As healthcare industry pressures like labor costs, policy changes and ongoing service cuts and closures continue, health systems reported a wide range of financial outcomes in the first quarter of 2026.
Tenet Healthcare led all systems with a 24.1% operating margin on $5.4 billion in revenue, while HCA Healthcare posted a 12% margin on $19.1 billion, the largest revenue base among for-profit systems in the quarter. On the nonprofit side, Baylor Scott & White and AdventHealth were among the stronger performers, with margins of 11.3% and 9.3%, respectively.
On the other end of the spectrum, Montefiore Health System saw the steepest loss, with a -4.5% operating margin and a $104.9 million operating loss on $2.3 billion in revenue. University Hospitals, Allina Health and Adventist Health also finished in negative territory.
Below is a ranking of 42 health systems based on their operating margins for the first quarter of 2026.
Editor’s note: This is not an exhaustive list. The following financial results are for the three months ending March 31, 2026, unless otherwise stated. This story was updated June 17 at 4:05 p.m. CT to reflect Banner Health’s correct 2026 Q1 margin. A previous version incorrectly cited Banner’s 2025 Q1 margin.
1. Tenet Healthcare (Dallas)
Revenue: $5.4 billion
Expenses: $4.5 billion
Operating income: $1.3 billion
Operating margin: 24.1%
2. HCA Healthcare (Nashville, Tenn.)
Revenue: $19.1 billion
Expenses: $16.8 billion
Operating income: $2.29 billion
Operating margin: 12%
3. Universal Health Services (King of Prussia, Pa.)
Revenue: $4.5 billion
Expenses: $4 billion
Operating income: $502.9 million
Operating margin: 11.2%
4. BayCare Health System (Clearwater, Fla.)
Revenue: $1.8 billion
Expenses: $1.5 billion
Operating income: $187.2 million
Operating margin: 10.6%
5. NewYork-Presbyterian (New York City)
Revenue: $3 billion
Expenses: $2.7 billion
Operating income: $283 million
Operating margin: 9.6%
6. Community Health Systems (Franklin, Tenn.)
Revenue: $3 billion
Expenses: $2.7 billion
Operating income: $281 million
Operating margin: 9.5%
7. AdventHealth (Altamonte Springs, Fla.)
Revenue: $6 billion
Expenses: $5.4 billion
Operating income: $555 million
Operating margin: 9.3%
8. Baylor Scott & White Health (Dallas)
*Results reflect the three months ended March 31, 2026, derived by subtracting six-month results ended December 31, 2025, from nine-month results ended March 31, 2026.
