February 16, 2026
CONTACT: Allan Baumgarten, 952/212-8589, baumg010@gmail.com
Florida Health Market Review 2026 finds:
South Florida hospital systems report record profits in 2024.
Health insurers lose enrollment in 2024 but see improved results in 2025.
Net income for South Florida hospital systems increased by 25% in 2024. In the first nine months of 2025, Florida HMOs improved their profits compared to 2024. Enrollment in Medicaid HMOs decreased by more than 34% since its peak in 2022.
These and other findings are presented in Florida Health Market Review 2026, Allan Baumgarten’s 17th report analyzing the financial performance and competitive strategies of Florida’s health care payer and provider organizations. Baumgarten is a Minneapolis-based analyst who publishes reports examining health market trends and competition in Florida and five other states: Colorado, Michigan, Minnesota, Ohio and Texas. He also conducts project research and has completed reports sponsored by the Robert Wood Johnson Foundation analyzing new provider-sponsored health plans and how states contract with Medicaid managed care organizations and oversee their performance. PDFs or excerpts from his reports can be downloaded at www.AllanBaumgarten.com
Key findings in the new report:
Florida hospital systems reported strong profitability in 2024, with South Florida health systems reporting average margins of 14.8%. Health systems in Miami-Dade, Broward and Palm Beach counties posted record profits in 2024, with combined net income of $3,351 billion, which was 14.8% of operating revenues of $22.586 billion. That 24.6% more than their net income of $2.643 billion in 2023 and more than their net income of $1.59 billion in 2020. All of the systems here were profitable, and the two largest systems in the region, Baptist Health and HCA Healthcare, both had net income above $800 million.
Health systems in the Orlando region were even more profitable, with combined net income of $3.968 billion or 25.3% of operating revenues. AdventHealth, the largest system in the region, had net income of $2.030 billion and Orlando Health posted net income of $1.825 billion. In the Tampa Bay region, hospital systems had combined net income of $2.794 billion, or 16.5% of operating revenues. BayCare Health, the largest system in the region, had net income of $664.5 million, or 14% of operating revenues. HCA Healthcare, the second largest system in the region, had net income of $826.6 million, or 22% of operating revenues.
Pursuing strategies of growth, Florida hospital systems of all kinds--for-profit, religious/community and public—are making huge investments in new hospitals and other facilities. Many new hospitals have recently opened or are under construction across the state. The state’s decision to largely repeal its Certificate of Need regulations opened the floodgates for new construction projects. Systems like HCA Healthcare have built new hospitals and have also opened numerous free-standing emergency departments, now numbering more than 70, and urgent care clinics. Florida Health Market Review 2021 Page -2-
Other health systems, including Tenet Health, Community Health Systems and Ascension in some other states, have sold some of their inpatient hospital facilities, while shifting their investments to new service lines, such as micro-hospitals and ambulatory surgery centers, or to other service areas.
Enrollment in Florida HMOs decreased in 2023 and 2024. Much of that was driven by a sharp decrease in Medicaid HMO enrollees as the state re-evaluated their eligibility and ended benefits for about 1.4 million beneficiaries. Enrollment in individual plans sold on the Healthcare.gov marketplace surged by almost 2 million after the enhanced tax credit subsidies took effect but decreased by more than 200,000 in the most recent open enrollment period, as premiums for those plans increased.
Florida HMOs improved their profitability in the first nine months of 2025. After reporting average profit margins of 1.8% in 2024, they posted margins of 2.4% in the first nine months of 2025.
Excerpts from the report and information about ordering the report and data set can be found at www.AllanBaumgarten.com. For additional information, contact him at baumg010@gmail.com or 952/212-8589.
ORDER NOW!
Exhibit 1Click to View
Agency for Health Care Administration
Baptist Health Systems of South Florida
Blue Cross Blue Shield of Florida
Florida Association of Health Plans
Florida Department of Children and Families
Florida Office of Insurance Regulation
Florida Hospital Association (FHA)
Florida Healthy Kids Corporation
Florida Legislature, Office of Economic and Demographic Research
Morton Plant Mease Health Center
| Introduction |
| 3 |
| Market Structure |
| 4 |
| Health Plans |
| 4 |
| Provider Systems |
| 8 |
| Market Trends |
| 12 |
| Health Plan Enrollment | 12 | |
| Individual Plans and Healthcare.gov | 14 | |
| Medicare Plans |
| 16 |
| Medicaid Managed Care |
| 17 |
| Enrollment by Region |
| 18 |
| Health Plan Revenues and Net Income |
| 19 |
| Financial Results by Line of Business |
| 22 |
| Administrative Expenses and Provider Payment |
| 27 |
| Health Plan Capital Adequacy |
| 29 |
| Hospital Systems and Regional Sub-markets | 32 | |
| South Florida |
| 32 |
| Tampa-St Petersburg |
| 39 |
| Jacksonville-Gainesville |
| 42 |
| Orlando Region |
| 46 |
| A Look Ahead |
| 49 |
Florida Health Market Review 2017 was released December 13: "HMOs return to profitability and reach record enrollment numbers; Florida hospitals continue expansion strategies and enjoy strong profits"
- Sammy Mack reported on WLRN Public Radio: "From Patients to Hospitals, Affordable Care Act Shapes Florida Health Care Market, Analyst Says." Click here to listen
- Charles Elmore quotes the new report in the Palm Beach Post: "Hurricane Irma, political storms roil finish of sign-up season." Click here to read
- Ron Hurtibise reported in the Sun Sentinel: "Profits for Broward's two public hospital systems going opposite ways." Click here to read
- Margie Manning wrote in the Tampa Bay Business Journal: "Here are the most profitable systems in Tampa Bay." Click here to read
Florida Health Market Review 2015 was released November 18: "Hospital systems expand and consolidate, report improved profits; HMO Medicaid and individual enrollment surges, but profits drop"
- Sammy Mack reported in Health News Florida: "Negotiating Power Shifts as Hospitals Consolidate" Click here to listen and read
- Charles Elmore wrote in the Palm Beach Post: "Florida HMO Enrollment Jumps 44% to biggest ever, report says" Click here to read
- Nina Lincoff wrote in the South Florida Business Journal: "Hospital network and health plan consolidation expected to continue in Florida" Click here to read
- Margie Manning wrote in the Tampa Bay Business Journal: "Humana leads, WellCare lags among Florida HMOs" Click here to read. She also wrote: "Here's a Peek at the Hospital of the Future." Click here to read.
- Ron Hurtibise wrote in the SunSentinel: "Hospital profits jump nearly 40%" Click here to read
- Naseem Miller reported in the Orlando Sentinel: "Report reveals most profitable hospital in central Florida." Click here to read
- Daniel Chang wrote in the Miami Heralnd: "How Baptist Health benefits from tax exemption." Click here to read
Florida Health Market Review 2013 was released September 13: "Consolidated hospital systems see profits despite declining utilization; HMO Medicare and commercial plans are strongly profitable"
- Abraham Aboraya wrote in the Orlando Business Journal: "Florida's most, and least profitable health plans"
- Brian Bandell wrote in the South Florida Business Journal: "Local hospital profits surge $51 million" and "Commercial HMOs report healthy profit margins"
- Allan Baumgarten presented at the annual conference of the South Florida Hospital and Healthcare Association on June 10, 2011. Click here to download his presentation on: "Managed Care: Can It Be Managed?"