Duke University Health System Inc: $4.7B Revenue, $3.6B Program Expenses

Duke University Health System Inc earns an A on the nonprofit efficiency rubric — a top-tier rating that reflects strong program-spending ratios, reasonable executive compensation, and stable financial reserves. The composite score of 86/100 places it in the upper bracket of U.S. tax-exempt organizations.

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. Duke University Health System Inc directs 80% of its expenses to programs — above the third-party-rater threshold for an efficient organization.

Revenue trend is mildly positive across the five-year filing window — modest growth, consistent with stable funding sources keeping pace with organizational costs. CEO compensation is reported as zero in the filing — typical for nonprofits where the chief executive is paid through a related entity (parent system, university, or foundation) rather than the filing organization itself, or for small organizations whose chief is a volunteer or board member. 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. Revenue-to-program ratios in this category often look different from smaller-program nonprofits because the underlying operations are capital-intensive.