The Philadelphia region's two smallest nonprofit health systems by revenue, Doylestown and Holy Redeemer, slipped into the red on an operating basis in the year ended June 30, according to preliminary operating results.

Doylestown Health had a consolidated operating loss of $1.76 million on revenue of $322.45 million. That was the system's first loss since 2010. Officials declined to comment before a presentation of audited results to the organization's board on Sept. 25.

Holy Redeemer Health System reported its first operating loss since at least 2008. The diversified Catholic health-care organization had an operating loss of $4.03 million on total revenue of $392.8 million.

Mike Laign, Holy Redeemer's chief executive, said in a statement that the operating results were consistent with the organization's forecast, as it moves from being paid based on the volume of patients and procedures to being paid based on the value it generates.

"We will continue to make strategic investments in people and partnerships that will result in transformative benefits to those we serve," Laign said. He noted that Holy Redeemer had strong returns on its investments, leading to a bottom line gain of $17.5 million.

Also reporting a loss was Einstein Healthcare Network, which had posted an operating profit in fiscal 2016 for the first time since fiscal 2012. The fiscal 2017 loss at Einstein, which unlike Holy Redeemer and Doylestown has a heavy load of Medicaid patients with low reimbursement rates, was $23.09 million. Einstein's total revenue was $1.2 billion.

The University of Pennsylvania Health System and Thomas Jefferson University, the region's two largest systems, were profitable in fiscal 2017. Children's Hospital of Philadelphia, Main Line Health, Temple University Health System, and the area systems that are part of Trinity Health have not yet reported results.