As fiscal year 2026 financial reports start rolling in from some of the country’s largest health systems, operating margins span a wide range.
Baylor Scott & White came in with an 8.3% margin while PeaceHealth saw a -2.2% margin. Seven systems finished in the black this year, and several improved on the previous year. Duke Health more than doubled its margin to 5.4% from 2.5% and Ascension narrowed its operating loss by $371 million.
Here are 10 health systems ranked by their fiscal year 2026 margin:
1. Baylor Scott & White (Dallas)
Revenue: $18.5 billion
Expenses: $16.9 billion
Operating income: $1.5 billion
Operating margin: 8.3%
2. OhioHealth (Columbus)
Revenue: $7.4 billion
Expenses: $6.8 billion
Operating income: $610.2 million
Operating margin: 8.2%
3. Moffitt Cancer Center (Tampa, Fla.)
Revenue: $3.4 billion
Expenses: $3.2 billion
Operating income: $238.4 million
Operating margin: 6.9%
4. Duke Health (Durham, N.C.)
Revenue: $8.4 billion
Expenses: $8 billion
Operating income: $453.1 million
Operating margin: 5.4%
5. Cedars-Sinai Health System (Los Angeles)
Revenue: $9.4 billion
Expenses: $9.2 billion
Operating income: $261 million
Operating margin: 2.8%
6. Trinity Health (Livonia, Mich.)
Revenue: $26.8 billion
Expenses: $26.3 billion
Operating income: $281 million
Operating margin: 1.1%
7. ChristianaCare (Wilmington, Del.)
Revenue: $3.6 billion
Expenses: $3.5 billion
Operating income: $17.4 million
Operating margin: 0.5%
8. Ascension (St. Louis)
Revenue: $24.5 billion
Expenses: $24.7 billion
Operating loss: $120 million
Operating margin: -0.2%
9. CommonSpirit (Chicago)
Revenue: $42.4 billion
Expenses: $42.9 billion
Operating loss: $430 million
Operating margin: -1.0%
10. PeaceHealth (Vancouver, Wash.)
Revenue: $4.2 billion
Expenses: $4.3 billion
Operating loss: $92.3 million
Operating margin: -2.2%
