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
| Rank | Definitive ID | Healthcare system name | Location | Total operating expenses | Explore dataset |
|---|---|---|---|---|---|
| 1 | 4710 | HCA Healthcare (FKA Hospital Corporation of America) | Nashville, TN | $36,403,674,734 | Explore |
| 2 | 981465 | CommonSpirit Health | Chicago, IL | $30,664,498,796 | Explore |
| 3 | 4695 | Ascension Health | Saint Louis, MO | $21,354,568,514 | Explore |
| 4 | 4713 | Kaiser Permanente | Oakland, CA | $20,789,810,903 | Explore |
| 5 | 4712 | Trinity Health (FKA CHE Trinity Health) | Livonia, MI | $20,506,649,563 | Explore |
| 6 | 4716 | Providence St Joseph Health (AKA Providence) | Renton, WA | $18,685,433,892 | Explore |
| 7 | 1057655 | Advocate Health | Charlotte, NC | $16,920,358,815 | Explore |
| 8 | 560423 | University of California Health (AKA UC Health-CA) | Oakland, CA | $15,503,082,174 | Explore |
| 9 | 4698 | Dignity Health | San Francisco, CA | $14,627,328,108 | Explore |
| 10 | 4744 | Northwell Health (AKA North Shore Long Island Jewish Health System) | New Hyde Park, NY | $13,025,392,983 | Explore |
| 11 | 4685 | Tenet Healthcare | Dallas, TX | $12,793,970,632 | Explore |
| 12 | 845347 | Kaiser Permanente Northern California | Oakland, CA | $11,410,309,906 | Explore |
| 13 | 7001 | Mass General Brigham (FKA Partners HealthCare) | Boston, MA | $11,298,833,557 | Explore |
| 14 | 274173 | Cleveland Clinic Health System | Cleveland, OH | $11,199,583,582 | Explore |
| 15 | 4694 | AdventHealth (FKA Adventist Health System) | Altamonte Springs, FL | $11,044,255,818 | Explore |
| 16 | 7066 | NewYork-Presbyterian Healthcare System | New York, NY | $10,218,916,403 | Explore |
| 17 | 6448 | University of Pittsburgh Medical Center (AKA UPMC) | Pittsburgh, PA | $9,664,165,775 | Explore |
| 18 | 7112 | NYC Health and Hospitals (FKA New York City Health and Hospitals Corporation) | New York, NY | $9,502,262,194 | Explore |
| 19 | 542233 | Community Health Systems (AKA CHS) | Franklin, TN | $9,008,371,101 | Explore |
| 20 | 7055 | Universal Health Services | King Of Prussia, PA | $8,781,522,623 | Explore |
| 21 | 845346 | Kaiser Permanente Southern California | Pasadena, CA | $8,578,561,607 | Explore |
| 22 | 4717 | Sutter Health | Sacramento, CA | $8,441,515,741 | Explore |
| 23 | 965729 | Advocate Aurora Health | Downers Grove, IL | $8,383,491,535 | Explore |
| 24 | 577357 | Baylor Scott & White Health | Dallas, TX | $7,988,132,198 | Explore |
| 25 | 975303 | Bon Secours Mercy Health | Cincinnati, OH | $7,920,981,710 | Explore |
| 26 | 4727 | Intermountain Healthcare | Salt Lake City, UT | $7,874,337,601 | Explore |
| 27 | 7104 | Mayo Clinic | Rochester, MN | $7,734,531,299 | Explore |
| 28 | 938977 | Stanford Medicine | Stanford, CA | $7,643,422,166 | Explore |
| 29 | 1044485 | Corewell Health (FKA BHSH System) | Grand Rapids, MI | $7,611,777,297 | Explore |
| 30 | 4732 | Banner Health | Phoenix, AZ | $7,546,621,196 | Explore |
| 31 | 274141 | University of Texas System | Austin, TX | $7,448,872,061 | Explore |
| 32 | 7033 | Penn Medicine (AKA University of Pennsylvania Health System) | Philadelphia, PA | $6,997,382,600 | Explore |
| 33 | 579801 | NYU Langone Health (FKA NYU Langone Medical Center) | New York, NY | $6,841,228,308 | Explore |
| 34 | 577655 | Mount Sinai Health System (FKA Mount Sinai Medical Center) | New York, NY | $6,659,977,399 | Explore |
| 35 | 7004 | LifePoint Health (FKA LifePoint Hospitals) | Brentwood, TN | $6,596,432,940 | Explore |
| 36 | 4729 | University Hospitals Health System | Cleveland, OH | $6,477,609,295 | Explore |
| 37 | 274282 | UNC Health (FKA UNC Health Care) | Chapel Hill, NC | $6,176,784,570 | Explore |
| 38 | 2754 | Montefiore Health System (AKA Montefiore Medical Center - Health System) | Bronx, NY | $6,168,161,490 | Explore |
| 39 | 835851 | RWJBarnabas Health | West Orange, NJ | $6,129,224,285 | Explore |
| 40 | 7012 | Indiana University Health (AKA IU Health) | Indianapolis, IN | $5,830,363,142 | Explore |
| 41 | 829066 | Hackensack Meridian Health | Edison, NJ | $5,675,850,304 | Explore |
| 42 | 550112 | Northwestern Medicine (AKA Northwestern Memorial Healthcare) | Chicago, IL | $5,625,996,921 | Explore |
| 43 | 829072 | Stanford Health Care | Stanford, CA | $5,609,678,997 | Explore |
| 44 | 542209 | Vanderbilt Health (FKA Vanderbilt University Medical Center System) | Nashville, TN | $5,575,114,126 | Explore |
| 45 | 4702 | CHRISTUS Health | Irving, TX | $5,525,213,560 | Explore |
| 46 | 4767 | Yale New Haven Health System | New Haven, CT | $5,486,300,135 | Explore |
| 47 | 846985 | Providence Health & Services - Southern California (FKA Providence Health & Services - California) | Mission Hills, CA | $5,481,985,634 | Explore |
| 48 | 7210 | Jefferson Health | Philadelphia, PA | $5,479,428,891 | Explore |
| 49 | 4868 | Ochsner Health System | New Orleans, LA | $5,471,984,077 | Explore |
| 50 | 6446 | SSM Health | Saint 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.
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