Ahead of anticipated cuts and headwinds from HR 1 in 2027, health systems reported a wide range of financial performance in the second quarter of 2026.
Tenet Healthcare led the systems with a 26.7% operating margin on $5.6 billion in revenue, while HCA Healthcare saw a 12.3% margin on $20.2 billion in revenue. On the opposite end, Dartmouth Health finished with a $52.5 million operating loss and a -4.8% margin, with Allina Health also landing in negative margin territory.
Below is a ranking of 28 health systems based on their operating margins for the second quarter of 2026.
Editor’s note: This is not an exhaustive list. The following financial results are for the three months ending June 30, 2026, unless otherwise stated.
1. Tenet Healthcare (Dallas)
Revenue: $5.6 billion
Expenses: $4.4 billion
Operating income: $1.5 billion
Operating margin: 26.7%
2. Community Health Systems (Franklin, Tenn.)
Revenue: $2.8 billion
Expenses: $2.4 billion
Operating income: $389 million
Operating margin: 13.8%
3. AdventHealth (Altamonte Springs, Fla.)
Revenue: $6.9 billion
Expenses: $5.9 billion
Operating income: $916.2 million
Operating margin: 13.4%
4. HCA Healthcare (Nashville, Tenn.)
Revenue: $20.2 billion
Expenses: $17.7 billion
Operating income: $2.5 billion
Operating margin: 12.3%
5. Universal Health Services (King of Prussia, Pa.)
Revenue: $4.6 billion
Expenses: $4.1 million
Operating income: $516.7 million
Operating margin: 11.1%
6. ProMedica (Toledo, Ohio)
Revenue: $809.7 million
Expenses: $690.7 million
Operating income: $83.3 million
Operating margin: 10.3%
7. Allegheny Health Network (Pittsburgh)
Revenue: $1.7 billion
Expenses: $1.5 billion
Operating income: $150.9 million
Operating margin: 9.1%
8. Park View Health (Fort Wayne, Ind.)
Revenue: $997.4 million
Expenses: $906.9 million
Operating income: $90.5 million
Operating margin: 9.1%
9. Baptist Health South Florida (Coral Gables)
Revenue: $2 billion
Expenses: $1.8 billion
Operating income: $176 million
Operating margin: 9%
10. Mayo Clinic (Rochester, Minn.)
Revenue: $5.9 billion
Expenses: $5.4 billion
Operating income: $501 million
Operating margin: 8.6%
11. Sutter Health (Sacramento, Calif.)
Revenue: $6.2 billion
Expenses: $5.8 billion
Operating income: $454 million
Operating margin: 7.3%
12. Scripps Health (San Diego)
Revenue: $1.5 billion
Expenses: $1.4 billion
Operating income: $101.5 million
Operating margin: 6.6%
13. Cleveland Clinic
Revenue: $4.9 billion
Expenses: $4.5 billion
Operating income: $245.6 million
Operating margin: 5%
14. Kaiser Permanente (Oakland, Calif.)
Revenue: $35.6 billion
Expenses: $34 million
Operating income: $1.7 billion
Operating margin: 4.6%
15. NewYork-Presbyterian (New York City)
Revenue: $3.1 billion
Expenses: $3 billion
Operating income: $124.2 million
Operating margin: 4%
16. SSM Health (St. Louis)
Revenue: $3.6 billion
Expenses: $3.5 billion
Operating income: $130.2 million
Operating margin: 3.6%
17. Adventist HealthCare (Gaithersburg, Md.)
Revenue: $616.7 million
Expenses: $598.5 million
Operating income: $18.2 million
Operating margin: 3%
18. Ardent Health (Brentwood, Tenn.)
Revenue: $1.6 billion
Expenses: $1.6 billion
Operating income: $43.2 million
Operating margin: 2.7%
19. Bon Secours Mercy Health (Cincinnati)
Revenue: $3.8 billion
Expenses: $3.6 billion
Operating income: $95.3 million
Operating margin: 2.5%
20. Novant Health (Winston-Salem, N.C.)
Revenue: $3.1 billion
Expenses: $3.1 billion
Operating income: $77.8 million
Operating margin: 2.5%
21. Indiana University Health (Indianapolis)
Revenue: $2.7 billion
Expenses: $5 billion
Operating income: $51.2 million
Operating margin: 1.9%
22. Mass General Brigham (Somerville, Mass.)
Revenue: $6.3 billion
Expenses: $6.2 billion
Operating income: $80.5 million
Operating margin: 1.3%
23. Providence (Renton, Wash.)
Revenue: $7.6 billion
Expenses: $7.6 billion
Operating income: $64 million
Operating margin: 0.8%
24. Essentia Health (Duluth, Minn.)
Revenue: $885.7 million
Expenses: $881.4 million
Operating income: $4.3 million
Operating margin: 0.5%
25. UPMC (Pittsburgh)
Revenue: $5.5 billion
Expenses: $8.5 billion
Operating loss: $18.3 million
Operating margin: -0.2%
26. Presbyterian Healthcare Services (Albuquerque, N.M.)
Revenue: $1.9 billion
Expenses: $1.9 billion
Operating loss: $23.7 million
Operating margin: -1.3%
27. Allina Health (Minneapolis)
Revenue: $1.6 billion
Expenses: $1.6 billion
Operating loss: $38.9 million
Operating margin: -2.5%
28. Dartmouth Health (Lebanon, N.H.)
Revenue: $1.1 billion
Expenses: $1.1 billion
Operating loss: $52.5 million
Operating margin: -4.8%
