Hailey Tran
Public hospitals in the US are owned by the government and funded by taxpayers. 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. Some notable public hospitals in the US include the UCSF Helen Diller Medical Center in San Francisco, the University Hospital in Ann Arbor, Michigan, and the Lyndon B. Johnson General Hospital in Houston, Texas.
| Characteristics | Values |
|---|---|
| Number of public hospitals in the US | 1,527 |
| Ownership categories | City, city-county, county, federal, hospital district, state, and other |
| Examples | John H. Stroger Jr. Hospital of Cook County (Chicago), Lyndon B. Johnson General Hospital (Houston), UCSF Helen Diller Medical Center at Parnassus Heights (San Francisco) |
| Funding | Government, taxpayer dollars, charitable donations |
| Municipal healthcare example | NYC Health + Hospitals |
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What You'll Learn
Examples of public hospitals in the US
In the United States, hospitals fall under several ownership models, including proprietary, voluntary nonprofit, and governmental ownership. Under governmental ownership, all hospital expenses are funded by the government and taxpayer dollars. These facilities are known as public hospitals.
There are 1,527 public hospitals actively operating in the U.S. California, the most populous state in the country, has the most public hospitals in the top 25, with six hospitals in the list.
- UCSF Helen Diller Medical Center at Parnassus Heights, San Francisco, California. This is the top-ranked public hospital in the U.S. by net patient revenue (NPR), with over $5.4 billion in NPR.
- University Hospital, Ann Arbor, Michigan. This hospital is ranked second in the U.S. by NPR, with $4.9 billion in revenue.
- University of Texas MD Anderson Cancer Center, Houston, Texas. This hospital is ranked third in the U.S. by NPR, with $4.6 billion in revenue.
- John H. Stroger Jr. Hospital of Cook County, Chicago.
- Lyndon B. Johnson General Hospital, Houston.
- Greenville General Hospital, Greenville, South Carolina. This hospital is owned by the city of Greenville but leased to Prisma Health for management.
- Martin Luther King Jr./Drew Medical Center, Los Angeles County, California.
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How are public hospitals funded?
Public hospitals in the US are funded by the government and taxpayer dollars. They fall under one of 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. There are 1,527 public hospitals actively operating in the US.
Public hospitals are not always non-profit hospital corporations. In the US, two-thirds of all urban hospitals are non-profit. The remaining third is split between for-profit and public hospitals. Nonprofit hospitals are funded by surplus funds, which they use to improve facilities, equipment, and patient care, as well as to advance medical training, education, and research. They are also funded by charitable donations and community benefit funds. However, the cost of their nonprofit status is borne by society in the form of forgone local, state, and federal tax revenue.
Public hospitals in other countries are funded differently. In France, public hospitals are financed by employee contributions and health insurance, all of which is public money. In Brazil, publicly funded hospitals receive payments based on the number of patients and procedures performed. In India, public hospitals are usually individual state-funded, although hospitals funded by the central (federal) government also exist.
Public health departments in the US have historically been underfunded, with a "long-established pattern of boom-and-bust funding." During the pandemic, a temporary surge of money allowed some health departments to expand and strengthen programs. However, as COVID funds dried up, many departments were forced to reduce staff numbers and scale back programs. The proposed 2026 HHS budget includes further cuts to public health funding, which has alarmed health experts and lawmakers.
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Ownership categories of public hospitals
Public hospitals in the US fall under several ownership categories based on the level of government at which the hospital is owned. These categories include city, city-county, county, federal, hospital district, state, and other. Hospitals under governmental ownership are funded by the government and taxpayer dollars and are considered public hospitals.
Public hospitals in the US include the UCSF Helen Diller Medical Center at Parnassus Heights in San Francisco, California, which is the top-ranked public hospital in the country in terms of net patient revenue (NPR). The University Hospital in Ann Arbor, Michigan, and the University of Texas MD Anderson Cancer Center in Houston, Texas, are also among the top-ranked public hospitals in the US.
Some public hospitals in the US are owned by the cities in which they are located. For example, Greenville General Hospital in Greenville, South Carolina, is owned by the city of Greenville but leases its management to Prisma Health, which operates it as Prisma Health Greenville Memorial Hospital.
County-owned public hospitals also exist, such as the John H. Stroger Jr. Hospital of Cook County in Chicago. Additionally, some public hospitals are owned by hospital districts, such as Central Health in Travis County, Texas.
While most hospitals in the US are funded primarily by taxpayers, some also receive charitable donations and engage in outsourcing certain services to private companies.
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Outsourcing of hospital services
There are indeed public hospitals in the US, with 1,527 public hospitals actively operating across the country. These hospitals are owned by different levels of government, including city, city-county, county, federal, hospital district, state, and other ownership categories.
Outsourcing non-core functions is an increasingly common strategy for hospitals in the US to reduce costs and improve efficiency, allowing medical workers to focus on patient care. Hospitals are inclined to outsource services that are not related to basic patient care, such as security, maintenance of information systems, catering, and record-keeping.
The healthcare process outsourcing market in the US reached nearly $53 billion in 2020 and is expected to grow to $66 billion by 2025. One of the most commonly outsourced areas is information technology (IT), with the global healthcare IT outsourcing market projected to reach $61 billion by 2023. Outsourcing IT services can help hospitals save costs by avoiding the need to invest in expensive upgrades to in-house equipment.
Another commonly outsourced service is diagnostic imaging, which allows hospitals to offer cutting-edge medical services without purchasing and maintaining costly equipment. Outsourcing can also help hospitals address staffing issues and reduce costs associated with hiring full-time employees.
However, outsourcing in healthcare is not without its risks and drawbacks. There have been concerns about for-profit radiology companies using less-expensive radiology technicians instead of radiologists, which may compromise the quality of patient care. Outsourcing clinically important services can potentially lead to patient harm, unhappy staff, and higher costs if not properly managed. Therefore, it is essential for hospitals to carefully consider the potential benefits and disadvantages of outsourcing specific services and choose the right partners to ensure that patient care remains the top priority.
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Public hospitals in New York City
Public hospitals in the US are owned by the government and funded by taxpayers. 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.
In New York City, NYC Health + Hospitals provides quality, affordable healthcare in every neighbourhood. They offer specialised services for people suffering from Long Covid, as well as cardiac care, endocrinology services for adults with Type 1 diabetes, and surgical innovations. NYC Health + Hospitals also provides women's health services and racial equity initiatives.
Some other notable public hospitals in the US include:
- UCSF Helen Diller Medical Center at Parnassus Heights, San Francisco, California
- University Hospital, Ann Arbor, Michigan
- University of Texas MD Anderson Cancer Center, Houston, Texas
- John H. Stroger Jr. Hospital of Cook County, Chicago
- Lyndon B. Johnson General Hospital, Houston
- Greenville General Hospital, Greenville, South Carolina
- Martin Luther King Jr./Drew Medical Center, Los Angeles County, California
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Frequently asked questions
Yes, there are public hospitals in the US. As of 2024, there were 1,527 public hospitals actively operating in the US.
Public hospitals are funded by the government and taxpayer dollars. Some hospitals also receive charitable donations.
Some examples of public hospitals in the US include:
- John H. Stroger Jr. Hospital of Cook County, Chicago
- Lyndon B. Johnson General Hospital, Houston
- Greenville General Hospital, Greenville, SC
- UCSF Helen Diller Medical Center, San Francisco
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