A new Baker Tilly Capital report found that physician practices and ambulatory care organizations represented roughly one-third of healthcare provider and services transactions during the first half of 2026 — the largest share of the market.
This means consolidation is not limited to billion-dollar hospital mergers. It is occurring doctor’s office by doctor’s office and surgery center by surgery center.
Some of these transactions may benefit patients. Independent practices face rising administrative costs, workforce shortages, expensive technology requirements, and difficult negotiations with large insurance companies. A partnership can provide capital, technology, and administrative support that helps a local practice survive.
The real question is accountability.
When a practice is acquired, the name on the building may remain the same. However, decisions about prices, referrals, staffing, scheduling, and available services may eventually be made by a hospital system, insurance company, investment firm, or distant corporate committee.
This is where consolidation connects directly to the emerging Republican healthcare approach.
President Donald Trump’s Great Healthcare Plan emphasizes accountability for large insurance companies, hospital systems, and healthcare middlemen. Its proposals for visible prices, Plain English Insurance, lower premiums, direct assistance, and lower drug costs all reflect the same principle: Powerful institutions should be required to serve the individual, not use complexity and market power to control the individual.
The person-centered healthcare system for which we are advocating builds on that approach. One of its central promises is support for locally owned or operated healthcare organizations that remain accountable to the people they serve.
Our July research shows how strongly this idea resonates. Ninety-three percent of respondents expressed concern about important healthcare decisions being made by distant organizations. Seventy-four percent preferred healthcare organizations that are locally owned or accountable to their communities.
The answer is not to prohibit acquisitions or assume that every large organization is bad. It is to require accountability regardless of size or ownership.
Patients should know who controls their doctor’s practice, what care will cost, whether corporate relationships influence referrals, and who is responsible when access deteriorates. Policymakers should also reduce the administrative burdens that make it increasingly difficult for independent and locally operated practices to compete.
The test for healthcare consolidation is simple: Does it give people better care, lower costs, and more choices — or does it transfer more control to institutions that are too distant to answer to the people they are supposed to serve?
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