Who profits from US health care
Twenty-eight companies, six parts of the health-care economy, ten fiscal years. Every figure is the company's own XBRL tag in its own annual report on Form 10-K, pulled from the SEC's company-facts service and cited to an accession number. The question this page answers is narrow and answerable: for the companies that publish audited numbers, how did revenue, net income and net margin move from fiscal 2016 to fiscal 2025, and how did that compare to inflation?
What this page is not. It is not a picture of US health care. It is a picture of the part of US health care that has public shareholders. The largest hospital systems in the country are nonprofit and file IRS Form 990s, not 10-Ks. The largest health insurer by membership in several states is a nonprofit Blue Cross licensee that files with state regulators, not the SEC. Nearly every physician practice in the country is private. Medicare and Medicaid, which between them pay for more US medical care than every company named here combined, are government programmes and file nothing. Six baskets of named companies are not six industries, and this page never writes “the industry.” It writes the names.
Three rules that govern every number below. First, nothing is estimated: where a company does not tag a concept for a year, the cell is empty and the method note says the concept is not disclosed in that form. Six of these companies publish no operating-income subtotal at all, so their operating-margin cells are blank rather than derived. Second, figures are as reported in the filing cited and are not restated for later spin-offs — where a spin-off or an acquisition breaks a year-over-year comparison, the note under that company says so and gives the closing date. Third, a high margin is not a verdict and a loss is not one either: the biggest swings in this dataset are tax law, goodwill impairments and acquisitions expensed in one go, and each is named where it occurs.
The six baskets, named in full
Every constituent is listed. Nothing is hidden inside an average.
Insurance and managed care
UnitedHealth Group, Elevance Health, The Cigna Group, Humana, Centene, Molina Healthcare, CVS Health
7 filers · FY2016–FY2025
Hospitals and health systems
HCA Healthcare, Tenet Healthcare, Community Health Systems, Universal Health Services
4 filers · FY2016–FY2025
Physician groups
Privia Health Group, agilon health
2 filers · FY2019–FY2025
Pharmaceutical manufacturers
Pfizer, Johnson & Johnson, Merck & Co., AbbVie, Eli Lilly, Bristol Myers Squibb, Amgen, Gilead Sciences
8 filers · FY2016–FY2025
Medical devices
Medtronic, Abbott Laboratories, Boston Scientific, Stryker, Becton, Dickinson and Company, Zimmer Biomet Holdings, Edwards Lifesciences
7 filers · FY2016–FY2025
Pharmacy benefit managers
No constituents, because none of the three largest is a separate filer. CVS Caremark, Express Scripts and Optum Rx are business units inside CVS Health, The Cigna Group and UnitedHealth Group. There is no PBM profit series on this page and there cannot be one. What those three parents do disclose — segment revenue, under three different segment names and three different profit measures — is set out in its own section below.
Latest fiscal year, side by side
Combined revenue and combined net income are the plain sum of each basket's named constituents; combined net margin is combined net income divided by combined revenue. The sums are not consolidated — intercompany revenue between constituents is not eliminated, and CVS Health sits in the insurance basket while also being a pharmacy benefit parent, so a dollar can appear in more than one basket. Figures in US$ millions.
| Basket | Fiscal year | Filers | Combined revenue | Combined operating income | Combined net income | Net margin | Operating margin |
|---|---|---|---|---|---|---|---|
| Insurance and managed care | FY2025 | 7 | 1,693,526 | 35,885 | 20,429 | 1.21% | 2.12% |
| Hospitals and health systems | FY2025 | 4 | 126,760 | not disclosed | 10,189 | 8.04% | not disclosed |
| Physician groups | FY2025 | 2 | 8,055 | (429) | (368) | -4.57% | -5.33% |
| Pharmaceutical manufacturers | FY2025 | 8 | 462,510 | not disclosed | 100,970 | 21.83% | not disclosed |
| Medical devices | FY2025 | 7 | 159,194 | 27,451 | 20,787 | 13.06% | 17.24% |
“Not disclosed” means what it says: HCA Healthcare, Pfizer, Johnson & Johnson, Merck, Eli Lilly and Bristol Myers Squibb present no operating-income subtotal on the face of their income statements, so no operating margin is computed for the hospital or pharmaceutical baskets rather than one being constructed from parts.
Net margin, year by year, across the baskets
Combined net income divided by combined revenue, for each basket, in each fiscal year in which every one of that basket's constituents filed. The physician-group basket begins at FY2019 because that is the first year both of its two constituents reported. Read the caveats in each basket's own section before drawing anything from a single cell — several of these numbers are dominated by one company's one-time item.
| Basket | FY2016 | FY2017 | FY2018 | FY2019 | FY2020 | FY2021 | FY2022 | FY2023 | FY2024 | FY2025 |
|---|---|---|---|---|---|---|---|---|---|---|
| Insurance and managed care | 2.98% | 4.07% | 3.02% | 3.85% | 4.08% | 3.68% | 3.33% | 3.46% | 2.25% | 1.21% |
| Hospitals and health systems | 1.88% | -0.22% | 4.33% | 3.62% | 6.06% | 8.81% | 6.45% | 5.73% | 8.01% | 8.04% |
| Physician groups | — | — | — | -17.36% | -1.42% | -21.24% | -2.83% | -4.01% | -3.15% | -4.57% |
| Pharmaceutical manufacturers | 21.83% | 13.01% | 19.90% | 24.04% | 12.11% | 22.59% | 22.54% | 17.36% | 11.60% | 21.83% |
| Medical devices | 9.42% | 8.95% | 10.17% | 15.73% | 10.60% | 13.03% | 13.44% | 13.06% | 19.54% | 13.06% |
An em dash means the basket had no complete year: Privia Health and agilon health did not file 10-Ks before FY2019.
Year-over-year revenue growth, across the baskets
| Basket | FY2016 | FY2017 | FY2018 | FY2019 | FY2020 | FY2021 | FY2022 | FY2023 | FY2024 | FY2025 |
|---|---|---|---|---|---|---|---|---|---|---|
| Insurance and managed care | — | 6.7% | 9.0% | 30.9% | 11.3% | 11.2% | 11.0% | 11.0% | 9.2% | 11.5% |
| Hospitals and health systems | — | -0.8% | 1.5% | 5.0% | -2.0% | 11.6% | 1.7% | 6.9% | 6.6% | 5.9% |
| Physician groups | — | — | — | — | 28.8% | 37.6% | 45.2% | 47.0% | 30.5% | 3.3% |
| Pharmaceutical manufacturers | — | 2.0% | 4.6% | 1.6% | 8.8% | 21.7% | 8.1% | -11.0% | 9.2% | 7.9% |
| Medical devices | — | 9.4% | 9.5% | 5.5% | -1.2% | 16.5% | 1.6% | 0.9% | 5.8% | 8.3% |
| CPI-U, all items (annual average) | — | 2.1% | 2.4% | 1.8% | 1.2% | 4.7% | 8.0% | 4.1% | 2.9% | 2.6% |
The CPI row is the change in the annual average of CPI-U, US city average, all items, annual average, not seasonally adjusted, series ID CUUR0000SA0, from the US Bureau of Labor Statistics. It is a calendar-year series and the company rows are fiscal-year series; three of the twenty-eight companies do not use a December fiscal year, and their years are not shifted to match.
