total facility area. It is the third-largest health system by member hospitals and the fourth-largest health system by area. Like HCA Healthcare, CommonsSpirit Health likely has higher operating expenses from managing a large number of hospitals with a larger facility footprint.

Ascension Health comes in third on the list of top health systems by operating expense. With 129 hospitals, this top health system by operating expense also tops the list of healthcare systems by number of member hospitals (sixth place) and the list of largest healthcare systems by total facility area (third place).

What are operating expenses in healthcare?

Healthcare operating expenses, as defined by the Health Resources and Services Administration (HRSA), are expenses that are incurred as part of care delivery. These expenses include the salaries and benefits of staff and providers, contracted and employed physicians, medical supplies, and interest and depreciation on buildings and equipment used in the delivery of care.

Not included in operating expenses are costs of rental property not used in care delivery, contributions made, and gains or losses on investments.

What is the average healthcare system operating expense?

The average total operating expense for the 877 active health systems tracked in the HospitalView product with operating expense data is $1.6 billion. The average operating expense for the 50 health systems listed above is $10.5 billion.

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