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Top 25 Integrated Health Systems – 2015 Update

SK&A has released its annual ranking of the largest integrated health systems. Based on the most facilities — hospitals, medical offices and groups, and nursing homes — the top five on the list are:

  1. Ascension Health – 2069 facilities
  2. Community Health System Inc. – 2038 facilities
  3. HCA Inc. – 1569 facilities
  4. Trinity Health – 1323 facilities
  5. Kaiser Permanente – 1005 facilities

Community Health System has the most hospitals – 207- but just announced it was spinning off 38 of its rural facilities to a newly independent subsidiary. Ascension Health has the most medical offices or groups [1890], while Kaiser Permanente has the largest number of physicians [8704]. Ascension Health is also the integrated system with the most nursing homes [43].


Top 25 integrated health systems; SK&A Market Insight Report, August 2015. http://www.skainfo.com/reports/top-integrated-health-systems [free registration may be needed]

Brino A. Community Health Systems spins off 38 rural hospitals to focus on regional networks. HealthcareFinance.com, Aug. 3, 2015. http://www.healthcarefinancenews.com/news/spin-lets-community-health-systems-focus-regional-networks

AHA Resource Center (312) 422-2050, rc@aha.org

Top 25 Integrated Health Systems – 2013

2014 update now available

Cegedim has ranked the top 25 integrated health systems based on the total number of facilities. Ascension Health tops the list, followed by Kaiser Permanente and HCA. The ranking lists the number of hospitals, medical offices and groups, nursing homes, and total physicians affiliated with each system.

In addition to most facilities overall, Ascension Health also has the most medical offices and groups and most nursing homes. Kaiser Permanente has the most affiliated physicians, and HCA has the most hospitals.

Source: Top 25 integrated health systems. SK&A, a Cegedim company, Sept. 2013. http://www.skainfo.com/registration_OneKey.php [free registration required to view/download]

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

IMS Top 100 Integrated Healthcare Networks for 2012

The annual ranking of the top 100 integrated health networks has been released by IMS Health [the new owner of SDI Health which published the 2011 list.] Topping the list are:

  • St John’s Health System [Springfield MO]
  • Geisinger Health System [Danville PA]
  • Intermountain Healthcare [Salt Lake City UT]
  • Sentara Healthcare [Norfolk VA]
  • ProMedica [Toledo OH] [tied with WellStar]
  • WellStar Health System [Marietta GA] [tied with ProMedica]
  • Providence Health & Services [Portland OR]
  • Advocate Health Care [Oak Brook IL]
  • St John’s Mercy Health Care [St Louis MO]
  • MultiCare Health System [Tacoma WA]

Geisinger is new to the top 10 ranking this year, while the other nine IHNs made last year’s top 10 as well. The IHNs were scored on financial stability, services and access, integration, integrated technology, and overall performance. Other national and regional rankings and more information on the scoring methodology are available from the IMS source:

Source: IMS top 100 integrated healthcare networks 2012. IMS Health, 2012. http://www.imshealth.com/portal/site/ims/menuitem.d248e29c86589c9c30e81c033208c22a/?vgnextoid=fb32aae2da1f4310VgnVCM100000ed152ca2RCRD&cpsextcurrchannel=1 

4/23/14 Update: Unfortunately, the IMS Health link above was recently inactivated. Here are links to 2 documents that had been included on the original page:

2012 National IMS top IHN  key findings: http://www.imshealth.com/deployedfiles/ims/Global/Content/Corporate/Press%20Room/Top-Line%20Market%20Data%20&%20Trends/SDI%20Reports/2012_National_IMS_Top_IHN_Key_Findings.pdf

2012 National IMS top IHN list:

Modern Healthcare magazine also published and discussed the IMS list in its Jan. 23, 2012 issue. Its list, available for sale, includes the regional rankings that have disappeared from the IMS web site. Here’s the purchase link: http://www.modernhealthcare.com/section/data-center?djoPage=product_details&template=djoCheckout&djoPid=25678&djocid=4FA9&djoCart=true#

See also related post: Top 25 Integrated Health Systems – 2013

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

Principles and Guidelines for Changes in Hospital Ownership

With renewed interest in clinical integration comes potential change in hospital ownership or control due to mergers/acquisitions, the formation of new integrated delivery networks, or the development of accountable care organizations.  To help  hospital leaders navigate the community interests and the regulatory requirements involved in an ownership change, the American Hospital Association and Jones Day have developed voluntary principles and guidelines.

The report discusses fiduciary duties in fulfilling the hospital’s mission, key considerations for potential control changes, and guidelines for review of possible ownership change. The guidelines cover:

  • Community engagement to identify future health improvement needs
  • Initial steps in considering a change
  • Evaluation of proposed changes
  • Conduct of  an appropriate review of state and federal laws
  • Appropriate antitrust analysis where necessary
  • Protection of the value of the community’s assets
  • Education of and communication to the community of the changes taking place

A comprehensive checklist of the documents needed for review of a proposed change in ownership is appended to the report.

American Hospital Association; Jones Day. Principles and guidelines for changes in hospital ownership. American Hospital Association, Jan. 2012. http://www.hpoe.org/hpoe/resources/hospital-ownership.pdf

Posted by the American Hospital Association Resource Center, (312) 422-2050, rc@aha.org.

Top 100 Integrated Healthcare Networks

May 1, 2012 UPDATE: See new 2012 top IHN rankings.

The 2011 SDI top 100 integrated healthcare networks ranking is based on a scoring methodology involving integration levels and financial and operational performance. Topping the list this year are:

  1. Sentara Healthcare [Virginia]
  2. ProMedica Health System [Ohio]
  3. St. John’s Health System [Missouri]
  4. Intermountain Healthcare [Utah]
  5. Providence Health & Services [Oregon]

The top 100 national rankings are published annually by Modern Healthcare [2011 rankings in Jan. 24, 2011 issue or available for sale] and the current rankings are available on the SDI web site. Regional rankings and an explanation of the ranking methodology are also available on the SDI  site at http://www.sdihealth.com/IHN/main.aspx.  SDI [or its predecessors SMG or Verispan before they were acquired] has annually ranked IHNs for the past 14 years.

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org