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Hospital M&A landscape shifting

The last few years have been wrought with change for hospitals and health systems amid increased consolidation and physician affiliation, according to a June 20 article in Health Affairs.

The article authors examined data from the AHRQ Compendium of U.S. Health Systems, updated in June, focused on the years 2018 to 2021. There were 635 health systems identified in the Compendium, defined as organizations with at least one non-federal general acute care hospital and a 50-plus member physician group.

Five findings:

1. The percentage of providers affiliated with vertically integrated health systems jumped from 72 percent to 76 percent from 2018 to 2021. Seventy-five percent of hospitals and 52 percent of physicians were affiliated with a health system by the end of 2021.

2. More than 10 percent of health systems, 49 systems total, lost "system" designation from 2018 to 2021 and were replaced by different health systems primarily due to mergers or acquisitions. There were nine new systems formed between 2018 and 2021.

3. Thirty-two new systems reached the designation in 2021 by adding affiliated physicians to meet the 50-plus member threshold.

4. The largest systems grew between 2018 and 2021 while the smallest systems shrank. The largest systems reported 10 percent more hospitals, 2.7 percent more hospital beds and nearly 5 percent more physicians over the study period. They also increased primary care physician volume 14.4 percent.

5. The median health system in 2021 had two hospitals, 404 beds and 60 physicians. Health systems at the 95th percentile had 22 hospitals, 3,274 beds and 3,631 physicians on average in 2021.

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