Cleveland Clinic reported an operating income of $913 million (5% margin) in 2025, a significant improvement on the $276 million operating gain (1.7% margin) posted in 2024, according to unaudited financial documents published Feb. 27.
Seven things to know:
1. Total operating revenue increased 14.7% year over year to $18.3 billion. The double-digit growth was driven by strong patient demand for inpatient and outpatient services — particularly higher-acuity, complex care — as well as new Medicare Advantage delegated premium and risk agreements that took effect Jan. 1, 2025. Net patient service revenue accounted for just over $15 billion of the $18.3 billion.
2. Operating expenses increased 10.9% year over year to $16.5 billion, with labor-related costs held to a 5.3% increase — rising from $9 billion in 2024 to $9.5 billion in 2025.
3. Operating cash flow totaled $1.8 billion in 2025, representing a 9.6% operating cash flow margin, compared to $1.1 billion and a 6.8% margin in 2024 .
4. Nonoperating gains reached $1.4 billion in 2025, up from $704.6 million in 2024. Investment returns approximated 12.8% for the year, compared to 7.7% in 2024 .
5. After accounting for nonoperating items, including investment returns, Cleveland Clinic reported a net income of $2.3 billion in 2025, reflecting an 11.7% total margin, compared to $980 million and a 5.9% total margin in 2024 .
6. In the fourth quarter, Cleveland Clinic posted $399 million in operating income (8% margin) on $5 billion in revenue. That compares to $137 million in operating income (3.3% margin) in the same quarter in 2024. Net income in the fourth quarter totaled $745 million, up from $85 million a year earlier.
7. Total assets were $29.6 billion as of Dec. 31, 2025, up from $26.1 billion at year-end 2024. Total cash and investments increased to $16.8 billion from $14.8 billion over the same period.
