In most U.S. metropolitan areas, there are only one or two remaining health systems. That was the conclusion of a recent analysis—One Or Two Health Systems Controlled The Entire Market For Inpatient Hospital Care In Nearly Half Of Metropolitan Areas In 2024. The analysis found that one or two health systems controlled the entire market for inpatient hospital care in nearly half (47%) of metropolitan areas in 2024, and that one or two health systems controlled more than 75% of the market in 83% of metropolitan areas. As a result, the inpatient market in most cities is essentially either a monopoly or oligopoly.

Since that analysis was conducted using 2024 data, the consolidation of hospital systems has…