The markets for hospitals’ and physicians’ services have become increasingly consolidated in recent decades. The share of hospitals affiliated with a health system increased from 53 percent in 2005 to 68 percent in 2022, and the share of physicians employed by a hospital or health system increased from 29 percent in 2012 to 41 percent in 2022.
The federal government subsidizes health care for enrollees in private health insurance and for enrollees in public health care programs, and consolidation increases costs in both cases. Consolidation can affect the federal budget by increasing prices in private health insurance, by increasing the intensity of services provided through public programs, or by shifting those services to more costly settings.
