This study in initial research on the healthcare provider (hospital companies) on IDX health - F121 that analyze the effect on firm size, capital structure, assets structure, and financial performance on the firm value of hospital companies in 2017-2021 and discusses lower NPM and ROE. The research method used is an explanatory with quantitative approach. The sampling technique used is purposive sampling with a total population of 10 hospital companies. Retrieval of company secondary data through IDX, the company's official website, yahoo finance and IDN financial. The data analysis used in this research is the classical assumption test, multiple linear regression analysis and hypothesis test using the smartPLS application. This research analyzed the effect and correlation among those variables and identified factors and problems that explain why hospital companies have lower NPM and ROE. Based on the results of the research, it was indicated that firm size, assets structure and financial performance have significant effects on firm value. An increase in asset utility contributed to generating revenue, however, fixed asset utilization tends to decrease as capital expenditure shifts from infrastructure to a technology base. Hospital companies tend to use internal capital rather than debt and to be conservative in finance and investment financing, Investors expect high returns and look for a better NPM and ROE. Their conservatism in finance is proven by the pecking order theory, and in trade of theory, their tendency to use internal capital will impact on the lower ROE.