In a Feb. 21 analysis, Kaufman Hall noted that too many hospitals are losing money but high-performing hospitals are faring far better, “effectively pulling away from the pack.”
Average operating margins have see-sawed over the last 12 months, from a -1.2% low in February 2023 to 5.5% highs in June and December. In February, average operating margins dropped to 3.96% before the Change Healthcare data breach, which has impacted claims processing.
Here are 43 health systems ranked by operating margins in their most recent financial results.
Editor’s note: The following financial results are for the 12 months ending Dec. 31, 2023, unless otherwise stated.
Revenue: $20.55 billion
Expenses: $18.31 billion
Operating income/loss: $2.5 billion
(*Includes grant income and equity in earnings of unconsolidated affiliates)
Operating margin: 12.2%
2. HCA Healthcare (Nashville, Tenn.)
Revenue: $65 billion
Expenses: $57.3 billion
Operating income/loss: $7.7 billion
Operating margin: 11.8%
3. Universal Health Services (King of Prussia, Pa.)
Revenue: $14.3 billion
Expenses: $13.1 billion
Operating income/loss: $1.2 billion
Operating margin: 8.4%
4. Baylor Scott & White (Dallas)
*Results for the first six months ending Dec. 31
Revenue: $7.6 billion
Expenses: $7 billion
Operating income/loss: $634 million
Operating margin: 8.3%
5. NYU Langone (New York City)
*Results for the 12 months ending Aug. 31
Revenue: $8.3 billion
Expenses: $7.7 billion
Operating income/loss: $686.2 million
Operating margin: 8.3%
*Results for the 12 months ending Sept. 30
Revenue: $6.1 billion
Expenses: $5.6 billion
Operating income/loss: $491.3 million
Operating margin: 8.1%
7. Community Health Systems (Franklin, Tenn.)
Revenue: $12.5 billion
Expenses: $11.5 billion
Operating income/loss: $957 million
Operating margin: 7.7%
8. Mayo Clinic (Rochester, Minn)
Revenue: $17.9 billion
Expenses: $16.8 billion
Operating income/loss: $1.1 billion
Operating margin: 6%
9. Sanford Health (Sioux Falls, S.D.)
Revenue: $7.2 billion
Expenses: $6.8 billion
Operating income/loss: $402.2 million
Operating margin: 5.6%
10. Stanford Health Care (Palo Alto, Calif.)
*Results for the 12 months ending Aug. 31
Revenue: $7.9 billion
Expenses: $7.5 billion
Operating income/loss: $414.9 million
Operating margin: 5.3%
11. Christus Health (Irving, Texas)
*For the 12 months ending June 30
Revenue: $7.8 billion
Expenses: $7.5 billion
Operating income/loss: $324.5 million
Operating margin: 4.2%
Revenue: $8.6 billion
Expenses: $8.3 billion
Operating income/loss: $343 million
Operating margin: 4%
13. Northwestern Medicine (Chicago)
*Results for the 12 months ending Sept. 30
Revenue: $8.7 billion
Expenses: $8.4 billion
Operating income/loss: $352.3 million
Operating margin: 4%
14. BJC HealthCare (St. Louis)
Revenue: $6.9 billion
Expenses: $6.8 billion
Operating income/loss: $141.6 million
Operating margin: 2%
Revenue: $14.1 billion
Expenses: $13.8 billion
Operating income/loss: $282.8 million
Operating margin: 2%
16. Sharp HealthCare (San Diego)
*Results for the 12 months ending Sept. 30
Revenue: $4.74 billion
Expenses: $4.65 billion
Operating income/loss: $88.3 million
Operating margin: 1.9%
17. Norton Healthcare (Louisville, Ky.)
Revenue: $4 billion
Expenses: $3.8 billion
Operating income/loss: $76.3 million
Operating margin: 1.9%
18. Montefiore Health (New York City)
Revenue: $7.7 billion
Expenses: $7.6 billion
Operating income/loss: $93.9 million
Operating margin: 1.2%
19. Penn State Health (Hershey, Pa.)
*Results for the first six months ending Dec. 31
Revenue: $2.1 billion
Expenses: $2 billion
Operating income/loss: $22.9 million
Operating margin: 1.1%
20. Prisma Health (Greenville, S.C.)
