Several health systems recently posted financial results for 2022, with many seeing higher expenses and losses from investments contributing to sizable net losses for the year.
Here are 20 health systems that reported net losses in 2022:
1. Oakland, Calif.-based Kaiser Permanente reported a net loss of $4.5 billion in 2022, down from a net income of $8.1 billion in 2021, with its operating margin dipping from 0.7 percent to -1.3 percent year over year. For the 12 months ended Dec. 31, Kaiser — an integrated healthcare provider with 39 hospitals — recorded an operating revenue of $95.4 billion, up 2.4 percent from $93.1 billion in 2021. However, Kaiser saw its operating expenses rise 4.5 percent from $92.5 billion to $96.7 billion in 2022.
2. Boston-based Mass General Brigham posted a $2.3 billion net loss for fiscal year 2022, which ended Sept. 30, Operating income for FY 2022 was $432 million loss — a sharp decline from a $442 million operating income the prior year. Total operating revenue for FY 2022 was $16.7 billion. Operating expenses increased 10 percent to $17.1 billion compared to 2021 and remain elevated due to increases in wages (9 percent), employee benefit costs (13 percent) and clinical supplies (13 percent), according to the health system.
3. Cleveland Clinic posted a $1.2 billion net loss in 2022 — down from a net gain of $2.2 billion the prior year — as losses from investments ate into its bottom line. In 2022, the 22-hospital system reported an operating loss of $211.3 million compared with an operating income of $746.3 million in 2021. Total unrestricted revenues increased 4.5 percent year over year to $13 billion, while total expenses increased 13.6 percent to $12.5 billion in 2022. Expenses were up across all categories, with salaries, wages and benefits seeing the biggest increase at 13.8 percent. Losses from investments in 2022 were $1 billion compared to a gain of $1.4 billion in 2021.
4. Pittsburgh-based UPMC reported a $916 million net loss in 2022. While the 40-hospital system was able to report an operating gain of $162 million, investment losses of $1.1 billion dragged the results down. The 2022 operating gain compared with $843 million in 2021. Operating revenue for 2022 totaled $25.5 billion while expenses totaled approximately $25.3 billion, up 7.5 percent from 2021. Outstanding debt as of Dec. 31 was $5.5 billion.
5. Altamonte Springs, Fla.-based AdventHealth recorded a $837.9 million net loss in 2022 on revenues of over $15 billion as investments slumped. The 49-hospital system reported a decline of nearly $1.2 billion in its investment return in 2022 compared with a $524.9 million gain the prior year. Operating income was $283.8 million, down from $994.6 million in 2021 as expenses increased 11 percent. However, there were signs of improvement in the fourth quarter as AdventHealth reported an operating gain of $269.3 million and an overall profit of $489.4 million.
6. Indianapolis-based Indiana University Health posted a $715 million net loss in 2022 — down from a net gain of $861.5 million the prior year — as labor costs and other expenses outpaced a slight uptick in operating revenue. In 2022, operating revenue increased 2.8 percent year over year to $8.09 billion, while operating expenses rose 3.3 percent to $7.97 billion. Operating income fell 24.9 percent from 2021 to $120.6 million in 2022. Investment losses from unfavorable financial markets drove a deficit of revenue over expenses to $715.1 million from a year-earlier.
7. Minneapolis-based Fairview Health, which is due to merge with Sioux Falls, S.D.-based Sanford Health, reported an overall loss of $562.9 million for the nine months ended Sept. 30 2022. While Fairview reported an operating loss of $248.5 million amid higher expenses, investment declines dragged the system down a further $314.4 million. The investment decline compared with a $125.3 million gain in 2021. A return to financial health could be a multiyear process, management said.
8. Tacoma, Wash.-based MultiCare Health System reported an overall loss of $515 million in 2022 amid inflationary pressures and investment declines. Operating losses totaled $287.4 million compared with an operating gain in 2021 of $65.5 million. The overall $515 million loss compared with net income of $291.6 million the previous year.
