While systems like Tenet Healthcare achieved an impressive 21.3% margin, buoyed by strong revenues and cost control, others, such as Tufts Medicine (-10.2%) and Community Health Systems (-6.6%), continue to grapple with rising costs, reimbursement pressures and operational headwinds.
The wide variation in third-quarter margins reflects both progress and persistent challenges in the sector’s financial recovery.
Here are 41 health systems ranked by their third-quarter operating margins.
Editor’s note: This is not an exhaustive list. The following financial results are for the three months ending Sept. 30, 2024, unless otherwise stated.
Revenue: $5.12 billion
Expenses: $4.1 billion
Operating income: $1.1 billion
Operating margin: 21.3%
2. HCA Healthcare (Nashville, Tenn.)
Revenue: $17.5 billion
Expenses: $15.6 billion
Operating income: $1.9 billion
Operating margin: 10.9%
3. Universal Health Services (King of Prussia, Pa.)
Revenue: $3.96 billion
Expenses: $3.58 billion
Operating income: $384.2 million
Operating margin: 9.7%
4. Allina Health (Minneapolis)
Revenue: $1.6 billion
Expenses: $1.4 billion
Operating income: $154.4 million
Operating margin: 9.6%
5. Norton Healthcare (Louisville, Ky.)
Revenue: $1.2 billion
Expenses: $1.1 billion
Operating income: $65 million
Operating margin: 5.4%
6. Cone Health (Greensboro, N.C.)
*Results for the 12 months ending Sept. 30
Revenue: $3.1 billion
Expenses: $3 billion
Operating income: $167.1 million
Operating margin: 5.3%
7. New-York Presbyterian (New York City)
Revenue: $2.7 billion
Expenses: $2.6 billion
Operating income: $123 million
Operating margin: 4.5%
8. UnityPoint Health (West Des Moines, Iowa)
Revenue: $1.3 billion
Expenses: $1.3 billion
Operating income: $54 million
Operating margin: 4.2%
9. Dartmouth Health (Lebanon, N.H.)
Revenue: $1 billion
Expenses: $961.3 million
Operating income: $40.7 million
Operating margin: 4.1%
10. Henry Ford Health (Detroit)
*Results for the nine months ending Sept. 30
Revenue: $6.5 billion
Expenses: $6.2 billion
Operating income: $268.9 million
Operating margin: 4.1%
Revenue: $801.4 million
Expenses: $731.8 million
Operating income: $32.4 million
Operating margin: 4%
12. Advocate Health (Charlotte, N.C.)
*Results for the nine months ending Sept. 30
Revenue: $25.8 billion
Expenses: $24.8 billion
Operating income: $964.2 million
Operating margin: 3.7%
13. Sanford Health (Sioux Falls, S.D.)
*Results for the nine months ending Sept. 30
Revenue: $5.6 billion
Expenses: $5.4 billion
Operating income: $195 million
Operating margin: 3.5%
14. Intermountain Health (Salt Lake City)
*For the nine months ending Sept. 30
Revenue: $12.8 billion
Expenses: $11.9 billion
Operating income: $399 million
Operating margin: 3.1%
15. IU Health (Indianapolis)
*Results for the nine months ending Sept. 30
Revenue: $6.86 billion
Expenses: $6.68 billion
Operating income: $173 million
Operating margin: 2.5%
16. West Virginia University Health System (Morgantown, W.Va.)
*Results for the nine months ended Sept. 30
Revenue: $5 billion
Expenses: $4.6 billion
Operating income: $123 million
Operating margin: 2.5%
17. HonorHealth (Scottsdale, Ariz.)
Revenue: $867.2 million
Expenses: $847.7 million
Operating income: $19.5 million
Operating margin: 2.3%
18. Montefiore Health (New York City)
*Results for the nine months ending Sept. 30
Revenue: $6.4 billion
