U.S. Integrated Delivery Network Market Size & Share Report, 2033
The U.S. integrated delivery network market size was valued at USD 1,442.20 billion in 2023 and is projected to surpass around USD 3,774.84 billion by 2033, registering a CAGR of 10.1% over the forecast period of 2024 to 2033.
The U.S. Integrated Delivery Network (IDN) market represents a transformative shift in the American healthcare system—one where clinical integration, coordinated care, and value-based delivery are at the core of organizational strategy. An Integrated Delivery Network is a system of healthcare providers and facilities hospitals, physician groups, post-acute care centers, and outpatient clinics that are connected through a common ownership or joint governance model and are responsible for delivering a continuum of care to a defined population.
This model is increasingly vital in a healthcare ecosystem marked by escalating costs, fragmented services, and rising consumer expectations. IDNs seek to resolve these inefficiencies by providing integrated, end-to-end patient care under a unified administrative and operational structure. They aim to enhance patient outcomes, reduce duplication of services, control expenditures, and improve access by aligning stakeholders under shared goals and incentives. As a result, the U.S. IDN market is now at the heart of policy reform, payer strategies, and provider innovation.
Fueled by regulatory mandates such as the Affordable Care Act (ACA), the Medicare Access and CHIP Reauthorization Act (MACRA), and the growing emphasis on accountable care and population health management, IDNs are rapidly evolving. Many of the country’s largest and most influential healthcare systems such as Kaiser Permanente, Ascension, and Providence—operate under the IDN model, blending insurance capabilities, primary care, specialty services, and acute care under a single umbrella.
In 2024 and beyond, the U.S. IDN market is expected to see continued consolidation, digitization, and vertical partnerships as organizations strive to achieve the elusive goals of the “Triple Aim”: improving the patient experience, enhancing population health, and reducing per capita healthcare costs.
Value-Based Care Acceleration: IDNs are leading the transition from fee-for-service to value-based reimbursement models, aligning incentives with outcomes.
Rise of Health IT and Data Interoperability: IDNs are investing heavily in EHR interoperability, population health analytics, and AI-driven care management platforms.
Consolidation and Mergers: Horizontal and vertical mergers continue to shape the IDN landscape, allowing systems to expand geographic reach and resource efficiency.
Integration of Behavioral Health: Behavioral and mental health services are being integrated into IDN care pathways to address whole-person health.
Telehealth and Virtual Care Expansion: IDNs are deploying telehealth across service lines, including chronic disease management and specialty consults.
Pharmacy Integration: In-house specialty pharmacies and retail pharmacy services are becoming common within IDNs to control drug spend and optimize medication adherence.
Outpatient Migration: A continued shift toward ambulatory, home health, and outpatient settings is influencing how IDNs structure care delivery.
Care Coordination Across Continuum: Emphasis on seamless transitions of care between primary, acute, and post-acute environments is driving technology and service integration.
| Report Attribute | Details |
| Market Size in 2024 | USD 1,587.86 Billion |
| Market Size by 2033 | USD 3,774.84 Billion |
| Growth Rate From 2024 to 2033 | CAGR of 10.1% |
| Base Year | 2023 |
| Forecast Period | 2024 to 2033 |
| Segments Covered | Integration Model, Service Type |
| Market Analysis (Terms Used) | Value (US$ Million/Billion) or (Volume/Units) |
| Report Coverage | Revenue forecast, company ranking, competitive landscape, growth factors, and trends |
| Key Companies Profiled | HCA Healthcare; Ascension; Kaiser Foundation Health Plan, Inc.; UNITEDHEALTH GROUP; Providence; UPMC; Trinity Health; TH Medical; CHSPSC, LLC; CommonSpirit Health |
One of the most powerful drivers of the U.S. IDN market is the nationwide shift toward value-based care, where provider reimbursement is increasingly tied to quality and outcomes instead of volume. This evolution in reimbursement models, propelled by CMS programs like the Medicare Shared Savings Program (MSSP) and commercial payer contracts, has incentivized hospitals and physician groups to collaborate more closely, manage risk, and standardize care delivery.
