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The problem is a mix of people leaving rural areas which increases per patient overhead at facilities, plus mergers and private equity takeovers.

Hospital chains and healthcare systems have been consolidating like crazy for decades and it's still going strong - 80 or so hospitals merge every year. PE has also been snapping up private practices like crazy, too.

https://www.kff.org/health-costs/issue-brief/ten-things-to-k...



Though the consolidation is something of a mixed bag. My community hospital network had some pretty good docs but lab work, appointments, and so forth was pretty much faxes and phone calls which sometimes worked. Now they're on Mass General Brigham's electronic records system and it's a lot better.




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