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Top 10 Hospital Systems in Texas

Top 20 Hospital Systems in Texas by Employee Size: 2026 Rankings & Community Impact.

Published by Healthcare Careers Texas

The Top 20 Texas Hospital Systems by Employee Size & Footprint

  1. Baylor Scott & White Health (Dallas/Temple)
  2. Christus Health (Irving/International)
  3. HCA Healthcare / Medical City (Statewide)
  4. Texas Health Resources (Arlington/DFW)
  5. Houston Methodist (Houston)
  6. Memorial Hermann Health System (Houston)
  7. UT MD Anderson Cancer Center (Houston)
  8. Ascension Texas (Austin/Waco)
  9. Parkland Health (Dallas)
  10. University Health (San Antonio)
  11. Covenant Health (Lubbock)
  12. Tenet Healthcare (Across Texas)
  13. Methodist Health System (Dallas)
  14. St. Luke’s Health (CommonSpirit)
  15. South Texas Health System (Edinburg/McAllen)
  16. Cook Children’s Health Care System (Fort Worth)
  17. UTMB Health (Galveston)
  18. UT Health East Texas
  19. JPS Health Network (Fort Worth)
  20. Texas Children’s Hospital (Houston)
Read more: Top 10 Hospital Systems in Texas

For medical professionals and administrators, these systems are more than mere employers; they represent the essential infrastructure of Texas’s resilience. In major urban corridors like Dallas and Houston, these networks are the lifeblood of the community, providing high-quality care while simultaneously driving the local economy. The following analysis explores the top ten hospital systems by employee footprint and clinical scale, detailing how they empower the diverse regions they serve.

The Scale of Stewardship: Texas Healthcare in 2026

The impact of Texas hospital systems is best understood through the lens of Community Benefit. In the most recent reporting cycles, non-profit hospitals in Texas provided over $14.8 billion in total community benefits, including nearly $4 billion in unreimbursed charity care. These figures are critical as the state faces the nation’s highest uninsured rate, making these systems the ultimate safety net for millions.

Regional Impact: The Major Metros

  • The Houston Gulf Coast: Houston remains the global epicenter of oncology and trauma care. Systems here, led by Memorial Hermann and Houston Methodist, have expanded into “micro-hospital” models to keep pace with suburban sprawl in Katy and The Woodlands.
  • The North Texas Corridor: Dallas and Fort Worth have seen the most aggressive infrastructure expansion. Baylor Scott & White and Texas Health Resources have shifted focus toward “population health management,” utilizing AI-driven predictive analytics to manage chronic diseases before they require emergency intervention.
  • The San Antonio & South Texas Gateway: Organizations such as University Health and Christus Health have pioneered specialized maternal and pediatric care hubs that address high-acuity needs in regions with historically limited access to specialty care.

The Top 10 Texas Hospital Systems by Employee Size & Footprint

  1. Baylor Scott & White Health (Dallas/Temple)
    • Footprint: 51+ Hospitals; 800+ Patient Care Sites.
    • Impact: As the state’s largest non-profit system, BSWH manages the health of over 3 million Texans through its integrated health plan.
  2. Christus Health (Irving/International)
    • Footprint: 39+ Hospitals in TX; hundreds of clinics.
    • Impact: A global leader in mission-driven care, Christus provides an essential clinical bridge for rural and border communities in South and East Texas.
  3. HCA Healthcare / Medical City (Statewide)
    • Footprint: 45+ Hospitals (including Medical City & HCA Houston).
    • Impact: By leveraging a massive national database, HCA implements clinical protocols that have significantly reduced sepsis mortality rates across its Texas facilities.
  4. Texas Health Resources (Arlington/DFW)
    • Footprint: 29+ Hospital Locations.
    • Impact: Focused heavily on the North Texas “Well-Being” initiative, THR has invested millions in Community Health Needs Assessments (CHNA) to tackle food insecurity and behavioral health.
  5. Houston Methodist (Houston)
    • Footprint: 8+ Primary Hospital Campuses.
    • Impact: Consistently leading in quality metrics, Houston Methodist serves as a primary academic partner, training thousands of residents and fellows annually.
  6. Memorial Hermann Health System (Houston)
    • Footprint: 17+ Hospitals; 300+ Care Sites.
    • Impact: Known for the “Life Flight” air ambulance program, they provide the state’s most robust trauma infrastructure, essential for the industrial corridors of the Gulf Coast.
  7. UT MD Anderson Cancer Center (Houston)
    • Footprint: Specialized Global Hub; Regional Care Centers.
    • Impact: Beyond treating patients, MD Anderson’s “Moon Shots” program drives global oncology standards, bringing billion-dollar research investments into the Texas economy.
  8. Ascension Texas (Austin/Waco)
    • Footprint: 14+ Hospital Locations.
    • Impact: Through the Seton and Providence brands, Ascension provides a critical Catholic-based healthcare safety net for the rapidly growing Central Texas population.
  9. Parkland Health (Dallas)
    • Footprint: 1 Major Teaching Hospital; 20+ Community Clinics.
    • Impact: Parkland manages one of the highest-volume emergency departments in the U.S. and serves as the clinical training ground for UT Southwestern.
  10. University Health (San Antonio)
    • Footprint: 2 Main Hospital Campuses; dozens of clinics.
    • Impact: A leader in organ transplantation and Level 1 pediatric trauma, University Health is the cornerstone of healthcare for the South Texas region.

Honorable Mentions: The Growing Powerhouses (Ranked 11-20)

While the top ten represent the largest footprints, these systems are rapidly expanding their influence through specialized care and regional dominance:

  1. Tenet Healthcare (United Surgical Partners): A major force in outpatient surgery across Texas.
  2. Methodist Health System (Dallas): A key player in the Southern Dallas County revitalization.
  3. St. Luke’s Health (CommonSpirit): Maintaining a high-prestige partnership with the Texas Heart Institute.
  4. South Texas Health System (Edinburg/McAllen): Recently recognized for excellence in patient safety and regional impact.
  5. Cook Children’s Health Care System (Fort Worth): A dominant force in pediatric specialty care in North Texas.
  6. UTMB Health (Galveston): The primary healthcare provider for the Texas island and coastal regions.
  7. UT Health East Texas: The largest provider for the rural and mid-sized markets of East Texas.
  8. JPS Health Network (Fort Worth): The public hospital system serving the diverse needs of Tarrant County.
  9. Texas Children’s Hospital (Houston): Consistently ranked as the nation’s top pediatric hospital.
  10. Covenant Health (Lubbock): The anchor for the West Texas and Panhandle healthcare regions.

Hospital Systems Built for the Future of Texas

The success of these hospital systems is intrinsically tied to Texas’s success. By balancing high-acuity medical research with grassroots community outreach, these employers provide a stable, innovative, and mission-aligned environment for the next generation of healthcare leaders. As population density continues to shift, these ten organizations remain the most significant architects of the state’s public health future.

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