
There are 1,527 public hospitals actively operating in the US, with expenses funded by the government and taxpayers. These hospitals are owned by different levels of government, including city, city-county, county, federal, hospital district, state, and other. The top three public hospitals by net patient revenue are the UCSF Helen Diller Medical Center, the University Hospital in Ann Arbor, and the University of Texas MD Anderson Cancer Center.
| Characteristics | Values |
|---|---|
| Number of public hospitals in the US | 1,527 |
| Ownership categories | City, city-county, county, federal, hospital district, state, and other |
| Funding for government-owned hospitals | Government and taxpayer dollars |
| Examples of top public hospitals | UCSF Helen Diller Medical Center, University Hospital, University of Texas MD Anderson Cancer Center |
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What You'll Learn
- Governmental ownership: expenses covered by the government and taxpayers
- Public hospitals: 1,527 in the US
- Ownership categories: city, city-county, county, federal, hospital district, state
- Community hospitals: non-federal, short-term, speciality services
- Excluded hospitals: those not accessible by the general public

Governmental ownership: expenses covered by the government and taxpayers
In the United States, hospitals under governmental ownership are funded by the government and taxpayers. These hospitals are also known as public hospitals. There are 1,527 public hospitals actively operating in the US, and they fall under several ownership categories based on the level of government at which the hospital is owned: city, city-county, county, federal, hospital district, state, and other.
Public hospitals are funded by taxpayer dollars and government funds, ensuring that all citizens have access to essential medical services. This funding model allows hospitals to provide care regardless of a patient's ability to pay, promoting equitable access to healthcare. The government funding covers various expenses, including infrastructure, equipment, staffing, and operational costs, ensuring that public hospitals can offer comprehensive services to the community.
The UCSF Helen Diller Medical Center at Parnassus Heights in San Francisco, California, is an example of a top-performing public hospital. With over $5.4 billion in net patient revenue (NPR), it ranks first among public hospitals in the US. The University Hospital in Ann Arbor, Michigan, and the University of Texas MD Anderson Cancer Center in Houston, Texas, are also notable public hospitals, with substantial NPRs of $4.9 billion and $4.6 billion, respectively.
The funding provided by the government and taxpayers plays a crucial role in maintaining and improving the healthcare infrastructure and services offered by public hospitals. It enables these hospitals to invest in advanced medical equipment, cutting-edge research, and specialized staff, ensuring that patients receive high-quality care. Additionally, governmental ownership of hospitals ensures stability and continuity in healthcare services, particularly in underserved or rural areas where private hospitals may be less prevalent.
Overall, governmental ownership of hospitals in the US plays a vital role in providing accessible and equitable healthcare to all citizens. Through taxpayer funding and government support, public hospitals can offer essential medical services, contribute to medical research and advancements, and serve their communities with high-quality healthcare. This ownership model reflects a commitment to ensuring that healthcare is a right for all, regardless of social or economic status.
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Public hospitals: 1,527 in the US
There are 1,527 public hospitals actively operating in the United States. These hospitals are owned by different levels of government, including city, city-county, county, federal, hospital district, state, and other categories. The first public hospital in the US, NYC Health + Hospitals/Bellevue, formerly known as Bellevue Hospital Center, was established in 1736. Since then, the number of hospitals in the country has grown to several thousand.
The US has a diverse range of hospitals, including community hospitals, which are nonfederal, short-term general, or special hospitals. These special hospitals encompass various disciplines, such as obstetrics and gynecology, eye, ear, nose, and throat care, long-term acute care, rehabilitation, and orthopedics. Academic medical centres and teaching hospitals are also included in this category if they meet the criteria of being nonfederal short-term hospitals.
Additionally, there are critical access hospitals, which are small, rural hospitals that cater to underserved communities. These hospitals play a crucial role in improving healthcare access and receive most of their reimbursement from the Centers for Medicare and Medicaid Services (CMS).
The American Hospital Association conducts annual surveys to gather comprehensive data on US hospitals. Their surveys include information on the number of government hospitals, the distribution of hospitals across states, and the availability of hospital beds.
The top public hospitals in the US by net patient revenue include the UCSF Helen Diller Medical Center at Parnassus Heights in San Francisco, California, with over $5.4 billion in net patient revenue, followed by the University Hospital in Ann Arbor, Michigan, with $4.9 billion. These hospitals play a vital role in providing healthcare services to the American public.
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Ownership categories: city, city-county, county, federal, hospital district, state
In the United States, hospitals are owned by various entities, including federal, state, county, city, and hospital district governments. These different ownership categories play a crucial role in providing healthcare services to the American people.
City-owned hospitals are governed and operated by the city government. These hospitals primarily serve as safety-net facilities for the local population, offering essential medical services. They are funded through the city's budget and taxpayer dollars, allowing them to provide low-cost or free emergency care to those in need.
