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While the total number of hospitals in the United States has remained relatively the same over the past several years, mergers and acquisitions have significantly consolidated the number of healthcare systems: from 2,542 in 2010 to 1,971 at the end of 2018. This activity is creating vast corporate entities with expanding geographical footprints.
Using Definitive Healthcare data - current and historical - we break down the largest U.S. healthcare systems by total staffed beds at member hospitals to better understand their financial presence, place among competitors, and operating power. Although square footage is a useful measurement as well, the value of a hospital ultimately lies in how many patients it can take in. In total, the top 10 healthcare systems cover: 1,179 hospitals; 163,155 licensed beds; and $52.3 billion in net patient revenue.
Fig 1 Data from Definitive Healthcare’s hospitals and IDNs platform. Number of staffed beds is from hospital self-reporting to CMS. Graphic is from the Definitive Healthcare Expert platform.
Here are some quick facts and figures about the top 5 largest U.S. health systems in descending order:
With 14,656 beds, Tenet Healthcare ranks as the fifth largest U.S. healthcare system by member hospital beds. The states of Texas, California, Florida, Arizona, Michigan and Alabama have the most Tenet Healthcare hospitals.
Ascension Health is the fourth largest U.S. healthcare system with 15,259 staffed member hospital beds. The faith-based organization has facilities in 26 states, concentrated in the Midwest, Southeast, and South.
Universal Health Services ranks third on total member beds among U.S. healthcare systems, with over 17,000 staffed beds. Its facilities are found in 41 states including Texas, Nevada, Florida, South Carolina, and California.
CHI and Dignity merged to form CommonSpirit Health, now the second largest healthcare system by bed size and total number of hospitals. The organization has 21,148 staffed beds and 196 hospitals across 23 states.
Ranked as the largest U.S. healthcare systems by total member hospital beds is HCA Healthcare with over 37,00 staffed beds. Its facilities cover 21 states, with the most hospitals in Texas, Florida, Virginia, Tennessee, Georgia and Utah.
While Universal Health Services is considered the third largest by number of beds, this system has the lowest net patient revenue among the top 5 and the third lowest among the top 10, ranking just above the systems in the ninth and tenth spots for size. This system is made up mostly of sub-acute care facilities with an average length of stay being 7 days. One thing that 4 out of the top 5 had in common was using Cerner as their inpatient EMR vendor; the exception being HCA Healthcare which uses Meditech .
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