Changes in the Composition and Affiliation of the US Primary Care Workforce and Ownership of Primary Care Clinical Sites, 2020-2023.

Authors

Lingrui Liu, Robert L Phillips, Jesse C Crosson

Published in

Journal of general internal medicine. Aug 04, 2026. Epub Aug 04, 2026.

Abstract

Ownership consolidation in US healthcare delivery is transforming how patients access primary care (PC), where PC clinicians practice, and the composition of the PC workforce with potential implications for healthcare costs and quality.
Describe US PC workforce and site ownership changes between 2020 and 2023.
Repeated cross-sectional analysis of 2020 and 2023 data from the IQVIA OneKey Healthcare Professional databases and the Agency for Healthcare Research and Quality Compendium of US Healthcare Systems.
Population-based study of US PC physicians, nurse practitioners, and physician assistants, and PC clinical sites.
Changes in size and distribution of the PC workforce by specialty and practice ownership; changes in the number and distribution of PC sites by size, rurality, and ownership (health system, corporation, or independent).
Between 2020 and 2023, the PC workforce grew 7% (257,907 to 274,925). Family medicine physicians increased 5% (76,563 to 80,712), while the number of PC nurse practitioners grew 17% (70,013 to 81,650). By 2023, 64% of PC physicians were affiliated with health systems or corporations (increase from 58% in 2020). During the same period, the number of PC sites decreased from 75,639 to 74,189, with independent and rural sites declining 7% and 2%, respectively, while health system and corporation sites increased by 4% and 17%, respectively.
The US PC landscape is increasingly dominated by health systems and large corporations, with these organizations accounting for all the growth in the physician workforce between 2020 and 2023. Despite a growing workforce, the reduction in PC sites, particularly in rural areas, may negatively impact PC access. These findings suggest the need for an accessible data source for monitoring the effects of policies intended to increase the PC workforce and examining how patterns of PC site ownership affect healthcare costs and quality.

PMID:
42550359
Bibliographic data and abstract were imported from PubMed on 04 Aug 2026.

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