9. Miami-based Cano Health reported a net loss of $428.4 million in 2022 as the value-based care system expanded its membership. Revenues totaled $2.7 billion as membership grew 36 percent to almost 310,000.
10. Minneapolis-based Allina Health reported a $378.1 million net loss in 2022 compared with a net income of $381.1 million in 2021. The operating loss for the year was $195.4 million as rising expenses and a nursing strike dented performance. For 2022, revenues for the 11-hospital system were up slightly to $4.9 billion and expenses increased by a larger margin to $5.1 billion.
11. Albuquerque, N.M.-based Presbyterian Healthcare Services reported a $370.7 million net loss in 2022 — down from a net gain of $274 million in 2021 — as investment declines ate into its financial performance. The system reported an overall gain of $46 million in the fourth quarter as an improved quarterly investment performance helped offset a $47.9 million net operating loss. The operating loss for 2022, totaled $105.4 million, compared with a $69 million gain in 2021.
12. Memphis, Tenn.-based Baptist Memorial Health Care reported a net loss of $275.4 million in fiscal 2022 amid higher expenses and lower investment returns. Expenses were up 6.5 percent on 2021 to total $3.62 billion. Investment losses totaled $55.1 million compared with a net gain of $174.7 million in 2021.
13. Rockledge, Fla.-based Health First recorded an overall loss of $232.5 million in the year ended Sept. 30 2022 compared with a net gain of $189.3 million in 2021. The system, which is partly owned by Altamonte Springs, Fla.-based AdventHealth, reported an operating loss of almost $75 million as expenses rose to over $2 billion, an increase of more than 11 percent.
14. Chicago-based CommonSpirit Health reported a $213 million loss for the six-month period ending Dec. 31. An operating loss of $451 million compared with a loss of $47 million in the same period in 2021. Overall income for the 2022 period included a gain of $200 million in the final quarter as investment returns improved. Staffing expenses, which proved to be a "major challenge," totaled $140 million more than the previous year, an increase of 1.7 percent. The system held approximately $14.6 billion of debt as of Dec. 31.
15. Brewer, Maine-based Northern Light Health reported a $178 million net loss in fiscal 2022. The operating loss for the period ending Sept. 30 totaled $131.7 million. Those figures compared with a $57 million operating gain and an overall net income of $84.6 million in fiscal 2021. The health system's days of cash on hand declined in 2022 to 75.2 compared with 135.8 in 2021.
16. Providence, R.I.-based Care New England reported a $111 million net loss in fiscal 2022 ending Sept. 30. Operating losses of $13.8 million in the final three months of 2022 were lower than the same period in 2021. Days of cash on hand totaled 45.4 as of Dec. 31 2022.
17. Hershey, Pa.-based Penn State Health reported a net loss of $110.4 million for the six months ended Dec. 31. The five acute care hospital system reported operating losses totaling $114 million for the period compared with a net operating gain of $24.3 million in 2021. Expenses totaled $1.9 billion for 2022, up 11 percent on the same 2021 period.
18. Lebanon, N.H.-based Dartmouth Health reported a net loss of $86.4 million for the six months ending Dec. 31 compared with a $104 million gain in the 2021 period. The system recorded a $78 million operating loss for the period compared with a net gain of $55.5 million in the same period in 2021. Operating expenses rose almost 13 percent from the previous year, totaling $1.57 billion. The health system, which described some of the lingering effects from the pandemic as "unprecedented," said it had hired two consulting firms to help it get out of its financial predicament.
19. Hartford (Conn.) HealthCare reported an overall loss of $36.9 million in fiscal 2022 amid significant declines in its investment portfolio. Operating net income totaled $60.7 million as revenue improved to $5.4 billion. The loss on investment values of $95.5 million compared with a net gain of $513.1 million in 2021.
20. Sioux Falls, S.D.-based Avera Health, which operates 37 hospitals, reported a net loss of $7.1 million in the six months ending Dec. 31. Operating income for the system totaled $15.7 million for the period but other divisions, including its insurance arm, dragged the figures down. Overall revenues for the period totaled $1.43 billion.