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The following table lists the top 50 IDNs in the U.S. according to total operating expenses. The IDN with the highest average daily census on our list, HCA Healthcare, leads by a significant margin with a total operating expense of over $33 billion. There is a 14% difference between the total operating costs of HCA Healthcare and CommonSpirit Health, the second IDN in the list. The difference between the second and third IDNs, CommonsSpirit Health and Kaiser Permanente, represent an even greater disparity with a 48% difference in total operating costs.
On average, the top 50 IDNs brought in more than $8.3 billion in net patient revenue during the most recent reporting period. The net patient revenue of HCA Healthcare, the largest IDN, is 138% more than the average of the top 50.
Top 50 IDNs by Total Operating Expenses
| IDN Name | Definitive ID | Total Operating Expenses | Net Patient Revenue | Number of Staffed Beds | |
|
1. |
HCA Healthcare |
4710 |
$33,300,008,566 |
$42,213,477,560 |
42,190 |
|
2. |
CommonSpirit Health |
981465 |
$28,888,478,741 |
$28,582,130,311 |
23,358 |
|
3. |
Kaiser Permanente |
4713 |
$17,660,010,388 |
$13,261,153,753 |
9,625 |
|
4. |
Ascension Health |
4695 |
$17,167,222,743 |
$17,441,876,135 |
16,713 |
|
5. |
Providence St Joseph Health |
4716 |
$16,315,418,947 |
$15,696,161,401 |
10,345 |
|
6. |
Trinity Health |
4712 |
$13,649,806,250 |
$13,132,792,081 |
10,471 |
|
7. |
Tenet Healthcare |
4685 |
$12,417,064,388 |
$13,652,040,731 |
15,870 |
|
8. |
Dignity Health |
4698 |
$12,106,979,191 |
$11,817,607,947 |
7,407 |
|
9. |
University of California (UC) Health |
560423 |
$12,076,399,009 |
$12,063,083,551 |
4,651 |
|
10. |
Northwell Health |
4744 |
$11,706,478,894 |
$9,410,545,687 |
6,075 |
|
11. |
Kaiser Permanente Northern California |
845347 |
$9,716,119,594 |
$7,224,288,886 |
4,163 |
|
12. |
Community Health Systems |
542233 |
$9,578,338,754 |
$10,516,859,767 |
13,783 |
|
13. |
Partners HealthCare |
7001 |
$9,384,902,385 |
$7,599,868,208 |
3,464 |
|
14. |
Cleveland Clinic Health System |
274173 |
$9,095,968,769 |
$8,636,380,142 |
4,504 |
|
15. |
University of Pittsburgh Medical Center |
6448 |
$8,284,711,893 |
$8,056,954,680 |
7,072 |
|
16. |
Universal Health Services |
7055 |
$8,083,891,361 |
$9,212,756,052 |
20,607 |
|
17. |
LifePoint Health |
7004 |
$7,869,059,572 |
$8,025,621,851 |
9,374 |
|
18. |
NewYork-Presbyterian Healthcare System |
7066 |
$7,654,676,520 |
$7,698,677,961 |
3,945 |
|
19. |
AdventHealth |
4694 |
$7,468,577,781 |
$7,952,813,318 |
8,019 |
|
20. |
Bon Secours Mercy Health |
975303 |
$7,260,348,716 |
$7,665,638,269 |
5,834 |
|
21. |
Advocate Aurora Health |
965729 |
$7,236,864,135 |
$8,026,280,391 |
6,695 |
|
22. |
Baylor Scott & White Health |
577357 |
$7,109,094,723 |
$7,190,163,055 |
4,779 |
|
23. |
Atrium Health |
4697 |
$6,850,312,196 |
$7,958,708,764 |
6,038 |
|
24. |
NYC Health and Hospitals |
7112 |
$6,809,806,459 |
$5,626,899,758 |
3,390 |
|
25. |
Kaiser Permanente Southern California |
845346 |
$6,684,088,335 |
$5,400,415,526 |
4,487 |
|
26. |
Sutter Health |
4717 |
$6,277,018,670 |
$6,676,610,412 |
4,308 |
|
27. |
NYU Langone Health |
579801 |
$5,980,491,570 |
$5,743,904,918 |
1,990 |
|
28. |
Mayo Clinic |
7104 |
$5,959,511,166 |
$6,881,687,038 |
3,561 |
|
29. |
Penn Medicine |
7033 |
$5,771,945,775 |
$5,674,917,621 |
2,758 |
|
30. |
Banner Health |
4732 |
$5,699,171,163 |
$5,978,246,087 |
5,274 |
|
31. |
Mount Sinai Health System |
577655 |
$5,692,425,783 |
$5,166,329,392 |
3,572 |
|
32. |
Stanford Medicine |
938977 |
$5,672,660,109 |
$5,857,963,567 |
942 |
|
33. |
University of Texas System |
274141 |
$5,482,915,384 |
$5,384,305,964 |
2,776 |
|
34. |
Indiana University Health |
7012 |
$5,218,549,857 |
$4,840,509,929 |
2,964 |
|
35. |
University Hospitals Health System |
4729 |
$5,076,206,993 |
$5,372,012,087 |
2,729 |
|
36. |
Montefiore Health System |
2754 |
$5,022,238,945 |
$3,972,696,844 |
3,307 |
|
37. |
SSM Health |
6446 |
$4,893,026,030 |
$4,763,284,753 |
4,519 |
|
38. |
BJC HealthCare |
7076 |
$4,875,745,564 |
$4,900,898,464 |
3,583 |
|
39. |
RWJBarnabas Health |
835851 |
$4,775,388,779 |
$4,823,961,325 |
4,269 |
|
40. |
Mercy (MO) |
7027 |
$4,575,171,446 |
$4,963,556,308 |
5,369 |
|
41. |
Beth Israel Lahey Health |
992199 |
$4,492,210,432 |
$4,133,231,979 |
2,313 |
|
42. |
Hackensack Meridian Health |
829066 |
$4,440,522,329 |
$4,502,658,114 |
4,440 |
|
43. |
CHRISTUS Health |
4702 |
$4,417,481,589 |
$4,458,272,875 |
5,574 |
|
44. |
Johns Hopkins Health System |
7213 |
$4,406,068,645 |
$4,406,170,200 |
2,290 |
|
45. |
Steward Health Care System |
4684 |
$4,331,846,541 |
$4,358,628,896 |
5,635 |
|
46. |
Northwestern Medicine |
550112 |
$4,329,442,569 |
$4,288,496,959 |
2,391 |
|
47. |
Memorial Hermann Health System |
7017 |
$4,322,955,548 |
$4,445,641,747 |
4,241 |
|
48. |
University of California San Francisco Health System |
551802 |
$4,287,577,607 |
$4,223,673,020 |
1,609 |
|
49. |
Prime Healthcare Services |
542003 |
$4,277,398,988 |
$4,376,608,561 |
6,548 |
|
50. |
Intermountain Healthcare |
4727 |
$4,246,262,963 |
$4,821,813,781 |
2,421 |
Fig 1. Data from Definitive Healthcare based on combined total operating expenses reported by IDN member hospitals from fiscal year 2018, the most recent data available. Data is from July 2019 Medicare Cost Report release; the next scheduled Medicare Cost Report release is October 2019.