Grounded in Health: The 2020 Ingram’s 100

Agribusiness accounts for the very largest companies in the Kansas City region, but the influence of health-care providers is plainly evident. And in this climate, we understand why.


By Dennis Boone



One need only pay attention to the past two months of headlines and TV chyrons to grasp the importance of health care to the U.S. economy. We see evidence of it every day in the heroic efforts of front-line health-care workers to combat the COVID-19 pandemic that has already claimed more than 80,000 lives and appears well on its a way to a six-figure place of infamy in the nation’s viral history.

We see it again with almost daily reports of how those same institutions are experiencing wrenching financial pangs. Ironically, it was their wholesale effort to prepare for the worst with this illness that placed them in such a precarious financial picture for 2020. They cut back on nearly all elective procedures—large elements of the top and bottom lines—to clear bed space for a human wave of misery that never crested.

That financial toll, however, is a concern for next year’s list of biggest companies. For this year, the collective health of everything from those sprawling health systems to mammoth medical centers to community hospitals comes shining through with the 2020 Ingram’s 100, our annual list of the region’s top private companies. One fundamental change in criteria for consideration this year has been the inclusion of roughly a dozen hospitals that sat out last year. Though technical private enterprises, they are owned by a public parent in HCA. Their inclusion is in part a recognition of the vital role that health care plays in the bigger economic picture.

Combined, those 26 hospitals—slightly more than one-fourth of all institutions on this list—generated $38.4 billion in revenues. And that doesn’t include well in excess of $10 billion in additional revenue recorded by health-insurance providers and brokers, non-acute-care providers or the health-care related dollars generated by other companies on this list, such as the health-care practices of large law firms. One impressive stat that emerges from this year’s Top 100 is the healthy gain in top-line revenues for the full field: That figure surged by $12.4 billion, from $120.5 billion to $132.9 billion. That increase, by the way, is larger than the individual revenues of 99 companies on this list.

Of course, at the top of the food chain are—well, food interests. Much like the health-care providers on this list, their contribution to the regional and national economy has also been brought into sharp relief by the current public-health crisis. COVID-19 has shown that, for all its resilience as a sector, food production and agribusiness can be particularly fragile after government edicts that shut down large aspects of their customer base.

The biggest firm on the list, the cooperative known as Dairy Farmers of America, recorded another stellar year; it’s revenues soared past the $15 billion mark to lead the way. Still trying to close that gap on No. 1 was Associated Wholesale Grocers, the grocery cooperative that serves thousands of individual stores in dozens of states as an anchor for food delivery.

A handful of companies chose not to participate this year, for reasons related to their own branding concerns, and some very large players that have never made an appearance on this list are nonetheless invited to join the party next year. Firms like American Century Investments, V2 Ventures and the biggest grocery-store chains in the region, Cosentino’s Food Service and Ball’s Foods, would surely alter the numbers in a list like this. Well, maybe next year.

For the record, a pair of Kansas City-area companies crossed the $1 billion revenue threshold this year: Garney Construction, the national powerhouse in water-services infrastructure, and Custom Truck One Source, which roared onto the list for the first time just a year ago. The year-over-year growth champion is Lenexa-based Pivot International, which has been on an acquisition tear over the past year. Adding new companies to the fold drove the top line from $83 million in 2018 to an impressive $194 million last year, a dizzying pace of 134 percent growth. The firm, led by Mark Dohnalek, provides materials, expertise and guidance in design and manufacture of a wide range of products, and now has overseas operations contributing to that track. Pivot was one of 20 firms on the list to secure growth of more than 20 percent last year, a significant bump up from the 13 that managed that metric in the previous cycle. And the number of companies that saw more than 30 percent growth year over year doubled, from four to eight. Such was the strength of an economy that, by some estimates, won’t revisit this nation for a decade as the rebuilding chore stretches out before us.

       Here, then, is the 2020 Ingram’s 100. Once opened click the image to enlarge.