These annual rankings show that the nation’s largest healthcare systems continue to grow in revenue and bed count

When it comes to the nation’s largest healthcare systems, it is no surprise that the U.S. Department of Veterans Affairs (VA) tops the list, at least when ranked by annual revenue. That is the finding of a “Top 10” survey of healthcare systems recently published by Modern Healthcare magazine.

This survey is useful to pathologists and clinical laboratory managers because these “Top 10” healthcare system rankings also provide insight as to where the nation’s largest hospital-based laboratory organizations can be found. For example, the VA operates 164 acute-care hospitals. That represents a large volume of clinical laboratory testing for those inpatients.

In this Dark Daily, we present Modern Healthcare’s list of the Top 10 healthcare systems ranked by revenue and the Top 10 healthcare systems ranked by number of hospitals. Modern Healthcare compiled these rankings using the survey responses it received from 210 hospitals nationwide. It analyzed the financial responses in the survey from only 199 of these hospitals because not all facilities provided the requisite financial information, the magazine said.

In its rankings of hospital systems by revenue, the VA (at $50 billion in revenue in 2010) was well ahead of the second place hospital system, HCA (at $30.6 billion).

When ranked by hospital count, however, HCA (with 164 facilities) was number one and the VA (with 152) was second.

10 Largest Healthcare Systems, by Revenue
Ranked by net patient rev., 2010 ($ millions)
2010 2009
1. U.S. Department of Veterans Affairs $50,015.1 $46,544.8
2. HCA $30,683.0 $30,052.0
3. Ascension Health $13,984.4 $13,508.4
4. Community Health Systems $12,986.5 $12,107.6
5. Catholic Healthcare West $9,141.6 $8,719.4
6. Tenet Healthcare Corp. $8,832.0 $8,672.0
7. Catholic Health Initiatives $8,504.2 $8,257.5
8. Sutter Health $7,858.0 $7,129.0
9. Mayo Clinic $6,735.7 $6,473.7
10.  Providence Health & Services $6,513.0 $6,180.9
(All figures rounded)
(Source: Modern Healthcare’s 2010 Hospital Systems Survey)

In its ranking of the Top 10 healthcare systems by hospital count, Modern Healthcare identified HCA (164) at number one and the VA (152) at number two. The third largest healthcare system is Ascension Health (126). The table below shows these rankings.

10 Largest Healthcare Systems, by Hospital Count
Ranked by total acute-care hospitals, 2010
2010 2009
1. HCA 164 163
2. U.S. Department of Veterans Affairs 152 153
3. Community Health Systems 126 122
4. Catholic Health Initiatives 73 78
5. Ascension Health 70 67
6 . Health Management Associates 59 55
7. LifePoint Hospitals 52 47
8. Tenet Healthcare Corp. 49 49
9. Adventist Health System 41 37
10.  Catholic Healthcare West 40 41
Note: Hospital count represents the total number of unique Medicare provider numbers.
(Source: Modern Healthcare’s 2010 Hospital Systems Survey)

In commenting on the findings of this annual survey, Modern Healthcare stated that the largest healthcare systems keep growing in size. It attributed this development to the financial problems at smaller hospitals. It concluded that the economic recession of 2007-2009 had pushed weaker hospitals into “the arms of more stable buyers.”

Two statistics will be of interest to pathologists and clinical laboratory managers. The number of acute-care hospitals owned by the 210 participating healthcare systems in the Modern Healthcare survey increased by 2% to 2,123. The survey also determined that the number of beds operated by these systems grew 1% to 401,879.

These developments should not surprise medical laboratory professionals. Healthcare in the United States continues to consolidate. Small providers are continuously being gobbled up by larger providers. Scale brings benefits, which is why the biggest keep getting bigger.

—Joe Burns

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