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Because the vast majority of it is privatized, the U.S.’s healthcare system has no shortage of health-related organizations. These health systems come in all shapes and sizes, from hospital chains to small, independent healthcare facilities.
Some of these are religious organizations that hospitals can opt to be a part of, while others are for-profit companies that act as parent companies for smaller organizations.
Still, others pair their healthcare services with consulting services or research efforts, making it their mission to share information with their colleagues to improve the healthcare field. Some even offer their health insurance plans to patients.
So, what are the largest health systems in the U.S.? Here is a list of the top 10, ranked by the number of hospitals they operated as of September 2020:
HCA Healthcare — Nashville, Tennessee
Veterans Health Administration — Washington, D.C.
Ascension — St. Louis, Missouri
CommonSpirit Health — Chicago, Illinois
Community Health Systems — Franklin, Tennessee
Trinity Health — Livonia, Michigan
LifePoint Health — Brentwood, Tennessee
Tenet Healthcare — Dallas, Texas
Baylor Scott & White Health — Dallas, Texas
Providence — Renton, Washington
These facilities also offer several other services and healthcare facilities, but we’re only paying attention to the number of hospitals each one owns for the sake of this list.
10 Largest Health Systems in the U.S.
HCA Healthcare. Nashville, Tennessee
Number of hospitals as of September 2020: 186
HCA Healthcare operates over 2,000 hospitals, surgery centers, ERs, urgent care centers, diagnostic and imaging centers, walk-in clinics, and physician clinics across 21 states and the U.K.
The HCA in HCA Healthcare’s name stands for Hospital Corporation of America, and the organization was founded in 1968 to expand access to healthcare across the U.S.
Today, HCA Healthcare employs about 280,000 people. It is a learning health system, which means it collects and analyzes data to inform advances in technology, improve its best practices, and share with other organizations in the industry.
Veterans Health Administration. Washington, D.C.
Number of hospitals as of September 2020: 170
This healthcare organization is different from the rest of the ones on this list because it’s government-funded and run by the U.S. Department of Veterans Affairs. It’s also unique in that it offers healthcare to U.S. military veterans only.
Because it is a government-funded organization and a benefit for U.S. veterans, VHA operates kind of like its own insurance, only charging patients a copay depending on what types of treatment they receive.
VHA’s history stretches back to 1865 when the U.S. government opened facilities that offered housing and medical care for veterans disabled during the Civil War. Eventually, the care at those facilities got so good that it was rivaling what hospitals could provide at that time.
Since then, VHA has expanded and undergone several structural changes, and today it has 1,454 healthcare facilities (including 170 hospitals) across the country, and it serves over nine million veterans.
Ascension. St. Louis, Missouri
Number of hospitals as of September 2020: 151
Founded in 1999 as Ascension Health, Ascension is one of the largest Catholic healthcare systems in the U.S. It began as a partnership between Daughters of Charity National Health System and Sisters of St. Joseph Health System and has continued to add hospitals and healthcare systems to its network since then.
Ascension has over 2,600 care sites, including hospitals and senior living facilities, and it operates in 19 states and the District of Columbia. One of the organization’s goals is to provide care for those who can’t afford it, and in FY 2020, it gave $2.4 billion worth of care away.
CommonSpirit Health. Chicago, Illinois
Number of hospitals as of September 2020: 137
CommonSpirit Health was founded in 2019 when Catholic Health Initiatives and Dignity Health merged into one ministry. Now, 17 different congregations are a part of CommonSpirit Health.
Another one of the largest Catholic healthcare systems and non-profit hospital chains in the country, CommonSpirit Health operates 137 hospitals and over 1,000 other medical care facilities throughout 21 states.
The organization also provides over $4 billion in charity care, government program services, and community benefits each year.
In addition, CommonSpirit Health is a part of various programs that work to find and address root causes of poor health, such as a lack of access to healthcare, affordable housing, or a safe and healthy environment.
