Independent practice has been declining over the last 20 years, with the most recent data indicating that only 18% of physicians still practice in physician-owned settings.
Just 36.1% of practices remain physician-owned — down by 48.5% since 2018 — according to a new report from the Physicians Advocacy Institute and Avalere Health tracking eight years of consolidation data. While these figures capture the issue at a national scale, the decline in independent practice looks different region to region.
Here’s a geographic breakdown of where independent practice is holding steady and where it’s dying off most:
1. Northeast
- Since 2018, physician employment has increased 83.4%, while hospital and corporate-owned physician practices increased 106.2%
- Specifically hospital-employed physicians increased 90.8% over the study period, and hospital-owned practices increased by 76.9%
- Specifically corporate-employed physicians increased by 65.4%, while corporate-owned practices increased by 152.3%.
2. South
- Overall employment of physicians by hospitals and corporations increased 106.7% in the South, and these entities’ ownership of physician practices increased 140.2%.
- Specifically hospital-employed physicians increased 102.4% over the study period, and hospital-owned practices increased 89.1%
- Corporate-employed physicians increased 116.5% in the South, and corporate-owned practices increased 199.5%.
- The South has the overall highest percentage of corporate-employed physicians at more than 25%.
3. Midwest
- Overall employment of physicians by hospitals and corporations increased by 66.1% in the Midwest, and these entities’ ownership of practices increased by 86.4%
- Hospital-employed physicians increased by 64.9% in the Midwest, and hospital-owned practices increased by 62.4%.
- Corporate-employed physicians increased by 71%, and corporate-owned practices increased by 137.1%.
- The Midwest leads all other regions with 72.7% of practices currently owned by hospitals or corporate entities.
4. West
- Employment of physicians by hospitals and corporate entities increased 76.9%, and practice ownership increased 128.8%.
- Hospital-employed physicians increased 70.6%, and hospital-owned practices increased 77.1%.
- Corporate-employed physicians increased by 96.2%, and corporate-owned practices increased by 192.6%.
- The West has seen the most significant hospital and corporate-owned practice growth over the last two years at an 11.3% rate.
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