Academic health systems posted a wide range of operating performance in 2025 and early fiscal 2026, with margins spanning from negative territory to double digits. While strong investment returns buoyed bottom lines at many organizations, core operations remain under strain from rising labor, supply and drug costs.
Across these systems, operating margins spanned from -2.6% to 10.7%, highlighting the uneven financial recovery taking shape in academic healthcare. Many organizations saw stronger net income driven by investment returns and nonoperating gains, even as core operating performance remained thin. Expense growth — particularly labor, supplies and drug costs — continues to pressure margins, while scale, integration and restructuring efforts are increasingly shaping financial trajectories across academic healthcare.
Here’s how 12 major academic and nonprofit systems stack up based on their most recent financial reports.
Editor’s note: This is not an exhaustive list.
1. Baylor Scott & White Health (Dallas): Baylor Scott & White reported $998 million in operating income (10.7% operating margin) in the first half of fiscal 2026, compared to $953 million (11.2% margin) in the same period last year. Operating revenue rose to $9.3 billion from $8.5 billion. Net income totaled $1.7 billion for the six-month period, up from $1.4 billion.
2. ProMedica (Toledo, Ohio): ProMedica recorded $249.4 million in operating income (8.1% margin) in 2025, up from $147.6 million (5% margin) in 2024. Revenue reached $3.1 billion, and net income improved to $260.8 million from $110.3 million.
3. Mayo Clinic (Rochester, Minn.): Mayo posted an operating income of $1.5 billion (6.8% margin) in 2025, up from $1.3 billion (6.5% margin) in 2024. Total operating revenue rose 8.7% to $21.5 billion, while operating expenses increased 8.4% to $20.1 billion. Net income climbed to $5.2 billion from $3.8 billion.
4. RWJBarnabas Health (West Orange, N.J.): RWJBarnabas recorded $708.9 million in operating income (6.4% margin), up from $290.7 million (3% margin) in 2024. Operating revenue rose to $11 billion from $9.6 billion. Operating expenses totaled $10.3 billion, up from $9.3 billion. RWJBarnabas reported a net income of $1.5 billion in 2025, up from $992.3 million.
5. Cleveland Clinic (Cleveland): Cleveland Clinic reported $913 million in operating income (5% margin) in 2025, up from $276 million (1.7% margin) in 2024. Operating revenue increased 14.7% to $18.3 billion, while expenses rose 10.9% to $16.5 billion. Net income hit $2.3 billion in 2025, up from $980 million in 2024.
6. Novant Health (Winston-Salem, N.C.): Novant posted $576.6 million in operating income (4.8% margin), down slightly from a 5.5% margin in 2024. Revenue increased 16.8% to $11.9 billion. Net income reached $1.2 billion, up from $919.8 million.
7. BJC Health System (St. Louis): BJC recorded $454.5 million in operating income (3.8% margin) in 2025, up from 3% in 2024 following its merger with Saint Luke’s. Total revenue rose to $12.1 billion. Net income totaled $1.5 billion, compared to $2.6 billion in 2024.
8. Corewell Health (Southfield, Mich.): Corewell reported $276 million in operating income (1.6% margin), up from $208 million (1.3% margin) in 2024. Operating revenue increased 7.5% to $17.6 billion. Net income was $1.3 billion in 2025, up from $921 million the prior year.
9. UPMC (Pittsburgh): UPMC recorded $286 million in operating income (0.9% margin) in 2025, compared to a $339 million operating loss in 2024. Operating revenue grew to $33.6 billion from $29.9 billion. Net income reached $635.4 million, up from a $14.7 million net loss.
10. IU Health (Indianapolis): IU Health reported $50 million in operating income (0.5% margin), down from $257 million (2.8% margin) in 2024. Operating revenue increased 2.9% to $9.5 billion, while expenses rose 5.3% to $9.4 billion. Net income climbed to $1.2 billion from $966 million.
11. Jefferson Health (Philadelphia): Jefferson recorded a $201 million operating loss (-2.3% margin) in the first half of fiscal 2026, compared to a $55.3 million loss during the same period last year. Operating revenue rose to $8.6 billion from $7.5 billion. For the six months ended Dec. 31, 2025, Jefferson reported a $76.8 million net loss for the six months ending Dec. 31, 2025, compared to a $2.6 billion net gain in the same period in 2024, which was largely driven by a $2.6 billion contribution related to its acquisition of Lehigh Valley Health Network.
12. Yale New Haven Health (New Haven, Conn.): Yale New Haven reported a $197 million operating loss (-2.6% margin) for fiscal 2025, down from a $46 million operating gain (0.6% margin) in fiscal 2024. Operating revenue totaled $7.6 billion. After nonoperating items, net income was $91 million, compared to $411 million the prior year.
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