The 10 largest health systems in the country manage billions of dollars in revenue and more than 1,150 hospitals combined. At the helm are CEOs and CFOs charged with balancing growth, operational stability and long-term sustainability amid increasingly complex payer dynamics.
Here are the leaders guiding the nation’s 10 largest health systems by hospital count.
1. HCA Healthcare (Nashville, Tenn.): 190 hospitals
Sam Hazen, CEO: Mr. Hazen was appointed CEO in January 2019 after serving as president and COO since 2015. He has been with HCA for more than four decades, holding leadership roles including president of operations from 2011 to 2015, during which he oversaw the system’s then-166 hospitals.
Before that, he spent a decade as president of HCA’s Western Group, leading seven divisions and 63 hospitals across nine states.
Mr. Hazen began his career in 1983 in Humana’s financial management training program. Earlier in his tenure, he served in multiple CFO roles, including CFO of HCA’s North Texas Division and CFO of HCA’s Western Group.
Mike Marks, Executive Vice President and CFO: Mr. Marks stepped into the CFO role in May 2024 following the retirement of Bill Rutherford, who served in the position for a decade. A longtime HCA leader, Mr. Marks joined the for-profit system in 1996 in its internal audit division and has held a series of senior finance roles over nearly 30 years.
He previously served as CFO of HCA’s West Florida Division, overseeing financial operations and development activities for 15 hospitals. In 2008, he became CFO of HCA’s National Group, managing financial operations across 13 states and 89 hospitals — one of the system’s largest operating segments.
Most recently, Mr. Marks served as senior vice president of finance, overseeing Parallon, HCA’s revenue cycle management subsidiary, as well as case management, performance improvement and the system’s financial resiliency program.
2. Veterans Health Administration: 170 hospitals
Douglas Collins, Secretary of Veterans Affairs: Mr. Collins was sworn in as the VA’s 12th secretary in February 2025 after being nominated by President Donald Trump. He succeeded Denis McDonough, who held the role from 2021 to 2025.
Mr. Collins served as a U.S. Representative for Georgia’s 9th Congressional District from 2013 to 2021 and previously represented the state’s 27th House District. He earned his law degree from John Marshall Law School in Atlanta during his first term in the state legislature and later established a legal practice.
He is also a colonel in the Air Force Reserve and previously served in the U.S. Navy Reserve. He completed a deployment to Iraq from 2008 to 2009 while stationed at Balad Air Base.
The Veterans Health Administration, along with the Veterans Benefits Administration and the National Cemetery Administration, comprises the Department of Veterans Affairs, which was established in 1988.
Richard Topping, Assistant Secretary for Management and CFO: Mr. Topping was appointed by President Trump to serve as CFO of the VA and was confirmed by the Senate in July 2025. He oversees the VA’s $440 billion budget, as well as financial management, capital asset oversight and enterprise business functions across the health system.
He is also responsible for leading the rollout of the VA’s new integrated financial and acquisition system — a major modernization effort aimed at improving transparency, accountability and operational efficiency.
Mr. Topping brings a background that spans managed healthcare, government contracting and executive leadership. He most recently served as chief legal officer and president of CareSource and previously led Cardinal Innovations Healthcare as CEO.
Earlier in his career, he served as a trial attorney for HHS and as a judge advocate in the U.S. Army. His experience across Medicaid, Medicare, Marketplace plans, Tricare and VA Community Care programs gives him broad exposure to public payer finance as the VA navigates modernization and budgetary oversight.
3. CommonSpirit Health (Chicago): 158 hospitals
Wright Lassiter III, President and CEO: Mr. Lassiter joined CommonSpirit as its president and CEO in August 2022. He previously held the same role at Detroit-based Henry Ford Health since 2017 and had been the system’s president since 2014.
He oversees CommonSpirit’s 158 hospitals and approximately 2,300 care sites across 24 states. He also serves as president and CEO of the CommonSpirit Health Foundation, which raised a record $316.1 million in fiscal year 2025.
Under his leadership, CommonSpirit has implemented artificial intelligence tools to improve patient outcomes, operations and clinical decision-making. Mr. Lassiter serves as co-chair of the National Academy of Medicine’s Steering Group for Patient Safety in the Era of AI, which is slated to launch in spring 2026. He serves on the board of Quest Diagnostics and Fortive.
Mr. Lassiter’s first CEO role was at Oakland, Calif.-based Alameda Health System, where he served for nearly a decade. Before that, he was senior vice president of operations at Fort Worth, Texas-based JPS Health Network and vice president of Dallas Methodist Medical Center.
Michael Browning, Senior Executive Vice President and CFO: Mr. Browning joined CommonSpirit as senior executive vice president and CFO effective Jan. 2, succeeding Daniel Morissette, who retired. He brings more than 30 years of healthcare finance experience to the role.
Before joining CommonSpirit, Mr. Browning served as executive vice president and CFO of Columbus-based OhioHealth. There, he helped guide financial strategy and capital planning for one of the Midwest’s largest nonprofit systems. At CommonSpirit, he oversees financial strategy, planning, accounting, treasury, reimbursement, revenue cycle and investor relations across 158 hospitals and more than 2,200 care sites in 24 states.
