Tenet, HCA, CHS, UHS: How each system ranks on pay and culture

The company culture and pay/promotion practices vary widely at the big four for-profit health systems, according to the most recent American Opportunity Index

The recently released ranking assesses the progress of a company's employees over five years, from 2018 to 2023. Companies are then rated across five metrics and given an overall score to determine where they fall on a ranking of the "best companies for career growth." 

The index uses data from LinkedIn, Glassdoor and Lightcast rather than figures companies self-report. This year's ranking includes 396 of the 500 largest companies headquartered in the U.S.; 102 were not included because there was insufficient data to rank them, and two were not included because they went out of business. 

Each company is ranked based on five criteria: how well they hire people without degrees or with little experience; how well they pay their employees and increase their pay over time; how well they promote employees and prepare them for better jobs; how well they promote all employees equally, regardless of race or gender; and how well they retain their employees and build their careers, as a measure of culture. 

Here's how the four for-profit health systems ranked. Note: a 4 is the highest score a company can receive on any metric. 

1. Universal Health Services (King of Prussia, Pa.) 

Overall score: 3.02

Pay: 4 (top 100 across all companies) 

Promotion: 4 (top 100 across all companies) 

Parity: 4 (top 100 across all companies) 

Culture: 1 

Hiring: 1

2. Community Health Systems (Franklin, Tenn.) 

Overall score: 2.2

Pay: 4 (top 100 across all companies)
Promotion: 1

Parity: 2

Culture: 4 (top 100 across all companies) 

Hiring: 3

3. Tenet Healthcare (Dallas) 

Overall score: 1.37

Pay: 1

Promotion: 2

Parity: 4 (top 100 across all companies) 

Culture: 1

Hiring: 3 

4. HCA Healthcare (Nashville, Tenn.) 

Overall score: 0.98

Pay: 1

Promotion: 1 

Parity: 4 (top 100 across all companies)

Culture: 1

Hiring: 3

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