A new policy analysis from the Progressive Policy Institute (PPI) highlights how the rapid acquisition of independent physician practices by hospitals and health systems has contributed to reduced access, higher costs, and less choice for patients across the United States. The report, “Fixing a Broken System: Policy Responses to Hospital Acquisitions of Physician Practices That Limit Health Care Access for U.S. Consumers,” draws on national data and a review of economic evidence to illustrate the mounting consequences of consolidation in healthcare markets.
A Decline in Independence and Access
PPI’s analysis shows that independent physician practices, including those in key specialties such as cardiology, have declined significantly as hospitals and large health systems increasingly employ local providers. Between 2019 and 2023, the share of independent practices owned by hospitals and corporate entities rose from 39% to 59%, while the percentage of physicians employed by these organizations increased from 62% to 78%. This nationwide trend reflects a broader structural shift away from locally owned practices toward consolidated systems.
Higher Prices and Less Competition
A key finding from PPI’s report is the significant negative economic impact associated with hospital acquisitions of physician practices. The review of more than 70 economic studies showed that hospital takeovers are linked to higher prices and increased healthcare spending for patients and insurers. Average price increases after acquisition have been measured at 14% or more, with some local markets seeing price spikes as high as 33%. Much of this increase is tied to payment differences across sites of care and the enhanced market power hospitals gain through consolidation.
Beyond cost, consolidation has also contributed to the erosion of physician autonomy in clinical and operational decision-making. As independent practices are absorbed into larger systems, physicians may face administrative and financial priorities that differ from those of traditional independent practice.
Policy Challenges and Roadblocks
The PPI report also highlights how current regulatory and policy frameworks have failed to slow the decline of independent practices. Antitrust enforcement remains below average for hospital and ambulatory service sectors despite compelling evidence of harm from consolidation. State policies like certificate of need (CON) and certificate of public advantage (COPA) laws, intended to manage healthcare costs and expansion, often create barriers to competition and shield consolidating entities from scrutiny.
What This Means for Cardiovascular Care
For cardiovascular practices, the implications of these trends are significant. As hospitals continue acquiring physician groups, market concentration can limit patient choice, inflate the cost of cardiac services, and reduce physicians’ control over clinical and operational decision-making.
These pressures highlight the growing need for partnership models that preserve independence rather than eliminate it. This is where organizations like Heart & Vascular Partners can play a meaningful role.
HVP’s approach is designed specifically to support cardiology groups in maintaining autonomy, strengthening operations, and continuing to serve partner hospitals and patients. This allows practices to compete effectively in increasingly consolidated markets without forcing practices into hospital ownership models. By providing operational and capital resources, governance support, and strategic affiliation options, HVP helps ensure that independent cardiovascular practices remain accessible, competitive, and patient-centered.
As the PPI report makes clear, health systems’ rapid acquisition of physician practices has reshaped markets across the country. Cardiovascular practices evaluating their future must consider partners who protect independence, preserve competition, and expand access, not limit it. Read the full report here: https://www.progressivepolicy.org/wp-content/uploads/2025/12/PPI-Hospital-Acquisitions-Dec2025.pdf