His appointment comes as CommonSpirit ended fiscal 2025 — the 12 months ending June 30, 2025 — with a $225 million operating loss (-0.6% operating margin), up from an $875 million loss (-2.4% margin) the previous year. The nonprofit system is in talks to sell seven hospitals in two different markets as it restructures its national footprint and improves its operating performance.
4. Lifepoint Health (Brentwood, Tenn.): 135 hospitals
David Dill, Chair and CEO: Mr. Dill has served as Lifepoint’s CEO since 2018 and added chair to his title in 2021. He joined the system in 2007 as executive vice president and CFO before becoming COO in 2009, a role he held for nearly a decade.
During his tenure, Lifepoint’s revenue has grown from $3 billion to more than $10 billion. The system has also launched more than 45 strategic partnerships to expand access under Mr. Dill’s leadership.
Prior to joining Lifepoint, Mr. Dill was executive vice president of Waltham, Mass.-based Fresenius Medical Care North American and CEO of Fresenius Medical Care Services’ East Division.
He also serves as board chair and member of the executive committee of the Washington, D.C.-based Federation of American Hospitals, a member of the American Hospital Association’s health systems committee and a board member of the Nashville (Tenn.) Health Care Council.
Aaron Lewis, President and CFO: Mr. Lewis was appointed president and CFO of Lifepoint Health — a 135-hospital system — in November 2023.
In addition to finance, Mr. Lewis oversees information technology, development and Lifepoint Business Services — the system’s shared services structure. He also plays a central role in Lifepoint Forward, the organization’s innovation strategy focused on transforming care delivery.
Prior to becoming CFO, he led growth and integrated solutions for the company, overseeing physician services, business transformation and strategic partnerships. His earlier career includes leadership roles at RCCH HealthCare Partners and Vanguard Health Systems, as well as experience in investment banking at Merrill Lynch.
5. Ascension (St. Louis): 119 hospitals
Eduardo Conrado, President and CEO: Mr. Conrado became president in 2023 and added the CEO title Jan. 1. As president, he led daily operations and set systemwide strategy, including portfolio transformation and innovation initiatives. As CEO, he is focused on strengthening care access, modernizing care delivery and deepening the system’s commitment to serving vulnerable populations.
Mr. Conrado served on Ascension’s board of directors from 2014 to 2018 and joined the system in 2018 as executive vice president and chief digital officer. He was executive vice president and chief strategy and innovation officer from 2019 to 2023, aligning the system’s portfolio, investments and actions to position it for long-term growth.
Before joining Ascension, Mr. Conrado spent 26 years with Chicago-based Motorola and later Motorola Solutions. He serves on the boards for the Catholic Health Association and ArcBest Corp., a transportation company.
Saurabh Tripathi, Executive Vice President and CFO: Mr. Tripathi was named executive vice president and CFO of Ascension in April 2024.
Under Mr. Tripathi’s leadership, Ascension trimmed its operating loss to $490.9 million (-1.6% margin) in fiscal 2025, improving on an operating loss of $1.8 billion (-6.3% margin) in 2024. After a period of restructuring and hospital divestitures, the faith-based system appears to be reentering growth mode and is expected to acquire AmSurg in a deal reportedly valued at about $3.9 billion.
He has more than 25 years of executive experience from Fortune 50 organizations, including Highmark Health, Fresenius Medical Care, General Electric and Procter & Gamble. His background includes large-scale operational oversight and strategic transformation.
6. ScionHealth (Louisville, Ky.): 94 hospitals
Rob Jay, CEO: Mr. Jay is the founding CEO of ScionHealth and stepped into the role in December 2021.
He previously served as executive vice president of integrated operations at Brentwood, Tenn.-based Lifepoint Health from 2018 to 2021. In that role, he oversaw the integration of Lifepoint and Brentwood, Tenn.-based RCCH HealthCare Partners. He earlier served as RCCH’s senior vice president of operations, executive vice president and COO.
Mr. Jay led the system through a transformative year in 2023, overseeing a major acquisition and the launch of ScionHealth’s first national quality program. The system acquired Cornerstone Healthcare Group, adding 15 long-term acute care hospitals, eight senior living facilities and 3,000 team members.
He serves on the board of directors of the Washington, D.C.-based Federation of American Hospitals.
Doug Shirley, CFO: ScionHealth appointed Mr. Shirley as CFO in April 2025.
Mr. Shirley brings more than 25 years of healthcare finance and revenue cycle experience. He most recently served as executive vice president and CFO of PathGroup and previously led enterprise revenue cycle management at Surgery Partners.
He also served as CFO of Cooper University Health Care in Camden, N.J. His background in revenue cycle and operational finance aligns with ScionHealth’s focus on financial improvement and strategic alignment across its acute and specialty hospital portfolio.
7. Trinity Health (Livonia, Mich.): 92 hospitals
Mike Slubowski, President and CEO: Mr. Slubowski has led Trinity Health since July 2019 after serving as president and COO for two years. In that role, he oversaw systemwide operations with a focus on people, processes, technology and culture.
