The jury is out on whether nonprofit hospitals are in a “new normal” of long-term lower than historical operating margins, or if 2024 will see a bigger step forward to something more akin to long-term performance, according to Fitch Ratings.
Here are 41 health systems ranked by operating margins:
Editor’s note: This is not an exhaustive list. The following financial results are for the three months ending June 30, 2024, unless otherwise stated.
Revenue: $5.1 billion
Expenses: $4.4 billion
Operating income: $761 million
(*Includes grant income and equity in earnings of unconsolidated affiliates)
Operating margin: 14.9%
2. HCA Healthcare (Nashville, Tenn.)
Revenue: $17.5 billion
Expenses: $15.3 billion
Operating income: $2.24 billion
Operating margin: 12.8%
3. Universal Health Services (King of Prussia, Pa.)
Revenue: $3.9 billion
Expenses: $3.5 billion
Operating income: $436.4 million
Operating margin: 11.2%
4. Mayo Clinic (Rochester, Minn)
Revenue: $5 billion
Expenses: $4.6 billion
Operating income: $449 million
Operating margin: 8.9%
Revenue: $1.8 billion
Expenses: $1.7 billion
Operating income/loss: $158.3 million
Operating margin: 8.7%
6. Community Health Systems (Franklin, Tenn.)
Revenue: $3.14 billion
Expenses: $2.9 billion
Operating income: $238 million
Operating margin: 7.6%
7. Inspira Health (Vineland, N.J.)
Revenue: $592.7 million
Expenses: $593 million
Operating income: $38.9 million
Operating margin: 6.5%
Revenue: $1.2 billion
Expenses: $1.1 billion
Operating income: $75.8 million
Operating margin: 6.2%
9. HonorHealth (Scottsdale, Ariz.)
Revenue: $862.7 million
Expenses: $735.6 million
Operating income: $41.5 million
Operating margin: 4.8%
10. Prisma Health (Greenville, S.C.)
*For the nine months ending June 30
Revenue: $4.96 billion
Expenses: $4/74 billion
Operating income: $217 million
Operating margin: 4.4%
11. New-York Presbyterian (New York City)
Revenue: $2.65 billion
Expenses: $2.54 billion
Operating income: $100.6 million
Operating margin: 3.8%
12. Intermountain Health (Salt Lake City)
*For the six months ending June 30
Revenue: $8.5 billion
Expenses: $7.8 billion
Operating income: $326 million
Operating margin: 3.8%
13. Sanford Health (Sioux Falls, S.D.)
*Results for the six months ending June 30
Revenue: $3.7 billion
Expenses: $3.5 billion
Operating income: $138.8 million
Operating margin: 3.8%
14. Henry Ford Health (Detroit)
*Results for the six months ended June 30
Revenue: $4.3 million
Expenses: $4.1 million
Operating income: $151.7 million
Operating margin: 3.5%
15. Kaiser Permanente (Oakland, Calif.)
Revenue: $29.1 billion
Expenses: $28.2 billion
Operating income: $908 million
Operating margin: 3.1%
16. Ardent Health (Nashville, Tenn.)
Revenue: $1.47 billion
Expenses: $1.39 billion
Net income: $43 million
Operating margin: 2.9%
17. Advocate Health (Charlotte, N.C.)
*Results for the six months ending June 30
Revenue: $16.7 billion
Expenses: $16.2 billion
Operating income: $449.8 million
Operating margin: 2.7%
18. Norton Healthcare (Louisville, Ky.)
Revenue: $1.14 billion
Expenses: $1.07 billion
Operating income: $30.2 million
Operating margin: 2.6%
19. UnityPoint Health (West Des Moines, Iowa)
Revenue: $1.31 billion
Expenses: $1.29 billion
Operating income: $33.9 million
Operating margin: 2.6%
20. Banner Health (Phoenix)
Results for the six months ending June 30
Revenue: $7.5 billion
Expenses: $7.3 billion
Operating income/loss: $182.7 million
Operating margin: 2.4%
21. Adena Health (Chillicothe, Ohio)
Revenue: $186.5 million
Expenses: $183.2 million
Operating income: $3.3 million
Operating margin: 1.8%
Revenue: $9.3 million
Expenses: $9.1 million
Operating income: $157.4 million
Operating margin: 1.7%
23. Northwell Health (New Hyde Park, N.Y.)
Revenue: $4.5 billion
Expenses: $4.3 billion
Operating income: $76.8 million
Operating margin: 1.7%
24. IU Health (Indianapolis)
*Results for the six months ending June 30
Revenue: $2.3 billion
Expenses: $2.2 billion
Operating income: $37.7 million
Operating margin: 1.6% margin
25. Lifespan (Providence, R.I.)
Revenue: $873 million
Expenses: $861.5 million
Operating income: $11.5 million
Operating margin: 1.3%
26. Dartmouth Health (Lebanon, N.H.)
*Results for the 12 months ending June 30
Revenue: $3.61 billion
Expenses: $3.57 billion
Operating income: $41.9 million
Operating margin: 1.2%
27. Cleveland Clinic
Revenue: $3.9 billion
Expenses: $3.7 billion
Operating income: $45.3 million
Operating margin: 1.2%
28. Bon Secours Mercy Health (Cincinnati)
Revenue: $3.25 billion
Expenses: $3.22 billion
Operating income: $30.1 million
Operating margin: 0.9%
29. Montefiore Health (New York City)
*Results for the six months ending June 30
Revenue: $4.1 billion
Expenses: $3.7 billion
Operating income: $32.3 million
Operating margin: 0.8%
30. Mass General Brigham (Boston)
Revenue: $5.1 billion
Expenses: $5.1 billion
Operating income: $29.7 million
Operating margin: 0.6%
31. Beth Israel Lahey Health (Cambridge, Mass.)
Revenue: $2.29 billion
Expenses: $2.31 billion
Operating loss: $23.3 million
Operating margin: -1%
Revenue: $2.8 billion
Expenses: $2.84 billion
Operating loss: $44.8 million
Operating margin: -1.6%
33. Providence (Renton, Wash.)
Revenue: $7.67 billion
Expenses: $7.79 billion
Operating loss: $123 million
Operating margin: -1.6%
34. Allegheny Health Network (Pittsburgh)
*Results for the six months ending June 30
Revenue: $1.3 billion
Expenses: $1.3 billion
Operating loss: $25.9 million
Operating margin: -2.1%
35. Premier Health (Dayton, Ohio)
Revenue: $608.6
Expenses: $662.2 million
Operating loss: $13.5 million
Operating margin: -2.2%
Revenue: $7.3 billion
Expenses: $7.5 billion
Operating loss: $210.3 million
Operating margin: -2.9%
37. University Hospitals (Cleveland)
Revenue: $3.1 billion
Expenses: $3.2 billion
Operating loss: $118.9 million
Operating margin: -3.8%
38. Nuvance Health (Danbury, Conn.)
Revenue: $664.5 million
Expenses: $680.7 million
Operating loss: $28.1 million
Operating margin: ‐4.2%
39. Allina Health (Minneapolis)
Revenue: $1.39 billion
Expenses: $1.44 billion
Operating loss: $63.2 million
Operating margin: ‐4.5%
Revenue: $709.3 million
Expenses: $751.1 million
Operating loss: $41.7 million
Operating margin: ‐5.9%
Revenue: $636.6 million
Expenses: $721.9 million
Operating loss: $40.7 million
Operating margin: -7.9%
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