Health Systems Ranked by Revenue: 2026 Report
The largest U.S. health systems operate at a scale that rivals Fortune 100 companies. Kaiser Permanente leads every other system at $115.8 billion in annual revenue, more than the next two systems combined, followed by HCA Healthcare at $70.6 billion1. The ranking below reflects each system’s most recent reported fiscal year.
Largest Health Systems by Revenue
The Full Ranking of the Largest Health Systems by Revenue
Rank | Health System | Annual Revenue |
1 | Kaiser Permanente (Oakland, CA) | $115.8B |
2 | HCA Healthcare (Nashville, TN) | $70.6B |
3 | CommonSpirit Health (Chicago, IL) | $37.0B |
4 | Advocate Health (Charlotte, NC) | $31.7B |
5 | Providence (Renton, WA) | $30.7B |
6 | UPMC (Pittsburgh, PA) | $29.9B |
7 | Ascension (St. Louis, MO) | $28.6B |
8 | Trinity Health (Livonia, MI) | $23.9B |
9 | Mass General Brigham (Boston, MA) | $21.0B |
10 | Tenet Healthcare (Dallas, TX) | $20.7B |
11 | Mayo Clinic (Rochester, MN) | $19.8B |
12 | Sutter Health (Sacramento, CA) | $18.2B |
13 | Universal Health Services (King of Prussia, PA) | $15.8B |
Nonprofit Systems Dominate the Top of the List
Ten of the 13 largest systems are nonprofit, and only three, HCA Healthcare, Tenet Healthcare, and Universal Health Services, are for-profit. Kaiser Permanente sits in a category of its own because its revenue includes its health plan, so premium dollars are counted alongside care delivery. That integrated insurer-and-provider model is the main reason its total dwarfs pure care-delivery systems like HCA.
Why These Figures Are Not Perfectly Comparable
Health systems close their books on different dates, so a direct comparison mixes fiscal years ending in December, June, and September. Revenue also reflects different business mixes: some systems own health plans, others run large physician networks or research enterprises. Revenue measures scale, not profitability, and several of these systems have operated near breakeven or at a loss in recent years despite their size.
References
1. Becker’s Hospital Review and Hospitalogy, U.S. health systems ranked by annual revenue, most recent reported fiscal year (2024). beckershospitalreview.com; hospitalogy.com
Comments