Expenses: $6.3 billion
Operating income: $147.4 million
Operating margin: 2.3%
19. Ardent Health (Nashville, Tenn.)
Revenue: $1.45 billion
Expenses: $1.39 billion
Net income: $26.3 million
Operating margin: 1.8%
20. Banner Health (Phoenix)
Results for the nine months ending Sept. 30
Revenue: $11.3 billion
Expenses: $11.1 billion
Operating income/loss: $198.5 million
Operating margin: 1.8%
21. Adena Health (Chillicothe, Ohio)
Revenue: $190.9 million
Expenses: $187.6 million
Operating income: $3.3 million
Operating margin: 1.7%
22. Northwell Health (New Hyde Park, N.Y.)
Revenue: $4.6 billion
Expenses: $4.5 billion
Operating income: $77.5 million
Operating margin: 1.7%
23. Carle Health (Urbana, Ill.)
*Results for the nine months ending Sept. 30
Revenue: $3.7 billion
Expenses: $3.6 billion
Operating income: $55.9 million
Operating margin: 1.5%
24. Nuvance Health (Danbury, Conn.)
Revenue: $741.4 million
Expenses: $726.4 million
Operating income: $11.4 million
Operating margin: 1.5%
25. Cleveland Clinic
Revenue: $3.98 billion
Expenses: $3.74 billion
Operating income: $43.4 million
Operating margin: 1.1%
26. Mayo Clinic (Rochester, Minn)
Revenue: $4.86 billion
Expenses: $4.62 billion
Operating income: $55 million
Operating margin: 1.1%
Revenue: $744.8 million
Expenses: $747.9 million
Operating loss: $3 million
Operating margin: ‐0.4%
28. Mass General Brigham (Somerville, Mass)
*Results for 12 months ending Sept. 30
Revenue: $20.6 billion
Expenses: $20.5 billion
Operating loss: $72 million
Operating margin: -0.4%
Revenue: $7.7 billion
Expenses: $7.8 billion
Operating loss: $57.6 million
Operating margin: -0.7%
Revenue: $2.9 billion
Expenses: $2.9 billion
Operating loss: $21.8 million
Operating margin: -0.8%
31. Bon Secours Mercy Health (Cincinnati)
Revenue: $3.27 billion
Expenses: $3.3 billion
Operating loss: $46.5 million
Operating margin: -1.4%
32. Premier Health (Dayton, Ohio)
Revenue: $621.7 million
Expenses: $633.2 million
Operating loss: $12 million
Operating margin: -1.9%
33. Kaiser Permanente (Oakland, Calif.)
Revenue: $29 billion
Expenses: $29.6 billion
Operating loss: $608 million
Operating margin: -2.1%
34. Providence (Renton, Wash.)
Revenue: $7.6 billion
Expenses: $7.8 billion
Operating loss: $208 million
Operating margin: -2.7%
35. Allegheny Health Network (Pittsburgh)
*Results for the nine months ending Sept. 30
Revenue: $1.3 billion
Expenses: $1.3 billion
Operating loss: $40 million
Operating margin: -3%
36. Brown Health (Providence, R.I.)
Revenue: $848.3 million
Expenses: $875.1 million
Operating loss: $26.8 million
Operating margin: -3.2%
37. University Hospitals (Cleveland)
*Results for the nine months ending Sept. 30
Revenue: $4.7 billion
Expenses: $4.9 billion
Operating loss: $163.3 million
Operating margin: -3.5%
38. Inspira Health (Vineland, N.J.)
Revenue: $982.7 million
Expenses: $1 billion
Operating loss: $51.6 million
Operating margin: -5.2%
39. Beth Israel Lahey Health (Cambridge, Mass.)
Revenue: $2.26 billion
Expenses: $2.39 billion
Operating loss: $138.8 million
Operating margin: -6.1%
40. Community Health Systems (Franklin, Tenn.)
Revenue: $3.09 billion
Expenses: $3.3 billion
Operating loss: $205 million
Operating margin: -6.6%
Revenue: $671.1 million
Expenses: $739.3 million
Operating loss: $68.2 million
Operating margin: -10.2%
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