Meet America’s Best Large Employers 2023

No workers have withstood the brunt of the pandemic more than those in healthcare. Those on the front lines burned out in droves, and many have resigned due to the immense amount of stress.

You’d think that they wouldn’t necessarily be singing the praises of their employers. But for the second year in a row, hospital systems and medical centers dominated the top of Forbes’ annual list of America’s Best Large Employers. Healthcare organizations took eight of the top 25 slots in our rankings and made up 20% of the top 100.

Employees at medical institutions feel particularly connected to their organizations’ mission to care for patients, says Sara Loewy, director of business development and hospital operations at Houston Methodist Hospital—the flagship for the Houston Methodist system, which shot up from No. 37 last year to No. 2 this year.

“The patient really is at the center of everything that we do,” Loewy said of Houston Methodist, which is comprised of an academic medical center, six community hospitals and one continuing care hospital. “At the same time, it’s clear that our senior leaders really know that ensuring that our employees are happy directly impacts the patients.”

To compile the list, Forbes partnered with the market research firm Statista, which surveyed about 45,000 workers at American companies and institutions with more than 5,000 employees. Participants were asked if they would recommend their current employers to friends and family (on a scale of 0 to 10), and to cite any other employer they would also recommend. The final list ranks the 500 companies that received the most recommendations.

Massachusetts Institute of Technology ranked No. 1 on the Large Employers list. Universities took 12 more of the top 100 spots; for more on how other educational organizations are keeping employees happy, see Forbes’ Best Midsize Employers 2023.

The rest of the top 10 on the Large Employers list featured a mix of industries: insurance (BlueCross BlueShield of Tennessee at No. 4), retail and wholesale (grocery store chain H-E-B, No. 5), banking and financial (Fidelity Investments, No. 7), IT, internet and software (Microsoft, No. 8) and restaurants (In-N-Out Burger, No. 9).

Houston Methodist keeps its employees engaged in part by supporting their career development through tuition reimbursement and invaluable on-the-job training, says Teal Riley, nurse director of Houston Methodist Hospital’s medical intensive care unit. Riley started at the hospital as a staff nurse in 1998 and says her mentor gave her pivotal guidance.

“This person is making sure that I get the opportunities and the exposure I need to keep progressing in my career,” Riley says, adding that there are also many informal opportunities to grow and learn. For example, physicians often ask the nursing staff if they want to observe a procedure so that the nurses—not just the physician residents and fellows—get a better understanding of their patients’ needs. “There is a lot of teaching involved, and there is a level of respect there, as well,” she says.

After completing her MBA, Loewy started at Houston Methodist’s 18-month management-trainee program, which allowed her to do rotations with different senior leaders. The program “gives you the opportunity to see how a successful organization like Methodist is run at that 10,000 foot level, which is unique for someone as young as I was in my career,” she says. “I probably could have gone anywhere afterwards, but for me, it was definitely a no brainer to stay here.”

Beyond career-advancement initiatives, Houston Methodist’s benefits package offers up to $20,000 for fertility treatments including in vitro fertilization (IVF)—which a majority of large U.S. companies do not offer. “You could be at a company where you hid those hard times that you’re going through,” says Loewy, who has leaned on her co-workers while undergoing IVF, “but that’s not the culture the organization has created.”

Cincinnati Children’s Hospital Medical Center (No. 10), an institution also on the pandemic’s front lines, offers an impressive range of mental health services. Employees can see a licensed therapist onsite (or virtually) at no cost for up to eight sessions. Another option: A program called Peer2Peer Supporters gives clinicians access to a trained peer within 24 hours.

“A lot of stressful things happen in the moment and you need support right then and there,” says Nerissa Morris, senior vice president and chief human resources and diversity officer at Cincinnati Children’s. With this program, employees can receive on-the-spot help from a colleague who can talk through stressful situations. “It’s been really, really powerful and helpful,” Morris says.

Cincinnati Children’s also understands how crucial it is for employees with children to have stable childcare. To alleviate some stress in that area, staff members can use the hospital’s onsite childcare facility or a free subscription to Care.com. These resources demonstrate that employees are more likely to thrive at work when they know their loved ones are in good hands.

Houston Methodist’s employees are so devoted to their patients and employer that that they will go not just the extra mile, but the mile and a half. During the snowstorm of February 2021 that brought much of Texas and its power grid to a halt, several staffers couldn’t drive to work—but Riley said one member of her team was so intent on working that he walked 1.5 miles through snow, slick ice and temperatures in the teens to get to the hospital.

“If that doesn’t speak loyalty, commitment and dedication,” Riley says, “I don’t know what does.”

For the full list of America’s Best Large Employers 2023, click here. For the full list of America’s Best Midsize Employers 2023, click here.

Methodology:

Forbes’s list of America’s Top 500 Large Employers, compiled via a survey by the market research firm Statista, was based on responses from about 45,000 Americans working for businesses with more than 5,000 employees. All questionnaires were conducted anonymously, allowing participants to openly share their opinions. The respondents were asked to rate, on a scale of 0 to 10, how likely they would be to recommend their current employer. They were also asked to nominate companies other than their own. The final list ranks the 500 large employers that received the most recommendations.

As with all Forbes lists, companies do not pay any fee to be considered.

For questions about this list, please contact listdesk (at) Forbes.com.