Health systems are recognized as organizations comprised of at least one healthcare facility and physician group or multiple cooperative physician groups. A health system can be as small as one hospital and one physician group (with at least three physicians), or as large as hundreds of hospitals, physician groups, and other facilities such as ambulatory surgery centers or skilled nursing facilities. Though the two have been used interchangeably, a health system is different than an integrated delivery network (IDN). While both health systems and IDNs are formal networks of cooperative providers, IDNs provide health insurance plans to constituents in a specific geographic region.
A health system can be privately owned, government-owned, or operated by a nonprofit group. Only one of the top health systems is managed by the federal government—the other 95 percent are either proprietary or volunteer-run. Government health systems are much smaller on average than other varieties of health systems. The top 20 health systems have nearly 10 times as many staffed beds than the average of all U.S. health systems. By comparison, the top 20 government-owned health systems only had about 1.5 times the number of staffed beds than the national average.
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