Nashville

Nashville is famous for music but runs on medicine. The city earned its 'Music City' nickname in 1873, when the Fisk Jubilee Singers toured Europe and Queen Victoria remarked they must come from a 'music city.' But the industry that truly defines Nashville today started in 1968, when HCA—Hospital Corporation of America—was founded here, inventing the modern for-profit hospital chain.

The music story is real: on November 28, 1925, WSM radio broadcast a barn dance featuring 78-year-old fiddler Uncle Jimmy Thompson. The show became the Grand Ole Opry, which celebrated its 100th anniversary in 2025. The Opry made Nashville the undisputed center of country music, drawing Patsy Cline, Johnny Cash, and Dolly Parton to a city where ambition could meet opportunity. Today, music contributes roughly $10 billion annually to Tennessee's economy.

But healthcare contributes $68 billion. Over 46 major healthcare companies are headquartered in Nashville—hospital systems, ambulatory surgery centers, behavioral health providers, health IT firms. The industry employs 330,000 people directly and indirectly, making it the city's largest employer by far. When Oracle built a $1.4 billion campus here for its global headquarters, chairman Larry Ellison explained the choice simply: Nashville is 'the center of the industry we're most concerned about, which is the healthcare industry.' Amazon followed with over 1 million square feet of office leases downtown.

Nashville now ranks second among major U.S. metros for job growth and income, trailing only Raleigh. The formula is clustering: one healthcare company attracts executives and suppliers, who attract more companies, who need more talent. By 2026, Nashville bets that the same network effects that made it Music City will make it Medicine City—though the Opry still runs every weekend, because some things you don't mess with.