City-county-owned hospitals are a collaboration between a city and a county, providing healthcare services to residents within their respective jurisdictions. These hospitals are governed and funded by both city and county governments, ensuring that the medical needs of their combined populations are met.
County-owned hospitals, as the name suggests, are owned and operated by the county government. They serve as vital safety nets for their local communities, often providing care for underserved populations. County taxes and government funding ensure that these hospitals can offer affordable or free emergency treatment.
Federal government hospitals are owned and operated by the federal government and overseen by departments such as the Department of Defense (DoD) and the Veterans Health Administration (VA). With approximately 200 federal hospitals across the nation, they cater to specific groups, including veterans, active-duty military personnel, and Native Americans.
Hospital districts, established through state legislation, are special-purpose governmental entities that own and manage hospitals. These districts are funded by local taxes and provide healthcare services within designated regions, often serving underserved communities and offering specialized care.
State-owned hospitals, managed by individual state governments, frequently serve academic or psychiatric purposes. They are an integral part of the state's healthcare system, providing essential services to specific populations, including veterans, active-duty military personnel, Native Americans, and low-income individuals.
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Community hospitals: non-federal, short-term, speciality services
In the United States, community hospitals are defined as all non-federal, short-term general, and other special hospitals. They are often funded, at least in part, by local governments or municipal bodies. These hospitals are open to the general public and provide short-term acute care services to local populations. They may also be referred to as federally funded or government hospitals. Community hospitals include academic medical centres or other teaching hospitals if they fall under the non-federal, short-term category.
Community hospitals offer a range of specialty services, including obstetrics and gynecology, eye, ear, nose, and throat care, rehabilitation, and orthopaedic services. They may also provide long-term acute care. Academic medical centres, as a type of community hospital, serve specific medical schools or universities. They offer both general healthcare services and specialised treatments, while also providing educational opportunities for students in healthcare.
Acute hospitals, another type of community hospital, focus on short-term patient care. Most patients treated in these hospitals stay for 10 days or fewer. They are not equipped for long-term or chronic patient care. Ambulatory surgery centres, as a subset of acute hospitals, offer cost-effective surgical procedures without requiring inpatient admission or extended hospital stays.
Community hospitals are distinct from non-community hospitals, which cater to specific groups such as veterans or Native American populations. They differ from general service hospitals, which offer necessary services but limited specialty care and may not provide long-term patient treatment.
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Excluded hospitals: those not accessible by the general public
In the United States, hospitals that are not accessible by the general public, such as prison hospitals or college infirmaries, are excluded from the category of community hospitals. These excluded hospitals are typically not open to the public and serve specific populations within controlled environments, like prisons or educational institutions.
The American Hospital Association (AHA) defines community hospitals as all nonfederal, short-term general, and other special hospitals. Special hospitals include those providing services in areas such as obstetrics and gynecology, eye, ear, nose, and throat care, long-term acute care, rehabilitation, and orthopaedics. While community hospitals can encompass academic medical centres and teaching hospitals, they specifically exclude hospitals that the general public cannot access.
The exclusion of these hospitals from the category of community hospitals is important for statistical and regulatory purposes. By defining community hospitals as those accessible to the general public, it allows for clearer distinctions when collecting data on hospital availability, capacity, and performance. This, in turn, helps inform healthcare policies, resource allocation, and strategic planning within the healthcare sector.
Additionally, the exclusion of these hospitals has implications for funding and payment systems. Hospitals that are not accessible by the general public may have different funding structures and are often not included in certain payment systems. For example, under the Electronic Code of Federal Regulations, hospitals excluded from the inpatient prospective payment system are addressed separately, with specific criteria and requirements outlined for their inclusion or exclusion.
It is worth noting that the Office of Inspector General (OIG) within the U.S. Department of Health and Human Services has the authority to exclude individuals and entities from Federally funded healthcare programs for reasons such as Medicare or Medicaid fraud. This can result in entities receiving no payment from Federal healthcare programs for the services they provide, further impacting the funding and accessibility of these excluded hospitals.
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Frequently asked questions
Hospitals in the USA fall under different ownership categories based on the level of government at which the hospital is owned: city, city-county, county, federal, hospital district, state, and other. These are known as public hospitals and are funded by the government and taxpayer dollars.
Some of the top public hospitals in the USA include:
- UCSF Helen Diller Medical Center at Parnassus Heights, San Francisco, California.
- University Hospital, Ann Arbor, Michigan.
As of July 2024, there were 1,527 public hospitals actively operating in the USA.
The top 25 public hospitals in the USA earned a total of $72.2 billion in net patient revenue in 2023.
Net patient revenue (NPR) is a hospital's total patient revenue minus discounts.











































