Healthcare Insights

How many IDNs are in the U.S.?  

An integrated delivery network (IDN) is an organization that owns and operates a network of one or more healthcare facilities. IDNs are designed to provide a wide range of care, and as a result, they often include a wide variety of both inpatient and outpatient facilities.

As of April 2023, Definitive Healthcare currently tracks more than 1,100 active IDNs in the U.S. The number of IDNs headquartered in each state varies greatly, as some states have nearly 100 headquartered there, while other states have only 2-3. The overall average number of IDNs based in each state is 20.

Using Definitive Healthcare’s HospitalView data, we ranked the U.S. states where the most IDNs are headquartered as of March 2023. Data on these systems is updated daily and based on proprietary research.

States with the most IDN headquarters

Rank State Number of IDNSExplore dataset
Texas 97 Explore
California 88 Explore
New York 57 Explore
Florida 52 Explore
Tennessee 50 Explore
Pennsylvania 49 Explore
Illinois 47 Explore
Georgia 38 Explore
10 Louisiana 34 Explore

Fig. 1. Data is from Definitive Healthcare’s HospitalView database. Data accessed on April 5, 2023.

Which states have the most health systems/IDNs?

Texas has the most IDN headquarters with 97. Texas has a total population of 28 million people and is one of the largest states in the country by both size and population. It is also home to some of the largest IDNs in the country, including Tenet Healthcare, Baylor Scott & White, and Steward Healthcare System.

The state with the second most IDN headquarters is California with 88. California is the largest state in the country by population, with more than 39 million people living there. Some of the most notable IDNs headquartered there include Dignity Health, Prime Healthcare Services, and Kaiser Permanente.

The state with the third most IDNs is New York with 57. New York has a population of nearly 20 million people and is also one of the largest states by both population and area. Some of the most notable IDNs headquartered there include Northwell Health, NewYork-Presbyterian Healthcare System, and Mount Sinai Health System. 

States with the fewest IDN headquarters

 Rank State Number of IDNs Explore dataset
Vermont Explore
Wyoming Explore
Delaware  Explore
North Dakota Explore
South Dakota Explore
Rhode Island Explore
Alaska Explore
Nevada Explore
New Mexico Explore
Utah Explore

Fig. 2.  Data is from Definitive Healthcare’s HospitalView database. Data accessed on April 5, 2023.

Which states have the fewest IDNs?

Vermont has the fewest IDNs as only the University of Vermont Health Network and North Star Health are headquartered within its borders. Vermont is one of the smallest and least crowded states, with a population under 650,000. This in part limits the need for numerous health systems throughout the state.

The state with the second fewest IDNs is a three-way tie between Wyoming, Delaware, and North Dakota with three IDNs headquartered within each. All three of these states are either incredibly small or very sparsely populated.

The third-place spot is also a tie between South Dakota and Rhode Island, with four IDNs headquartered within each. These two states are also some of the smallest and/or the least populated in the country as well.

What is the difference between an IDN and a health system?

An IDN is a form of a health system, but the general difference between a traditional health system and an IDN is that health systems are generally independent organizations that are working together through varying levels of contractual agreements. These organizations share financial and medical responsibilities in order to best care for patients.

An IDN, on the other hand, oversees all the facilities, physicians, hospitals, technologies, and administrations under them. The IDN, therefore, has a more cohesive structure and can sometimes have agreements with specific health plans.

Why are IDNs important to healthcare?

Integrated delivery networks are important to healthcare because they utilize networks of healthcare providers across multiple specialties to provide the highest quality of care possible for patients. Unlike ACOs, an IDN’s structure enables patients to receive all the care that they need within the same network. Keeping patients in-network improves collaboration and communication throughout their treatment and also prevents revenue loss from network leakage.

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