More than four in five U.S. physicians (82%) are employed by hospitals, health systems or corporate entities like health insurance plans as of January 1, 2026, according to a report from Avalere Health for the Physicians Advocacy Institute (PAI). The report adds the most recent two years of data to earlier research on the shifting physician practice landscape, now offering a nearly decade-long analysis of the dramatic restructuring of medical practice in the United States. 

“Physicians are fighting to survive, to practice medicine as unadulterated as possible,” ISMA President Ryan Singerman, DO, said. “The current stormy climate has driven the majority of physicians to the perceived safe refuge of hospital networks. For sure, some of that is because of salaries, support, and safeguards promised by a large institution, but what is lost is autonomy, individuality, and true ownership of your practice and patients. It is supremely challenging and no wonder that physicians feel lost and demoralized as they are regulated to "providers".”

Hospitals and corporate entities employed an additional 48,000 physicians in 2024 and 2025, leaving just 18% of physicians practicing in physician-owned settings. Hospitals and corporate entities acquired 13,900 additional physician practices over the same period, now accounting for 64% of all practices in the United States. 

“The corporate takeover of physician practices continues unabated, causing fundamental changes in how physicians practice medicine in this country. Whereas corporate owners have a fiduciary responsibility to their shareholders, physicians always have an ethical responsibility to their patients. Now is the time to adopt policies to protect against corporate interference in physicians’ medical decision-making,” said Kelly Kenney, CEO of PAI. “Corporate profits must never take precedence over patients.” 

Corporations continued to acquire physician practices at a faster pace than hospitals and health systems. Of the nearly 14,000 practices acquired since 2024, 8,000 went to corporations— including health insurers, private equity firms and large pharmacy chains. This represents a 10.2% increase in practice ownership, compared to hospitals’ 7.8% increase. Notwithstanding this growth in corporate practice ownership, overall physician employment by corporate entities remained relatively flat (0.9% growth). 

ISMA’s Chair of the Commission on Legislation and on the Board of the AMA Council on Legislation Elizabeth Struble, MD, noted that the corporate practice of medicine, especially from private equity firms, is a huge concern for both the state and the ISMA membership. “There have been several bills aimed at trying to determine who actually owns practices that have been met with some challenges over the last couple years,” Dr. Struble said. “There is certainly a growing body of policy at the AMA regarding the corporate practice of medicine as well, as it is certainly not unique to Indiana.”

Hospitals and health systems drove most physician employment gains, adding 44,000 physicians to payrolls in 2024 and 2025—an 8.2% increase. A survey conducted by NORC at the University of Chicago and PAI found that a majority of employed physicians feel that ownership changes negatively affect patient care quality and physician autonomy. This survey will be updated later this spring. In addition to national data, the report provides insights into physician employment and practice ownership by region and state, and in rural areas specifically. 

Dr. Singerman says this study drives home the need for a unifying Medical Society that brings networking, community, voice, and identity to the true leaders of the medical team. “Not a bureaucrat, CEO, or insurance agency, but the physicians who are ultimately responsible for the care of our patients,” Dr. Singerman said. 

ISMA has reached out to the organization to request Indiana-specific data. Stay tuned for upcoming articles.