Revenue: $4.4 billion
Expenses: $4 billion
Operating income: $321 million
Operating margin: 7.4 %
9. Mayo Clinic (Rochester, Minn.)
Revenue: $5.5 billion
Expenses: $5.1 billion
Operating income: $398 million
Operating margin: 7.2%
10. ProMedica (Toledo, Ohio)
Revenue: $759.4 million
Expenses: $64.5 million
Operating income: $52.3 million
Operating margin: 6.9%
11. RWJBarnabas Health (West Orange, N.J.)
Revenue: $2.95 billion
Expenses: $2.8 billion
Operating income: $180.6 million
Operating margin: 6.1%
12. Intermountain Health (Salt Lake City)
Revenue: $4.8 billion
Expenses: $4.3 billion
Operating income: $227 million
Operating margin: 4.8%
13. Inova Health System (Fairfax, Va.)
Revenue: $1.8 billion
Expenses: $1.7 billion
Operating income: $84.4 million
Operating margin: 4.6%
14. Banner Health (Phoenix)
Revenue: $4.1 billion
Expenses: $3.9 billion
Operating income: $180 million
Operating margin: 4.4%
15. HonorHealth (Scottsdale, Ariz.)
Revenue: $1.1 billion
Expenses: $1 billion
Operating income: $47.4 million
Operating margin: 4.2%
16. Sanford Health (Sioux Falls, S.D.)
Revenue: $3.2 billion
Expenses: $3.1 billion
Operating income: $136.1 million
Operating margin: 4.2%
17. Corewell Health (Southfield, Mich.)
Revenue: $4.7 million
Expenses: $4.5 million
Operating income: $196.5 million
Operating margin: 4%
18. Advocate Health (Charlotte, N.C.)
Revenue: $10.2 billion
Expenses: $9.8 billion
Operating income: $380.1 million
Operating margin: 3.7%
19. Cleveland Clinic
Revenue: $4.7 billion
Expenses: $4.3 billion
Operating income: $172.8 million
Operating margin: 3.7%
20. OHSU (Portland, Ore.)
Revenue: $1.5 billion
Expenses: $1.5 billion
Operating income: $53 million
Operating margin: 3.5%
21. Aspirus Health (Wausau, Wis.)
Revenue: $770.9 million
Expenses: $745.1 million
Operating income: $25.8 million
Operating margin: 3.4%
22. UPMC (Pittsburgh)
Revenue: $8.4 billion
Expenses: $8.2 billion
Operating income: $261 million
Operating margin: 3.1%
23. Orlando (Fla.) Health
Revenue: $2.5 billion
Expenses: $2.4 billion
Operating income: $76.1 million
Operating margin: 3%
24. Novant Health (Winston-Salem, N.C.)
Revenue: $3.1 billion
Expenses: $3 billion
Operating income: $91.3 million
Operating margin: 3%
25. Northwell Health (New Hyde Park, N.Y.)
Revenue: $5.3 billion
Expenses: $5.1 billion
Operating income: $144 million
Operating margin: 2.7%
26. Bon Secours Mercy Health (Cincinnati)
Revenue: $3.7 billion
Expenses: $3.6 billion
Operating income: $97.7 million
Operating margin: 2.6%
27. BJC Health (St. Louis)
Revenue: $3.1 billion
Expenses: $3.1 billion
Operating income: $65 million
Operating margin: 2.1%
28. Kaiser Permanente (Oakland, Calif.)
Revenue: $34.6 billion
Expenses: $33.9 billion
Operating income: $711 million
Operating margin: 2.1%
29. Sutter Health (Sacramento, Calif.)
Revenue: $5.2 billion
Expenses: $5.2 billion
Operating income: $84 million
Operating margin: 1.6%
30. Providence (Renton, Wash.)
Revenue: $7.5 billion
Expenses: $7.3 billion
Operating income: $111 million
Operating margin: 1.5%
31. Trinity Health (Livonia, Mich.)
*Results reflect the three months ended March 31, 2026, derived by subtracting six-month results ended December 31, 2025, from nine-month results ended March 31, 2026.
Revenue: $6.7 billion
Expenses: $6.6 billion
Operating income: $45.6 million
Operating margin: 0.7%
32. Mount Sinai Health System (New York City)
Revenue: $3.1 billion
Expenses: $3.1 billion
Operating income: $23 million
Operating margin: 0.7%
33. Mass General Brigham (Somerville, Mass.)
Revenue: $6 billion
Expenses: $5.9 billion
Operating loss: $20.2 billion
Operating margin: 0.3%
34. Henry Ford Health (Detroit)
Revenue: $3.4 billion
Expenses: $3.4 billion
Operating income: $6.6 million
Operating margin: 0.2%
35. SSM Health (St. Louis)
Revenue: $3.3 billion
Expenses: $3.3 billion
Operating loss: $7.4 million
Operating margin: -0.2%
36. Indiana University Health (Indianapolis)
Revenue: $2.35 billion
Expenses: $2.37 billion
Operating loss: $14.6 million
Operating margin: -0.6%
37. Parkview Health (Fort Wayne, Ind.)
Revenue: $873.4 million
Expenses: $881.1 million
Operating loss: $7.6 million
Operating margin: -0.9%
38. Ascension (St. Louis)
Revenue: $6 billion
Expenses: $6 billion
Operating loss: $64 million
Operating margin: -1.1%
39. Allina Health (Minneapolis)
Revenue: $1.5 billion
Expenses: $1.5 billion
Operating loss: $26.1 million
Operating margin: -1.7%
40. Adventist Health (Roseville, Calif.)
Revenue: $1.9 billion
Expenses: $1.92 billion
Operating loss: $34 million
Operating margin: -1.8%
41. University Hospitals (Cleveland)
Revenue: $1.8 billion
Expenses: $1.9 billion
Operating loss: $60.7 million
Operating margin: -3.3%
42. Montefiore Health System (New York City)
Revenue: $2.3 billion
Expenses: $2.4 billion
Operating loss: $104.9 million
Operating margin: -4.5%