Integrated Delivery Networks are uniquely positioned to thrive in this environment because they offer aligned care across different settings acute, primary, long-term, and specialty. They facilitate data sharing, quality tracking, and cost containment, enabling real-time interventions and coordinated patient journeys. IDNs are leveraging care managers, predictive analytics, and clinical pathways to reduce readmissions and unnecessary ED visits metrics crucial to maximizing shared savings and bonuses under value-based contracts.
For example, Advocate Aurora Health, one of the largest IDNs in the Midwest, reported saving over $80 million in its MSSP participation year due to coordinated primary care efforts and real-time EHR alerts. This integration makes IDNs both financial stewards and clinical drivers of population health, propelling their expansion across the U.S.
While the IDN model offers many advantages, one of its significant restraints is operational complexity and cultural misalignment. Merging hospitals, physician groups, outpatient facilities, and insurers under a single governance framework creates challenges in aligning organizational culture, policies, and performance standards. Diverse clinical practices, varying documentation protocols, and siloed information systems can impede the promise of seamless care integration.
Furthermore, achieving consistent performance across distributed teams—especially in large, multi-state IDNs—is an ongoing challenge. Standardizing quality metrics, managing clinician resistance, and reconciling competing priorities can slow progress. Physician autonomy is often perceived to be at risk in integrated settings, especially when care guidelines and productivity metrics are imposed from centralized administrative bodies.
Financially, the integration process can be costly and time-consuming. Building interoperable IT systems, aligning compensation models, and navigating anti-trust regulations are significant hurdles. While large systems with extensive capital can weather these challenges, smaller networks may face difficulty scaling their operations to meet the demands of the IDN structure.
An exciting opportunity in the U.S. IDN market lies in leveraging digital transformation to predict, prevent, and personalize patient care. With the proliferation of health data across EHRs, claims systems, wearable devices, and patient portals, IDNs are well-positioned to harness analytics for clinical and financial insight.
Leading IDNs are using predictive modeling tools to identify high-risk patients, flag care gaps, optimize resource allocation, and automate outreach. For instance, Providence St. Joseph Health uses machine learning algorithms to predict sepsis risk and alert providers for timely intervention. Similarly, Cleveland Clinic has adopted real-time dashboards that track chronic condition management across its network, resulting in improved A1C and blood pressure control for diabetic patients.
Moreover, digital health startups are partnering with IDNs to offer modular solutions ranging from remote patient monitoring to AI-based scheduling that complement existing infrastructure. This ecosystem of innovation not only enhances care delivery but also helps IDNs differentiate themselves in competitive insurance markets, retain patients, and attract payer contracts that reward digital maturity.
Vertical integration dominated the integration model segment, driven by the strategic alignment of payers, providers, and post-acute care providers under a single enterprise. Vertical IDNs enable control across the full care continuum right from primary care diagnosis to inpatient treatment, rehabilitation, and follow-up. Organizations such as Kaiser Permanente exemplify this model, owning health plans, hospitals, specialty clinics, and a physician network, thus minimizing fragmentation and optimizing outcomes. Vertical integration supports care standardization, reduces redundant services, and enhances financial predictability, particularly in capitation-based reimbursement models.
Horizontal integration is the fastest-growing segment, as hospital systems across the U.S. merge with or acquire other hospitals and physician groups to expand their footprint and market leverage. In an era of healthcare consumerism and payer consolidation, these horizontally aligned IDNs seek to scale operations, negotiate better contracts, and create regionally dominant networks. For example, the merger of Intermountain Healthcare and SCL Health in 2022 created a multistate IDN with over 60,000 caregivers. Horizontal models also enable centralization of administrative functions like supply chain, IT, and billing, improving cost efficiencies.
Acute care services lead the IDN market by service type, as hospitals remain the operational core and primary revenue source for most IDNs. Emergency departments, surgical suites, ICUs, and inpatient care units require seamless coordination with pre- and post-hospital care providers, a task well suited to the IDN model. With acute care facilities managing critical conditions such as heart attacks, strokes, and trauma, integration ensures continuity in the treatment pathway and faster transitions to rehabilitation, reducing length of stay and readmissions. Additionally, bundled payment models for procedures like joint replacements have reinforced the need for acute-post-acute collaboration under IDNs.
