HCA Healthcare, Community Health Systems, Tenet Healthcare and Universal Health Services are among the largest for-profit health systems in the country. Each system has a unique backstory and commands an extensive network of facilities and physicians.
Here are 50 things to know about each health systems' leadership, size, financial statistics and executive compensation:
Leadership
HCA Healthcare (Nashville, Tenn.)
1. Sam Hazen was appointed CEO of HCA in January 2019 after serving as president and COO since 2016.
2. Mr. Hazen is a 40-year veteran of HCA, and has held various senior positions for the health system, including president of operations from 2011 to 2015.
3. He also served as president of HCA's Western Group, which included all operations west of the Mississippi River and represented about 50 percent of the system's revenue.
4. Mr. Hazen began his career in Humana's financial management specialist program in 1983 and has held CFO positions at hospitals in Georgia and Las Vegas.
Tenet Healthcare (Dallas)
5. Saum Sutaria, MD, was appointed CEO of Tenet in September 2021 and elected board chair in August 2023.
6. Dr. Sutaria previously served as president and COO of Tenet with responsibilities spanning the enterprise.
7. He joined the for-profit system in 2019 after working for nearly two decades at McKinsey & Company. At McKinsey, Dr. Sutaria was a leader in the healthcare and private equity practices, advising clients on strategic, operational and financial matters.
8. Dr. Sutaria previously held an associate clinical faculty appointment at the University of California at San Francisco, where he also engaged in postgraduate training with a focus in internal medicine and cardiology.
Community Health Systems (Franklin, Tenn.)
9. Tim Hingtgen was named CEO of CHS in January 2021 after serving as president and COO from September 2016 through December 2020.
10. Mr. Hingtgen, who also serves on the board, joined CHS as a vice president of operations in 2008. In January 2014, he was promoted to president of division IV operations, and in May 2016, he was promoted to executive vice president of operations.
11. Before joining CHS, Mr. Hingtgen served as a CEO or COO of hospitals affiliated with UHS and Brentwood, Tenn.-based Province Healthcare.
12. Mr. Hingtgen has a master's degree in business administration from the University of Nevada, Las Vegas.
Universal Health Services (King of Prussia, Pa.)
13. Marc Miller was named CEO of UHS in January 2021 and has served as president since 2009.
14. Mr. Miller is also a member of the UHS board, serving on the executive committee and the finance committee.
15. He began his career at UHS in 1995 and has held multiple positions of increasing responsibility at hospitals and at the corporate office. Before stepping into executive leadership roles at, he held various operating roles at UHS acute care hospitals.
16. Mr. Miller's prior executive roles include group director for the health system's acute care operations in Pennsylvania, South Carolina and Florida; Eastern region vice president of the acute care division; and senior vice president and co-head of the UHS acute care division.
Financial performance
HCA
17. HCA reported $5.2 billion in net income in 2023, down 7% from $5.6 billion in 2022. Operating income was $7.7 billion, down from $8.6 billion the previous year.
18. Revenue for the year totaled $65 billion, up from $60 billion in 2022. Fourth-quarter revenue was $17.3 billion, compared to $15.5 billion during the same period in the previous year.
19. In 2024, HCA expects revenues between $67.75 billion and $70.25 billion and net income of $5.2 billion to $5.6 billion. Capital expenditures, excluding acquisitions, are projected to be between $5.1 billion and $5.3 billion
Tenet
20. Tenet reported $1.3 billion in net income in 2023, up 30% from $1 billion in 2022. Operating income hit $2.5 billion, growing 12.2% year over year.
21. Revenue for the year totaled $20.5 billion, up from $19.2 billion in 2022. Fourth-quarter revenue grew by 7.8% year over year to $5.4 billion.
22. In 2024, Tenet expects revenues between $19.9 billion and $20,3 billion and net income from continuing operations to be in the range of $2,17 to $2,42 billion. Its adjusted EBITDA outlook is anticipated to be in the range of $3.29 billion to $3.49 billion.
CHS
23. CHS reported a net income of $16 million in 2023, down from $179 million in 2022. Operating income was $957 million for the year, improving on the $821 million posted in 2022.
24. Revenue increased 2.3% year over year to $12.5 billion in 2023. On a same-store basis, net operating revenues increased 4.8%, admissions increased 3.5% and adjusted admissions increased 5.3% over 2022.
25. In 2024, CHS expects net operating revenues between $12.3 billion and $12.7 billion. Adjusted EBITDA is projected to be in the range of $1.48 billion to $1.63 billion.
UHS
26. UHS posted $719.3 million in net income in 2023, compared to $656.9 million the previous year. Operating income was $1.2 billion, up from $1 billion.
27. The system saw overall revenue increase 6.6% year over year to $14.3 billion while expenses rose 5.7% to $13.1 billion.
28. In 2024, the health system expects net revenues to be between $15.4 billion and $15.7 billion, representing an increase of 7.9% to 10% year over year. UHS plans to spend $1 billion on capital expenses this year, up from $850 million in 2023.
