Hospital Consolidation Rose in U.S. Markets Through 2024

U.S. markets through 2024. In 47 percent of metropolitan areas, one or two systems controlled the full inpatient hospital market that year, according to a KFF analysis published in March. U.S. Government Accountability Office reported. An ultrasound performed in a doctor's office averaged $164, compared with $339 when performed in a hospital, according to Third Way estimates from March 2024.

A basic physician visit cost $118 in an independent office versus $186 in a hospital setting. Recent studies cited by the GAO linked these shifts to higher prices for office visits conducted inside hospital facilities.

A Families USA analysis published in May found that five or fewer health systems controlled at least half of all hospital care in 42 states and the District of Columbia in 2023. In nearly half the states, three systems accounted for the majority of hospital care that year.

The report stated that this concentration allows major hospitals to set prices without meaningful competition. Hospital prices have risen three times faster than inflation and twice as fast as wage growth since 2000, according to a Paragon Health Institute report released in April.

Hospital price inflation outpaced every other major sector of the economy, the analysis found.

McGrath, executive director of the Center for Healthcare Affordability, said consolidation itself is not always the problem. He stated that government policies such as the Affordable Care Act's expansion of the 340B drug pricing program can encourage larger systems to acquire smaller hospitals to gain access to discounted drugs.

McGrath added that when large systems face little competition, patients often see higher prices and fewer choices. American Hospital Association President and CEO Rick Pollack said in March that some physicians prefer hospital employment to shift administrative tasks to a larger organization.

He noted that some rural hospitals choose acquisition to remain in business, according to Healthcare Dive reporting. U.S. adults view healthcare affordability as a major national problem, an increase of six percentage points since February 2025. John R.

Graham, visiting fellow at the Paragon Health Institute, said hospitals are the largest contributor to the affordability issue and that government policies forcing spending through insurers add administrative costs.