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America’s 82 top non-profit hospital groups have experienced massive growth in annual revenues and asset value even as health care costs for most families and individuals are zooming upward, according to government watchdog Open The Books.

The 82 largest U.S. non-profit hospitals recorded revenues of $296.6 billion for their primary entity in FY2017 (or latest year available). The largest systems ranked by revenues are Kaiser Foundation, Oakland, CA ($54 billion); Partners HealthCare, Somerville, MA ($12.7 billion); University of Pittsburgh Medical Center Group, Pittsburgh, PA ($12.5 billion); MayoClinic, Rochester, MN ($11.1 billion); and Dignity Health, San Francisco, CA ($9.9 billion).

Average net asset growth year-over-year for the 82 non-profit hospitals was 23.6 percent: $164.2 billion grew to $203.1 billion. The largest percentage increases in net assets were individually recorded by Ascension Health, St. Louis, MO(1211%); Highmark Health, Pittsburgh, PA (271%); Baylor Scott & White Health, Dallas, TX (247%); and Texas Health Resources, Arlington, TX (146%).

The 82 large non-profit healthcare providers paid out $297.5 million in compensation to their single most highly compensated employee. On average, the top executive in each organization made $3.5 million.

For comparison, the five for-profit corporations had revenues of $96 billion with disclosed expenses of $80 billion. Their net assets increased by $600 million last year – an increase in assets from $40.1 billion to $40.7 billion (1.5 % growth). The most highly compensated executive was Tenet HealthCare Corporation CEO who made $6.3 million. Furthermore, Medicare/Medicaid comprised 25 percent of their annual revenues.

Only 14 of the 82 non-profit organizations Open the Books studied properly disclosed the amount of revenues derived from Medicare/Medicaid on their IRS 990 returns last year. The 14 hospitals who disclosed their program service revenues had $100.2 billion in total revenues of which $28 billion came from Medicare/Medicaid (28%). Therefore, Open the Books estimated that the 82 non-profit hospitals did $83 billion in Medicare/Medicaid work last year.

Roughly $2 billion flowed into these non-profit organizations from federal agencies via grants primarily used for research (FY2018). The largest recipients were Partners HealthCare, Sommerville, MA ($903.4 million); Mayo Clinic in Rochester, MN at $282.9 million followed by the Children’s Hospital of Philadelphia in Philadelphia, PA ($182.6 million); Cleveland Clinic in Independence, OH ($101.6 million); and Kaiser Foundation in Oakland, CA ($78.6 million).

These large non-profit hospitals received charitable contributions of $5.2 billion last year (includes affiliated organizations). The largest recipients of charity (excluding government grants) were Partners HealthCare, Somerville, MA ($2.2 billion); Mayo Clinic, Rochester, MN ($1.1 billion); Cleveland Clinic, Independence, OH ($179.3 million); Cedars-Sinai, Los Angeles, CA ($130.9 million); ProMedica, Toledo, OH ($124.7 million); and Texas Children’s Hospital, Houston, TX ($112.2 million).

The 82 non-profit hospital organizations collectively spent $26.4 million on lobbying last year. The top four providers with the most lobbying were University of Pittsburgh Medical Group, Pittsburgh, PA ($2.3 million); Mayo Clinic, Rochester, MN ($1.8 million); Dignity Health, San Francisco, CA ($1.7 million); and Christus Health, Irving, TX ($1.3 million). Non-profits cannot use charitable contributions or government payments for lobbying purposes.

The non-profits must re-invest in their communities and therefore construction of new facilities is on-going. For example, in Illinois, the top contractor at Advocate Medical isn’t a healthcare service vendor, but a construction project manager ($26.1 million). Illinois lost population during the last ten-years. This pales in comparison to Partners HealthCare in Massachusetts – the top three vendors are construction contractors who reaped $191.4 million last year.

Neither the non-profit nor the for-profit hospital corporations disclose the real prices actually paid by their patients.