The 25 Biggest Nonprofits in America by Revenue

The largest nonprofits in America aren't charities in any traditional sense — they're economic empires. With combined revenues exceeding $500 billion, the top 25 nonprofits generate more economic activity than most countries. They employ hundreds of thousands of people, manage billions in assets, and operate with the complexity of Fortune 500 corporations. Here's a data-driven look at who they are and what they do.

The Top 25 by Revenue

Based on the most recent IRS Form 990 filings available through GiveScope, the largest nonprofits in America are overwhelmingly healthcare organizations:

Tier 1: The $20 Billion+ Club

1. Kaiser Foundation Health Plan — ~$82.5B revenue. The nation's largest integrated health system, serving 12.5 million members across 8 states and D.C.
2. Kaiser Foundation Hospitals — ~$40B revenue. The hospital arm of the Kaiser system, operating 39 hospitals.
3. CommonSpirit Health — ~$35B revenue. Formed from the 2019 merger of Catholic Health Initiatives and Dignity Health, operating 140+ hospitals in 21 states.
4. Ascension Health — ~$28B revenue. The largest Catholic health system, with 140 hospitals across 19 states.
5. Providence St. Joseph Health — ~$27B revenue. A major West Coast health system with 51 hospitals.
6. UPMC (University of Pittsburgh Medical Center) — ~$26B revenue. A healthcare and insurance giant dominating western Pennsylvania.

Tier 2: $10-20 Billion

7. Fidelity Charitable — ~$19B in contributions received. The largest charitable entity by incoming donations — a donor-advised fund sponsor, not a traditional charity.
8. Cleveland Clinic — ~$15B revenue. A world-renowned hospital and research center.
9. Trinity Health — ~$14B revenue. A Catholic health system operating in 22 states.
10. Mass General Brigham — ~$13B revenue. The combined system of Massachusetts General Hospital and Brigham and Women's Hospital.
11. NYU Langone Health / New York University — ~$11.6B revenue. One of the largest private universities with an integrated health system.
12. University of Pennsylvania — ~$10.7B revenue. Ivy League university with Penn Medicine, a major health system.
13. Johns Hopkins University — ~$10.5B revenue. A research powerhouse with its own hospital system.

Tier 3: $5-10 Billion

14. Stanford University — ~$9.5B revenue
15. Mayo Clinic — ~$9B revenue
16. Sutter Health — ~$8.5B revenue
17. Memorial Sloan Kettering Cancer Center — ~$7.5B revenue
18. Duke University Health System — ~$7B revenue
19. Atrium Health — ~$6.5B revenue
20. Northwestern University — ~$6B revenue
21. Baylor Scott & White Health — ~$6B revenue
22. Yale University — ~$5.6B revenue
23. Northwell Health — ~$5.5B revenue
24. Cedars-Sinai Medical Center — ~$5.3B revenue
25. Partners HealthCare (now Mass General Brigham system entities) — ~$5B revenue

View the complete rankings on our highest-revenue nonprofits page.

Key Patterns

Healthcare Dominance

Of the top 25, approximately 18-20 are healthcare organizations. This reflects the fact that health nonprofits generate $1.81 trillion in revenue — 44% of the entire sector. The U.S. healthcare system's unique structure, where nonprofit hospitals compete with for-profit chains while receiving tax exemptions, has created these massive institutional behemoths.

The University-Hospital Complex

Several entries (NYU, Penn, Johns Hopkins, Stanford, Duke, Yale) are universities whose revenue is dramatically amplified by integrated health systems. Johns Hopkins University without its hospital would generate perhaps $3-4 billion; with the hospital system, it exceeds $10 billion. This university-hospital model is one of the most financially powerful structures in the nonprofit world.

Concentration of Power

These 25 organizations — representing just 0.001% of all nonprofits — generate roughly 12-15% of the sector's total revenue. This extreme concentration mirrors wealth inequality in the broader economy. The bottom 50% of nonprofits (nearly a million organizations) collectively account for less than 2% of total revenue.

What About Traditional Charities?

Organizations that most people would recognize as "charities" — the Red Cross, United Way, Salvation Army, Feeding America — typically rank in the $3-6 billion range. While impressive, they're dwarfed by the healthcare and university giants. The American Red Cross, perhaps America's most recognized charity, generates about $3.5 billion — less than 5% of Kaiser's revenue.

Are These Really "Nonprofits"?

This is the trillion-dollar question. When a nonprofit hospital system generates $80 billion in revenue, pays its CEO $16 million, and operates identically to a for-profit competitor, what exactly makes it a nonprofit? The legal answer is clear: it doesn't distribute profits to shareholders. But the philosophical question of whether these organizations deserve tax-exempt status — and the associated tax benefits worth billions — is one of the most contentious debates in American policy.

Explore all of these organizations in detail on GiveScope, where you can see their complete financial data, compensation information, and asset holdings.