Nonprofit health systems are making slow but steady financial progress in an era marked by rising costs and operational challenges.
CommonSpirit, Ascension and Trinity, three major players in the sector, operated more than 380 acute care hospitals combined. The systems reported varied results in the fiscal first quarter of 2025, reflecting a mix of resilience, recovery, and innovation in the face of ongoing pressures including labor costs, supply inflation and cybersecurity disruptions. Executives at each system are content with recent progress but maintain there is still much work to do.
Here's how the three largest nonprofit systems performed in the first quarter of fiscal 2025:
Chicago-based CommonSpirit posted a $331 million operating loss (-3.5% operating margin) during the three months ended Sept. 30 — the first quarter of fiscal 2025 — improving on a $402 million loss (-4.7% margin) in the same period last year.
Revenue for the quarter increased 10.7% year over year to $9.4 billion while expenses grew by 9.4% to $9.7 billion. Salaries and benefits rose 6.3% to $4.8 billion and supply costs increased 10.4% to $1.5 billion. Net patient service revenues increased 10.9% to $8.5 billion and premium revenue increased 1.8% to $401 million.
Net income in the first quarter of fiscal 2025 was $189 million, up from a net loss of $699 million in the first quarter of FY 2024.
"Our modest revenue increases, while encouraging, affirm our continued focus on receiving the revenue we are entitled to for services provided," CFO Dan Morissette said. "Our multi-pronged strategy to improve operating performance will ensure we are able to deliver on our mission to improve health in the communities we serve for generations to come."
St. Louis-based Ascension posted a $221 million operating loss (-3.1% margin) in the first quarter of fiscal 2025, compared to a $193.7 million operating loss (-2.7%) in the same quarter last year.
The $221 million loss is a $1.2 billion improvement on the $1.4 billion operating loss reported in the previous quarter, the three months ending June 30. Additionally, Ascension's Q1 FY25 operating revenue increased $925 million from the prior quarter — $1 billion on a same facility basis — demonstrating recovery progress from the May cybersecurity attack.
Revenue for the three months ending Sept. 30 decreased 2.5% year over year to $7.1 billion while expenses dropped 1.5% to $7.3 billion. Ascension reported a 2.4% increase in same facility net patient service revenue, while same facility operating expenses were managed to a 2.6% increase over the prior year.
Net income for the period was $387.1 million, compared to a $597.6 million net loss in the same period last year.
"This quarter's financial results mark a pivotal step forward, illustrating the effectiveness of our focused economic improvement strategies," CFO Saurabh Tripathi said. "An uplift in recurring operating performance reflects our commitment to disciplined financial management, carefully balanced between growth and efficiency. Despite ongoing challenges, including the continuing recovery from May's cybersecurity attack, we are solidifying our operational foundation to support stability and future investments."
Livonia, Mich.-based Trinity posted $36.7 million in operating income (0.6% operating margin) in the first quarter of fiscal 2025, up from a $58.6 million loss (-1% margin) during the same quarter last year.
Revenue for the period increased 10.2% year over year to $6.2 billion, including a 9.9% jump in net patient revenue to $5.3 billion. Expenses totaled $6.2 billion for the first quarter of fiscal 2025, an 8.4% increase year over year. Salaries and wages rose 7.5% to $2.7 billion while supply costs increased 9.5% to $1.1 billion.
Net income for the period was $586.9 million, up from a $211.5 million net loss for the same period last year.
Trinity said it is addressing workforce shortages through "TogetherTeam," a three-person onsite and virtual nursing initiative that is being implemented systemwide. It has already been implemented in 24 hospitals and 62 nursing units. More sites will implement the model over the coming months.