Despite persistent workforce pressures, rising drug costs and ongoing payer headwinds, a number of large health systems delivered strong financial results in 2025. Several posted record operating income, while others turned around losses from prior years or absorbed major mergers and acquisitions without sacrificing profitability.
From national giants like HCA Healthcare and Kaiser Permanente to regional systems such as RWJBarnabas Health and ProMedica, these organizations leveraged volume growth, operational discipline and, in some cases, transformative deals to bolster their bottom lines.
Here are 23 of the most profitable health systems in 2025, according to their most recent financial results.
Editor’s note: This is not an exhaustive list. Unless otherwise noted, financial results reflect full-year 2025 performance (Jan. 1 – Dec. 31). Some systems report on a non-calendar fiscal year; those are noted individually.
1. Dallas-based Tenet Healthcare reported an operating income of $3.5 billion (16.5% margin) in 2025, down from $6 billion (28.8% margin) in 2024. The decline reflects the absence of a $2.9 billion pre-tax gain from hospital divestitures that inflated 2024 results; Tenet sold 14 hospitals that year. Revenue was $21.3 billion in 2025, up from $20.7 billion. Net income was $1.4 billion (6.6% margin), down from $3.2 billion (15.5% margin) in 2024.
2. Franklin, Tenn.-based Community Health Systems reported an operating income of $1.5 billion (11.9% margin) for the year ended Dec. 31, 2025, up from $542 million (4.3% margin) in 2024. Total revenue decreased to $12.5 billion from about $12.7 billion, and total expenses were $11 billion. Net income was $509 million, compared to a $516 million net loss in 2024. CHS’ 2025 operating results were significantly influenced by gains from hospital divestitures; the company divested partial or full ownership in seven hospitals during the year.
3. Altamonte Springs, Fla.-based AdventHealth recorded an operating income of $2.7 billion (11.6% operating margin) in 2025, consistent with an 11.6% margin in 2024 on lower revenue. Total operating revenue was $23 billion, up from $19.8 billion. Operating expenses were $20.3 billion, up from $17.5 billion. Net income was $4.1 billion, up from $2.7 billion in 2024.
4. Nashville, Tenn.-based HCA Healthcare reported a net income of $6.8 billion (11.1% margin), up 17.8% from the $5.8 billion (12.2% margin) posted in 2024. Revenue hit $75.6 billion in 2025, up from $70.6 billion. Expenses were $65.8 billion, up from $62.1 billion.
5. Dallas-based Baylor Scott & White Health reported $998 million in operating income (10.7% operating margin) in the first half of fiscal 2026 — the most recent period available — compared to $953 million (11.2% margin) in the same period last year. Operating revenue rose to $9.3 billion from $8.5 billion. Net income totaled $1.7 billion for the six-month period, up from $1.4 billion.
6. King of Prussia, Pa.-based Universal Health Services recorded an operating income of $2 billion (11.5% operating margin) in 2025, up from $1.7 billion (10.6% margin) in 2024. Net revenue was $17.4 billion, up from $15.8 billion. Total operating expenses were $15.3 billion, up from $14.1 billion. Net income was $1.5 billion, up from $1.1 billion in 2024.
7. Toledo, Ohio-based ProMedica recorded $249.4 million in operating income (8.1% margin) in 2025, up from $147.6 million (5% margin) in 2024. Revenue reached $3.1 billion, and net income improved to $260.8 million from $110.3 million in 2024.
8. Rochester, Minn.-based Mayo Clinic posted an operating income of $1.5 billion (6.8% margin) in 2025, up from $1.3 billion (6.5% margin) in 2024. Total operating revenue rose 8.7% to $21.5 billion, while operating expenses increased 8.4% to $20.1 billion. Net income climbed to $5.2 billion from $3.8 billion in 2024.
9. West Orange, N.J.-based RWJBarnabas Health recorded $708.9 million in operating income (6.4% margin) in 2025, up from $290.7 million (3% margin) in 2024. Operating revenue rose to $11 billion from $9.6 billion, and operating expenses totaled $10.3 billion, up from $9.3 billion. RWJBarnabas reported a net income of $1.5 billion, up from $992.3 million in 2024.
10. Cleveland Clinic reported $913 million in operating income (5% margin) in 2025, up sharply from $276 million (1.7% margin) in 2024. Operating revenue increased 14.7% to $18.3 billion, while expenses rose 10.9% to $16.5 billion. Net income hit $2.3 billion, up from $980 million in 2024.
11. Winston-Salem, N.C.-based Novant Health posted $576.6 million in operating income (4.8% margin) in 2025, down slightly from a 5.5% margin in 2024. Revenue increased 16.8% to $11.9 billion. Net income reached $1.2 billion, up from $919.8 million in 2024.
