Several large health systems reported operating losses in 2024, underscoring ongoing financial strain despite rising patient volumes and revenue growth. While inpatient revenue is climbing, expense pressures, cybersecurity disruptions and shifting care dynamics continue to weigh on margins — leaving even some of the nation’s largest systems in the red.
In February, average hospital operating margins fell to 2.5%, down from 3.4% in January, according to Kaufman Hall’s latest “National Hospital Flash Report.” Despite the dip, margins remained above 2024’s year-to-date average, suggesting that while performance has improved compared to recent years, financial stability remains fragile.
“In the early months of 2025, volumes remain strong across the board,” Erik Swanson, managing director and data and analytics group leader at Kaufman Hall, said in an April 8 report. “Emergency visits are rising, which is leading to challenges with ED boarding for many organizations. Data also show that inpatient revenue is growing while outpatient revenue has slowed, which points to the rapid growth in outpatient care in the last few years reaching its peak.”
Editor’s note: This is not an exhaustive list.
1. Somerville, Mass.-based Mass General Brigham reported a $72 million operating loss (-0.4% margin) for the fiscal year ending Sept 30, compared to a $48 million loss (-0.3% margin) in fiscal 2023. Operating revenue increased 9% year over year to $20.6 billion in FY 2024 while expenses increased 9% year over year to $20.5 billion. Despite the operating loss, Mass General Brigham reported a net income of $2 billion in FY 2024, up from $1.2 billion in FY 2023.
2. Pittsburgh-based Allegheny Health Network recorded an operating loss of $147 million (-2.9% operating margin) in 2024, improving on a $172.7 million loss (-3.7% margin) in 2023. Operating revenue was $5.1 billion in 2024, up from $4.7 billion the prior year. Expenses reached $5.3 billion, up from $4.9 billion. The health system reported a net loss of $129.1 million in 2024, compared to a $140.3 million loss in 2023.
3. Pittsburgh-based UPMC posted a $338.9 million operating loss (-1.1 operating margin) in 2024, compared to an operating loss of $198.3 million (-0.7 margin) in 2023. Operating revenue was $29.9 billion in 2024, up from $27.7 billion in 2023. Expenses totaled $30.1 billion, up from $27.9 billion. After accounting for nonoperating items, such as investment returns, UPMC reported a net loss of $14.7 million in 2024, up from a $30.1 million loss in 2023.
4. Renton, Wash.-based Providence recorded an operating loss of $644 million (-2.1% margin) in 2024, an improvement from the $1.2 billion loss (-4.1% margin) in 2023. Revenue increased 6.8% year over to $30.7 billion in 2024 while expenses grew by 4.2% to $31.2 billion. Providence posted a $231 million net loss in 2024, compared to a $596 million loss in 2023.
5. St.-Louis-based Ascension saw a $79 million operating loss (-0.3% margin) for the 10 months ending April 30, improving on a $1.2 billion operating loss in the previous 10-month period. In May and June 2024, operations were hampered by a May ransomware attack, resulting in reduced revenues from the associated business interruption along with costs incurred to address the issues and other business-related expenses. For the ten months ended April 30, 2024, Ascension reported a 5.2% year-over-year increase in revenue to $24.8 billion while expenses grew by 0.5% to $24.9 billion. Ascension reported a $1.1 billion net loss in FY 2024, representing a $1.6 billion turnaround from FY 2023.
6. Chicago-based CommonSpirit posted a $581 million operating loss (-1.5% margin) in fiscal 2024, up from an operating loss of $1.3 billion (-3.6% margin) in FY 2023. Operating revenues were $37.5 billion for the year ended June 30, up from $34.1 billion in the same period the previous year. Expenses were $38.1 billion, up from $35.3 billion. CommonSpirit posted a net income of $681 million in fiscal 2024, up from a net loss of $187 million the prior year.
7. Franklin, Tenn.-based Community Health Systems reported a $362 million net operating loss (-2.9% margin) for 2024, compared to a $16 million net operating gain (0.1% margin) in 2023. Revenue increased 1.2% year over year to $12.6 billion while expenses grew by 4.9% to $12.1 billion. CHS reported an overall net loss of $516 million (-4.1% margin) for 2024, compared to a $133 million net loss (-1.1% margin) in 2023.
8. Cleveland-based University Hospitals posted an operating loss of $172.6 million in 2024 (-2.7% operating margin), improving on a $256.1 million operating loss (-4.4% margin) in 2023. Operating revenue was $6.4 billion in 2024, up from $5.9 billion in 2023. Expenses were $6.6 billion, up from $6.1 billion. University Hospitals reported a net income of $18.1 million in 2024, up from a net loss of $48.4 million in 2023.
9. Minneapolis-based Allina Health reported an operating loss of $16.6 million (-0.3% margin) in 2024, a $344 million turnaround from the $360.5 million loss (-7% margin) reported in 2023. Revenue increased 12.3% year over year to $5.8 billion while expenses grew by 4.8% to $5.8 billion in 2024. Allina reported a net income of $163.8 million in 2024, compared to a net loss of $163.9 million in 2023.
10. Vineland, N.J.-based Inspira Health reported an $88.6 million operating loss (-0.7% margin) in 2024, down from a $49.8 million loss (-0.4% margin) in 2023, according to financial documents published April 15. Revenue increased 7.7% year over year to $1.35 billion while expenses grew by 10.4% to $1.44 billion. Inspira Health reported a $36.7 million net loss in 2024, compared to a $47.1 million net gain in 2023.
11. Akron, Ohio-based Summa Health reported an operating loss of $8.1 million (-0.4% margin) in 2024, an improvement from a $43.5 million operating loss (-2.3% margin) in 2023. Revenue was $2 billion in 2024, up from $1.9 billion in 2023. Expenses were $2 billion, up from $1.9 billion. Summa reported a net income of $35.1 million in 2024, up from $20.7 million in 2023.
