Integrated Delivery Networks (IDNs) represent a significant organizing structure in the modern US healthcare system. These entities emerged as a response to the need for greater coordination and efficiency in a historically fragmented industry. An IDN is fundamentally a system designed to manage patient care across multiple settings under a single umbrella. This model contrasts sharply with traditional care delivery, where hospitals, physicians, and other facilities often operate in isolation.
Defining the Integrated Delivery Network
An Integrated Delivery Network is an organization that owns or controls a variety of healthcare providers and facilities, linking them together through common management. This unified structure allows for the seamless transfer of patient information and care coordination across different medical settings. The IDN typically includes hospitals, physician groups, clinics, and other related services, all aligned under a shared administrative and financial system.
The primary objective of an IDN is to improve the quality of patient care while also enhancing operational efficiency and managing costs. By coordinating services and standardizing procedures across their network, these systems seek to reduce unnecessary duplication of tests and treatments. This integration attempts to ensure that a patient’s journey, from primary care to specialty services and back, is as smooth and high-quality as possible.
Quantifying IDNs in the US Healthcare Landscape
Determining the exact number of Integrated Delivery Networks operating across the United States is complex, as there is no single, universally accepted registry or definition. Industry analyses offer varying estimates based on specific inclusion criteria. Current data suggests that the total number of active IDNs in the US is well over 500, with some sources tracking over 900 to 1,100 such organizations.
Establishing a precise count is difficult due to varied organizational structures, ranging from small regional systems to massive national conglomerates. A more informative measure of their influence is market penetration, which demonstrates the degree of consolidation in the healthcare sector. Between 40% and 70% of providers nationwide are affiliated with an IDN or a similar provider network. Furthermore, data indicates that approximately 70% of all hospitals in the country are now part of some kind of integrated system structure.
Estimates show that IDNs own or control between 30% and 70% of healthcare facilities, with the acute care segment—hospitals—being particularly dominated by these systems. The sheer economic footprint of IDNs is also a measure of their scale. The US integrated delivery network market was valued at approximately $1.92 trillion in 2023 and is projected to continue its rapid expansion.
Structural Models and Scope of IDNs
Integrated Delivery Networks are categorized into different structural models based on how they organize their component services. One of the most common models is vertical integration, which involves the IDN owning diverse types of facilities across the entire continuum of care. This structure aims to keep the patient within the same network for all their needs, from primary care and acute hospital stays to post-acute care and rehabilitation.
Vertical integration is the most prevalent model, accounting for a significant majority of the industry’s total revenue share. Under this structure, an IDN typically includes acute care hospitals, physician practices, ambulatory surgery centers, imaging and laboratory services, and long-term care facilities. Some IDNs further extend their scope by incorporating their own health insurance plans, creating a highly cohesive system where both the provider and the payer are aligned under the same corporate entity.
Another model is horizontal integration, which focuses on owning multiple facilities of the same type, such as a multi-hospital system operating across a region or even nationally. These multi-hospital systems often standardize administrative functions, bulk-purchasing, and technology across their facilities. Regardless of the model, the core scope of an IDN almost always centers on the acute care setting, with hospitals representing the largest segment of the IDN market in terms of revenue.