Billings Clinic
Nonprofit profile at a glance
- EIN
- 810231784
- IRS 990 coverage
- 2009–2024
- Official website data refreshed
- Sep 2026
- Forms available
- Form 990 2024, Form 990-T 2024
- Location
- Billings, MT, USA
- Phone
- 4062382500
- Rating
- 78
- Verdict
- SUPPORTED
- Rating confidence
- Moderate
- Sector
- Community Health Systems
Reported finances
- Revenue
- $1,225,617,600
- Expenses
- $1,244,167,405
- Assets
- $1,395,798,536
- Liabilities
- $490,387,916
Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.
Leadership & pay
24 people listed
Executive titles in this filing
- CLINTON SEGER MD (CEO)
- KEVIN ABEL (SYSTEM CO-CEO)
- CRAIG LAMBRECHT MD (SYSTEM CEO (UNTIL 3/11/2024))
- SCOTT ELLNER DO (FORMER CEO)
Highest reported compensation
- VANCE FREDRICKSON MD (PHYSICIAN): $2,234,126 total reported compensation
- ANTHONY RUSSO MD (PHYSICIAN): $2,226,832 total reported compensation
- DEAN SUKIN MD (PHYSICIAN): $1,927,461 total reported compensation
Source: IRS Form 990. Selected filing: tax year 2024. Names and roles reflect this filing, not necessarily current officeholders.
Overview
Mission
Billings Clinic is a Montana-based not-for-profit health system focused on keeping patients and families close to home, with services including a Level I Trauma Center, specialty care, and education and research. Last year, Billings Clinic’s cost of Community Benefit totaled more than $76 million, including $19 million in financial assistance provided to more than 14,000 patients. Billings Clinic’s services to meet our mission of health care, education and research include: Level I Trauma Center** provides emergency and critical care, with support from MedFlight advanced life support fixed-wing aircraft and helicopter air ambulance service to transport critically ill or injured patients from rural communities. Specialty MedFlight teams include trauma, neonatal (infant) and maternal (childbirth) care. Already the busiest trauma center in the region, Billings Clinic was designated as...
What it reported doing in 2024
Billings clinic specialty pharmacy focuses on the pharmacy care of chronic, rare or complex conditions that require specialty medications. Specialty medications typically require special handling, administration or monitoring beyond that which a traditional retail pharmacy can provide. We work to ensure appropriate medication use and promote adherence. Billings clinic specialty pharmacy is part of the largest health care system in the region. Our staff works withyou, your provider and your insurance company to make sure your needs are met. Our goal is to make billings clinic a one-stop solution.
Operating model
- Revenue model
- Other-operating. 98% of the money available for current operations came from other operating revenue.
- Distribution model
- Direct operator. The filing allocates 100% of reported program-service expenses outside its grant, affiliate-payment, and member-benefit lines. This expense classification does not rule out separately announced grant awards.
The verdict
SUPPORTED - A large share of available resources goes toward mission work and the filed numbers largely add up. The filing does not identify recipients for some grant dollars and expenses are high relative to revenue.
Rating breakdown
- Financial Efficiency: 72
- Transparency & Controls: 84
- Accountability: 84
- Sustainability: 36
- Growth: 100
Detailed rating inputs
Financial Efficiency
- Mission deployment rate: 82%; rating input score 82
- Program expense ratio: 77.8%; rating input score 78
- Fundraising efficiency: Limited
Transparency & Controls
- Consistency checks: 92.3%; rating input score 92; 12th percentile among comparable filings
- Pay-setting controls: 5 of 6 controls in place; rating input score 83
- Compensation committee: Pass
- Independent consultant: Pass
- Other Form 990s reviewed: Pass
- Written employment contract: Missing
- Compensation survey or study: Pass
- Board or committee approval: Pass
- Foreign activity oversight: Limited
- Grant itemization coverage: 54.2%; rating input score 54; 11th percentile among comparable filings
- Major donor itemization: Yes; rating input score 100
- Related-party transparency: Yes; rating input score 100
Accountability
- Independent voting board: 72.7%; rating input score 73; 22nd percentile among comparable filings
- Governance controls: 9 of 9 controls in place; rating input score 100
- Conflict-of-interest policy: Pass
- Whistleblower policy: Pass
- Document-retention policy: Pass
- CEO compensation review process: Pass
- Other executive compensation review process: Pass
- Form 990 shared with the board: Pass
- Board meeting minutes documented: Pass
- Audit committee oversight: Pass
- Independent financial-statement audit: Pass
Sustainability
- Operating margin: -1.5%; rating input score 20; 20th percentile among comparable filings
- Total-asset coverage ratio: 1.12; rating input score 43; 43rd percentile among comparable filings
- Liabilities to assets ratio: 0.35; rating input score 50; 50th percentile among comparable filings
- Officer compensation ratio: 1.3%; rating input score 68; 68th percentile among comparable filings
Growth
- Program expense growth: 5.9% per year; rating input score 100; 48th percentile among comparable filings
- Revenue growth: 4.8% per year; rating input score 100; 41st percentile among comparable filings
- Asset growth: 7.6% per year; rating input score 100; 56th percentile among comparable filings
Details
- What they do: Mission, programs, and operating context captured from the official website.
- Where the money goes: 82% of revenue deployed · 77.8% of spending went to programs
- Governance: 8 of 11 board members independent · 9 of 9 filing controls reported
- Programs: 3 filed program accomplishments · $967.6M in reported program spending
- Leadership: top reported pay $2.2M · 24 people listed · 5 of 6 pay-setting controls reported
- Highest-paid contractors: 5 contractors listed · $34.5M reported
- Consistency: 36 of 37 current checks pass · 1 finding to review
- Schedules: 11 filed schedules · includes major donors, grants, executive pay, and related organizations
- Filing history: 16 filing years from 2009 to 2024
- Contacts: How to reach this organization
- Money network: 21 filed money-flow records
- Related organizations: 27 filed related-organization links
- Grant readiness: Federal tax and exclusion status, award history, and grant-maker relationships.
- People: Everyone the filings name, and which of them the filings identify by more than a name.
Key Signals
Signals prioritize questions for review. They are not findings of misconduct.
- Review — Transparency & Controls: Grant itemization coverage scored 54/100.
- High — Sustainability: Operating margin scored 20/100.
- Moderate — Sustainability: Total-asset coverage ratio scored 43/100.
- Review — Transparency & Controls: Domestic grant itemization did not reconcile in the filed values.
- Review — Sustainability: Liabilities to assets ratio scored 50/100.