Practically half (47%) of metropolitan areas nationwide had just one or two hospitals or well being care techniques that supplied common inpatient hospital care in 2022, a brand new KFF evaluation reveals.

The evaluation examines the extent of competitors amongst hospitals amid a wave of hospital consolidation that has attracted the eye of state and federal regulators. About one in 5 (19%) metropolitan statistical areas have just one hospital or well being care system offering hospital care, and greater than 1 / 4 (27%) are managed by two hospitals or techniques.

In a big majority of metro areas (82%), one or two hospitals or well being care techniques had been accountable for no less than three-quarters of all hospital discharges of their space, assembly the definition of extremely concentrated markets beneath present federal antitrust tips.

The variety of hospitals or well being care techniques in an city space tends to extend with the inhabitants of the area, with a big majority of the smallest city areas (lower than 200,000 inhabitants) having just one or two hospitals or well being care techniques that present inpatient hospital care, whereas nearly all largest areas (no less than a million individuals) have no less than 4 hospitals or well being care techniques.

Different findings embody:

• Practically all (97%) metropolitan areas had extremely concentrated inpatient hospital care markets in 2022 primarily based on the Herfindahl-Hirschman Index, which takes into consideration the market shares of individuals in a given market. The Federal Commerce Fee and the Division of Justice embody this measure of competitiveness of their present tips for evaluating mergers between hospitals or well being care techniques.
• Two-thirds (67%) of hospitals nationwide had been affiliated with well being care techniques in 2022, up from 56% in 2010. The rise within the variety of affiliated hospitals affected each rural and non-rural areas, though almost half (48%) of hospitals in rural areas are nonetheless not linked to bigger healthcare techniques.