Community Health Systems. Franklin, Tennessee
Number of hospitals as of September 2020: 93
Founded in 1985, Community Health Systems is a publicly owned Fortune 500 company. CHS was running about 200 hospitals at its peak, but since then has spun off or sold a number of them. Now the organization has around 90 hospital facilities across 16 states.
CHS initially expanded by purchasing or renting small and community hospitals across the country. As a result of this, you’ll find that most of their locations aren’t in major cities.
In 2016, CHS spun off 38 of its hospitals and its hospital management and consulting firm to create Quorum Health Corporation.
Trinity Health. Livonia, Michigan
Number of hospitals as of September 2020: 92
Trinity Health as it exists today began in 2013 when two Catholic health systems, Trinity Health, and Catholic Health East, combined their efforts and resources to form a single ministry.
Today, the organization serves over 30 million people in its 92 hospitals and more than 100 continuing care centers located throughout 22 states. These continuing care centers provide senior living facilities, home care, PACE programs, and hospice services and receive almost two million visits each year.
Trinity Health employs 123,000 people across all of its locations and is recognized for its focus on elder care. A Catholic non-profit organization, Trinity Health, donates over $1 billion to its community through charity care and various other programs each year.
LifePoint Health. Brentwood, Tennessee
Number of hospitals as of September 2020: 88
LifePoint Health’s main focus is on providing healthcare to residents of small towns and rural communities. The company was founded in 1999 when it and its 23 community hospitals spun off from Hospital Corporation of America.
A few different mergers and acquisitions later, including a joint venture between LifePoint and the Duke University Health System, LifePoint Health grew to have locations in 29 states and 80 communities.
LifePoint Health employs over 55,000 people and has two of its hospitals recognized by the National Rural Health Association in 2019 as part of the nation’s top 20 critical access hospitals.
Tenet Healthcare. Dallas, Texas
Number of hospitals as of September 2020: 65
One of the older organizations on this list, Tenet Healthcare, was founded in 1969. It started with four hospitals and now has 65, not to mention more than 550 other medical facilities run by its 110,000 employees.
Tenet Healthcare has three operating segments: Hospital Operations, United Surgical Partners International (USPI), and Conifer Health Solutions. As you would guess, Tenet’s Hospital Operations includes the company’s hospitals and other healthcare facilities.
Tenet acquired USPI in 2015, which is now the largest ambulatory platform in the U.S. and offers ambulatory surgery centers and surgical hospitals, and urgent care centers. Conifer Health Solutions was founded in 2008 to provide health administration consulting services.
In 2020, Tenet Healthcare was listed as number 174 in the Fortune 500.
Baylor Scott & White Health. Dallas, Texas
Number of hospitals as of September 2020: 52
Baylor Scott and White Healthcare were founded when Baylor Health Care System and Scott and White Healthcare merged in 2013. It can trace its roots back to 1897. However, when Drs. Arthur C. Scott, Sr. and Raleigh R. White, Jr. became medical partners.
Today, the non-profit serves patients in Texas and the surrounding states through its 52 hospitals and over 800 other healthcare facilities. It employs more than 6,000 physicians and 40,000 employees and even offers its own Scott and White Health Plan.
As of publishing the 2020-2021 U.S. News and World Report’s Best Hospitals list, Baylor Scott and White has won more awards than any other non-profit health system in Texas for three years in a row.
Providence. Renton, Washington
Number of hospitals as of September 2020: 51
Providence was founded in 1859 by the Sisters of Providence. The Roman Catholic sisters came from Canada to care for Washington state residents, which included both native tribes and settlers. They eventually built the first permanent hospital in the Pacific Northwest.
As the years went on, Providence acquired and partnered with several other health systems, expanding its network and resources.
Today, Providence operates in seven states via 51 hospitals and 1,085 clinics. The organization also offers educational programs, supportive housing facilities, and a health plan covering 2.1 million people.
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