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Happy Thursday Hospitalogists! I've been spending some time in the world of hospital financial statements and thought you'd find an updated look at top health systems by total revenue, patient revenue, and patient revenue growth interesting. I'll likely do a refresh on operating margins next. Since I'm not everywhere at once, I would love Hospitalogist insights as to what's driving these year over year changes in all of these hospitals and health systems. Many are dealing with similar macro issues, but much of what drives a hospital or health system's success is also local market dynamics. Demographics, payor dynamics, local medical group economics, tight or loose labor markets, and more. Let's dive into the top health system revenue analysis. And this information is probably the most up to date info you'll find. I went through each health system's most recently disclosed financials and updated them all through calendar year 2024. When that wasn't available, I took the last 9 months from calendar year 2024 and annualized that period, using this number as a proxy (for now - until they release their full year audit). For those systems who report fiscal years of June or September, I took partial financial periods that they report quarterly to create an apples-to-apples comparison between all of the health systems. Finally, if you notice a name missing in the top 80 names, let me know. It's highly possible I missed some given how many there are. |
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Going deeper on an interesting topic, theme, or trend |
Top 20 Health Systems by Total Revenue |
Of course given its status as an integrated health plan, Kaiser takes the total revenue crown. But if you're looking at mostly patient services revenue (the next table), HCA reigns supreme by a wide margin over its nonprofit and for-profit counterparts. |
Top 20 Health Systems by Patient Revenue |
You can see all of the typical names here on the patient revenue side (excluding Kaiser, which hasn't completed its audit, nor do I think they break out the patient revenue generated on the provider side of the business). Advocate has secured its spot in the top 3 given its recent merger with Atrium and the second year of combined financials. Ascension slid into 4th given its asset sales, and so on. |
Top 20 Health Systems by Patient Revenue Growth |
Several names on the list saw spikes or drops in revenues from divestitures or portfolio add-ons. Novant Health comes to mind here in tacking on several Tenet hospitals. BJC just merged with Saint Luke's. Wellstar merged with August University Healht System. On the other side of the growth equation, Tenet and Ascension come to mind as notable players who either saw no revenue growth, or declines in patient revenue growth stemming from hospital divestitures for portfolio realignment purposes. Health systems like Henry Ford and Prime Healthcare picked up a material amount of Ascension's book of business. I covered Ascension's whole 2024 portfolio realignment here. |
Here's the full list of 80 or so health system names updated through calendar year 2024. The names highlighted in orange either just announced a significant merger, or closed on in recent years. For instance, Northwell-Nuvance, BJC-Saint Luke's, Sanford-Marshfield, and Kaiser/Risant-Cone-Geisinger as a few examples. An Excel file with links to source data has been made available to Hospitalogy plus and pro subscribers as of today! |
UPCOMING HEALTHCARE HAPPENINGS |
The latest from inside my community of healthcare thinkers |
The first quarter of 2025 is in the books; so what just went down? Join me and your fellow Hospitalogists for a Pulse Check on Q1 2025 Healthcare Trends. Expect to hear insights from Grant Hesser on the current state of the healthcare IPO environment and digital health public market performance, Jeff DelVerne on a retrospective look at health insurance carrier Q1 trends, Eric Epstein on the latest in the early-stage digital health startup environment and where AI is making an impact, and Drew Wozniak from Advocate Health on the latest strategies affecting hospitals and health systems across health system transformation, physician alignment, along with a look at Advocate Health's 'Re-Wire' strategy. |
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Thanks for the read! Let me know what you thought by replying back to this email. — Blake |
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