From -1.6% to 16.8%: 20 health systems ranked by operating margins
As policy uncertainties, reimbursement pressures and continued cuts and closures weigh on hospitals and health systems heading into 2026, third-quarter operating margins showed wide variation.
Several systems, such as UnityPoint, Montefiore Health System and Providence, saw operating losses or near-break-even results, while others like Allegheny Health Network, UPMC and Northwell Health saw only modest gains. On the stronger end, Tenet Healthcare led all systems with a 16.8% operating margin, followed by HCA Healthcare at 12.6% and Universal Health Services at 11.6%.
Below is a ranking of 20 health systems based on their operating margins for the third quarter of 2025.
Editor’s note: This is not an exhaustive list. The following financial results are for the three months ended Sept. 30, 2025, unless otherwise stated.
1. Tenet Healthcare (Dallas)
Revenue: $5.3 billion
Expenses: $4.5 billion
Operating income: $889 million
Operating margin: $16.8%
2. HCA Healthcare (Nashville)
Revenue: $19.2 billion
Expenses: $16.7 billion
Operating income: $2.4 billion
Operating margin: 12.6%
3. Universal Health Services (King of Prussia, Pa.)
Revenue: $4.5 billion
Expenses: $4 billion
Operating income: $521.7 million
Operating margin: 11.6%
4. BayCare (Clearwater, Fla.)
*For the nine months ending Sept. 30
Revenue: $5.2 billion
Expenses: $4.3 billion
Operating income: $543.5 million
Operating margin: 10.5%
5. Mayo Clinic (Rochester, Minn.)
Revenue: $5.2 billion
Expenses: $5 billion
Operating income: $442 million
Operating margin: 8.1%
6. Community Health Systems (Franklin, Tenn.)
Revenue: $3.087 billion
Expenses: $2.8 billion
Operating income: $243 million
Operating margin: 7.9%
7. Advocate Health (Charlotte, N.C.)
*For the nine months ending Sept. 30
Revenue: $28.8 billion
Expenses: $27.5 billion
Operating income: $1.3 billion
Operating margin: 4.5%
Revenue: $4.5 billion
Expenses: $4.1 billion
Operating income: $206.2 million
Operating margin: 4.5%
9. NewYork-Presbyterian (New York City)
Revenue: $2.9 billion
Expenses: $2.8 billion
Operating income: $115 million
Operating margin: 3.9%
10. BJC Health System (St. Louis)
*For the nine months ending Sept. 30 through the third quarter
Revenue: $8.9 billion
Expenses: $8.6 billion
Operating income: $335.5 million
Operating margin: 3.8%
11. Intermountain Health (Salt Lake City)
*For the nine months ending Sept. 30
Revenue: $13.8 billion
Expenses: $12.7 billion
Operating income: $442 million
Operating margin: 3.2%
12. Banner Health (Phoenix)
*For the nine months ending Sept. 30
Revenue: $11.9 billion
Expenses: $11.6 billion
Operating income: $338 million
Operating margin: 2.8%
13. Sanford Health (Sioux Falls, S.D.)
*For the nine months ending Sept. 30
Revenue: $8.5 billion
Expenses: $8.4 billion
Operating income: $93.3 million
Operating margin: 1.1%
14. Kaiser Permanente (Oakland, Calif.)
Revenue: $31.8 billion
Expenses: $31.6 billion
Operating income: $218 million
Operating margin: 0.7%
15. Allegheny Health Network (Pittsburgh)
Revenue: $1.4 billion
Expenses: $1.4 billion
Operating income: $7 million
Operating margin: 0.5%
16. Northwell Health (New Hyde Park, N.Y.)
Revenue: $5 billion
Expenses: $5 billion
Operating income: $26.9 million
Operating margin: 0.5%
17. UPMC (Pittsburgh)
Revenue: $8.5 billion
Expenses: $8.5 billion
Operating income: $45.6 million
Operating margin: 0.5%
18. Providence (Renton, Wash.)
Revenue: $8 billion
Expenses: $7.9 billion
Operating income: $21 million
Operating margin: 0.3%
19. UnityPoint Health (West Des Moines, Iowa)
*For the nine months ending Sept. 30
Revenue: $1.4 billion
Expenses: $1.5 billion
Operating loss: $17 million
Operating margin: -1.3%
20. Montefiore Health System (New York City)
*For the nine months ending Sept. 30
Revenue: $6.5 billion
Expenses: $6.6 billion
Operating loss: $103.7 million
Operating margin: -1.6%
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