Key takeaways
- NYC Health + Hospitals is the largest municipal health system in the US, with 11 hospitals and a budget of about $13.1 billion in the FY2027 executive plan.
- Many big-city safety-net hospitals are run by hospital districts or authorities — Harris Health, Parkland, Grady, University Health in San Antonio and JPS among them.
- State universities own some of the largest systems: the University of California's medical centers reported about $25.9 billion in operating revenue in FY2025.
- Systems report size differently — beds, revenue, budget or visits — so compare with care.
City, county and hospital district systems
Public hospitals and health systems owned by cities, counties, hospital districts or public authorities. Figures are as each system or its government reports them, with the year where given. Search by name, city or state.
Showing all 28 systems
| System | Owner | Hospitals | Beds | Budget or revenue | Source |
|---|---|---|---|---|---|
| NYC Health + HospitalsNew York, NY | NYC public benefit corporation | 11 | — | $13.13 billion budget (FY2027 executive plan) | NYC Council |
| Cook County HealthChicago, IL | Cook County | 2 | — | $5.1 billion (FY2026) | Civic Federation |
| Memorial Healthcare SystemHollywood, FL | South Broward Hospital District | 6 | 1,978 | $3.63 billion operating expenses (FY2025-26) | Safety Net Hospital Alliance of Florida |
| University HealthSan Antonio, TX | Bexar County Hospital District | 2 | — | $3.46 billion operating revenue (FY2025) | University Health audited report |
| San Francisco Department of Public HealthSan Francisco, CA | City and County of San Francisco | 2 | — | $3.38 billion department budget (FY2025-26 proposed) | SF DPH budget |
| Harris HealthHouston, TX | Harris County Hospital District | 2 | 617 licensed | $2.76 billion net revenue (FY2025) | Harris Health |
| Jackson Health SystemMiami, FL | Public Health Trust of Miami-Dade County | 4 | 2,255 licensed | $2.26 billion operating revenue (FY2025) | Miami-Dade County |
| MetroHealth SystemCleveland, OH | Cuyahoga County | 5 | — | $1.97 billion revenue (2024) | MetroHealth |
| Denver HealthDenver, CO | Denver Health and Hospital Authority | 1 | 525 | $1.58 billion operating revenue (2025) | Denver Health |
| Hennepin HealthcareMinneapolis, MN | Hennepin County subsidiary | 1 | 484 | $1.5 billion budget (2024) | Hennepin Healthcare |
| Broward HealthFort Lauderdale, FL | North Broward Hospital District | 6 | 1,584 licensed | — | Safety Net Hospital Alliance of Florida |
| Sarasota Memorial Health Care SystemSarasota, FL | Sarasota County Public Hospital District | 2 | 1,109 | — | Safety Net Hospital Alliance of Florida |
| Erie County Medical CenterBuffalo, NY | NY public benefit corporation | 1 | 583 plus 390 long-term care | $982.4 million operating revenue (2026 budget) | ECMC |
| Grady Health SystemAtlanta, GA | Fulton-DeKalb Hospital Authority | — | 953 licensed | — | Grady |
| Halifax HealthDaytona Beach, FL | Halifax Hospital Medical Center taxing district | 1 | 944 licensed | — | Safety Net Hospital Alliance of Florida |
| Santa Clara Valley HealthcareSan Jose, CA | County of Santa Clara | 3 | 731 (Valley Medical Center) | — | SCVMC |
| Nassau University Medical CenterEast Meadow, NY | NY public benefit corporation | 1 | 530 plus 589 nursing | $586.5 million operating revenue (2026 budget) | NHCC budget |
| JPS Health NetworkFort Worth, TX | Tarrant County Hospital District | — | 582 licensed | — | JPS |
| University Medical Center of Southern NevadaLas Vegas, NV | Clark County | 1 | 541 licensed | — | UMC |
| Arrowhead Regional Medical CenterColton, CA | San Bernardino County | 1 | 456 | — | ARMC |
| Riverside University Health SystemMoreno Valley, CA | Riverside County | 1 plus psychiatric facility | 439 licensed | — | RUHS |
| University Medical Center of El PasoEl Paso, TX | El Paso County Hospital District | 2 | 394 licensed (FY2024) | — | UMC El Paso |
| Eskenazi HealthIndianapolis, IN | Health and Hospital Corporation of Marion County | 1 | 333 staffed | — | Eskenazi Health |
| Los Angeles County Department of Health ServicesLos Angeles, CA | Los Angeles County | 4 | — | 2.9 million visits a year | LA Health Services |
| Parkland HealthDallas, TX | Dallas County Hospital District | — | — | 1.2 million outpatient visits (FY2024) | Parkland |
| Alameda Health SystemOakland, CA | Public hospital authority | 4 | — | — | Alameda County |
| Valleywise HealthPhoenix, AZ | Maricopa County Special Health Care District | 1 | — | About 550,000 patient visits a year | AHA case study |
| Harborview Medical CenterSeattle, WA | King County (managed by UW Medicine) | 1 | — | — | ITHS |
State university health systems
Health systems owned by public universities or state authorities. Operating revenue is the most consistent size measure these systems publish.