Primary care services are the fastest-growing, reflecting the national shift toward preventive medicine and population health. Integrated primary care helps IDNs manage risk-based contracts by reducing avoidable ED visits, catching diseases early, and facilitating wellness coaching. Many IDNs are investing in advanced primary care hubs with behavioral health integration, social workers, and nutritionists to address social determinants of health. Organizations like Geisinger Health have shown that primary care-centered models can significantly reduce total cost of care while improving patient satisfaction.
Specialty Clinics are gaining traction within IDNs as sub-acute and chronic disease management hubs. These include cardiology, endocrinology, oncology, and behavioral health centers that work in close coordination with both primary care and acute facilities. Their integration allows for optimized referral patterns, shared care plans, and consistent tracking of outcomes. Many IDNs now offer specialty centers as part of “hubs” that facilitate rapid diagnostic and therapeutic access without overwhelming hospitals.
Long-term care services such as skilled nursing, home health, and hospice are being increasingly integrated into IDNs, particularly those with accountable care contracts or Medicare Advantage plans. By managing post-acute transitions, these networks reduce complications and readmissions, improving both patient experience and financial performance. Large IDNs like Trinity Health have developed proprietary long-term care networks to manage aging populations effectively.
In the U.S., Integrated Delivery Networks are the engine of healthcare transformation. With over 1,000 IDNs currently operating across the country, these networks influence procurement, policy, clinical innovation, and reimbursement models. States such as California, New York, Texas, and Pennsylvania are home to the largest and most advanced IDNs. However, the model is also expanding in rural regions where critical access hospitals are joining larger networks to maintain viability.
U.S. IDNs are increasingly blending payer and provider functions, with systems like UPMC, Intermountain, and Geisinger offering health insurance products and managing capitated risk. This vertical integration allows control over cost, network utilization, and patient experience, aligning all stakeholders toward shared outcomes.
Federal policies such as CMS Innovation Center pilots, ACO expansion, and Medicaid managed care reforms continue to incentivize IDN development. Meanwhile, the private sector especially insurers and retail health giants is forming alliances or launching health systems that mimic IDN features, such as Walgreens' VillageMD initiative or CVS Health's expansion into primary care.
The U.S. also serves as a laboratory for IDN tech innovation, with companies like Epic Systems, Cerner, Innovaccer, and Health Catalyst providing the digital infrastructure for integrated operations, population health, and analytics. As financial pressure mounts on both public and private health sectors, IDNs are likely to become the dominant care model in the country.
April 2025 – Kaiser Permanente announced a $1.2 billion investment in digital infrastructure across its IDN, aiming to expand virtual care and predictive analytics capabilities for chronic disease populations.
February 2025 – CommonSpirit Health integrated behavioral health services into all of its primary care clinics across 21 states, expanding whole-person care across its IDN.
January 2025 – Cleveland Clinic launched an AI-powered command center to support care navigation, bed management, and surgical scheduling across its integrated network.
November 2024 – Ascension Health partnered with Medline to implement system-wide supply chain standardization, resulting in a projected $100 million savings over five years.
September 2024 – Providence Health announced the spinout of its internal telehealth platform, DexCare, to scale digital care coordination across its IDN and license to external networks.
This report forecasts revenue growth at country levels and provides an analysis of the latest industry trends in each of the sub-segments from 2021 to 2033. For this study, Nova one advisor, Inc. has segmented the U.S. Integrated Delivery Network market.
By Integration Model
By Service Type
Cross-segment Market Size and Analysis for Mentioned Segments
Additional Company Profiles
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Additional Countries (Apart
From Mentioned Countries)
Country/Region-specific Report
Go To Market Strategy
Region Specific Market DynamicsRegion Level Market Share Import Export AnalysisProduction AnalysisOthers