Long-term debt has long been a staple in healthcare, but many hospitals and health systems are responding to the increasing cost of debt and debt service in the rising rates environment.
Highly levered health systems are looking to sell hospitals, facilities or business lines to reduce their debt leverage and secure long-term sustainability, which creates significant growth opportunities for systems with balance sheets on a more solid financial footing.
Forty-three 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.): $37.2 billion
2. CommonSpirit (Chicago): $15.3 billion
3. Tenet Healthcare (Dallas): $14.9 billion
4. Community Health Systems (Franklin, Tenn.): $11.5 billion
5. Kaiser Permanente (Oakland, Calif.): $10.6 billion
6. Providence (Renton, Wash.): $8.1 billion
7. Trinity Health (Livonia, Mich.): $6.8 billion
8. UPMC (Pittsburgh): $6.6 billion
9. Ascension (St. Louis): $6.1 billion
10. Mass General Brigham (Boston): $5.5 billion
11. Universal Health Services (King of Prussia, Pa.): $4.7 billion
12. Banner Health (Phoenix): $4.4 billion
13. Cleveland Clinic: $4.3 billion
14. Bon Secours Mercy Health (Cincinnati): $4.2 billion
15. Mayo Clinic (Rochester, Minn): $4.1 billion
16. Intermountain Health (Salt Lake City): $3.8 billion
17. Baylor Scott & White (Dallas): $3.8 billion
18. NYU Langone (New York City): $3.1 billion
19. Advocate Health (Charlotte, N.C.): $2.9 billion
20. IU Health (Indianapolis): $2.3 billion
21. Stanford Health Care (Palo Alto, Calif.): $2.3 billion
22. Orlando (Fla.) Health: $2.7 billion
23. Montefiore (New York City): $2 billion
24. BJC HealthCare (St. Louis): $1.9 billion
25. Christus Health (Irving, Texas): $1.9 billion
26. MedStar Health (Columbia, Md.): $1.8 billion
27. ProMedica (Toledo, Ohio): $1.8 billion
28. Northwestern Medicine (Chicago): $1.7 billion
29. Geisinger (Danville, Pa.): $1.7 billion
30. Allina Health (Minneapolis): $1.7 billion
31. OSF HealthCare (Peoria, Ill.): $1.7 billion
32. Norton Healthcare (Louisville, Ky.): $1.6 billion
33. Beth Israel Lahey Health (Cambridge, Mass.): $1.6 billion
34. SSM Health (St. Louis): $1.6 billion
35. Scripps Health (San Diego): $1.5 billion
36. Henry Ford Health (Detroit): $1.4 billion
37. Sanford Health (Sioux Falls, S.D.): $1.4 billion
38. Prisma Health (Greenville, S.C.): $1.4 billion
39. Allegheny Health Network (Pittsburgh): $910.5 million
40. HonorHealth (Scottsdale, Ariz.): $898.7 million
41. Sharp HealthCare (San Diego): $866.5 million
42. Premier Health (Dayton, Ohio): $850 million
43. Tufts Medicine (Boston): $782.3 million