At a time of uncertainty in the healthcare industry driven by high labor costs, workforce shortages and reimbursement challenges, health systems across the U.S. saw varied financial outcomes in 2024.
Tenet Healthcare led the pack with a 28.8% margin, while Palomar Health saw a -18.5% margin in fiscal 2024. The differences in margins across health systems highlights both the strides made by some organizations in stabilizing their finances and the continued obstacles facing others.
Below is a ranking of 28 health systems based on their operating margins for 2024.
Editor’s note: This is not an exhaustive list. The following financial results are for the 12 months ending Dec. 31, 2024, unless otherwise stated.
Revenue: $20.7 billion
Expenses: $17.9 billion
Operating income: $6 billion
Operating margin: 28.8%
Revenue: $70.6 billion
Expenses: $62.1 billion
Operating income: $8.5 billion
Operating margin: 12.1%
3. Baylor Scott & White Health (Dallas)
*Results for the six months ending Dec. 31, 2024
Revenue: $8.5 billion
Expenses: $7.5 billion
Operating income: $953 million
Operating margin: 11.2%
4. Universal Health Services (King of Prussia, Pa.)
Revenue: $15.8 billion
Expenses: $14.1 billion
Operating income: $1.7 billion
Operating margin: 10.6%
5. BayCare Health System (Clearwater, Fla.)
Revenue: $6.3 billion
Expenses: $5.7 billion
Operating income: $603.4 billion
Operating margin: 9.6%
6. Mayo Clinic (Rochester, Minn.)
Revenue: $19.8 billion
Expenses: $18.5 billion
Operating income: $1.3 billion
Operating margin: 6.5%
7. Sanford Health (Sioux Falls, S.D.)
Revenue: $7.7 billion
Expenses: $7.3 billion
Operating income: $400.3 million
Operating margin: 5.2%
Revenue: $10.7 billion
Expenses: $10.4 billion
Operating income: $325.6 million
Operating margin: 3%
9. Indiana University Health (Indianapolis)
Revenue: $9.2 billion
Expenses: $9 billion
Operating income: $257 million
Operating margin: 2.8%
Revenue: $15.6 billion
Expenses: $15.2 billion
Operating income: $362.5 million
Operating margin: 2.3%
11. Ochsner (New Orleans)
Revenue: $7.7 billion
Expenses: $7.6 billion
Operating income: $104 million
Operating margin: 2%
12. Cleveland Clinic
Revenue: $15.9 billion
Expenses: $14.9 billion
Operating income: $276 million
Operating margin: 1.7%
13. Trinity Health (Livonia, Mich.)
*Results for the six months ending Dec. 31, 2024
Revenue: $12.6 billion
Expenses: $12.5 billion
Operating income: $147.6 million
Operating margin: 1.2%
14. Bon Secours Mercy Health (Cincinnati)
Revenue: $13.3 billion
Expenses: $13 billion
Operating income: $133 million
Operating margin: 1%
15. Kaiser Permanente (Okland, Calif.)
Revenue: $115.8 billion
Expenses: $115.2 billion
Operating income: $569 million
Operating margin: 0.5%
16. Allina Health (Minneapolis)
Revenue: $5.8 billion
Expenses: $5.8 billion
Operating loss: $16.6
Operating margin: -0.3%
17. Mass General Brigham (Somerville, Mass.)
*Results for the 12 months ending Sept. 30, 2024
Revenue: $20.6 billion
Expenses: $20.5 billion
Operating loss: $72 million
Operating margin: -0.4%
*Results for the six months ending Dec. 31, 2024
Revenue: $5 billion
Expenses: $5 billion
Operating loss: $19.1 million
Operating margin: -0.4%
19. SSM Health (St. Louis)
Revenue: $11.4 billion
Expenses: $11.5 billion
Operating loss: $69.9 million
Operating margin: -0.6%
*Results for the six months ending Dec. 31, 2024
Revenue: $19.5 billion
Expenses: $19.7 billion
Operating loss: $196 million
Operating margin: -1%
Revenue: $29.9 billion
Expenses: $30.1 billion
Operating loss: $338.9 million
Operating margin: -1.1%
22. Providence (Renton, Wash.)
Revenue: $30.7 billion
Expenses: $31.2 billion
Operating loss: $644 million
Operating margin: -2.1%
*Results for the six months ending Dec. 31, 2024
Revenue: $13.5 billion
Expenses: $13.8 billion
Operating loss: $364.5 million
Operating margin: -2.7%
24. Allegheny Health Network (Pittsburgh)
Revenue: $5.1 billion
Expenses: $5.3 billion
Operating loss: $147 million
Operating margin: -2.9%
25. Community Health Systems (Franklin, Tenn.)
Revenue: $12.6 billion
Expenses: $12.1 billion
Operating loss: $362 million
Operating margin: -2.9%
26. Nuvance (Danbury, Conn.)
Revenue: $2.9 billion
Expenses: $2 billion
Operating loss: $98.1 million
Operating margin: -3.4%
27. University Hospitals (Cleveland)
Revenue: $6.4 billion
Expenses: $6.6 billion
Operating loss: $172.6 million
Operating margin: -4.4%
28. Palomar Health (Escondido, Calif.)
*Results for the 12 months ending June 30, 2024
Revenue: $890 million
Expenses: $1.06 billion
Operating loss: $165.1 million
Operating margin: -18.5%