Growth relative to inflation
What this comparison can and cannot say. Revenue growth above CPI is not, by itself, evidence of price increases. A basket's revenue can grow because it raised prices, because it sold more, because it bought another company, or because a government programme enrolled more people. The insurance basket's growth over this window includes three large acquisitions with known closing dates, and the physician basket consists of two companies that were tiny in FY2019, so their percentage growth is arithmetic off a small base rather than a statement about medical practice. CPI-U is the general consumer price index; the medical-care component of the same index is given beside it because it is the more demanding comparison, and both are calendar-year annual averages.
| Basket | Window | Revenue, first year | Revenue, last year | Revenue, cumulative | Revenue, annualised | CPI-U, cumulative | CPI-U, annualised | Medical-care CPI, cumulative | Revenue less CPI-U |
|---|---|---|---|---|---|---|---|---|---|
| Insurance and managed care | FY2016–FY2025 (9 years) | 599,835 | 1,693,526 | 182.3% | 12.22% | 34.1% | 3.32% | 25.1% | 110.5% |
| Hospitals and health systems | FY2016–FY2025 (9 years) | 89,315 | 126,760 | 41.9% | 3.97% | 34.1% | 3.32% | 25.1% | 5.8% |
| Physician groups | FY2019–FY2025 (6 years) | 1,581 | 8,055 | 409.6% | 31.18% | 25.9% | 3.92% | 16.4% | 304.7% |
| Pharmaceutical manufacturers | FY2016–FY2025 (9 years) | 284,189 | 462,510 | 62.7% | 5.56% | 34.1% | 3.32% | 25.1% | 21.3% |
| Medical devices | FY2016–FY2025 (9 years) | 93,202 | 159,194 | 70.8% | 6.13% | 34.1% | 3.32% | 25.1% | 27.3% |
“Revenue less CPI-U” is cumulative revenue growth deflated by the CPI-U index over the same window, not a subtraction of the two percentages. Sources: CPI-U, US city average, all items, annual average, not seasonally adjusted (series ID CUUR0000SA0) and CPI-U, US city average, medical care, annual average, not seasonally adjusted (series ID CUUR0000SAM), US Bureau of Labor Statistics public data API, retrieved 2026-09-04.
Insurance and managed care
UnitedHealth Group · Elevance Health · The Cigna Group · Humana · Centene · Molina Healthcare · CVS Health
Read this before the numbers
- These seven are the publicly traded, SEC-filing managed-care companies. Blue Cross Blue Shield plans that are nonprofit or mutual — including the largest, Health Care Service Corporation, and Kaiser Permanente's health plan — do not file 10-Ks and are absent. So is every state Medicaid agency and Medicare itself, which together pay for a larger share of US medical care than every company on this page combined.
- CVS Health appears in this basket and again as a pharmacy benefit parent below. It is one company counted once inside this basket; the segment table below is a different cut of the same 10-K, not an addition to it.
- Managed-care net margins are structurally low because premium revenue passes through as medical claims. A 3% net margin on $400B of revenue is $12B. Margin percentage and dollars of profit are different questions, and the table gives both.
- Revenue in this basket jumps for acquisitions, not only for growth: Cigna/Express Scripts closed December 20, 2018, CVS/Aetna closed November 28, 2018, and Centene/WellCare closed January 23, 2020. The year-over-year growth cells that follow those dates are mostly the acquisition.
Combined, year by year
| Fiscal year | Revenue | Operating income | Net income | Net margin | Operating margin | Revenue YoY | Net income YoY |
|---|---|---|---|---|---|---|---|
| FY2016 | 599,835 | 34,465 | 17,899 | 2.98% | 5.75% | — | — |
| FY2017 | 639,801 | 37,749 | 26,024 | 4.07% | 5.90% | 6.7% | 45.4% |
| FY2018 | 697,499 | 36,640 | 21,069 | 3.02% | 5.25% | 9.0% | -19.0% |
| FY2019 | 913,066 | 51,765 | 35,149 | 3.85% | 5.67% | 30.9% | 66.8% |
| FY2020 | 1,015,808 | 59,975 | 41,460 | 4.08% | 5.90% | 11.3% | 17.9% |
| FY2021 | 1,129,242 | 58,539 | 41,603 | 3.68% | 5.18% | 11.2% | 0.3% |
| FY2022 | 1,253,131 | 59,338 | 41,762 | 3.33% | 4.74% | 11.0% | 0.4% |
| FY2023 | 1,390,448 | 71,652 | 48,158 | 3.46% | 5.15% | 11.0% | 15.3% |
| FY2024 | 1,518,701 | 65,526 | 34,124 | 2.25% | 4.31% | 9.2% | -29.1% |
| FY2025 | 1,693,526 | 35,885 | 20,429 | 1.21% | 2.12% | 11.5% | -40.1% |
Combined net margin for these seven fell from 3.46% in FY2023 to 1.21% in FY2025 while combined revenue rose by $303bn. FY2025 includes Centene's $6,674M net loss, which the FY2025 10-K accompanies with $7,311M of tagged asset impairment charges. Excluding Centene entirely, the other six reported combined revenue of $1,498,749M and combined net income of $27,103M in FY2025, a 1.81% margin. Both figures are given because the choice of which to quote changes the answer.
Net income YoY is left empty where the prior year's combined net income was zero or negative, because a percentage change from a negative base is not interpretable.
Each company's net margin, year by year
| Company | FY2016 | FY2017 | FY2018 | FY2019 | FY2020 | FY2021 | FY2022 | FY2023 | FY2024 | FY2025 |
|---|---|---|---|---|---|---|---|---|---|---|
| UnitedHealth Group | 3.8% | 5.2% | 5.3% | 5.7% | 6.0% | 6.0% | 6.2% | 6.0% | 3.6% | 2.7% |
| Elevance Health | 2.9% | 4.3% | 4.1% | 4.6% | 3.8% | 4.4% | 3.8% | 3.5% | 3.4% | 2.8% |
| The Cigna Group | 4.7% | 5.4% | 5.4% | 3.3% | 5.3% | 3.1% | 3.7% | 2.6% | 1.4% | 2.2% |
| Humana | 1.1% | 4.6% | 3.0% | 4.2% | 4.4% | 3.5% | 3.0% | 2.3% | 1.0% | 0.9% |
| Centene | 1.4% | 1.7% | 1.5% | 1.8% | 1.6% | 1.1% | 0.8% | 1.8% | 2.0% | -3.4% |
| Molina Healthcare | 0.3% | -2.6% | 3.7% | 4.4% | 3.5% | 2.4% | 2.5% | 3.2% | 2.9% | 1.0% |
| CVS Health | 3.0% | 3.6% | -0.3% | 2.6% | 2.7% | 2.7% | 1.3% | 2.3% | 1.2% | 0.4% |
Each company, latest fiscal year in this window
| Company | Fiscal year ended | Revenue | Operating income | Net income | Net margin | Total assets | Filing |
|---|---|---|---|---|---|---|---|
| UnitedHealth Group | 2025-12-31 (FY2025) | 447,567 | 18,964 | 12,056 | 2.69% | 309,581 | 10-K 0000731766-26-000062 |
| Elevance Health | 2025-12-31 (FY2025) | 199,125 | 7,199 | 5,662 | 2.84% | 121,494 | 10-K 0001156039-26-000013 |
| The Cigna Group | 2025-12-31 (FY2025) | 274,900 | 9,200 | 5,957 | 2.17% | 157,919 | 10-K 0001739940-26-000006 |
| Humana | 2025-12-31 (FY2025) | 129,664 | 2,704 | 1,188 | 0.92% | 48,909 | 10-K 0000049071-26-000009 |
| Centene | 2025-12-31 (FY2025) | 194,777 | (7,623) | (6,674) | -3.43% | 76,747 | 10-K 0001071739-26-000049 |
| Molina Healthcare | 2025-12-31 (FY2025) | 45,426 | 781 | 472 | 1.04% | 15,564 | 10-K 0001179929-26-000005 |
| CVS Health | 2025-12-31 (FY2025) | 402,067 | 4,660 | 1,768 | 0.44% | 253,538 | 10-K 0000064803-26-000010 |
What the filings say about the swings
- UnitedHealth Group, FY2024. Net income fell while revenue rose: the FY2024 10-K's segment table reports a $8,310M loss on sale of subsidiary and subsidiaries held for sale, absent from every other year in this window.
