# For-Profit Hospital A **for-profit hospital** (also "investor-owned" or "proprietary") is owned by a private corporation or a publicly traded company and operates explicitly to generate profit for shareholders. For-profits are about **24% of U.S. hospitals** and are heavily consolidated into a few large chains: [[HCA Healthcare]], [[Community Health Systems]], [[Tenet Healthcare]], and [[Universal Health Services]]. ## The Loaded Core The critique is structural rather than moral: profit incentives systematically shape **which service lines a hospital offers**. Research (Agency for Healthcare Research and Quality) finds for-profits are significantly more likely than nonprofits or government hospitals to offer profitable services and avoid unprofitable ones — and for-profit operating margins run far higher (around 14% versus mid-single-digits for nonprofits and government hospitals). The downstream concern is that expensive, low-margin functions — emergency, obstetric, psychiatric, and rural care — get trimmed or closed, a dynamic visible in [[Tenet Healthcare]]'s pivot to ambulatory surgery and in [[Rural Hospital Closures]]. The most intensive version of the model is the [[Private Equity Hospital Rollup]]. See [[Healthcare Industry Ecosystem]].