While hospital finances continue to stabilize, a Kaufman Hall July "National Hospital Flash" report found that financial performance for health systems is trending lower than hospitals.
To combat long-term debt, many health systems continue to offload hospitals, facilities and other services to improve financial health.
Here are 33 health systems ranked by their long-term debt:
Note: This is not an exhaustive list. The following long-term debt figures are taken from each health system's most recent financial report.
1. HCA Healthcare (Nashville, Tenn.): $36.3 billion
2. CommonSpirit Health (Chicago): $17.6 billion
3. Tenet Healthcare (Dallas): $12.8 billion
4. Kaiser Permanente (Oakland, Calif.): $12 billion
5. Community Health Systems (Franklin, Tenn.): $11.5 billion
6. Providence (Renton, Wash.): $8 billion
7. Advocate Health (Charlotte, N.C.): $7.4 billion
8. Ascension (St. Louis): $6.76 billion
9. UPMC (Pittsburgh): $6.2 billion
10. Mass General Brigham (Boston): $5.9 billion
11. Cleveland Clinic: $4.4 billion
12. Universal Health Services (King of Prussia, Pa.): $4.4 billion
13. Banner Health (Phoenix): $4.4 billion
14. Bon Secours Mercy Health (Cincinnati): $4.3 billion
15. Intermountain Health (Salt Lake City): $4.3 billion
16. Mayo Clinic (Rochester, Minn.): $4 billion
17. Orlando (Fla.) Health: $2.7 billion
18. Mercy Health (St. Louis): $2.6 billion
19. IU Health (Indianapolis): $2.2 billion
20. Beth Israel Lahey Health (Cambridge, Mass.): $2 billion
21. Montefiore (New York City): $2 billion
22. Scripps Health (San Diego): $1.9 billion
23. Allina Health (Minneapolis): $1.7 billion
24. University Hospitals (Cleveland): $1.7 billion
25. OSF HealthCare (Peoria, Ill.): $1.6 billion
26. Norton Healthcare (Louisville, Ky.): $1.6 billion
27. SSM Health (St. Louis): $1.6 billion
28. Sanford Health (Sioux Falls, S.D.): $1.4 billion
29. Prisma Health (Greenville, S.C.): $1.4 billion
30. Sharp HealthCare (San Diego): $1.2 billion
31. Allegheny Health Network (Pittsburgh): $886 million
32. Premier Health (Dayton, Ohio): $849 million
33. Tufts Medicine (Boston): $796 million
Editor's note: This story was updated Sept. 26 at 1:55 p.m. CT.