Duke University Health System Inc: $4.7B Revenue, $4.6B Expenses

Duke University Health System Inc grades a B on the NonprofitTruth efficiency rubric. 76/100 on the composite — above the national median, with strong performance on some factors balanced by middling performance on others.

On revenue, Duke University Health System Inc is among the largest U.S. nonprofits: $4.7B in 2023 reported revenue. Organizations at this scale typically operate hospitals, university systems, or national federations — the financial pattern looks more like a corporation than the small-charity stereotype. On the reserves factor, Duke University Health System Inc scores well — assets relative to annual spending sit in the range nonprofit-finance experts consider healthy (roughly three months to two years of operating expenses).

Revenue trend is mildly positive across the five-year filing window — modest growth, consistent with stable funding sources keeping pace with organizational costs. Officer compensation is modest relative to organizational size: Duke University Health System Inc reports $11.6M in total compensation for current officers and key employees (Form 990 Part IX, line 5) against $4.7B in revenue. The ratio is well within the bands third-party charity raters consider reasonable at this scale. Duke University Health System Inc is categorized under Health — the largest segment of U.S. nonprofit revenue, dominated by hospitals, hospital systems, and health-research organizations. The financial profile in this category is capital-intensive, with large balance sheets and program service revenue that often dwarfs donations.