*For the 12 months ending Sept. 30
Revenue: $6 billion
Expenses: $5.9 billion
Operating income/loss: $67.1 million
Operating margin: 1.1%
21. HonorHealth (Scottsdale, Ariz.)
Revenue: $3.1 billion
Expenses: $3 billion
Operating income/loss: $32.8 million
Operating margin: 1.1%
22. Henry Ford Health (Detroit)
Revenue: $7.8 billion
Expenses: $7.7 billion
Operating income/loss: $80.5 million
Operating margin: 1%
23. Intermountain Health (Salt Lake City)
Revenue: $16.1 billion
Expenses: $15.2 billion
Operating income/loss: $137 million
Operating margin: 0.9%
24. Advocate Health (Charlotte, N.C.)
*For the nine months ending Sept. 30
Revenue: $22.83 billion
Expenses: $22.75 billion
Operating income/loss: $79.4 million
Operating margin: 0.4%
25. Cleveland Clinic
Revenue: $14.5 billion
Expenses: $13.7 billion
Operating income/loss: $64.3 million
Operating margin: 0.4%
26. OSF HealthCare (Peoria, Ill.)
*For the 12 months ending Sept. 30
Revenue: $4.1 billion
Expenses: $4.1 billion
Operating income/loss: $1.2 million
Operating margin: 0%
*Results for the first six months ending Dec. 31
Revenue: $18.69 billion
Expenses: $18.63 billion
Operating income/loss: ($46 million)
Operating margin: (0.2%)
28. Kaiser Permanente (Oakland, Calif.)
Revenue: $100.8 billion
Expenses: $100.5 billion
Operating income/loss: $329 million
Operating margin: (0.3% margin)
29. Mass General Brigham (Boston)
*Results for the 12 months ended Sept. 30
Revenue: $18.8 billion
Expenses: $18.7 billion
Operating income/loss: ($48 million)
Operating margin: (0.3%)
30. Geisinger Health (Danville, Pa.)
Revenue: $7.7 billion
Expenses: $7.8 billion
Operating income/loss: ($37 million)
Operating margin: (0.5%)
Revenue: $10.5 billion
Expenses: $10.6 billion
Operating income/loss: ($58.5 million)
Operating margin: (0.6%)
Revenue: $27.7 billion
Expenses: $27.9 billion
Operating income/loss: ($198 million)
Operating margin: (0.7%)
33. Scripps Health (San Diego)
*For the 12 months ending Sept. 30
Revenue: $4.3 billion
Expenses: $4.3 billion
Operating income/loss: ($36.6 million)
Operating margin: (0.9%)
*Results for the first six months ending Dec. 31
Revenue: $15.01 billion
Expenses: $15.03 billion
Operating income/loss: ($155.2 million)
Operating margin: (1%)
35. Bon Secours Mercy Health (Cincinnati)
Revenue: $12.2 billion
Expenses: $12.4 billion
Operating income/loss: ($123.9 million)
Operating margin: (1%)
Revenue: $3.3 billion
Expenses: $3.1 billion
Operating income/loss: ($44.5 million)
Operating margin: (1.3%)
37. Beth Israel Lahey Health (Cambridge, Mass.)
*Results for the 12 months ending Sept. 30
Revenue: $7.7 billion
Expenses: $7.8 billion
Operating income/loss: ($131.2 million)
Operating margin: (1.7%)
*Results for the nine months ending Sept. 30,
Revenue: $5.7 billion
Expenses: $2.3 billion
Operating income/loss: ($104.4 million)
Operating margin: (1.8%)
39. Premier Health (Dayton, Ohio)
Revenue: $2.3 billion
Expenses: $2.4 billion
Operating income/loss: ($85.3 million)
Operating margin: (3.7%)
40. Allegheny Health Network (Pittsburgh)
Revenue: $4.7 billion
Expenses: $4.2 billion
Operating income/loss: ($172.7 million)
Operating margin: (3.7% margin)
41. Providence (Renton, Wash.)
Revenue: $28.7 billion
Expenses: $29.9 billion
Operating income/loss: ($1.2 billion)
Operating margin: (4.2%)
*Results for the 12 months ending Sept. 30
Revenue: $2.6 billion
Expenses: $2.8 billion
Operating income/loss: ($171 million)
Operating margin: (6.6%)
43. Allina Health (Minneapolis)
Revenue: $5.2 billion
Expenses: $5.5 billion
Operating income/loss: ($352.6 million)
Operating margin: (6.8%)
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