As policy uncertainties, reimbursement pressures and continued cuts and closures weigh on hospitals and health systems heading into 2026, third-quarter operating margins showed wide variation.
Several systems, including UnityPoint, Montefiore Health System and Providence, reported operating losses or near-break-even results, while others, such as Allegheny Health Network, UPMC and Northwell Health, recorded only modest gains. On the stronger end, Tenet Healthcare led all systems with a 16.8% operating margin, followed by HCA Healthcare at 12.6% and Universal Health Services at 11.6%.
Below is a ranking of 20 health systems based on their operating margins for the third quarter of 2025.
Editor’s note: This is not an exhaustive list. The following financial results are for the three months ended Sept. 30, 2025, unless otherwise stated.
1. Tenet Healthcare (Dallas)
Revenue: $5.3 billion
Expenses: $4.5 billion
Operating income: $889 million
Operating margin: $16.8%
2. HCA Healthcare (Nashville)
Revenue: $19.2 billion
Expenses: $16.7 billion
Operating income: $2.4 billion
Operating margin: 12.6%
3. Universal Health Services (King of Prussia, Pa.)
Revenue: $4.5 billion
Expenses: $4 billion
Operating income: $521.7 million
Operating margin: 11.6%
4. BayCare (Clearwater, Fla.)
*For the nine months ending Sept. 30
Revenue: $5.2 billion
Expenses: $4.3 billion
Operating income: $543.5 million
Operating margin: 10.5%
5. Mayo Clinic (Rochester, Minn.)
Revenue: $5.2 billion
Expenses: $5 billion
Operating income: $442 million
Operating margin: 8.1%
6. Community Health Systems (Franklin, Tenn.)
Revenue: $3.087 billion
Expenses: $2.8 billion
Operating income: $243 million
Operating margin: 7.9%
7. Advocate Health (Charlotte, N.C.)
*For the nine months ending Sept. 30
Revenue: $28.8 billion
Expenses: $27.5 billion
Operating income: $1.3 billion
Operating margin: 4.5%
Revenue: $4.5 billion
Expenses: $4.1 billion
Operating income: $206.2 million
Operating margin: 4.5%
9. NewYork-Presbyterian (New York City)
Revenue: $2.9 billion
Expenses: $2.8 billion
Operating income: $115 million
Operating margin: 3.9%
10. BJC Health System (St. Louis)
*For the nine months ending Sept. 30 through the third quarter
Revenue: $8.9 billion
Expenses: $8.6 billion
Operating income: $335.5 million
Operating margin: 3.8%
11. Intermountain Health (Salt Lake City)
*For the nine months ending Sept. 30
Revenue: $13.8 billion
Expenses: $12.7 billion
Operating income: $442 million
Operating margin: 3.2%
12. Banner Health (Phoenix)
*For the nine months ending Sept. 30
Revenue: $11.9 billion
Expenses: $11.6 billion
Operating income: $338 million
Operating margin: 2.8%
13. Sanford Health (Sioux Falls, S.D.)
*For the nine months ending Sept. 30
Revenue: $8.5 billion
Expenses: $8.4 billion
Operating income: $93.3 million
Operating margin: 1.1%
14. Kaiser Permanente (Oakland, Calif.)
Revenue: $31.8 billion
Expenses: $31.6 billion
Operating income: $218 million
Operating margin: 0.7%
15. Allegheny Health Network (Pittsburgh)
Revenue: $1.4 billion
Expenses: $1.4 billion
Operating income: $7 million
Operating margin: 0.5%
16. Northwell Health (New Hyde Park, N.Y.)
Revenue: $5 billion
Expenses: $5 billion
Operating income: $26.9 million
Operating margin: 0.5%
17. UPMC (Pittsburgh)
Revenue: $8.5 billion
Expenses: $8.5 billion
Operating income: $45.6 million
Operating margin: 0.5%
18. Providence (Renton, Wash.)
Revenue: $8 billion
Expenses: $7.9 billion
Operating income: $21 million
Operating margin: 0.3%
19. UnityPoint Health (West Des Moines, Iowa)
*For the nine months ending Sept. 30
Revenue: $1.4 billion
Expenses: $1.5 billion
Operating loss: $17 million
Operating margin: -1.3%
20. Montefiore Health System (New York City)
*For the nine months ending Sept. 30
Revenue: $6.5 billion
Expenses: $6.6 billion
Operating loss: $103.7 million
Operating margin: -1.6%
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.