PAI Research

Physicians Advocacy Institute

Updated April 2024

Physician Employment Trends

PAI-Avalere Report on Physician Employment Trends and Acquisitions of Medical Practices:  2019-2023

PAI and Avalere Health have engaged in a long-term research collaboration to study how consolidation trends are impacting physicians. This latest report adds two additional years’ data (2022 and 2023) to previous research and provides insights into: (1) the trend of acquisitions of physician practices by hospitals/health systems and other types of corporate entities (e.g., private equity firms, insurers); and (2) the dramatic shift of physicians from independent practice to employment.

Key Findings     

  • Continuing a decade-long trend away from private practice, nearly four of five physicians (77.6%) of physicians are now employees of hospitals/health systems and other corporate entities.
  • The marketplace race to acquire physician practices has resulted in nearly six of ten (58.5%) of physician practices owned by hospitals/health systems and other corporate entities.

These staggering facts show that hospital systems and other corporate entities continued to drive consolidation in healthcare by aggressively acquiring physicians practices, particularly in the period following the beginning of the COVID-19 pandemic. 

2022-2023 Findings

The most recent two years’ data shows these trends moderating but overall employment and practice acquisitions still growing at a slower pace. 

  • The percentage of employed physicians grew by 5.1% from 2022-2023. Recent growth in physician employment is attributable to hospitals, not other types of corporate owners.
  • 19,100 additional physicians became employees of hospitals or corporate entities.  This represents a slowing of the significant jump in employment in the post-COVID-19 period. 
  • 16,000 additional physicians became hospital employees.
  • Corporate physician employment peaked in January 2023 and has leveled off.

Regional Findings

All regions of the country experienced continued growth in physician employment and practice acquisitions throughout the five-year study period that accelerated in the last half of 2020 and throughout 2021, suggesting a significant country-wide Covid-19 impact. In the most recent study period, growth continued but at a pre-COVID-19 pace.

Over the five-year period between 2019-2023:

  • The percentage increase in all hospital- or corporate-owned practices was between 38.3% (Midwest) and 57.2% (South).
  • The percentage increase in all hospital-l or corporate-employed physicians was between 17.6% (Midwest) and 31.1% (South).
  • Acquisitions by corporate entities grew between 87.4% (Midwest) and 115.6% (South).
  • Corporate employment of physicians increased between 30.4% (Northeast) and 59.5% (South). However, corporate employment leveled in the most recent two-year study period.

At the start of 2024:

  • The Midwest leads other regions in hospital employment at 66%.
  • The South has the highest percentage of corporate-employed physicians at 26.4%.
  • The Northeast had the fastest growth in overall physician practice acquisitions at 10.0%.
  • The West saw steady growth in hospital and corporate-owned practices, but at 52.1% of practices is the lowest in the nation. 

Download the Full Report, Key Findings and Press Release