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A Mixed Bag: The Largest For-Profit Healthcare Systems See EBITDA Falls, Rises

Analysis  |  By Amanda Norris  
   July 20, 2023

Moody's latest report details how some of the largest healthcare systems are faring in 2023.

Moody's Healthcare Quarterly: July 2023 report shows a mixed bag of financial performance for some of the largest for-profit health systems in the country.

Coming up short is Community Health Systems, the U.S.’ third-largest for-profit system. The system saw its EBITDA fall by 18.1 percent to $335 million in the first quarter as salaries and benefits as a share of revenue increased by 1.3 percentage points, the report said.

For the first quarter of 2023, the system’s net operating revenues totaled $3.108 billion, beating analysts’ estimates by just 1.3%. The net loss attributable to Community Health Systems stockholders was $(51) million, or $(0.40) per diluted share—missing expectations by 145%.

"Our first quarter results include solid growth metrics and other promising indicators that demonstrate core demand for healthcare services is returning and that we are making progress with our initiatives and investments to capture volume," Community Health Systems CEO Tim Hingtgen said at the time.

"Some other more challenging dynamics such as payer mix changes and increased medical specialist fees affected our earnings in the quarter despite our ability to favorably manage other controllable expenses," Hingtgen said.

According to the July 2023 Moody’s report, a significant portion of the systems’ business is in rural areas, potentially driving up costs to recruit and retain staff. An unfavorable payer mix in these areas may also be a contributing factor, as it’s CEO noted.

The other two largest for-profit systems are faring better this year, according to the Moody’s report.

Both HCA Healthcare and Tenet Healthcare saw improved EBITDA in the first quarter of 2023 as salary and benefit obligations were alleviated, the report said.

In contrast to Community Health, the report says HCA and Tenet hospitals provide care in predominantly urban areas and the payer mix is more favorable. 



Amanda Norris is the Associate Content Manager of Finance, Payer, Revenue Cycle, and Strategy for HealthLeaders.


Two out of the three largest health systems saw an improved EBITDA in the first quarter of 2023.

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