Before Trinity Health’s 2013 merger with Catholic Health East, Mr. Slubowski served as president of health networks for the system. He also served as president and CEO of Denver-based SCL Health, formerly known as Sisters of Charity of Leavenworth Health System, and held executive leadership roles at Detroit-based Henry Ford Health and Phoenix-based Samaritan Health Services.
He serves on Trinity Health’s board of directors and on the board of Universal Technical Institute, a trade and technical college. He is also an elected board member of the American Hospital Association.
Daniel Isacksen, Executive Vice President and CFO: Trinity Health appointed Mr. Isacksen CFO in July 2021, replacing Cynthia Clemence, who retired.
He has spent three decades in Catholic healthcare finance and previously served as executive vice president and regional CFO of Loyola Medicine in Maywood, Ill., where he helped drive operational improvements and financial turnaround efforts. During his eight-year tenure at Loyola Medicine, he was vice president, finance and assistant treasurer, controller and director of finance for the Loyola University Physician Foundation, as well as manager of finance and treasury.
His earlier leadership roles included CFO of the physician enterprise for Ascension’s Alexian Brothers Health System and multiple finance positions at Loyola University Health System. He began his career at Deloitte & Touche.
8. Advocate Health (Charlotte, N.C.): 69 hospitals
Eugene Woods, CEO: Mr. Woods has served as CEO of Advocate Health since its formation through the 2022 combination of Atrium Health and Advocate Aurora Health. He began leading Atrium Health as president and CEO in April 2016.
Under his leadership, Advocate Health in 2025 launched The Pearl, an innovation district that houses Wake Forest University School of Medicine’s Charlotte campus — the city’s first four-year medical school.
Before joining Atrium Health, Mr. Woods served as president and CEO of Irving, Texas-based Christus Health, CEO of Lexington, Ky.-based Saint Joseph Health System and COO of MedStar Washington Hospital Center in Washington, D.C. He also served as chair of the American Hospital Association’s board of trustees in 2017.
Brad Clark, Executive Vice President and CFO:
Mr. Clark officially assumed the CFO role after serving as interim CFO following a leadership transition in 2023. He joined Advocate Health’s executive leadership team after previously serving as senior vice president of financial planning and treasurer for Atrium Health.
He also served as CFO of Wake Forest Baptist Medical Center prior to its merger with Atrium. Advocate Health was formed through the merger of Advocate Aurora Health and Atrium Health, creating one of the largest nonprofit systems in the country.
With more than two decades of healthcare finance experience, Mr. Clark’s background spans financial planning, treasury, revenue cycle, mergers and acquisitions and supply chain management — key capabilities as Advocate continues to scale.
9. Christus Health (Irving, Texas): 66 hospitals
Ernie Sadau, President and CEO: Mr. Sadau has served as president and CEO since 2011 after holding roles as COO and senior vice president. He also previously held leadership roles at Roseville, Calif.-based Adventist Health.
Mr. Sadau serves as a board and executive committee member of the Texas Hospital Association, an advanced member of the Health Care Financial Management Association and chair of the Illinois Hospital Association’s policy council.
Randy Safady, Executive Vice President and CFO: Mr. Safady has served as executive vice president and CFO of Christus Health since 2011, providing more than a decade of financial leadership for the faith-based system.
A certified public accountant, Mr. Safady oversees financial operations across Christus’ four-state footprint — Texas, Louisiana, New Mexico and Arkansas — guiding capital allocation and operational discipline across its hospital and ambulatory network.
He has more than 30 years of experience in finance, accounting and healthcare operations. Prior to joining Christus, he served as CFO of Centennial, Colo.-based Centura Health, which recently folded into CommonSpirit.
10. Community Health Systems (Franklin, Tenn.): 65 hospitals
Kevin Hammons, CEO: Mr. Hammons was appointed CEO in December after serving in the role on an interim basis since October. He succeeded Tim Hingtgen, who had served as CEO since 2021 and retired Sept. 30. Mr. Hammons was also appointed to the board of directors.
Mr. Hammons joined CHS in 1997 and held multiple financial reporting roles before being promoted to vice president and chief accounting officer in 2012. He was appointed assistant CFO in 2017 and served as treasurer from 2018 to 2019.
Mr. Hammons also led CHS’ enterprise resource planning implementation, Project Empower, which was projected to save the organization up to $60 million in 2025.
Jason Johnson, Executive Vice President and CFO: CHS, a for-profit system, appointed Mr. Johnson executive vice president and CFO effective Dec. 12 after he had served in the role on an interim basis.
He previously served as senior vice president and chief accounting officer and has been with CHS since 2012. Over the years, he has held roles in corporate controller functions and enterprise financial oversight.
His appointment follows leadership transitions at CHS, including the retirement of former CEO Tim Hingtgen and the promotion of Kevin Hammons to CEO. As CHS continues to divest select assets and streamline operations, Mr. Johnson is positioned to help guide capital strategy and financial restructuring efforts.
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