- UnitedHealth Group, FY2025. Earnings from operations fell to $18,964M from $32,287M while revenue rose $47.3B. Income tax expense was $1,890M, the lowest in the window.
- Elevance Health, FY2022. Anthem, Inc. changed its name to Elevance Health, Inc. in June 2022. Same registrant, same CIK — the series is continuous.
- The Cigna Group, FY2019. Revenue more than tripled year over year because Cigna completed its acquisition of Express Scripts on December 20, 2018 — FY2019 is the first full year that includes it.
- The Cigna Group, FY2024. Net income fell to $3,434M on rising revenue; income tax expense rose to $1,491M from $141M in FY2023.
- Centene, FY2020. Revenue rose 49% because Centene completed its acquisition of WellCare Health Plans on January 23, 2020.
- Centene, FY2025. A net loss of $6,674M on record revenue. The FY2025 10-K tags $7,311M of asset impairment charges (us-gaap:AssetImpairmentCharges) — more than four times any prior year in this window.
- Molina Healthcare, FY2017. A net loss of $512M. The FY2017 10-K tags a $434M goodwill impairment loss.
- Molina Healthcare, FY2019. Revenue fell for a second year as Molina withdrew from marketplace and Medicaid contracts; the company returned to revenue growth in FY2020.
- CVS Health, FY2018. A net loss of $594M in the year CVS completed its acquisition of Aetna (November 28, 2018). The FY2018 10-K tags a $6,149M goodwill impairment loss.
- CVS Health, FY2019. Revenue rose 32% — the first full year including Aetna.
- CVS Health, FY2025. Net income of $1,768M on $402,067M of revenue. The FY2025 10-K tags a $5,725M goodwill impairment, which the segment note attributes to the Health Care Delivery reporting unit inside the Health Services segment, plus $1,220M of legacy litigation charges and a $320M opioid litigation charge.
Every filing cited for this basket
An asterisk marks a figure taken from the comparative column of a later 10-K rather than that year's own annual report. Almost all of them are fiscal 2016 and 2017 revenue, which companies retagged when they adopted the ASC 606 revenue standard in their fiscal 2018 filings.
Pharmacy benefit managers
There is no such thing as a PBM profit line. The three largest pharmacy benefit managers do not file with the SEC, because none of them is a separate registrant.
CVS Caremark is a business inside CVS Health. Express Scripts is a business inside The Cigna Group, acquired December 20, 2018. Optum Rx is a business inside UnitedHealth Group. Each parent files one consolidated 10-K, and none of them publishes a standalone income statement for its pharmacy benefit business. What each parent does publish is a reportable-segment disclosure. Those segment figures are below, under the segment name each company actually uses. They are not profit, they are not measured the same way, and the three segments do not contain the same businesses.
Read this before the numbers
- Segment revenue is not profit. Total revenue for a pharmacy benefit segment is dominated by the cost of the drugs it passes through; what the manager keeps is a fraction of it.
- The three segments are not defined identically. Optum Rx is UnitedHealth's pharmacy care services segment. Evernorth Health Services is Cigna's segment for pharmacy benefit services together with specialty pharmacy and care-delivery businesses. CVS's Health Services segment contains Caremark and also the Health Care Delivery reporting unit — Oak Street Health and Signify Health — which is where CVS booked its FY2025 goodwill impairment. Adding these three numbers together produces a meaningless total, and this page does not add them.
- Two of the three include revenue from selling to the parent's own insurance arm. Optum Rx's and CVS Health Services' segment totals include intersegment revenue that is eliminated in consolidation. Cigna reports intersegment revenue for Evernorth in the same way.
- CVS states that its Health Services segment revenue includes retail co-payments — approximately $10.9 billion in 2025, $11.4 billion in 2024 and $13.7 billion in 2023 — money paid by patients at a pharmacy counter, counted inside the segment's revenue.
- The profit measures below are three different measures with three different names. UnitedHealth reports GAAP earnings from operations by segment. Cigna reports segment income before income taxes. CVS reports adjusted operating income, an explicitly non-GAAP measure that excludes intangible amortization, realized capital gains and losses, and items management judges not to reflect underlying performance. They are printed here under the names their filings give them, and they must not be compared as if they were the same thing.
- Neither CVS nor Cigna discloses total assets by segment. Both filings state that segment assets are not a measure the chief operating decision maker uses.
UnitedHealth Group — segment “Optum Rx”
Source: 10-K for FY2025, accession 0000731766-26-000062 — the filing on EDGAR. Figures in US$ millions, from the segment-reporting note.
| Fiscal year | Segment total revenues | Earnings from operations (GAAP, as reported in the segment table) | Segment total assets |
|---|---|---|---|
| FY2025 | 154,726 | 7,193 | 62,262 |
| FY2024 | 133,231 | 5,836 | 59,086 |
| FY2023 | 116,087 | 5,115 | 51,266 |
Total revenues include revenue from affiliated customers — sales to UnitedHealthcare, the group's own insurer. UnitedHealth reports $167,956M of Optum revenue from affiliated customers across all Optum segments in FY2025.
The Cigna Group — segment “Evernorth Health Services”
Source: 10-K for FY2025, accession 0001739940-26-000006 — the filing on EDGAR. Figures in US$ millions, from the segment-reporting note.
| Fiscal year | Segment total revenues | Income before income taxes (segment basis, as reported in the segment table) | Segment total assets |
|---|---|---|---|
| FY2025 | 234,953 | 5,826 | not disclosed in this form |
| FY2024 | 201,973 | 3,929 | not disclosed in this form |
| FY2023 | 153,499 | 4,768 | not disclosed in this form |
Revenues from customers, before net investment income, were $232,098M in FY2025, $198,177M in FY2024 and $147,588M in FY2023. Cigna states it does not report total assets by segment.
