Health systems, or integrated delivery networks (IDNs), are a key component of care delivery in the U.S. These entities bring together distinct healthcare facilities under one management system by coordinating patient care, retaining revenue, and controlling costs.
In the Definitive Healthcare HospitalView product, we track more than 800 IDNs and 7,300 hospitals across the country. Below, we break down the 10 largest health systems in the U.S. by beds. The bed size is based on the total member hospitals’ staffed beds for the healthcare system. By reviewing this information, we can get a better understanding of each health system’s financial presence, place among competitors, and operating power.
Top 10 largest healthcare systems in the U.S. by bed count
Fig. 1 Data is from the Definitive Healthcare HospitalView product and obtained from a variety of sources including the Medicare Cost Report and proprietary research. Accessed February 2024.
Which healthcare system has the most beds?
HCA Healthcare hospitals have more than 41,600 beds in total making it the largest health system in the U.S. by bed size. It is also the largest health system by total number of hospitals and net patient revenue. It has about 16,400 more beds than the second largest U.S. health system.
The U.S. Department of Veterans Affairs is the second largest healthcare system in the country with more than 25,200 beds across its hospitals.
The top 10 healthcare systems cover 1,210 hospitals and more than 185,000 hospital beds.
Here are some quick facts and figures about the top five largest IDNs by bed count in the U.S. in descending order:
5. Ascension Health
Ascension Health, based in St. Louis, Missouri is the fifth largest U.S. healthcare system with 17,286 staffed member hospital beds. The faith-based organization has facilities in 12 states and Washington D.C., with facilities concentrated in the Midwest, Southeast, and South.
Fast facts:
- 17,286 staffed beds
- 129 hospitals
- 740 facilities
- 695,096 discharges
- $22.6 billion net patient revenue
4. CommonSpirit Health
Catholic Health Initiatives and Dignity Health merged in 2019 to form CommonSpirit Health, now the fourth largest healthcare system by bed size. The organization has 19,405 staffed beds and 157 hospitals across 18 states. Some of the states with the most CommonSpirit Health hospitals are located in the western U.S. including California, Colorado, Arizona, and Washington.
Fast facts:
- 19,405 staffed beds
- 157 hospitals
- 797 facilities
- 809,039 discharges
- $30.6 billion net patient revenue
3. Universal Health Services
Universal Health Services ranks third for total hospital beds among U.S. healthcare systems, with more than 21,000 staffed beds. . The health system is headquartered in King of Prussia, Pennsylvania and its facilities are found in 40 states including Texas, Florida, and Nevada.
Fast facts:
- 21,201 staffed beds
- 182 hospitals
- 316 facilities
- 702,099 discharges
- $10.4 billion net patient revenue
2. Department of Veterans Affairs (VA)
VA hospitals provide healthcare services to nine million veterans that served in the U.S. military. It is the second largest healthcare system in the U.S. by hospital bed count with more than 25,000 beds and 161 hospitals. VA hospitals cover all 50 states, Washington D.C. and Puerto Rico. VA hospitals are government run and do not report financial figures.
Fast facts:
- 25,260 staffed beds
- 161 hospitals
- 544 facilities
- 2.2 million ER visits
- 18 Veterans Integrated Services Networks (VISNs)
1. HCA Healthcare
Ranked as the largest U.S. healthcare system by total member hospital beds is HCA Healthcare with over 41,000 staffed beds. Headquartered in Nashville, Tennessee, its facilities cover 18 states, with the most hospitals in Texas, Florida, Tennessee, and Virginia.
Fast facts:
- 41,694 staffed beds
- 219 hospitals
- 1,245 facilities
- 1,943,582 discharges
- $50.5 billion net patient revenue
HCA Healthcare has remained the largest IDN in the country for a number of years and has continued to grow. Compared to historical HospitalView data, HCA’s bed count increased by 10% from 2019 to 2024.
Learn more
IDNs provide an array of healthcare services, from outpatient surgical centers and imaging facilities to specialized cancer centers and children’s hospitals. They grow their coverage by adding to their service offerings, building new healthcare facilities, and through mergers and acquisitions. Large health systems aim to retain as many patients as possible in network while providing quality care.
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