Independent physician practices are rapidly disappearing as hospitals, insurers, corporate entities and private equity firms expand their reach, according to a new Government Accountability Office report.
Here are 10 key statistics from the report:
1. At least 47% of physicians were employed by or affiliated with hospital systems in 2024, up from around 30% in 2012.
2. Only 42% of physicians worked in private practice in 2024, down from 60% in 2012.
3. Corporate entities (including health insurers and private equity-backed companies) employed 23% of physicians in 2024, up from 15% in 2019.
4. About 6.5% of physicians worked in PE-owned practices in 2024 (4.5% in 2022). In some specialties (including gastroenterology, dermatology and ophthalmology), PE involvement exceeds 30%.
5. Hospital-physician consolidation reached 66% in the Midwest and 58% in rural areas in 2024.
6. All 10 of the largest U.S. insurers have bought practices or management service organizations. UnitedHealth Group’s Optum reportedly employs 9,000 physicians and affiliates with around 90,000 and holds about 2.7% of the national primary-care market in 2023.
7. Insurer-run primary care accounted for roughly 4% of national Medicare primary-care service volume in 2023, higher in counties with a high percentage of residents enrolled in Medicare Advantage (5.5%) compared to low-MA counties (1.5%).
8. Hospital-physician consolidation tends to raise commercial prices: studies find about 17% higher office-visit prices after consolidation (2010–2016), 3%-5% higher inpatient hospital prices (2009-2015), and about 15% higher physician prices for childbirth in OB/GYN, alongside modest increases in hospital prices.
9. In Medicare, spending often rises due to site-of-service shifts. Evidence shows a 5% increase in total spending for selected elective surgeries (2010-2015), an additional $40 million for imaging and $33 million for lab services tied to moves into hospital-outpatient settings (2013-2016), and higher colonoscopy spending after gastroenterology-hospital consolidation.
10. The Congressional Budget Office estimates that equalizing outpatient and physician-office rates could save nearly $157 billion from 2025 through 2034, reducing both Medicare spending and beneficiary cost-sharing.
