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72% of hospitals were affiliated with a system in 2018, study finds

Seventy-two percent of hospitals in the U.S. were affiliated with a health system in 2018, according to a study published Aug. 3 in Health Affairs

For the study, researchers analyzed data from the IQVIA OneKey dataset and the Agency for Healthcare Research and Quality’s Compendium of US Health Systems, a publicly available database that contains information about the systems operating in the U.S., including system size, ownership type and links to healthcare systems.

Researchers sought to find how the consolidation of providers into health systems, the size of systems and the landscape of health system ownership changed between 2016 and 2018.

Five study findings:

1. The number of health systems in the U.S. increased from 626 in 2016 to 637 in 2018. Of the 626 systems identified in 2016, 556 were still operating in 2018. Study authors say the changes were explained by mergers and acquisitions, as well as newly identified systems. 

2. Consolidation among health systems from 2016 to 2018 increased. Study authors identified 50 deals M&A deals involving two systems in the study period. Of those deals, two were mergers that resulted in new systems, and 48 were acquisitions. 

3. Health systems' size, based on the number of median affiliated physicians, grew by 29 percent in the two-year period, from 285 to 369. Health systems' size based on the number of hospitals included remained the same from 2016 to 2018. The average health system had two hospitals in both 2016 and 2018. 

4. The number of hospitals affiliated with health systems increased slightly, from 70 percent in 2016 to to 72 percent in 2018. 

5. The consolidation of physicians into vertically integrated health systems increased 11 percentage points from 2016 to 2018, according to the study. In particular, 38 percent of primary care physicians were affiliated with a health system in 2016, compared to 49 percent in 2018.

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