CVS Health — segment “Health Services”
Source: 10-K for FY2025, accession 0000064803-26-000010 — the filing on EDGAR. Figures in US$ millions, from the segment-reporting note.
| Fiscal year | Segment total revenues | Adjusted operating income (non-GAAP, as defined and reported by CVS) | Segment total assets |
|---|---|---|---|
| FY2025 | 190,425 | 7,151 | not disclosed in this form |
| FY2024 | 173,605 | 7,243 | not disclosed in this form |
| FY2023 | 186,843 | 7,312 | not disclosed in this form |
Total revenues include $25,802M of intersegment revenue in FY2025 and, per the filing, approximately $10.9B of retail co-payments. Revenues from external customers alone were $164,603M in FY2025, $158,016M in FY2024 and $174,018M in FY2023. CVS states it does not report total assets by segment.
No other company in the six baskets on this page reports a pharmacy benefit management segment. Humana operates a pharmacy benefit business (Humana Pharmacy Solutions) and Elevance operates CarelonRx, but neither is a reportable segment with its own revenue line in the filings used here, so no figure is reported for either.
What these three do, how rebates and spread pricing work, and what the FTC's staff reports and the companies themselves say about it, is the subject of what is a PBM.
Hospitals and health systems
HCA Healthcare · Tenet Healthcare · Community Health Systems · Universal Health Services
Read this before the numbers
- READ THIS BEFORE THE NUMBERS. These four are the for-profit, publicly traded hospital operators. They are not the US hospital system. The American Hospital Association's Fast Facts on US Hospitals, 2026 edition, drawing on its 2024 Annual Survey, counts 5,121 community hospitals in the United States: 2,984 nongovernment not-for-profit, 1,224 investor-owned for-profit, and 913 state or local government. Three quarters of US community hospitals are therefore nonprofit or government-run, and they file IRS Form 990s and state financial reports rather than 10-Ks. There is no audited, comparably tagged annual revenue and profit series for them anywhere on EDGAR.
- What that omits, concretely: Kaiser Permanente, Ascension, CommonSpirit Health, Advocate Health, Trinity Health, Providence, Mass General Brigham, the Cleveland Clinic, the Mayo Clinic, every academic medical center, every public hospital, and every rural critical-access hospital. Nothing in this basket's margin can be read as the margin of US hospital care. This page also cannot tell you what share of the 775,297 staffed community-hospital beds these four operate, because the AHA source used here reports hospitals by ownership and beds only in total.
- A nonprofit hospital does not report 'net income'; it reports change in net assets, and its surplus is not distributed to shareholders. Comparing a nonprofit system's surplus to a for-profit operator's net income is not a like-for-like comparison, which is one of the reasons this page does not attempt it.
- Within the basket, three of the four have been net sellers of hospitals across this window. Community Health Systems' revenue fell by a third between FY2016 and FY2020 on divestitures, and Tenet's FY2024 net income is dominated by hospital sales. Growth rates here mix organic change with portfolio change.
Combined, year by year
| Fiscal year | Revenue | Operating income | Net income | Net margin | Operating margin | Revenue YoY | Net income YoY |
|---|---|---|---|---|---|---|---|
| FY2016 | 89,315 | not disclosed | 1,679 | 1.88% | not disclosed | — | — |
| FY2017 | 88,556 | not disclosed | (195) | -0.22% | not disclosed | -0.8% | -111.6% |
| FY2018 | 89,917 | not disclosed | 3,890 | 4.33% | not disclosed | 1.5% | — |
| FY2019 | 94,403 | not disclosed | 3,413 | 3.62% | not disclosed | 5.0% | -12.3% |
| FY2020 | 92,521 | not disclosed | 5,608 | 6.06% | not disclosed | -2.0% | 64.3% |
| FY2021 | 103,247 | not disclosed | 9,092 | 8.81% | not disclosed | 11.6% | 62.1% |
| FY2022 | 105,017 | not disclosed | 6,776 | 6.45% | not disclosed | 1.7% | -25.5% |
| FY2023 | 112,288 | not disclosed | 6,438 | 5.73% | not disclosed | 6.9% | -5.0% |
| FY2024 | 119,730 | not disclosed | 9,586 | 8.01% | not disclosed | 6.6% | 48.9% |
| FY2025 | 126,760 | not disclosed | 10,189 | 8.04% | not disclosed | 5.9% | 6.3% |
HCA Healthcare alone is 60% of this basket's FY2025 revenue and 67% of its net income. The basket's margin is largely HCA's margin.
Net income YoY is left empty where the prior year's combined net income was zero or negative, because a percentage change from a negative base is not interpretable.
Each company's net margin, year by year
| Company | FY2016 | FY2017 | FY2018 | FY2019 | FY2020 | FY2021 | FY2022 | FY2023 | FY2024 | FY2025 |
|---|---|---|---|---|---|---|---|---|---|---|
| HCA Healthcare | 7.0% | 5.1% | 8.1% | 6.8% | 7.3% | 11.8% | 9.4% | 8.1% | 8.2% | 9.0% |
| Tenet Healthcare | -1.0% | -3.7% | 0.6% | -1.3% | 2.3% | 4.7% | 2.1% | 3.0% | 15.5% | 6.6% |
| Community Health Systems | -9.3% | -16.0% | -5.6% | -5.1% | 4.3% | 1.9% | 0.4% | -1.1% | -4.1% | 4.1% |
| Universal Health Services | 7.2% | 7.2% | 7.2% | 7.2% | 8.2% | 7.8% | 5.0% | 5.0% | 7.2% | 8.6% |
Each company, latest fiscal year in this window
| Company | Fiscal year ended | Revenue | Operating income | Net income | Net margin | Total assets | Filing |
|---|---|---|---|---|---|---|---|
| HCA Healthcare | 2025-12-31 (FY2025) | 75,600 | not disclosed in this form | 6,784 | 8.97% | 60,720 | 10-K 0001193125-26-044769 |
| Tenet Healthcare | 2025-12-31 (FY2025) | 21,310 | 3,508 | 1,407 | 6.60% | 29,677 | 10-K 0000070318-26-000012 |
| Community Health Systems | 2025-12-31 (FY2025) | 12,485 | 1,488 | 509 | 4.08% | 13,204 | 10-K 0001193125-26-059509 |
| Universal Health Services | 2025-12-31 (FY2025) | 17,365 | 1,994 | 1,489 | 8.57% | 15,528 | 10-K 0001193125-26-071676 |
What the filings say about the swings
- HCA Healthcare, FY2020. Revenue was essentially flat in the first pandemic year while net income rose. HCA returned the CARES Act provider relief funds it had received, during 2020.
- Tenet Healthcare, FY2024. Net income of $3,200M on $20,665M of revenue — a 15.5% margin, more than three times any other year in this window. Tenet sold multiple hospital markets during 2024; income tax expense rose to $1,184M from $306M in FY2023.
- Community Health Systems, FY2016. A net loss of $1,721M. The FY2016 10-K tags a $1,395M goodwill impairment loss.
- Community Health Systems, FY2017. A net loss of $2,459M. The FY2017 10-K tags a $1,419M goodwill impairment loss. Community Health Systems has divested hospitals in every year of this window; revenue fell by a third between FY2016 and FY2020.
