The Midwest is the most consolidated region, according to an Avalere study sponsored by Physicians Advocacy Institute.
The study, published May 13, analyzed biannual data from IQVIA’s OneKey database spanning January 2018 through January 2026, tracking physician employment and practice ownership across unique National Provider Identifiers and practice locations.
Editor’s note: The study’s methodology notes that physician-owned Professional Corporations may be miscategorized as “corporate-owned,” meaning the share of truly independent physicians could be higher than reported.
Here’s a breakdown of regional consolidation
Employment by region:
- Midwest leads with 86.9% of physicians employed by hospitals or corporate entities
- Northeast: 83.7% | West: 80.5% | South: 80.4%
Practice ownership by region:
- Midwest leads with 72.7% of practices owned by hospitals or corporate entities
- Northeast: 64.6% | South: 64.0% | West: 58.0%
Outliers within regions
- The South has the highest corporate-employed physician share at 25.9% and highest corporate-owned practice share at 37%
- The Northeast saw the biggest jump in hospital employment over 8 years, a 129.9% increase, suggesting it is rapidly catching up
Rural areas
- Eighty-percent of rural physicians are employed by hospitals or corporate entities
- Nearly 68% of rural practices are hospital or corporate-owned
- Rural independent physicians fell below corporate-employed physicians for the first time in 2024, with the gap widening through 2026
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