Showing all 17 systems
| System | Hospitals | Beds | Revenue or budget | Source |
|---|---|---|---|---|
| University of California HealthAll UC medical centers, CA | 17 | 5,840 licensed | $25.86 billion operating revenue (FY2025) | UC Office of the President |
| Michigan MedicineAnn Arbor, MI | 12 | 1,043 licensed | $9.5 billion operating revenue (FY2026 forecast) | Michigan Medicine |
| UCSF HealthSan Francisco, CA | — | — | $8.91 billion operating revenue (FY2025) | UC Office of the President |
| UT MD Anderson Cancer CenterHouston, TX | — | 803 inpatient | $7.82 billion operating revenue (FY2025) | MD Anderson |
| Ohio State Wexner Medical CenterColumbus, OH | 6 | 1,463 staffed | $7.27 billion revenue (FY2026) | Ohio State |
| UNC HealthChapel Hill, NC | 15 | 1,001 at UNC Hospitals | $6.11 billion operating revenue (FY2023) | UNC Health annual report |
| UCLA HealthLos Angeles, CA | — | — | $5.03 billion operating revenue (FY2025) | UC Office of the President |
| UT Southwestern Medical CenterDallas, TX | — | More than 820 | $4.9 billion operating budget | UT Southwestern |
| UC San Diego HealthSan Diego, CA | — | — | $4.27 billion operating revenue (FY2025) | UC Office of the President |
| UC Davis HealthSacramento, CA | — | — | $4.06 billion operating revenue (FY2025) | UC Office of the President |
| UTMB HealthGalveston, TX | 4 | 1,123 | $3.80 billion revenue (FY2025) | UTMB |
| UCI HealthOrange, CA | — | — | $3.58 billion operating revenue (FY2025) | UC Office of the President |
| UVA Health (University Medical Center)Charlottesville, VA | 1 | 679 | $3.06 billion operating expenses (FY2025) | UVA Health |
| VCU Health SystemRichmond, VA | 4 | — | $2.50 billion operating revenue (FY2021) | VCU |
| UAB MedicineBirmingham, AL | — | 1,400 (UAB Hospital) | — | UAB News |
| University of Utah HealthSalt Lake City, UT | 5 | — | About 2.5 million patient visits (FY2024) | University of Utah Health |
| University of Iowa Health CareIowa City, IA | — | — | 40,000+ admissions (FY2025) | UI Health Care |
Federal: the VA
The largest public health system in the country is federal. The Veterans Health Administration runs 170 VA medical centers and 1,193 outpatient sites and has more than 9.1 million enrolled veterans, according to the VA. VA purchasing follows federal acquisition rules and often runs through contract vehicles and VA-specific schedules.
Selling to public hospitals
Public hospitals buy like hospitals and like governments at the same time. Clinical and supply decisions follow hospital processes, but contracts, budgets and board approvals follow public rules.
- Know the governing body. County boards, hospital district boards and university regents approve large contracts in public meetings.
- Watch the budget cycle. County and district budgets, bond programs and capital plans show upcoming projects and equipment.
- Group purchasing matters. Many public systems buy through group purchasing organizations and cooperative contracts as well as their own solicitations.
- Reach both sides. Clinical leaders, IT, supply chain and finance each own different decisions.
See our public healthcare market page and selling to government by category.
Sources
- NYC Council, Report on the Fiscal 2027 Executive Plan: Health + Hospitals
- University of California Office of the President, Medical Center Report 2025
- Veterans Health Administration, About Us
- Each system's own report or fact page, linked in the tables above
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