Every filing cited for this basket
An asterisk marks a figure taken from the comparative column of a later 10-K rather than that year's own annual report. Almost all of them are fiscal 2016 and 2017 revenue, which companies retagged when they adopted the ASC 606 revenue standard in their fiscal 2018 filings.
Physician groups
Privia Health Group · agilon health
Read this before the numbers
- READ THIS BEFORE THE NUMBERS. This basket is too thin to describe an industry, and this page does not claim it does. Two companies file 10-Ks: Privia Health Group and agilon health. Between them they reported $8.1B of revenue in FY2025 against a US physician-services economy measured in hundreds of billions. Treat the table below as two companies' results, not as 'physician groups'.
- The two are also not the same kind of business. Privia Health is a physician enablement and practice-management platform; agilon health contracts with primary-care groups for total-cost-of-care risk in Medicare Advantage. Their revenue recognition differs accordingly, and agilon's revenue includes the medical costs it is at risk for.
- Most of the sector is unobservable. The overwhelming majority of US physician practices are private partnerships, LLCs, hospital-employed groups, or private-equity portfolio companies — none of which files with the SEC. There is no public income statement for them.
- Two of the most visible public primary-care companies were acquired and stopped filing. CVS Health completed its acquisition of Oak Street Health on May 2, 2023, and Amazon completed its acquisition of 1Life Healthcare (One Medical) on February 22, 2023. Their results are now inside those parents and are not separable from this outside. Cano Health, another public primary-care filer, entered Chapter 11 in February 2024 and emerged as a private company.
- Both remaining constituents have reported net losses in most years. agilon health has never reported a profitable fiscal year in a 10-K. A negative basket margin here is a fact about two companies, not evidence about the economics of medical practice.
Combined, year by year
| Fiscal year | Revenue | Operating income | Net income | Net margin | Operating margin | Revenue YoY | Net income YoY |
|---|---|---|---|---|---|---|---|
| FY2019 | 1,581 | (91) | (274) | -17.36% | -5.73% | — | — |
| FY2020 | 2,035 | (31) | (29) | -1.42% | -1.54% | 28.8% | — |
| FY2021 | 2,800 | (611) | (595) | -21.24% | -21.84% | 37.6% | — |
| FY2022 | 4,065 | (140) | (115) | -2.83% | -3.43% | 45.2% | — |
| FY2023 | 5,974 | (212) | (240) | -4.01% | -3.54% | 47.0% | — |
| FY2024 | 7,797 | (275) | (246) | -3.15% | -3.53% | 30.5% | — |
| FY2025 | 8,055 | (429) | (368) | -4.57% | -5.33% | 3.3% | — |
Combined revenue grew 409.6% from FY2019 to FY2025 and combined net income was negative in every one of those years. High growth and no profit is the pattern the two filings show.
Net income YoY is left empty where the prior year's combined net income was zero or negative, because a percentage change from a negative base is not interpretable.
Each company's net margin, year by year
| Company | FY2016 | FY2017 | FY2018 | FY2019 | FY2020 | FY2021 | FY2022 | FY2023 | FY2024 | FY2025 |
|---|---|---|---|---|---|---|---|---|---|---|
| Privia Health Group | — | — | — | 1.0% | 3.8% | -19.5% | -0.6% | 1.4% | 0.8% | 1.1% |
| agilon health | — | — | — | -35.6% | -4.9% | -22.2% | -3.9% | -6.1% | -4.3% | -6.6% |
Each company, latest fiscal year in this window
| Company | Fiscal year ended | Revenue | Operating income | Net income | Net margin | Total assets | Filing |
|---|---|---|---|---|---|---|---|
| Privia Health Group | 2025-12-31 (FY2025) | 2,123 | 34 | 23 | 1.08% | 1,369 | 10-K 0001759655-26-000010 |
| agilon health | 2025-12-31 (FY2025) | 5,933 | (463) | (391) | -6.60% | 1,271 | 10-K 0001628280-26-011655 |
What the filings say about the swings
- Privia Health Group, FY2021. A net loss of $188M in the year Privia Health completed its initial public offering (April 2021), driven by share-based compensation recognized at IPO.
- agilon health, FY2025. Revenue fell for the first time as agilon exited markets. agilon health has reported a net loss in every year it has filed a 10-K.
Every filing cited for this basket
| Company | CIK | Fiscal year end | Filings used, by fiscal year |
|---|---|---|---|
| Privia Health Group | 0001759655 | December 31 | FY2019 0001759655-22-000032* · FY2020 0001759655-22-000032* · FY2021 0001759655-22-000032 · FY2022 0001759655-23-000026 · FY2023 0001759655-24-000022 · FY2024 0001759655-25-000018 · FY2025 0001759655-26-000010 |
| agilon health | 0001831097 | December 31 | FY2019 0000950170-22-002826* · FY2020 0000950170-22-002826* · FY2021 0000950170-22-002826 · FY2022 0000950170-23-005541 · FY2023 0001628280-24-007242 · FY2024 0001628280-25-007721 · FY2025 0001628280-26-011655 |
An asterisk marks a figure taken from the comparative column of a later 10-K rather than that year's own annual report. Almost all of them are fiscal 2016 and 2017 revenue, which companies retagged when they adopted the ASC 606 revenue standard in their fiscal 2018 filings.
Pharmaceutical manufacturers
Pfizer · Johnson & Johnson · Merck & Co. · AbbVie · Eli Lilly · Bristol Myers Squibb · Amgen · Gilead Sciences
Read this before the numbers
- These eight are the same eight manufacturers used elsewhere in this library, kept identical so the two pages can be read against each other. They are large-cap US-listed manufacturers, not the whole industry: Novartis, Roche, AstraZeneca, Sanofi, GSK and Novo Nordisk file 20-Fs or nothing with the SEC and are outside this basket, and so is every generic manufacturer.
- Pharmaceutical net income swings violently on one-time items, in both directions, and the largest swings in this table are tax and accounting, not trading. Four of the eight report a loss or near-zero year in this window; each has an identified cause in its filing, stated in the notes under the table.
- None of these eight presents an operating-income subtotal on the face of its income statement except AbbVie, Amgen and Gilead, so the combined operating margin for this basket is not computed and those cells are empty.
- A high net margin in one year can be a tax benefit and a loss year can be an acquisition write-off. Bristol Myers Squibb's FY2024 net loss of $8,948M followed its acquisition of Karuna Therapeutics, accounted for as an asset acquisition — the entire purchase price was expensed. The asset acquired is now marketed as Cobenfy for schizophrenia. The loss is not evidence the business shrank.