12. St. Louis-based BJC Health System recorded $454.5 million in operating income (3.8% margin) in 2025, up from $325.6 million (3% margin) in 2024, following its merger with Kansas City, Mo.-based Saint Luke’s Health System. Total revenue rose to $12.1 billion from $10.7 billion. Net income totaled $1.5 billion, compared to $2.6 billion in 2024; the prior year included merger-related gains.
13. Orlando (Fla.) Health posted a $345.7 million operating gain (3.5% margin) for the fiscal year ended Sept. 30, 2025, down from a $525.1 million operating gain (7.3% margin) in fiscal 2024. Revenue rose nearly 38% to $9.9 billion, driven by the system’s $963.5 million acquisition of Birmingham, Ala.-based Brookwood Baptist Health System and a $439 million purchase of three Florida hospitals from the now-defunct Steward Health Care. Net income was $727.5 million, down from $1.1 billion in fiscal 2024.
14. Salt Lake City-based Intermountain Health recorded an operating income of $515 million (2.8% operating margin) in 2025, up from $370 million (2.2% margin) in 2024. Total operating revenue was $18.5 billion, up from $17.1 billion. Total operating expenses were $17.2 billion, up from $16.1 billion. The 33-hospital system reported a net income of $2.6 billion, up from $1.7 billion in 2024.
15. Phoenix-based Banner Health reported $444 million in operating income (2.8% margin) in 2025, up from $362 million (2.3% margin) in 2024. Revenue increased 2.4% to $16 billion, while operating expenses totaled $15.5 billion. Banner’s results benefited from $353 million in revenue tied to Arizona’s state-directed payment program. Net income was $1.45 billion, up from $1.08 billion in 2024.
16. Sacramento-based Sutter Health recorded an operating income of $509 million (2.6% operating margin) in 2025, up from $142 million (0.8% margin) in 2024. Total operating revenue was $19.8 billion, up from $18.2 billion. Total operating expenses were $19.3 billion, up from $18.1 billion. Net income was $1.9 billion, up from $1 billion in 2024.
17. Brentwood, Tenn.-based Ardent Health recorded a net income of $135.8 million (2.2% margin) in 2025, down from $210.3 million (3.8% margin) in 2024. Total revenue was $6.3 billion, up from $6 billion. Total operating expenses were $6 billion, up from $5.6 billion.
18. Sioux Falls, S.D.-based Sanford Health recorded an operating income of $210.9 million (1.8% operating margin) in 2025, down from $400.3 million (5.2% margin) in 2024. The decline reflects Sanford’s merger with Marshfield (Wis.) Clinic Health System at the start of 2025, which expanded the organization to a 56-hospital system. Total operating revenue was $11.7 billion, up from $7.7 billion. Total operating expenses were $11.4 billion, up from $7.3 billion. Net income was $1.1 billion, up from $395 million in 2024.
19. Southfield, Mich.-based Corewell Health reported $276 million in operating income (1.6% margin) in 2025, up from $208 million (1.3% margin) in 2024. Operating revenue increased 7.5% to $17.6 billion. Net income was $1.3 billion, up from $921 million in 2024.
20. Oakland, Calif.-based Kaiser Permanente recorded an operating income of $1.4 billion (1.1% operating margin) in 2025, up from $569 million (0.5% margin) in 2024. Total operating revenue was $127.7 billion, up from $115.8 billion. Operating expenses were $126.3 billion, up from $115.2 billion. Kaiser’s 2025 results include Risant Health, its nonprofit subsidiary, which acquired Geisinger and Cone Health in 2024. Net income was $9.3 billion, down from $12.9 billion in 2024; the prior year included $6.8 billion related to Risant’s acquisitions.
21. Detroit-based Henry Ford Health recorded an operating income of $133.8 million (1% operating margin) in 2025, down from $294.2 million (3.1% margin) in 2024. The decline reflects the October 2024 launch of a joint venture with Ascension Michigan, which significantly expanded Henry Ford’s cost base. Total operating revenue was $13.1 billion, up from $9.6 billion. Total operating expenses were $12.9 billion, up from $9.3 billion. Net income was $543.5 million, essentially flat compared to $542.4 million in 2024.
22. Pittsburgh-based UPMC recorded $286 million in operating income (0.9% margin) in 2025, compared to a $339 million operating loss in 2024. Operating revenue grew to $33.6 billion from $29.9 billion. Net income reached $635.4 million, up from a $14.7 million net loss in 2024.
23. Indianapolis-based Indiana University Health reported $50 million in operating income (0.5% margin) in 2025, down from $257 million (2.8% margin) in 2024. Operating revenue increased 2.9% to $9.5 billion, while expenses rose 5.3% to $9.4 billion. Net income climbed to $1.2 billion from $966 million in 2024.
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