Colorado hospitals return to strong profitability in 2023 and 2024; HMOs lose enrollees but improve profits
Pre-tax profits for Denver-area hospitals increased 14.4% in 2024, and net income for hospitals in other parts of the state increased by 30.5%. Enrollment in Colorado HMOs dropped by 4.9% in 2024, but their profits grew compared to 2022.
First published in 1994, this is the 23rd edition of this analysis of the payer and provider markets in the state. The report was published by a Minneapolis-based analyst studying health care policy, finance and local markets and currently publishes reports analyzing trends and strategies for health insurers and hospital systems in Colorado and five other states.
Key findings in the report:
Denver-area hospitals had net income of $1.3 billion in 2024, or 9.5% of net patient revenues of $13.945 billion.
Analyzing financial data from Medicare cost reports for 2024, the report finds that these hospitals improved their results by 14.4% compared to 2023. These hospitals had operating income of $52.6 million and other revenues from government grants, philanthropy and investments of $1.559 billion.
University of Colorado Health hospitals in the Denver area reported net income of $689 million in 2024 or 20.4% of net patient revenues. HealthOne/HCA hospitals posted pre-tax net income of $616.8 million or 21.3% of net patient revenues. While the CommonSpirit Health hospitals in the Denver Metro area had net income of $114.7 million, the AdventHealth hospitals lost $68.6 million. Intermountain Health lost $155.1 million, or 9.9% of net patient revenues, including losses of $115.6 million at Lutheran Medical Center.
Outside the Denver metro area, the University of Colorado hospitals, including Poudre Valley in Fort Collins and Memorial in Colorado Springs, were strongly profitable.
The UC hospitals had combined net income of $518.6 million, or 15.5% of net patient revenues, with Poudre Valley alone reporting $355.9 million in net income. The UC system has grown through new construction, particularly in Colorado Springs, and through acquisitions, most recently Parkview in Pueblo. In 2025, it announced plans to take over Estes Park hospital. The CommonSpirit Health hospitals, including Penrose-St. Francis in Colorado Springs and St. Anthony Summit in Frisco, had net income of $107.5 million, or 7.8% of net patient revenues. The five Banner Health hospitals in northern Colorado had combined losses of $20.3 million. Valley View in Glenwood Springs was the most profitable independent hospital.
After reporting losses in 2022, Colorado HMOs were profitable in 2023 and 2024.
In 2024, Colorado HMOs had net income of $89.1 million, or. 1.2% of underwriting revenues. That was similar to their net income of $90.6 million in 2023, and much improved over their combined losses of $72.5 million in 2022. That year, large investment losses for Kaiser Permanente wiped out the profits for the health plans. In 2024, Kaiser had net income of $51.2 million, while HMO Colorado had net income $85.8 million. However, Denver Health Medical Plan lost $55.9 million, and Colorado Access also lost money. Anthem Blue Cross Blue Shield reported net income of $417.7 million, or 18% of underwriting revenues. `HMOs improved their results in the first half of 2025, reporting net income of $134.6 million or 3.4% of revenues.
Since 2022, enrollment in Colorado HMOs has dropped by 11.7% or 221,000 lives.
Most of the decrease has been in persons covered by Medicaid, where enrollment has dropped by more than 20% since the state began re-evaluating the eligibility of Medicaid beneficiaries in 2023. Enrollment in Medicare Advantage plans has grown, and in 2025 more than 52% of Medicare beneficiaries in Colorado were in a Medicare Advantage health plan. Enrollment in individual plans has also grown but is expected to decrease for the 2026 benefit year as enrollees see significant premium increases, especially if Congress does not extend the enhanced subsidies that will expire at the end of 2025. Anthem Blue Cross Blue Shield lost more than 14,000 enrollees in employer group plans in 2024
Table of Contents
- Introduction
- Market Structure
- Health Plan Companies
- Colorado Provider Systems
- Trend Review
- Health Plan Enrollment
- Medicare and Medicaid Plans
- Revenues and Net Income
- Financial Results by Line of Business
- Paymentsand Administrative Expenses
- Capital Adequacy for Health Plans
- Hospitals and Hospital Systems
- Denver Metro Region Hospitals
- Revenues and Net Income
- Inpatient Occupancy and Payer Mix
- Medicare Bonus and Penalty Programs
- Other Colorado Hospitals
- Revenues and Net Income
- Inpatient Occupancy and Payer Mix
- Medicare Bonus and Penalty Programs
- A Look Ahead
Companies Mentioned
- Blue Cross and Blue Shield
- Center for Improving Value in Health Care
- Colorado Department of Health Care Policy and Financing
- Colorado Department of Public Health and Environment
- Colorado Health Foundation
- Colorado Health Institute
- Colorado Hospital Association
- Colorado Medical Society
- Colorado Rural Health Center
- HealthOne/HCA
- Kaiser Permanente
- National Jewish Health
- The Children's Hospital
- UnitedHealthcare/PacifiCare/Secure Horizons
- University of Colorado Denver Anschutz Medical Campus
Methodology
The reports analyzing state health care markets are intended to be a resource to health care organizations facing a full range of challenges but also seeking to identify and benefit from opportunities that present themselves.
This report is presented in three main sections. The first part, Market Structure, describes the major health insurers and hospital systems in the state, showing recent entrants and the high-level of consolidation that has occurred in both the health plan and provider markets. Market Trends, the next section, presents our analysis of enrollment trends and financial results for the health insurers. The last section contains our analysis of financial and inpatient utilization data on the hospitals in the state.
The analysis of health plan companies is based on their annual and quarterly statements filed with the Department of Insurance, including forms prescribed by the National Association of Insurance Commissioners and supplemental reports required by the state. The publisher also uses Medicaid data from the Department of State Health Services and Medicare health plan and hospital data from the Centers for Medicare and Medicaid Services. The publisher has that data together with insights that they have gained in interviews with dozens of leaders in health care organizations in the state.
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