Combined, year by year
| Fiscal year | Revenue | Operating income | Net income | Net margin | Operating margin | Revenue YoY | Net income YoY |
|---|---|---|---|---|---|---|---|
| FY2016 | 284,189 | not disclosed | 62,046 | 21.83% | not disclosed | — | — |
| FY2017 | 289,937 | not disclosed | 37,721 | 13.01% | not disclosed | 2.0% | -39.2% |
| FY2018 | 303,266 | not disclosed | 60,358 | 19.90% | not disclosed | 4.6% | 60.0% |
| FY2019 | 308,191 | not disclosed | 74,102 | 24.04% | not disclosed | 1.6% | 22.8% |
| FY2020 | 335,204 | not disclosed | 40,579 | 12.11% | not disclosed | 8.8% | -45.2% |
| FY2021 | 407,951 | not disclosed | 92,142 | 22.59% | not disclosed | 21.7% | 127.1% |
| FY2022 | 440,914 | not disclosed | 99,384 | 22.54% | not disclosed | 8.1% | 7.9% |
| FY2023 | 392,524 | not disclosed | 68,147 | 17.36% | not disclosed | -11.0% | -31.4% |
| FY2024 | 428,471 | not disclosed | 49,704 | 11.60% | not disclosed | 9.2% | -27.1% |
| FY2025 | 462,510 | not disclosed | 100,970 | 21.83% | not disclosed | 7.9% | 103.1% |
This basket's combined net margin is the highest of the five and also the most volatile: it ranged from 11.60% in FY2024 to 24.04% in FY2019 without the underlying businesses changing size by anything like that much. FY2024 and FY2025 are $34bn apart in combined revenue and $51bn apart in combined net income.
Net income YoY is left empty where the prior year's combined net income was zero or negative, because a percentage change from a negative base is not interpretable.
Each company's net margin, year by year
| Company | FY2016 | FY2017 | FY2018 | FY2019 | FY2020 | FY2021 | FY2022 | FY2023 | FY2024 | FY2025 |
|---|---|---|---|---|---|---|---|---|---|---|
| Pfizer | 13.7% | 40.6% | 20.8% | 31.4% | 23.1% | 27.0% | 31.3% | 3.6% | 12.6% | 12.4% |
| Johnson & Johnson | 23.0% | 1.7% | 18.8% | 18.4% | 17.8% | 22.3% | 18.9% | 41.3% | 15.8% | 28.5% |
| Merck & Co. | 9.8% | 6.0% | 14.7% | 21.0% | 14.7% | 26.8% | 24.5% | 0.6% | 26.7% | 28.1% |
| AbbVie | 23.2% | 18.8% | 17.4% | 23.7% | 10.1% | 20.5% | 20.4% | 9.0% | 7.6% | 6.9% |
| Eli Lilly | 12.9% | -0.9% | 13.2% | 37.3% | 25.2% | 19.7% | 21.9% | 15.4% | 23.5% | 31.7% |
| Bristol Myers Squibb | 22.9% | 4.8% | 21.8% | 13.2% | -21.2% | 15.1% | 13.7% | 17.8% | -18.5% | 14.6% |
| Amgen | 33.6% | 8.7% | 35.3% | 33.6% | 28.6% | 22.7% | 24.9% | 23.8% | 12.2% | 21.0% |
| Gilead Sciences | 44.4% | 17.7% | 24.7% | 24.0% | 0.5% | 22.8% | 16.8% | 20.9% | 1.7% | 28.9% |
Each company, latest fiscal year in this window
| Company | Fiscal year ended | Revenue | Operating income | Net income | Net margin | Total assets | Filing |
|---|---|---|---|---|---|---|---|
| Pfizer | 2025-12-31 (FY2025) | 62,579 | not disclosed in this form | 7,771 | 12.42% | 208,160 | 10-K 0000078003-26-000026 |
| Johnson & Johnson | 2025-12-28 (FY2025) | 94,193 | not disclosed in this form | 26,804 | 28.46% | 199,210 | 10-K 0000200406-26-000016 |
| Merck & Co. | 2025-12-31 (FY2025) | 65,011 | not disclosed in this form | 18,254 | 28.08% | 136,866 | 10-K 0000310158-26-000063 |
| AbbVie | 2025-12-31 (FY2025) | 61,160 | 15,075 | 4,226 | 6.91% | 133,960 | 10-K 0001551152-26-000008 |
| Eli Lilly | 2025-12-31 (FY2025) | 65,179 | not disclosed in this form | 20,640 | 31.67% | 112,476 | 10-K 0000059478-26-000013 |
| Bristol Myers Squibb | 2025-12-31 (FY2025) | 48,194 | not disclosed in this form | 7,054 | 14.64% | 90,038 | 10-K 0000014272-26-000004 |
| Amgen | 2025-12-31 (FY2025) | 36,751 | 9,080 | 7,711 | 20.98% | 90,586 | 10-K 0000318154-26-000010 |
| Gilead Sciences | 2025-12-31 (FY2025) | 29,443 | 10,022 | 8,510 | 28.90% | 59,023 | 10-K 0000882095-26-000006 |
What the filings say about the swings
- Pfizer, FY2017. Net income of $21,308M on flat revenue. The FY2017 10-K reports a net income tax benefit of $9,049M, following the Tax Cuts and Jobs Act enacted December 22, 2017.
- Pfizer, FY2020. Revenue fell 20% because Pfizer separated its Upjohn off-patent business into Viatris on November 16, 2020; prior years in this window still include it.
- Pfizer, FY2023. Revenue fell 42% and net income fell to $2,119M as COVID-19 product revenue declined from its FY2022 peak. Income tax was a $1,115M benefit.
- Johnson & Johnson, FY2017. Net income of $1,300M — the lowest in the window — on record revenue. The FY2017 10-K reports income tax expense of $16,373M, following the Tax Cuts and Jobs Act.
- Johnson & Johnson, FY2023. Net income of $35,153M, the highest in the window, in the year Johnson & Johnson separated its consumer health business as Kenvue. Reported revenue falls from FY2022 to FY2023 for the same reason.
- Merck & Co., FY2021. Merck spun off Organon & Co. on June 2, 2021. Figures for FY2016–FY2020 above are as originally reported and still include the businesses that went to Organon.
- Merck & Co., FY2023. Net income of $365M on record revenue, after charges for acquired in-process research from the Prometheus Biosciences acquisition completed June 2023.
- AbbVie, FY2020. Revenue rose 38% because AbbVie completed its acquisition of Allergan on May 8, 2020.
- Eli Lilly, FY2017. A net loss of $204M on rising revenue, following the Tax Cuts and Jobs Act.
- Eli Lilly, FY2025. Revenue rose 44.7% and net income rose 94.9% year over year. That revenue increase is the largest Eli Lilly reported in this window; in dollar terms the largest single-year revenue increase anywhere in these baskets is Cigna's FY2019, which was the Express Scripts acquisition.
- Bristol Myers Squibb, FY2020. A net loss of $9,015M on revenue that rose 63%, the year after the Celgene acquisition closed (November 20, 2019).
- Bristol Myers Squibb, FY2024. A net loss of $8,948M on rising revenue. Bristol Myers Squibb completed its acquisition of Karuna Therapeutics on March 18, 2024; the acquisition was accounted for as an asset acquisition, expensing the purchase price as acquired in-process research and development. Karuna's asset is KarXT, marketed as Cobenfy for schizophrenia.
- Amgen, FY2017. Net income fell to $1,979M on flat revenue; income tax expense was $7,618M following the Tax Cuts and Jobs Act.
- Gilead Sciences, FY2020. Net income of $123M on rising revenue. The FY2020 10-K tags $5,856M of acquired in-process research and development expense.
- Gilead Sciences, FY2024. Net income of $480M on rising revenue, after acquired in-process research charges.
Every filing cited for this basket
An asterisk marks a figure taken from the comparative column of a later 10-K rather than that year's own annual report. Almost all of them are fiscal 2016 and 2017 revenue, which companies retagged when they adopted the ASC 606 revenue standard in their fiscal 2018 filings.