Executive compensation
29. The CEOs and CFOs of all four health systems saw compensation packages drop substantially in 2022, according to proxy statements filed with the SEC. However, most of the top-earning executives saw their overall compensation rebound in 2023 as financial results largely improved.
30. The CEOs of the four systems earned compensation packages of more than $63 million combined in 2023, compared to about $43 million in 2022 and $65 million in 2021.
31. The five highest-earning executives at HCA in 2023 were:
- Sam Hazen, CEO: $21,315,984
- Jon Foster, EVP and COO: $8,699,360
- Bill Rutherford, EVP and CFO: $7,763,050
- Timothy McManus, president, national group: $5,582,431
- Erol Akdamar, president, American group: $5,400,861
32. The five highest-earning executives at Tenet in 2023 were:
- Saum Sutaria, MD, CEO: $18,518,109
- Dan Cancelmi, CFO: $9,272,504
- Tom Arnst, EVP, chief administrative officer, general counsel and corporate secretary: $3,672,298
- Lisa Foo, EVP, commercial operations: $3,235,506
- Paola Arbour, EVP, chief information officer: $2,467,441
33. The five highest-earning executives at CHS in 2023 were:
- Tim Hingtgen, CEO:$8,348,223
- Kevin Hammons, President and CFO: $3,750,006
- Lynn Simon, MD, president of clinical operations and chief medical officer:
$2,144,471 - Chad Campbell, regional president: $1,657,282
- Kevin Stockton, EVP of operations and development: $1,602,702
34. The five highest-earning executives at UHS in 2023 were:
- Marc Miller, CEO and president: $14,407,937
- Alan Miller, executive chair: $8,369,731
- Edward Sim, EVP and president of acute care: $5,469,137
- Steve Filton, EVP and CFO: $4,650,157
- Matthew Peterson, EVP and president of behavioral health: $4,049,604
Editor's note: Total compensation can include salary, bonuses, stock and option awards, change in pension value and nonqualified deferred compensation earnings and other compensation.
History/system size
HCA
35. HCA was founded in 1968 by Thomas Frist Sr., MD, Thomas Frist Jr., MD, and Jack Massey. Dr. Frist Sr., who was the father of former U.S. Senate majority leader Bill Frist, built Park View Hospital in Nashville with a group of physicians. They wanted to manage and expand the hospital, eventually creating the hospital management company known as HCA.
36. HCA comprises 185 hospitals and more than 2,300 care sites in 20 states and the United Kingdom.
37. The system's care sites include ASCs — of which it operates about 150 — freestanding ERs, urgent care centers, diagnostic and imaging centers, walk-in clinics and physician clinics.
38. HCA has more than 270,000 employees, including 94,000 registered nurses and 38,000 active physicians
Tenet
39. Tenet launched as a small operation in California. In May 1969, it acquired four hospitals along with some additional care sites and real estate for future hospital developments.
40. The system operates 52 acute care and specialty hospitals, about 110 other outpatient facilities, a network of employed physicians and a global business center in Manila, Philippines.
41. United Surgical Partners International, Tenet's ambulatory arm, operates or has ownership interests in more than 465 ASCs — the most of any health system — and 24 surgical hospitals. It also operates Conifer Health Solutions, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients.
42. Tenet has more than 100,000 employees and 6,000 physicians.
CHS
43. CHS was founded in 1985 when Thomas Chaney, former executive of Hospital Affiliates, Inc., and David Steffy and Richard Ragsdale, former HCA executives, spun off Republic Health Corp. to form Community Health Systems. The second hospital acquisition took place in January 1986.
44. The system operates 71 acute care hospitals with about 13,000 beds and more than 1,000 care sites, across 15 states. Its healthcare portfolio includes physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ASCs.
45. In 2014, CHS had approximately 200 hospitals. In 2016, CHS began refining its portfolio with the spinoff of Brentwood, Tenn.-based Quorum Health, which included 38 hospitals and its hospital management and consulting business. Over the next several years, CHS sold or closed dozens of hospitals.
46. CHS has more than 90,000 employees and 20,000 physicians — employed and independent — serving on the medical staff of its hospitals.
UHS
47. UHS was founded in 1979 by Alan B. Miller, who currently serves as the system's executive chair. Eighteen months later, UHS owned four hospitals and had management contracts with two others.
48. The system operates 27 acute care hospitals, 333 behavioral health inpatient facilities, 22 freestanding emergency departments and 48 outpatient facilities and ambulatory care centers in 39 states in the U.S., Washington, D.C., Puerto Rico and the United Kingdom.
49. UHS also offers health insurance plans through Prominence Health Plan, and manages a network of physicians through Independence Physician Management.
50. UHS has about 94,000 employees —- 34,000 of whom operate at its acute care facilities and 55,000 of whom are focused on behavioral health. It also has 12 physician networks comprising more than 700 providers.