Cleveland Clinic posts $746M operating income, 'served more patients than ever' in 2021

Cleveland Clinic Health System more than tripled its operating income during 2021 thanks to revenue growth that outpaced industrywide expense increases.

In filings published this week, the academic system reported $746.2 million in annual operating income for the year ended Dec. 31, 2021, up from the prior year’s $232.4 million as well as 2019’s $390.2 million.

Total revenue for the year landed at $12.4 billion, beating out 2020’s $10.6 billion in large part due to greater net patient service revenue.

Expenses throughout 2021 were just shy of $11 billion, up again from the prior year’s more than $9.6 billion. Similarly to other systems, these gains included a jump in salaries, wages and benefits costs from $5.2 billion to $5.7 billion, as well as a supplies expense increase from $941.6 million to more than $1 billion.

These, plus a roughly $1.4 billion return from Cleveland Clinic’s investments, brought the system’s net income to $2.2 billion for the year. In 2020, the nonprofit had logged over $1.1 billion in investment returns and a net income just above $1.3 billion.

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Looking at the fourth quarter of 2021 alone, Cleveland Clinic logged $3.3 billion in total unrestricted operating revenues, just under $3 billion in expenses, $196.8 million in operating income and a net income of $532.8 million.

As of Dec. 31, 2021, the system reported total assets of $24.3 billion and $667.5 million in cash and cash equivalents. It had $21.8 billion in total assets and just over $1 billion in cash during the same time a year prior.

In a late January “State of the Clinic” previewing the results, CEO and President Tom Mihaljevic, M.D., told employees that Cleveland Clinic “served more patients than ever" in 2021, yielding "our finest financial performance, remarkably, during the pandemic.”

Cleveland Clinic’s financials look to have made it through 2021 in a better position than several other large nonprofits' did.

While Mayo Clinic and UPMC recently reported operating incomes in the nine- and 10-figure range, others, like Trinity, Ascension and CommonSpirit Health, ended the fiscal year with slim or even negative operating margins.