Mayo Clinic rebounded from a poor start to 2022 with a strong first quarter this year, the nonprofit health system reported Thursday.

The Rochester, Minnesota-based company generated $420 million in net income during the first three months of 2023 after losing $177 million a year before. Operating income increased 4.9% to $149 million. Revenue rose 8.8% to $4.27 billion. Expenses grew 9% to $4.12 billion, including 7.7% more for salaries and benefits and 11.3% more for supplies and services. Cash and investments totaled $17.65 billion, a 2% increase from the fourth quarter, largely due to investment gains.

Mayo is embroiled in conflict with Minnesota legislators and other providers in the state over legislation that would require inpatient care units to form committees with caregivers and executives to set staffing levels.

However, the state legislature is poised to exempt the Mayo Clinic after the health system threatened to pull billions of dollars of investment from Minnesota—a power play that has angered smaller providers in the state.

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