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13 CFO / FINANCE 13 profitable health systems in 2024 By Alan Condon D espite ongoing workforce and financial pressures across the healthcare industry, several large health systems managed to report substantial profits in 2024. From industry giants like HCA Healthcare and Kaiser Permanente to regional players such as BayCare Health System and Sanford Health, these organizations leveraged strategic growth, operational efficiencies and cost management to bolster their bottom lines. Here are 13 of the most profitable health systems in 2024, according to their most recent financial results. Editor's note: is is not an exhaustive list. Financial results reflect full- year 2024 performance (Jan. 1 – Dec. 31). 1. Nashville, Tenn.-based HCA Healthcare reported an operating income of $8.5 billion (12.1% margin) in 2024, up from $7.7 billion (11.9% margin) in 2023. HCA posted revenues of $70.6 billion, up from $65 billion in 2023. Expenses were $62.1 billion, up from $57.3 billion. e health system saw a net income of $5.8 billion in 2024, up 9.9% from $5.2 billion in 2023. 2. Dallas-based Tenet Healthcare reported an operating income of $6 billion (28.8% margin) in 2024, up from $2.5 billion (12.2% margin) in 2023. Revenue for the health system was $20.7 billion in 2024, up from $20.5 billion the year prior. Expenses were $17.9 billion in 2024. Net income was $4.1 billion, up from $1.3 billion in 2023. 3. King of Prussia, Pa.-based Universal Health Services reported an operating income of $1.7 billion (10.6% margin) in 2024, up from $1.2 billion (8.2% margin) in 2023, UHS posted revenues of $15.8 billion in 2024, a 10.8% increase year over year. Expenses hit $14.1 billion in 2024, up 7.9% year over year. Net income was $1.1 billion, up from $717.8 million in 2023. 4. Rochester, Minn.-based Mayo Clinic reported an operating income of $1.3 billion (6.5% margin) in 2024, up from an operating income of $1.1 billion (6% margin) in 2023. e health system recorded revenue of $19.8 billion in 2024, up from $17.9 billion the previous year. Expenses totaled $18.5 billion, up from $16.9 billion. Net income was $3.8 billion in 2024, up from $1.8 billion in 2023. 5. Clearwater, Fla.-based BayCare Health System saw an operating income of $603.4 million (9.6% margin) in 2024, up from a $330.1 million operating gain (6% margin) in 2023. Revenue increased 13.8% year over year to $6.3 billion and expenses rose 9.4% to $5.7 billion in 2024. Net income for BayCare was $1.2 billion in 2024, up from $1.1 billion in 2023. 6. Oakland, Calif.-based Kaiser Permanente posted an operating income of $569 million (0.5% operating margin) in 2024, up from f $329 million (0.3% margin) in 2023. Revenues hit $115.8 billion 2024, up from $100.8 billion in 2023. Expenses were $115.2 billion, up from $100.5 billion. Kaiser posted a net income of $12.9 billion in 2024, up from $4.1 billion in 2023. 7. Sioux Falls, S.D.-based Sanford Health posted an operating income of $400.3 million (5.2% operating margin) in 2024, compared to $402.2 million (5.6% margin) in 2023. Revenues hit $7.7 billion in 2024, a 6.3% increase year over year, while expenses hit $7.3 billion, a 6.7% increase. Sanford reported a net income of $395 million in 2024, down from $494.8 million in 2023. 8. Salt Lake City-based Intermountain Health reported an operating income of $370 million (2.2% margin) in 2024, up from $137 million (0.9% margin) in 2023. Revenue increased 6.8% year over year to $17.1 billion while expenses climbed 5.7% 35% of Americans cannot afford or access healthcare: Gallup By Paige Twenter R eaching the highest level since 2021, 11% of U.S. adults are considered "cost desperate," a group Gallup defines as those who recently could not afford needed care and medicine. Overall, more than one-third of U.S. adults report they cannot access quality, affordable healthcare. Gallup and West Health surveyed 6,296 adults in late 2024 for their annual Healthcare Indices Study. Since 2021, the share of cost desperate Americans has increased most significantly among Hispanic adults (18%), Black adults (14%) and households earning less than $24,000 annually (25%), according to survey results released April 2. The survey found no meaningful change among white adults or middle- to high-income households. Disparities in healthcare access across race, ethnicity and income are at their highest point since this annual survey began in 2021. In the past year, 64% of households earning under $48,000 (up 11 percentage points from 2023) and 57% of households earning between $24,000 and $48,000 (up 12 points) reported difficulty accessing affordable healthcare. The proportion of Americans who are "cost secure" — those with access to quality care who can afford both care and medication — has dropped to a record low of 51%. With 35% of Americans reporting they are unable to access affordable, quality care, Gallup and West Health said this "erosion of cost security in healthcare" reveals "that the already-existing gap between haves and have- nots in affording care is now bigger than ever." n