Top 10 Largest Health Systems in the U.S.

Health systems are organizations of healthcare providers that deliver care services to a local community or region. They vary in size, geography, facility type, and may even cater toward specific health conditions.  

Conceptually speaking, the WHO defines a health system as “all the organizations, people, and actions whose primary purpose is to promote, restore, and/or maintain health.” They consider a good health system to be one that delivers quality services to all people, when and where they need them.  

Not only do health systems strive to improve patient outcomes and serve their communities, but they often act as thought leaders and advocates for activities of great importance to the fields of health and medicine. 

What is a Health System? 

For a practical definition, a health system, sometimes referred to as an integrated delivery network (IDN), is an organization bringing together people, institutions, and resources to support, provide, and improve health outcomes for a population.  

Because even the largest health systems may differ in their approach to care coordination—and the ways patients receive care may vary—the precise definition of a health system is expected to evolve over time.  

That being said, there are a few characteristics universal to nearly all health systems: 

  • The organization owns and operates a network of at least one or more healthcare facilities, like a hospital. 

  • The organization includes at least one group of physicians who provide comprehensive care. 

  • The physicians are connected with each other and the healthcare facility either through common ownership or joint management; and 

  • Generally speaking, a health system is committed to providing care for people and their communities and taking measures to preserve a healthy community.  

Top 10 Health Systems by Net Patient Revenue 

Health System Name 

Total Net Patient Revenue 

HCA Healthcare (FKA Hospital Corporation of America) 


CommonSpirit Health 


Dignity Health 


Ascension Health 


Northwell Health (AKA North Shore Long Island Jewish Health System) 


Cleveland Clinic Health System 


NewYork-Presbyterian Healthcare System 


Trinity Health (FKA CHE Trinity Health) 


Tenet Healthcare 



Providence St Joseph Health (AKA Providence) 


Fig 1 – Data from Definitive Healthcare’s Hospitals & IDNs database. Net patient revenue is an aggregate of member hospital financial information from the April 2021 Medicare Cost Report release. The next scheduled Medicare Cost Report release is July 2021. Accessed June 2021. 

The top health systems listed above reported combined net patient revenue of approximately $226 billion as of April 2021—making these networks a lucrative sales and marketing opportunity for organizations selling into the healthcare market.  

Many of the health systems we’ve reported on often act as IDNs or group purchasing organizations (GPOs) for their member hospitals. As uncertainties in the healthcare market give rise to financial risk, providers use price negotiators like IDNs and GPOs. It’s an effective tactic to cut costs, expand market share and increase leverage. According to Definitive Healthcare data, about 93 percent of U.S. hospitals are affiliated with a GPO—up from 84 percent in 2019. 

It’s important to note that IDNs and GPOs can be distinct entities. Small, independent practices or IDNs may negotiate with vendors within the region they serve to better address the needs of their community.  

However, their small size may prevent them from securing better deals. These organizations may turn to IDNs or GPOs who act as price negotiators on their behalf to maximize their negotiating power.  

Determining the relationships that exist among your prospects, whether they belong to an IDN, GPO, or both, is one of the first steps your marketing and sales teams can take to create a solid business strategy.  

Top 10 Largest Health Systems by Member Hospitals 

Hospital Network Name 

Number of Networked Hospitals 

HCA Healthcare (FKA Hospital Corporation of America) 


CommonSpirit Health 


Universal Health Services 


Department of Veterans Affairs (AKA Veterans Health Administration) 


Select Medical Corporation 


Encompass Health Corporation (FKA HealthSouth) 


Ascension Health 


Community Health Systems (AKA CHS) 


LifePoint Health (FKA LifePoint Hospitals) 



Tenet Healthcare 


Fig 2 – Data from Definitive Healthcare’s Hospitals & IDNs database. Health system data is sourced from proprietary Definitive Healthcare data and the April 2021 Medicare Cost Report Release. The next scheduled Medicare Cost Report release is July 2021. Accessed June 2021. 

According to the table above, HCA Healthcare is one of the largest health systems in the U.S., with 226 hospitals in its network.  

Collectively, the largest health systems in the U.S. manage more than 1400 hospitals—just over 20% of active hospitals in the United States. Which means these hospitals could have an advantage in lowering care costs. In addition to negotiating purchasing prices, large health systems also help to keep patient referrals in-network. This improves care coordination, enhances the patient experience, and prevents revenue loss by referring outside of a hospital’s network. 

Why It Matters to You 

For your business, you may find that size matters when it comes to connecting with the right stakeholders, capitalizing on new growth opportunities, or simply having a clear picture of the market in your territory.  

The largest healthcare providers simply have a greater potential ability to streamline processes (especially administrative tasks) and bring in more money.  

As a result, they can offer their physicians the room to further specialize and develop their profession, and spend more time treating patients and less time managing billing, ordering medical supplies, or scheduling.  

Of course, smaller health systems also offer their own advantages your business can leverage. While we’re still considering organizations with at least one or more institutions in their hospital network, a smaller network likely could address the specific healthcare needs of its local community more nimbly. Smaller hospitals or clinics may also spend more attention building strong, positive relationships and patient experiences.  

Learn More 

Health systems play a crucial role in bettering healthcare delivery throughout the United States. Health systems can manage dozens of hospitals and other care facilities—expanding service offerings and providing specialty physicians and clinics to ensure that patients are satisfied and treated properly. Because they manage an entire network of facilities, health systems have the power to influence industry practices and set the bar for clinical and quality program performance. 

Eager to learn how you can best leverage healthcare data to engage with health systems, IDNs, and GPOs and grow your business? Watch our on-demand webinar, 10 Key Strategies for Selling to IDNs and GPOs.  

In this 60-minute discussion, you’ll gain a deep understanding of the 10 best strategies to employ when working with health systems, IDNs, and GPOs and why these tactics have proven to be successful. 


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