Ascension wrapped its 2026 fiscal year with a $1.5 billion net income and operating losses just a quarter of what the nonprofit had reported the year prior.
In results for the year ended June 30, shared Wednesday afternoon, the system outlined a $119.8 million operating loss (-0.2% operating margin), a substantial improvement from the previous $490.9 million loss (-1.6% operating margin).
When limiting performance to “core operations”—namely, removing one-time transaction costs related to its $3.9 billion acquisition of AmSurg as well as newly issued bond interest payments tied to the ambulatory surgery business—flips the year’s operations into the positive, Ascension noted in a release discussing its latest financial statement. And on a same-facility basis, total income from operations jumped $696 million compared to the prior fiscal year, while net income rose $826 million, it said.
The improvements, leadership said, are the fruit of a multi-year effort to more tightly focus Ascension’s acute care footprint while building its network of outpatient services.
“Three years ago, we set out to strengthen Ascension so we could better serve our patients and communities,” Eduardo Conrado, president and CEO of Ascension, said in the release. “Our results this year show the significant progress we have made.”
The health system reported $24.5 billion in total operating revenue and $24.7 billion in total operating expenses. On a same-facility basis, this rose 9.8% and 6.5%, respectively.
With the former, Ascension’s management highlighted capacity and outpatient investments that shifted some procedures to low-cost settings and helped bump same-facility acute case mix index by 1.7%. Volumes also broadly increased across the organization, with total discharges up 1.5%, inpatient surgery visits up 1%, outpatient surgery visits up 1.5% and emergency room visits up 0.8%.
On the expense side, Ascension said it saw increases “across all major categories” with the exception of purchased services, though the organization found some relief with its 1% decrease in same-facility average length of stay. Total salaries, wages and benefits increased 3.4% on a same-facility basis due “largely” to increased volumes and acuity as well as a 4.3% increase in average hourly wage. Same-facility supply costs rose 9.6%.
Ascension’s nonoperating items included nearly $2.1 billion of net investment returns, which helped fuel its $1.5 billion bottom line.
Leadership also noted roughly $2.6 billion of same-facility community benefits it provided during the year, $1.5 billion of which they said reflect uncompensated care for Medicare patients. Other highlights include opened or planned service line expansions in Florida, Texas, Wisconsin, Kansas and Tennessee, as well as homecare and other community-based initiatives.
Ascension, one of the country’s largest nonprofit health systems, operates 91 wholly owned or consolidated hospitals, with noncontrolling interests in another 27. It employs over 98,000 people and, thanks in large part to this summer’s $3.9 billion AmSurg acquisition, operates 312 ambulatory surgery centers.
“We have improved our financial performance, expanded access, advanced our clinical capabilities, and grown our ambulatory and community-based network,” Conrado said. “Most importantly, we have built a stronger foundation that allows us to invest in the future of healthcare and better meet the needs of the communities we serve.”