Despite many U.S. health systems seeing improved margins, some continue to be weighed down by long-term debt from investments in technology, large expansions, and asset transactions.
Here are 28 health systems ranked by their long-term debt in fiscal year 2024:
Note: This is not an exhaustive list. The following long-term debt figures are taken from each health system’s most recent financial report.
1. HCA Healthcare (Nashville, Tenn.): $38.3 billion
2. CommonSpirit Health (Chicago): $17 billion
3. Tenet Healthcare (Dallas): $13.1 billion
4. Kaiser Permanente (Okland, Calif.): $12.7 billion
5. Community Health Systems (Franklin, Tenn.): $11.4 billion
6. Providence (Renton, Wash.): $7.5 billion
7. Ascension (St. Louis): $7.1 billion
8. Trinity Health (Livonia, Mich.): $6.4 billion
9. UPMC (Pittsburgh): $6.1 billion
10. Mass General Brigham (Somerville, Mass.): $5.8 billion
11. Cleveland Clinic: $4.6 billion
12. Universal Health Services (King of Prussia, Pa.): $4.5 billion
13. Banner Health (Phoenix): $4.2 billion
14. Baylor Scott & White (Dallas): $4 billion
15. Mayo Clinic (Rochester, Minn.): $4 billion
16. Bon Secours Mercy Health (Cincinnati): $3.9 billion
17. BayCare Healthcare (Clearwater, Fla.): $2.6 billion
18. Mercy (Chesterfield, Mo.): $2.6 billion
19. BJC HealthCare (St. Louis): $2.3 billion
20. Ochsner Health (New Orleans): $2.2 billion
21. Allina Health (Minneapolis): $1.7 billion
22. University Hospitals (Cleveland): $1.7 billion
23. SSM Health (St. Louis): $1.6 billion
24. Palomar Health (Escondido, Calif.): $1.4 billion *Year ended June 30, 2024
25. Sanford Health (Sioux Falls, S.D.): $1.3 billion
26. Allegheny Health Network (Pittsburgh): $910.5 million
27. Nuvance Health (Danbury, Conn.): $901.4 million
28. Indiana University Health (Indianapolis): $131.3 million