Medical devices
Medtronic · Abbott Laboratories · Boston Scientific · Stryker · Becton, Dickinson and Company · Zimmer Biomet Holdings · Edwards Lifesciences
Read this before the numbers
- Fiscal years in this basket do not line up, and this page does not align them. Medtronic's fiscal year ends on the last Friday in April, so its 'FY2025' is the twelve months ended April 25, 2025 — mostly calendar 2024. Becton Dickinson's fiscal year ends September 30. The other five end December 31. A basket total for FY2025 therefore sums three different twelve-month windows.
- For the same reason, Medtronic has since filed a further annual report for the fiscal year ended April 24, 2026, reporting $36,364M of revenue and $4,801M of net income (accession 0001628280-26-044354). That year sits outside this page's FY2016–FY2025 window and is not included in any total above or below.
- These seven are diversified device and diagnostics manufacturers, not pure-play implant makers. Abbott's revenue includes diagnostics, nutrition and established pharmaceuticals; its FY2023 revenue decline is COVID-19 test sales falling away, not device demand.
- Device revenue tracks elective procedure volume. Medical devices and hospitals were the only two of the five baskets whose combined revenue fell in FY2020.
Combined, year by year
| Fiscal year | Revenue | Operating income | Net income | Net margin | Operating margin | Revenue YoY | Net income YoY |
|---|---|---|---|---|---|---|---|
| FY2016 | 93,202 | 14,096 | 8,783 | 9.42% | 15.12% | — | — |
| FY2017 | 101,924 | 14,007 | 9,126 | 8.95% | 13.74% | 9.4% | 3.9% |
| FY2018 | 111,594 | 16,623 | 11,350 | 10.17% | 14.90% | 9.5% | 24.4% |
| FY2019 | 117,700 | 19,075 | 18,513 | 15.73% | 16.21% | 5.5% | 63.1% |
| FY2020 | 116,313 | 14,585 | 12,327 | 10.60% | 12.54% | -1.2% | -33.4% |
| FY2021 | 135,505 | 21,961 | 17,653 | 13.03% | 16.21% | 16.5% | 43.2% |
| FY2022 | 137,662 | 23,331 | 18,504 | 13.44% | 16.95% | 1.6% | 4.8% |
| FY2023 | 138,845 | 23,117 | 18,126 | 13.06% | 16.65% | 0.9% | -2.0% |
| FY2024 | 146,952 | 23,322 | 28,707 | 19.54% | 15.87% | 5.8% | 58.4% |
| FY2025 | 159,194 | 27,451 | 20,787 | 13.06% | 17.24% | 8.3% | -27.6% |
Two of this basket's ten combined-year figures are dominated by single tax and divestiture events: Boston Scientific's FY2019 $4,013M tax benefit and Abbott's FY2024 $6,389M tax benefit, plus Edwards Lifesciences' FY2024 gain on the sale of Critical Care to Becton Dickinson. Combined margin in those years is not an operating result.
Net income YoY is left empty where the prior year's combined net income was zero or negative, because a percentage change from a negative base is not interpretable.
Each company's net margin, year by year
| Company | FY2016 | FY2017 | FY2018 | FY2019 | FY2020 | FY2021 | FY2022 | FY2023 | FY2024 | FY2025 |
|---|---|---|---|---|---|---|---|---|---|---|
| Medtronic | 12.3% | 13.6% | 10.4% | 15.2% | 16.6% | 12.0% | 15.9% | 12.0% | 11.4% | 13.9% |
| Abbott Laboratories | 6.7% | 1.7% | 7.7% | 11.6% | 13.0% | 16.4% | 15.9% | 14.3% | 31.9% | 14.7% |
| Boston Scientific | 3.8% | 1.1% | 17.0% | 43.8% | -1.2% | 8.3% | 5.1% | 11.0% | 11.1% | 14.4% |
| Stryker | 14.5% | 8.2% | 26.1% | 14.0% | 11.1% | 11.7% | 12.8% | 15.4% | 13.2% | 12.9% |
| Becton, Dickinson and Company | 7.8% | 9.1% | 1.9% | 7.1% | 5.1% | 10.3% | 9.4% | 7.7% | 8.4% | 7.7% |
| Zimmer Biomet Holdings | 4.0% | 23.2% | -4.8% | 14.2% | -2.0% | 5.1% | 3.3% | 13.8% | 11.8% | 8.6% |
| Edwards Lifesciences | 19.2% | 17.0% | 19.4% | 24.1% | 18.8% | 28.7% | 28.3% | 23.4% | 76.7% | 17.7% |
Each company, latest fiscal year in this window
| Company | Fiscal year ended | Revenue | Operating income | Net income | Net margin | Total assets | Filing |
|---|---|---|---|---|---|---|---|
| Medtronic | 2025-04-25 (FY2025) | 33,537 | 5,955 | 4,662 | 13.90% | 91,680 | 10-K 0001613103-25-000091 |
| Abbott Laboratories | 2025-12-31 (FY2025) | 44,328 | 8,053 | 6,524 | 14.72% | 86,713 | 10-K 0001628280-26-010185 |
| Boston Scientific | 2025-12-31 (FY2025) | 20,074 | 3,613 | 2,898 | 14.44% | 43,673 | 10-K 0000885725-26-000010 |
| Stryker | 2025-12-31 (FY2025) | 25,116 | 4,889 | 3,246 | 12.92% | 47,844 | 10-K 0000310764-26-000010 |
| Becton, Dickinson and Company | 2025-09-30 (FY2025) | 21,840 | 2,579 | 1,678 | 7.68% | 55,325 | 10-K 0000010795-25-000099 |
| Zimmer Biomet Holdings | 2025-12-31 (FY2025) | 8,232 | 1,098 | 705 | 8.57% | 23,092 | 10-K 0001193125-26-059853 |
| Edwards Lifesciences | 2025-12-31 (FY2025) | 6,068 | 1,264 | 1,074 | 17.69% | 13,697 | 10-K 0001099800-26-000009 |
What the filings say about the swings
- Medtronic, FY2020. The fiscal year ended April 24, 2020 — the only year in this basket whose fourth quarter falls entirely inside the first pandemic quarter.
- Abbott Laboratories, FY2023. Revenue fell 8.1% as COVID-19 test sales declined from their FY2022 level.
- Abbott Laboratories, FY2024. Net income of $13,402M on $41,950M of revenue — a 31.9% net margin. The FY2024 10-K reports a net income tax benefit of $6,389M.
- Boston Scientific, FY2019. Net income of $4,700M on $10,735M of revenue — a 43.8% net margin driven by tax, not operations: the FY2019 10-K reports a net income tax benefit of $4,013M.
- Boston Scientific, FY2020. A net loss of $115M as revenue fell 7.7% in the first pandemic year — elective procedures, which drive most device volume, were deferred.
- Becton, Dickinson and Company, FY2018. Net income of $311M on revenue up 32%, the first full year after the C. R. Bard acquisition (December 29, 2017); income tax expense was $862M.
- Zimmer Biomet Holdings, FY2017. Net income of $1,814M on flat revenue; the FY2017 10-K reports a net income tax benefit of $1,349M.
