Nashville, Tenn.-based HCA Healthcare is the largest U.S. health system by net patient revenue, generating $60.3 billion during the most recent 12-month period tracked in Definitive Healthcare’s database, according to an Oct. 23 report from the healthcare data company.
Oakland, Calif.-based Kaiser Permanente and Chicago-based CommonSpirit Health finished in a near tie for second place, each with roughly $32.5 billion, according to the report. HCA’s total is nearly double either system’s.
Definitive analyzed more than 800 reporting integrated delivery networks using its HospitalView product. The figures aggregate affiliated facilities’ Medicare Cost Report data. Definitive accessed the data in October 2026.
The top 10 systems averaged $27 billion in net patient revenue, compared with a $2.1 billion average across all tracked systems, according to the report.
Here are the 10 health systems with the highest net patient revenue:
- HCA Healthcare (Nashville, Tenn.): $60.3 billion
- Kaiser Permanente (Oakland, Calif.): $32.6 billion
- CommonSpirit Health (Chicago): $32.5 billion
- Advocate Health (Charlotte, N.C.): $25.8 billion
- University of California Health (Oakland, Calif.): $25.1 billion
- Providence (Renton, Wash.): $21.6 billion
- Trinity Health (Livonia, Mich.): $19.4 billion
- AdventHealth (Altamonte Springs, Fla.): $19.3 billion
- Ascension (St. Louis): $17.8 billion
- Northwell Health (New Hyde Park, N.Y.): $16.1 billion
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