A bold truth shakes the Denver healthcare scene: Only half of the region's health systems reported strong profits in 2024, revealing a financial divide that many local hospitals argue misses crucial context. But here's where it gets controversial—figures can look drastically different depending on what's being measured, sparking heated debates about the true health of these systems.
The 2025 Colorado Health Market Review highlights that three out of six major Denver-area health systems enjoyed notably profitable years. This data primarily focuses on total profits, which have generally risen compared to previous years. Allan Baumgarten, the report’s author and a healthcare consultant, emphasizes that counting income streams like investments, government grants, and philanthropy provides a fuller picture of hospital resources. "2024 was especially favorable for investments," he notes, suggesting that excluding such income underestimates hospitals' financial strength.
In contrast, the Colorado Hospital Association and several member hospitals argue that the key financial indicator should be operating margins—the profits made strictly from patient care and related support services like cafeterias or parking. The association reported that around 70% of Colorado hospitals were running unsustainable operating margins, defined as below 4%. Dan Mager, a spokesperson, contends that this gives a more accurate snapshot of hospital finances, shedding light on the gap between the actual cost of delivering patient care and the reimbursements received.
Looking at the numbers, the report revealed that Denver hospitals’ total profits before taxes increased by nearly 14%, amassing $1.3 billion collectively. UCHealth led the way with a hefty profit near $1.2 billion, followed by HCA HealthOne at $616.8 million, and CommonSpirit Health with $222.2 million. Notably, HCA HealthOne is the state's sole for-profit system, thus subject to income taxes. Yet, UCHealth stresses its focus on operating margin—reporting roughly 4% for the fiscal year ending June. They caution that investment income is volatile and can fluctuate wildly year to year, making it unreliable for assessing ongoing financial health. Additionally, federal payments to resolve past undercompensations likely boosted 2024 profits artificially.
On the flip side, three area systems operated at a loss: Denver Health lost $52.9 million, AdventHealth $68.6 million, and Intermountain Health faced a $138.3 million deficit. Intermountain explained much of its loss as tied to accounting related to an older hospital facility replaced in 2024, alongside rising costs and increased charity care. Despite these hurdles, Intermountain vows to continue providing affordable, quality healthcare to its communities.
Among the complexities lies a deeper controversy: rural hospitals, often ignored in such reports, face the toughest financial storms. These smaller facilities struggle with capital access and staffing, especially as rising uninsured patient numbers and tighter Medicaid eligibility loom. Baumgarten predicts many rural hospitals will turn to large health systems for survival, gaining bargaining power for better insurance rates but sacrificing independence. This shift raises a thorny question—are these affiliations genuine rescues or savvy business moves? UCHealth’s recent alliance with Estes Park Health, which had to cut services and close a nursing home before joining, illustrates the delicate balance between financial pragmatism and community care.
This ongoing tug-of-war poses a critical question for all Coloradans: Should we accept higher prices through consolidated healthcare systems or risk the loss of vital rural hospitals? The answers may reshape the future of healthcare accessibility in the state.
Denver-area hospital profit and loss summary for 2024:
- AdventHealth: $68.6 million loss, -4.5% operating margin
- CommonSpirit Health: $222.2 million profit, 9.2% margin
- Denver Health: $52.9 million loss, -4.1% margin
- HCA HealthOne: $616.8 million profit, 21.3% margin
- Intermountain Health: $138.3 million loss, -6.5% margin
- UCHealth: $1.2 billion profit, 17.9% margin
Even with some systems struggling, Baumgarten believes Denver hospitals are relatively prepared to handle an expected rise in uninsured patients next year—unless Congress extends subsidies for individual marketplace insurance. However, the challenges are real and growing, especially as stricter Medicaid rules threaten coverage further in 2027.
What will the future hold for Colorado’s healthcare landscape? Will the giants continue to dominate while rural hospitals get absorbed or vanish? And how do consumers feel about the trade-off between cost and care accessibility? These questions invite robust discussion, and your opinion matters—agree or disagree, share your thoughts below.
Source: 2025 Colorado Health Market Review and statements from Colorado Hospital Association and hospital representatives.
