Physicians in practices that sold to a hospital, private equity group or insurer most often named payer negotiation as the reason: 70.8% rated better rates with payers as important or very important in the AMA's 2024 Physician Practice Benchmark Survey. Better access to costly resources followed at 64.9%, and handling payer regulatory and administrative requirements came third at 63.6%.
The AMA published the findings in May 2025 in a Policy Research Perspective by Carol K. Kane, PhD. The sale questions went to 520 physicians who were members of their practice when it was acquired after 2014.
The six reasons physicians gave
Each physician rated six reasons on a five-point scale, from not important at all to very important. The AMA reports the share who answered 4 or 5. Three reasons cleared 63%, and the same three ranked first whether the practice sold before or after 2019.
| Reason for the sale | Rated important or very important |
|---|---|
| Better negotiate higher payment rates with payers | 70.8% |
| Improve access to costly resources | 64.9% |
| Better manage payers' regulatory and administrative requirements | 63.6% |
| Ease participation in risk-based payment models | 55.1% |
| Increase availability of additional services patients need | Just under 50% |
| Better compete for employees in the labor market | Just under 50% |
Source: AMA, Physician Practice Characteristics in 2024, Exhibit 4, N=520 physicians.
The labor market reason ranked last. A bit under half of these physicians called it important, so pay and hiring played a smaller part in the decision than rate negotiation, which led by more than 20 percentage points.
When the sales happened
The survey asked 2,027 physicians in hospital-, private equity- or insurer-owned practices when their practice was sold. Across all of them, 15.1% said after 2019, 15.3% said between 2015 and 2019, and 41.6% said before 2015. Another 28.0% did not know.
The split by buyer is large. Among physicians in private equity-owned practices, 38.3% said the sale came after 2019. Among physicians in hospital-owned practices, 10.0% said so, and 47.2% said the sale came before 2015.
| Year of sale | Hospital-owned (N=1,626) | Private equity-owned (N=327) | All (N=2,027) |
|---|---|---|---|
| Before 2015 | 47.2% | 17.1% | 41.6% |
| 2015 to 2019 | 13.6% | 22.2% | 15.3% |
| After 2019 | 10.0% | 38.3% | 15.1% |
| Do not know | 29.2% | 22.4% | 28.0% |
Source: AMA, Physician Practice Characteristics in 2024, Exhibit 3. Insurer-owned practices are in the "All" column only, because the sample was under 100.
An additional 7.7% of physicians said they or a colleague kept an ownership stake in a practice that they described as owned by a hospital, private equity group or insurer.
How the three ownership types differ in size
Size is where the three types separate most. In the AMA's 2024 data, 49.2% of physicians in private practice worked in groups of fewer than five physicians. That share was 16.1% in hospital-owned practices and 12.9% in private equity-owned practices.
At the other end, 11.8% of private practice physicians worked in groups of 50 or more, against 31.3% in hospital-owned practices and 32.6% in private equity-owned ones.
| Practice size | Private practice (N=2,149) | Hospital-owned (N=1,461) | Private equity-owned (N=284) |
|---|---|---|---|
| Fewer than 5 physicians | 49.2% | 16.1% | 12.9% |
| 5 to 10 | 19.7% | 23.0% | 21.9% |
| 11 to 24 | 11.6% | 16.4% | 20.9% |
| 25 to 49 | 7.8% | 13.3% | 11.7% |
| 50 or more | 11.8% | 31.3% | 32.6% |
Source: AMA, Physician Practice Characteristics in 2024, Exhibit 7.
Specialty mix differs too. Solo or single specialty practices made up 77.9% of private practice physicians, 63.4% of private equity-owned practice physicians and 31.3% of hospital-owned practice physicians. Multi-specialty groups held 20.5%, 27.7% and 44.3% respectively.
Where ownership stood in 2024 against 2012
The AMA has run the benchmark survey every other year since 2012. Wholly physician-owned practices employed 42.2% of physicians in 2024, down from 60.1% in 2012. Hospital-owned practices rose from 23.4% to 34.5%, and physicians employed or contracted directly by a hospital doubled from 5.6% to 12.2%.
Private equity ownership was 4.4% in 2020 and about 4.5% in 2022, then reached 6.5% in 2024. The AMA first asked about it in 2020.
Personal ownership fell as well. Owners were 35.4% of physicians in 2024, against 53.2% in 2012, while employees rose from 41.8% to 57.5%. Independent contractors were 7.1%. The AMA estimates that about 80,000 fewer physicians worked in private practice in 2024 than in 2012, using eligible physician counts of 650,750 in 2012 and 737,195 in 2024.
Group size moved the same way. Physicians in practices of 10 or fewer made up 47.4% in 2024, the first reading under half, compared with 61.4% in 2012. Practices of 50 or more held 18.3%.
How the AMA collected the data
The 2024 survey went to a sample of 5,000 physicians, up from 3,500 in earlier years. It ran from the end of August through the end of September 2024 and drew a 43% response rate. WebMD/Medscape supplied the panel, which held about 55,000 eligible physicians, and NORC at the University of Chicago built the weights.
Eligible physicians had finished residency, saw patients at least 20 hours a week and did not work for the federal government. The AMA changed the ownership question in 2024 to add joint ownership by insurers and private equity firms, so trends before and after 2024 are not an exact match.
The AMA also cites a Physicians Advocacy Institute count that differs. That analysis put the share of physicians in independent practice at 22.4% in 2024, down from 37.8% in 2019, because it tracks the practices where physicians are affiliated, not where they are employed or hold an ownership stake.
Sources
- American Medical Association, Physician Practice Characteristics in 2024: Private Practices Account for Less Than Half of Physicians in Most Specialties, May 2025
- American Medical Association, Physician Practice Benchmark Survey, 2024 results page
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