- Zimmer Biomet Holdings, FY2018. A net loss of $379M. The FY2018 10-K tags $980M of goodwill and intangible asset impairment.
- Zimmer Biomet Holdings, FY2022. Revenue fell 11% because Zimmer Biomet spun off its dental and spine business as ZimVie on March 1, 2022.
- Edwards Lifesciences, FY2024. Net income of $4,175M on $5,440M of revenue. Edwards sold its Critical Care business to Becton Dickinson on September 3, 2024; reported revenue falls year over year because Critical Care moved to discontinued operations.
Every filing cited for this basket
An asterisk marks a figure taken from the comparative column of a later 10-K rather than that year's own annual report. Almost all of them are fiscal 2016 and 2017 revenue, which companies retagged when they adopted the ASC 606 revenue standard in their fiscal 2018 filings.
Who is missing, and why
This is the most important list on the page. Everything below is a real part of US health care with real money in it, and none of it appears in any number above.
- Nonprofit and government hospital systems. They file IRS Form 990s and state financial reports, not SEC annual reports. There is no audited, comparably tagged annual revenue and surplus series for them on EDGAR, so they are absent from the hospital basket. By the American Hospital Association's count, 2,984 of the 5,121 US community hospitals are nongovernment not-for-profit and a further 913 are state or local government — three quarters of US community hospitals, none of which files a 10-K.
- Nonprofit and mutual health insurers. Health Care Service Corporation, Kaiser Foundation Health Plan, Highmark, and most Blue Cross Blue Shield licensees are not SEC registrants. Their statutory financial statements go to state insurance regulators and the NAIC, not to EDGAR.
- Private and private-equity-owned physician groups and hospital operators. No SEC filing obligation, no public income statement. This is the single largest gap on this page, and it is unfixable from EDGAR.
- Standalone pharmacy benefit managers. None exists at scale. The three largest are business units inside CVS Health, The Cigna Group and UnitedHealth Group, and their results are only visible as segment disclosures, which are shown separately and are not treated as a sector.
- Foreign-listed manufacturers. Novartis, Roche, AstraZeneca, Sanofi, GSK, Novo Nordisk, Bayer, Siemens Healthineers, Philips and Olympus either file Form 20-F under IFRS or do not file with the SEC at all. Mixing IFRS results into a US-GAAP basket would make the totals incomparable, so they are excluded rather than converted.
- Medicare, Medicaid and the Veterans Health Administration. Government programs, not registrants. They pay for a larger share of US medical care than every company on this page combined, and none of their spending appears here.
What to do with this
These are facts, not verdicts. A 21.8% combined net margin in the pharmaceutical basket and a 1.2% combined net margin in the insurance basket do not mean one set of companies is virtuous and the other is not; they mean the two businesses convert revenue to profit at completely different rates, because a managed-care premium dollar mostly passes straight through as a medical claim while a patented medicine has almost no marginal cost. Percentage margin and dollars of profit answer different questions, and the tables above give both. What the ten-year series does establish is which baskets grew faster than prices, which company-years turn on a single tax or impairment entry, and how much of US health care simply does not appear in any audited public series at all.
The rest of the money trail — what the manufacturers spend on research versus selling, what physicians are paid by industry, and who funds the advocacy groups and the news coverage — is the follow-the-money shelf. The eight manufacturers in the pharmaceutical basket here are the same eight in how pharma makes and spends money, deliberately, so the two pages can be read against each other. The same money, as a time series, is where the money goes: sixty-five years of national spending totals and categories, prices, and these two profit baskets summed year by year.
Method, in full
Source. US Securities and Exchange Commission, EDGAR. Company facts were pulled from https://data.sec.gov/api/xbrl/companyfacts/CIK##########.json on 2026-09-04, one request per company, with a descriptive user agent as the SEC requires. Segment figures for the three pharmacy benefit parents were read from the segment-reporting note of each company's most recent 10-K as rendered in that filing's own financial report exhibits.
Concepts. Revenue is the first of us-gaap:Revenues, us-gaap:RevenueFromContractWithCustomerExcludingAssessedTax, us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax, us-gaap:HealthCareOrganizationRevenue, us-gaap:HealthCareOrganizationPatientServiceRevenue or us-gaap:SalesRevenueNet that the company tagged for that fiscal year. Net income is us-gaap:NetIncomeLoss where tagged, otherwise us-gaap:NetIncomeLossAvailableToCommonStockholdersBasic (Tenet, Cigna through FY2022, Boston Scientific FY2018-FY2025, Edwards through FY2020), otherwise us-gaap:ProfitLoss (Boston Scientific FY2016 and FY2017 only, years in which the company reported no noncontrolling interests). Operating income is us-gaap:OperatingIncomeLoss. Assets is us-gaap:Assets at fiscal year end.
Which filing a number comes from. For each fiscal year the value is taken from the earliest-filed Form 10-K that carries it, which is that year's own annual report except where a concept was introduced later. Figures marked with an asterisk come from a later 10-K's comparative column — chiefly fiscal 2016 and 2017, whose revenue was retagged when ASC 606 was adopted in the fiscal 2018 10-K.
Restatements. Figures are as reported in the cited filing and are NOT restated for later spin-offs, divestitures or discontinued-operations reclassifications. Where a spin-off or divestiture breaks year-over-year comparability, the note on that company-year says so.
Omissions. Where a company does not tag a concept for a fiscal year, the cell is empty and reads 'not disclosed in this form'. Nothing on this page is estimated, modeled or interpolated. HCA Healthcare, Pfizer, Johnson & Johnson, Merck, Eli Lilly and Bristol Myers Squibb present no operating-income subtotal on the face of their income statements, so their operating-margin cells are empty and the combined operating margin for the pharmaceutical and hospital baskets is not computed.
How baskets are combined. A basket's combined figures are the plain sum of its named constituents for that fiscal year, and combined net margin is combined net income divided by combined revenue. A basket year is computed only when every constituent reports that year; the physician-group basket therefore begins at FY2019, when both of its constituents first filed. Sums are not consolidated: intercompany revenue between constituents is not eliminated, and where a basket contains a company that sells to another basket, the same dollar can appear twice across baskets.
Fiscal years. Fiscal years are labelled by the calendar year in which they end. Twenty-five of the twenty-eight companies end their fiscal year on or within days of December 31. Three do not: Medtronic's fiscal year ends on the last Friday in April, Becton Dickinson's on September 30, and Johnson & Johnson's on the Sunday nearest December 31. Their years are placed in the label bucket they carry in their own filings and are NOT shifted or interpolated to a calendar basis.
Inflation. US Bureau of Labor Statistics, CPI-U, US city average, all items, not seasonally adjusted, annual average. Series ID CUUR0000SA0. Medical care reference line: series ID CUUR0000SAM. Retrieved from https://api.bls.gov/publicAPI/v2/timeseries/data/ on 2026-09-04.
The hospital counts. The figures used above to say what the for-profit hospital basket leaves out come from the American Hospital Association's Fast Facts on US Hospitals, 2026 edition, which reports 2024 AHA Annual Survey data. That sheet counts hospitals by ownership and reports staffed beds only as a single total, so this page makes no claim about the share of beds any operator holds.