Livonia, Mich.-based Trinity Health reported $200 million in operating income for the nine months ended March 31, 2026, a thin but stable 1% margin that held steady with the same period a year earlier, according to financial documents published May 21.
Eight things to know.
1. Trinity Health generated $1.1 billion in operating cash flow through the first three quarters of fiscal 2026, a 5.4% operating cash flow margin. That figure rose $23.6 million, or 2.2%, from the prior-year period, though the margin edged down slightly from 5.6%.
2. Operating revenue reached $20 billion for the nine-month period, up $1 billion from a year earlier. Net patient service revenue grew $503.4 million, or 3.1%, driven by higher payment rates and increased patient care volumes. Premium and capitation revenue jumped $286.6 million, or 31%, primarily within the system’s health plans and PACE programs — a key investment area for the health system, President and CEO Mike Slubowski told Becker’s.
3. Expenses rose 5.4% year over year to $19.8 billion. Adjusted operating costs per case mix adjusted equivalent discharge increased just 2.1%, which the system said was well below the rate of medical inflation. Labor was the largest driver, with salaries, wages and benefits up $289.3 million, or 2.9%. The system cut full-time equivalent positions by 0.7% but saw a 3.5% increase in salary rates. Contract labor costs rose $14.5 million, or 7.3%, largely due to a 7.2% increase in contract labor FTEs.
4. Net income reached $1.1 billion, or a 5% net margin, up from $725.4 million and a 3.7% margin in the prior-year period. A $337.6 million spike in investment earnings accounted for the bulk of the improvement. Operating income grew just $2.1 million year over year.
5. The system held $16.1 billion in unrestricted cash and investments as of March 31, 2026, equal to 230 days cash on hand, compared to $15.6 billion and 234 days at the close of fiscal 2025. Total assets were $36 billion. Long-term debt was $6.3 billion.
6. Trinity Health sold Sioux City, Iowa-based MercyOne Siouxland Medical Center to West Des Moines, Iowa-based UnityPoint Health for $3.5 million, effective Sept. 1, 2025. The sale ended a drag on the system’s finances: MercyOne Siouxland had generated a $9.2 million operating loss through the first nine months of fiscal 2026, down from a $44.5 million operating loss in the same period of fiscal 2025, according to financial documents.
7. The health system plans to sell Mercy Medical Center in Springfield, Mass., to Baystate Health. The deal is subject to regulatory approval and is expected to close in fiscal 2027. For the nine months ended March 31, 2026, Mercy Medical Center contributed $328.6 million in operating revenue but posted a $20.7 million operating loss, a narrowed deficit from the $46.8 million loss in the same period a year earlier.
8. Trinity Health cited Medicaid and ACA changes as a significant threat to future performance. Medicaid requirements, tightened eligibility verification, constrained certain state Medicaid financing mechanisms, and imposed new limits on provider tax structures are projected to have significant effects on hospital finances and care access. These developments could reduce Medicaid enrollment and coverage levels, increasing uninsured and self-pay volumes, particularly in markets with high Medicaid utilization, according to the health system.
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