Six months into 2026, the country’s third-largest nonprofit health system has grown its operating revenues by 8.6% but has seen a slowdown in its operating performance compared to last year.
Advocate Health, which spans six states, nearly seven dozen acute care hospitals and over 1,000 other locations, reported on Friday a six-month operating margin of 3.8%, reflecting $775.3 million of operating income. That margin lags the 4.4% of H1 2025 ($824.4 million operating income), and is a hair over the immediately preceding quarter’s 3.7% ($380.1 million operating income).
Total revenue reported over six months was nearly $20.5 billion, a roughly $1.6 billion year-over-year increase, while total expenses grew $1.7 billion to $19.7 billion.
Fueling the growth was an increase in patient volumes. Total bedded patients rose 3.5% year over year, and the system improved its average inpatient length of stay from 5.35 days to 5.25 days. Total surgeries increased 3.1%, largely on the outpatient side, ED visits dipped by 0.1% and work relative value units (wRVUs, a measure of provider productivity) rose 7.9%.
Advocate also noted that its patient case mix index was on par with the prior year’s first half, though its payer mix has shifted for the worse—commercial’s share of patient service revenue fell from 50% to 45%, while Medicaid grew from 18% to 20% and “self-pay and other” rose from 1% to 4%.
Beyond care delivery, the system reported over $1.9 billion of nonoperating revenues almost entirely comprised of net investment income. That led to a bottom line of almost $2.7 billion (attributable to controlling interest), up from the prior first half’s $2 billion.
Advocate is on pace to beat the $38.9 billion in total revenue it reported across 2025, with further growth likely as one of the organization’s affiliates. Earlier this year, its Charlotte, North Carolina-based Atrium Health unveiled plans to absorb North Carolina’s WakeMed Health in exchange for a $2 billion investment. The combination has triggered some skepticism from local leaders and groups, but has not been derailed as of yet.
Atrium—which during the six-month period logged about $6 billion of operating revenue—more recently shared that it and the Morehouse School of Medicine have been approved to build a teaching hospital in Atlanta, which would open with just 50 beds and accompanying non-acute care but could be expanded to more than 700 beds in total.