Publisher’s Letter

The Top 50 IDNs

John Pritchard

I recently came across a great list of the Top 50 IDNs by Net Patient Revenue. Not surprisingly, HCA Healthcare topped the list with $35 billion in revenue from its 205 hospitals and corresponding facilities. Following that, however, there were many surprises.

Top 50 IDNs by the numbers:

  • HCA has twice the revenue of the second-place IDN, and more than 25 percent more hospitals
  • The average Net Patient Revenue of the Top 50 IDNs is $7.2 billion (Total Revenue is $7.7 billion)
  • Top 50 IDNs average 40 hospitals
  • Half of the Top 10 are faith-based organizations
  • Stanford Health has the fewest hospitals in the Top 50 with only four

These types of lists give some context to what our nation’s IDNs are all about. When you add in the attributes of these IDNs, you can start to get a clearer picture as to what truly drives them. Attributes that can add great depth to these figures include:

  • Average population of their service areas
  • Market share by service area
  • Profit status (investor-owned or tax-exempt)
  • Do they own a health plan?

We know there is a huge land grab happening across the industry, with IDNs chasing scale, so we can only expect these numbers to get bigger. I am always curious – how big is big enough? When I ask Supply Chain Leaders, I usually hear two levels: $10 billion and $5 billion in revenue. Within the list of Top 50 IDNs there are;

  • 28 IDNs with over $5 billion in revenue
  • 10 IDNs with over $10 billion in revenue

This will be an interesting watermark to track. I wonder how many IDNs will be in each category this time next year?

To download the list of the Top 50 IDNs, visit

Thanks for reading this issue of The Journal of Healthcare Contracting.



*Special thanks to Definitive Healthcare for assembling the Top 50 IDNs

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