Chicago by all accounts has a strong presence in healthcare, being home to a number of established systems, medical societies and trade associations.
And yet, it does not possess a clear leading hospital in the same vein as its counterparts in New York, which has New York-Presbyterian, and Los Angeles, with renowned Cedars-Sinai.
The third-largest metropolitan area in the country does not have an entry on the list of the largest hospitals—measured by total operating revenue—until No. 10, a spot held by Rush University Medical Center, which sits just west of the city’s central business district.
Theories abound as to why Chicago, home to the American Hospital Association and the American Medical Association, does not have its own supersized hospital or health system.
One argument is that in Chicago, known as a city of neighborhoods, a highly competitive and fragmented healthcare market has evolved out of those neighborhoods and the local providers serving them. The metro area has five sizable academic medical centers all competing for market share and patient visits. Yet those medical centers were late to the party in terms of building systems, and only in recent years have they started growing their networks. Feeding that dispersion is the strong suburban sprawl that has grown around the city.
“There’s a lack of strategic conditions that really would create an M&A environment like you see in other markets,” said David Smith, a consultant and co-founder of the Health Care Council of Chicago, which recently produced a report on the local healthcare landscape. “You see big systems grow up in Chicago, but you don’t have a megasystem or megahospital like you do in other cities.”