If there’s one trend that has had staying power in American health care, it’s been the rise of the system. Today, roughly two-thirds of American hospitals belong to a health system, up from 10% in 1970, and those systems have inevitably become larger and increasingly diversified providers of care—with some owning physician specialty groups, surgical centers, and home care services among other business.
In this spirit, the PINC AI Top 15 Health Systems study crunches the numbers on this increasingly dominant landscape to identify the nation’s best performers and provide a benchmark for others. In its 15th year, the study relies on Medicare data and considers clinical outcomes, operational efficiency, and patient experience at 361 U.S. health systems to determine standout organizations. The list honors five systems per size category—small, medium, and large—though due to a tie, this year includes six medium-sized systems.
The difference between these top organizations and their peers is not trivial. According to PINC AI’s analysis, if all health systems operated as this year’s winners, more than 207,000 patient lives would be saved and 432,000 patients would be spared in-hospital complications each year. Inpatient mortality was 20.8% lower for winning systems compared to their non-winning peers, and health care-acquired infections were 20.7% lower for the group. Hospital stays were also shorter at the Top 15 systems. (This year 16 made the list due to a tie.)
One of America’s oldest and most storied health systems, the Mayo Clinic, topped the large system category and made its 11th appearance on the ranking. Health systems do not apply for the 15 Top Health Systems selection process, and winners do not pay to market their honor.
5 Top Large Health Systems
1. Mayo Clinic
Location: Rochester, Minn.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★★
Total number of years on 100 Top list: 11
Website
2. HCA Continental Division
Location: Denver
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★
Patient experience: ★★★
Total number of years on 100 Top list: 3
Website
3. Intermountain Health
Location: Salt Lake City
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★★
Total number of years on 100 Top list: 1
Website
4. Houston Methodist
Location: Houston
Clinical outcomes: ★★★★★
Operation efficiency: ★★★
Patient experience: ★★★★★
Total number of years on 100 Top list: 1
Website
5. Baylor Scott & White Health
Location: Dallas
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★
Patient experience: ★★★★★
Total number of years on 100 Top list: 3
Website
6 Top Medium Health Systems
1. HCA Mountain Division
Location: Cottonwood Heights, Utah
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★
Total number of years on 100 Top list: 2
Website
1. Scripps Health
Location: San Diego
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★★
Total number of years on 100 Top list: 7
Website
3. Bronson Healthcare
Location: Kalamazoo, Mich.
Clinical outcomes: ★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★★
Total number of years on 100 Top list: 1
Website
4. Edward-Elmhurst Health
Location: Naperville, Ill.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★★
Total number of years on 100 Top list: 5
Website
5. CHI Saint Joseph Health
Location: Lexington, Ky.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★
Patient experience: ★★
Total number of years on 100 Top list: 1
Website
5. Munson Healthcare
Location: Traverse City, Mich.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★
Total number of years on 100 Top list: 1
Website
5 Top Small Health Systems
1. CHI Memorial
Location: Chattanooga, Tenn.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★★
Total number of years on 100 Top list: 2
Website
2. Franciscan Sisters of Christian Charity Sponsored Ministries
Location: Manitowoc, Wis.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★
Total number of years on 100 Top list: 2
Website
3. AdventHealth-Great Lakes Region
Location: Chicago
Clinical outcomes: ★★★★★
Operation efficiency: ★★★
Patient experience: ★★★★
Total number of years on 100 Top list: 1
Website
4. Saint Joseph Health System
Location: Mishawaka, Ind.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★
Total number of years on 100 Top list: 4
Website
5. Excela Health
Location: Greensburg, Pa.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★
Total number of years on 100 Top list: 1
Website
Fortune partnered with PINC AI on the 2023 ranking of the 100 Top Hospitals and the 15 Top Health Systems in the U.S. Learn more about the lists and see which community and teaching hospitals ranked high among their peers below.
PREMIER, PINC AI, 100 TOP HOSPITALS, 15 TOP HEALTH SYSTEMS, and 50 TOP CARDIOVASCULAR HOSPITALS are registered/unregistered trademarks of Premier Healthcare Alliance, L.P. in the United States.