Five IDNs to watch in 2023

In a fiercely competitive U.S. healthcare provision landscape, integrated delivery networks, or IDNs, are differentiating their offerings by adding outpatient treatment centers, pursuing National Cancer Institute designations and investing in value-based care.

In the famously fragmented healthcare provider ecosystem of the United States, integrated delivery networks, or IDNs, are increasingly prominent. These health systems combine multiple sites and services, and sometimes a health maintenance organization, to provide end-to-end care to patients locally or regionally. Some of the larger IDNs are vast – Nashville-based HCA Healthcare operates 182 hospitals and 2,300 sites of care across 20 U.S. states and the United Kingdom and sees more than 35 million patient encounters per year.

Beyond the biggest players, however, there are a number of IDNs that stand out. Clarivate™ surveyed expert analysts to see what IDNs they see as having the potential to become more prominent regional destinations. Our analysts looked at factors such as expansion of top specialties, population health management, new or enhanced medical school affiliations and other factors specific to selected IDNs. Here, these analysts highlight five under-the-radar integrated delivery networks that have taken innovative steps to expand their health ecosystems to offer more specialty services within their markets, with the aim of pushing value-based care to greater heights. Common threads among those looking to advance their capabilities include more outpatient treatment centers, pursuit of National Cancer Institute (NCI) designations and investments in value-based care, among others. These organizations are building the foundations necessary to expand their service offerings and engage in risk-based reimbursement. While marquee IDNs attract national headlines, these smaller systems reflect how markets are adjusting to an increasingly value-based and competitive landscape.


ChristianaCare, Wilmington, Delaware

IDN status: Advanced

ChristianaCare, the major IDN between Philadelphia and Baltimore, scaled back plans for significant expansion into Pennsylvania. The 2020 acquisition of Union Hospital in Maryland signaled ChristianaCare’s desire to expand from its Wilmington base and the retreat of for-profit hospital companies presented an opportunity to expand into the Philly suburbs. In July 2022, ChristianaCare acquired the shuttered Jennersville Hospital from Tower Health, but plans to purchase four-hospital Crozer Health from for-profit Prospect Medical Holdings fell through in September 2022.

ChristianaCare’s clinically integrated network, eBrightHealth, has helped dictate Delaware’s transition to a value-based care model, which may accelerate under the IDN’s new partnership with Highmark, one of the region’s largest insurers. The two launched a joint-venture company in April 2021 designed to integrate their collective data to improve efficiencies and outcomes. Highmark often works with IDNs that can serve as a counterweight to key competitor University of Pittsburgh Medical Center, including the ownership of Allegheny Health Network in Pittsburgh and support for Penn State Health. ChristianaCare’s future expansion plans could escalate the competition between Highmark and UPMC.

Christopher Silva, Senior Healthcare Research Analyst


UR Medicine, Rochester, New York

IDN status: Intermediate

After years of peacefully co-existing and collaboration with market rival Rochester Regional Health, market leader and academic medical center UR Medicine (University of Rochester) is pivoting and pushing an aggressive strategic plan that includes opening outpatient facilities and enhancing clinical services that target more local patients. UR Med’s Wilmot Cancer Institute is waiting to see if it receives the coveted National Cancer Institute (NCI) designation. It would be the second NCI-designated facility in western New York and would allow the IDN to compete with Buffalo’s internationally known Roswell Park Comprehensive Cancer Institute, which operates a statewide community cancer network. To expand its massive footprint, UR Medicine is working on nearly $1 billion in expansion projects including new orthopedics and cancer treatment centers. While still hesitant to take on full risk contracting, UR Med’s clinically integrated network , Accountable Health Partners, is designed to drive that transition. Congeniality had been a hallmark of healthcare in Rochester, the former company town for Kodak, but intense competition is quickly changing that across the Upstate region.

Valerie E. Pillo, Senior Healthcare Research Analyst


Froedtert Health, Milwaukee & Central Wisconsin

IDN Status: Intermediate

Froedtert Health’s proximity to the Medical College of Wisconsin and long-standing reputation of clinical excellence allows the IDN to differentiate and grow in Wisconsin’s rapidly consolidating healthcare landscape. Froedtert’s strategy involves partnering with ThedaCare to open two small hospitals in Wisconsin’s more rural-suburban markets, which will join the two other micro-hospitals Froedtert opened in Milwaukee in 2022. The IDN also plans to open a proton beam therapy center by 2024, which will be the first in Wisconsin. The confluence of highly specialized oncology care and new locations in Wisconsin’s primary and secondary markets has expanded Froedtert’s reach and reputation—which will be critical as local rival Advocate Aurora prepares to merge with North Carolina-based Atrium Health. Froedtert co-owns a large health plan, Network Health, with Catholic IDN Ascension and combined with ThedaCare, the three IDNs form a counterweight to Advocate Aurora on the western shore of Lake Michigan.

Addie Blanchard, Senior Healthcare Research Analyst


Loma Linda University Health, Riverside, Calif.

IDN status: Intermediate

Loma Linda University Health is trying to achieve NCI designation, partnering with Grand Rapids, Michigan-based BAMF Health to support that goal. BAMF Health manufactures non-invasive cancer diagnostics and therapeutics. The partnership with BAMF Health aims to build a 30,000 to 40,000 square-foot Tier 1 Theranostics Center of Excellence on campus. The IDN has already formed a new Division of Transplant and Cellular Therapy to enhance blood and marrow transplantation and offer novel treatment with individualized transplant and therapeutic options, including immune effector, cell and gene therapies and graft engineering. LLUH’s molecular cytogenetics laboratory does genetic testing to diagnose and treat cancer. In the crowded Southern California healthcare market, specialized services can be a key differentiator.

Stephanie Hoops, Senior Healthcare Research Analyst


Renown Health, Reno, Nevada

IDN status: Intermediate

After a tumultuous 2022, Renown Health has moved toward becoming an academic medical center and boasts solid enrollment through its own insurance operations, Hometown Health Plan. Renown has publicly cited its goal of reaching National Cancer Institute certification and wants to provide advanced specialties locally in northern Nevada, reducing the need to travel to Sacramento or Salt Lake City. Renown’s affiliation with the University of Nevada, Reno School of Medicine, will boost local physician rolls and increase integration with area providers. Renown has not been afraid to take matters into its own hands to improve alignment – the IDN ended its anesthesiology contract, then formed an internal anesthesiology practice within Renown Medical Group.

Bill Melville, Lead Healthcare Research Analyst


For more on the forces driving IDNs, please view our recent webinar on IDN and provider trends. You can learn more about how Clarivate helps life science companies understand the provider landscape and navigate market access here.