1. Kaiser Permanente
2023 Total Operating Revenue: $100.85 billion
2022 Total Operating Revenue: $95.41 billion
Headquarters: Oakland, California
Kaiser Permanente retains its position as the largest nonprofit health system in the U.S., reporting significant revenue growth driven by health plan premiums and operational efficiencies. Despite challenges such as high labor costs and supply expenses, Kaiser turned a substantial operating loss in 2022 into a small gain in 2023. The system’s entry into value-based care through Risant Health marks a strategic move towards cost reduction and system expansion.
2. CommonSpirit Health
2023 Total Operating Revenue: $34.51 billion
2022 Total Operating Revenue: $33.91 billion
Headquarters: Chicago
Formed from the merger of Dignity Health and Catholic Health Initiatives, CommonSpirit Health reported a slight increase in operating revenue but continued to struggle with operating losses. The system’s fiscal challenges were partially offset by significant investment income, highlighting ongoing financial management strategies amidst tough operating conditions.
3. Advocate Health
2023 Total Operating Revenue: $31.75 billion
2022 Total Operating Revenue: $28.2 billion
Headquarters: Charlotte, North Carolina
Advocate Health emerged as a major player following its merger with Atrium Health and Advocate Aurora Health. The newly formed entity reported substantial revenues and benefited from strong investment income, positioning itself for improved financial performance in 2024 through strategic realignment and divestment of non-core assets.
4. Ascension
2023 Total Operating Revenue: $28.35 billion
2022 Total Operating Revenue: $27.98 billion
Headquarters: St. Louis
Ascension faced a challenging fiscal year marked by a significant operating loss primarily attributed to noncash impairment charges. The system continues to navigate operational challenges including a major cyberattack while leveraging its strong liquidity position to mitigate financial impacts and sustain long-term growth.
5. Providence St. Joseph Health
2023 Total Operating Revenue: $28.75 billion
2022 Total Operating Revenue: $26.43 billion
Headquarters: Renton, Washington
Providence St. Joseph Health reported a notable increase in operating revenue driven by volume growth and strategic payment rate adjustments. Despite progress, the system grapples with operational losses and ongoing regulatory scrutiny, including leadership changes amidst legal challenges.
6. UPMC (University of Pittsburgh Medical Center)
2023 Total Operating Revenue: $27.70 billion
2022 Total Operating Revenue: $25.53 billion
Headquarters: Pittsburgh
UPMC expanded its integrated health services and insurance offerings, reporting revenue growth across its health services and insurance divisions. Operational losses in 2023 were partly mitigated by robust investment income, with ongoing efforts to streamline operations and enhance growth strategies.
7. Trinity Health
2023 Total Operating Revenue: $21.59 billion
2022 Total Operating Revenue: $19.93 billion
Headquarters: Livonia, Michigan
Trinity Health saw significant revenue growth from mergers and acquisitions, although operational losses persisted due to restructuring and asset impairment charges. The system’s cost management strategies and increased revenue from expanded services position it for improved financial performance in fiscal year 2024.
8. University of California Medical Centers
2023 Total Operating Revenue: $19.27 billion
2022 Total Operating Revenue: $17.52 billion
Headquarters: Oakland, California
UC Health’s academic medical centers reported revenue growth driven by increased patient volumes and specialty care revenues. Despite rising expenses, the system’s strong investment income contributed to overall financial stability amidst ongoing challenges in healthcare delivery and academic partnerships.
9. Mass General Brigham
2023 Total Operating Revenue: $18.83 billion
2022 Total Operating Revenue: $16.71 billion
Headquarters: Somerville, Massachusetts
Mass General Brigham achieved significant revenue growth through expanded care delivery models and operational efficiencies. The system navigated financial restructuring and operational challenges while focusing on community-based care initiatives and academic partnerships for sustainable growth.
10. Mayo Clinic
2023 Total Operating Revenue: $17.94 billion
2022 Total Operating Revenue: $16.29 billion
Headquarters: Rochester, Minnesota
Mayo Clinic reported strong revenue growth fueled by patient care services and investments in technology and innovation. The system’s robust operating income reflects ongoing expansion efforts and strategic investments in healthcare delivery and research, positioning Mayo Clinic as a leader in nonprofit healthcare.
These top nonprofit health systems navigated a challenging fiscal landscape in 2023, marked by revenue growth, operational efficiencies, and strategic investments amidst ongoing healthcare reforms and economic pressures.
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