Becker’s reports 2024 revenue growth for top U.S. health systems, despite costs.
In a year marked by cautious optimism and persistent financial hurdles, Becker’s Hospital Review has released its annual ranking of the top 39 U.S. health systems by revenue, highlighting both progress and ongoing strain within the healthcare sector. Its February 2025 issue also presented data for the 12-month period ending December 31, 2024, capturing a snapshot of an industry still adjusting and attempting to recalibrate after years of instability. While most health systems revenues grew in 2024, many continued to struggle with rising expenses, which in many cases outpaced their financial gains.
Leading the rankings is Kaiser Permanente, based in Oakland, California, which reported an industry-topping $115.8 billion in revenue. This figure underscores the organization’s expansive reach as an integrated managed care consortium and its continued dominance in the nonprofit sector. In second place, HCA Healthcare of Nashville, Tennessee, reported $70.6 billion, marking its strength as the largest for-profit health system in the country. Other major players in the top five included CommonSpirit Health in Chicago with $37 billion, Providence in Renton, Washington with $30.7 billion, and UPMC in Pittsburgh, which posted $29.9 billion. Ascension, headquartered in St. Louis, closely followed with $28.6 billion, based on financial results ending in mid-2024.
Further down the list, Trinity Health of Livonia, Michigan ranked seventh with $23.9 billion in annual revenue, reflecting its enduring presence as a leading Catholic health system. Tenet Healthcare in Dallas and Mass General Brigham in Somerville, Massachusetts, rounded out the top ten with $20.7 billion and $20.6 billion, respectively. Mayo Clinic reported $19.8 billion, continuing to balance its roles in clinical care, research, and education. Intermountain Health in Salt Lake City reported $17.1 billion, while Cleveland Clinic came in at $15.9 billion, each demonstrating steady financial performance driven by regional demand and specialized care.
Mid-sized systems also posted strong results despite increasing pressure from rising labor and supply chain costs. Banner Health in Phoenix and Baylor Scott & White Health in Dallas each posted revenues over $15 billion. Jefferson Health in Philadelphia reported $15 billion, and NYU Langone Health in New York City followed closely with $14.2 billion. Bon Secours Mercy Health, Community Health Systems, and SSM Health each saw figures in the $11 to $13 billion range, underscoring a broad trend of resilience among systems operating in multiple states.
However, the challenges for smaller and regionally constrained systems remained significant. Scripps Health in San Diego reported $4.9 billion, Tufts Medicine in Boston posted $2.6 billion, and Palomar Health in Escondido, California, closed out the list with $890 million in annual revenue. Though these organizations experienced modestgrowth in revenues, they remain more susceptible to volatility driven by workforce shortages, drug costs, inflation, and the lingering effects of deferred care during the pandemic years.
Despite encouraging signs of recovery in patient volumes and clinician productivity, healthcare organizations are far from financially secure. Many continue to grapple with wage inflation, staffing shortages, delayed capital projects, and tighter margins. The rebound in revenue is not yet enough to guarantee long-term financial health. To address these issues, health systems are turning to cost containment measures, digital transformation, and strategic partnerships. Still, the path forward likely requires broader policy support and sector-wide innovation. Becker’s encourages health systems not included in the current rankings to submit updated financial data for consideration in future editions, ensuring that the evolving landscape is accurately represented as the industry continues to adapt.
Sources:
39 health systems ranked by annual revenue
February 2025 Issue of Becker’s Hospital Review
