Private health care and social assistance averaged 55,519 more establishments in 2025

The annual average number of private health-care and social-assistance establishments reached 2,080,080 in 2025, an increase of 55,519, or 2.7%, from 2024, according to the Bureau of Labor Statistics' Quarterly Census of Employment and Wages.

More establishments do not necessarily mean 55,519 newly formed companies. In QCEW, an establishment is generally a single physical location where business is conducted or services are performed. A company can operate multiple establishments, and administrative changes can affect counts.

Quick read

• Ambulatory health-care services added 26,928 annual-average establishments, the largest increase among the four component industries.
• Social assistance added 25,905; nursing and residential care added 1,382; hospitals added 1,303.
• The component changes sum to one fewer establishment than the published sector change because BLS annual averages are rounded.

Growth was broad, but uneven

Ambulatory care reached 762,177 private establishments in the 2025 annual average, up 3.7%. Social assistance reached 1,207,989, up 2.2%. Nursing and residential care reached 92,816, up 1.5%.

Hospitals had the smallest numerical increase but the largest percentage change: 1,303 more establishments, or 8.2%, to 17,098. That figure should not be read as 1,303 new full-service hospitals. QCEW establishment definitions, reporting units, ownership, and industry coding can produce more than one establishment associated with a health system, and the series covers private ownership only in this comparison.

Establishments are not jobs

The same 2025 rows reported 22.998 million annual-average jobs across private health care and social assistance. An establishment count describes reporting locations; employment counts covered workers who worked during or received pay for the period including the 12th of the month.

The industries differ sharply in scale. Private hospitals reported 5.573 million annual-average jobs across 17,098 establishments, while social assistance reported 4.984 million jobs across more than 1.2 million establishments. Comparing establishment totals without workforce scale would distort the structure of each industry.

Why QCEW is useful

QCEW is built from unemployment-insurance records and covers the great majority of U.S. payroll employment. That makes it less timely than a monthly survey but well suited to annual structural comparisons. It can show where reporting locations, employment, and wages changed across industries.

It cannot by itself distinguish an independent practice opening from a corporate reorganization, determine whether a location is accepting patients, or measure service capacity. Industry classification follows the establishment's primary activity, not every service performed there.

What to watch

The next analytical step is geographic: whether establishment growth occurred broadly or concentrated in a small set of counties. County reporting introduces suppression and comparability constraints, so that work should preserve BLS disclosure flags and consistent NAICS definitions rather than turn missing cells into zeros.

Methodology and limitations

MedDataUSA retrieved BLS QCEW 2025 annual-average national rows for private ownership and NAICS 62, 621, 622, 623, and 624. We used BLS-published over-the-year establishment changes and percent changes. The four component changes total 55,518, one below the sector's 55,519 because annual-average counts are rounded.

QCEW excludes some workers outside unemployment-insurance coverage and can revise historical values. Establishments are reporting locations, not firms, facilities certified under a particular health program, or proof of patient access.

Sources

• BLS, Employment and Wages, Annual Averages 2025.
• BLS QCEW open data access.
• Reproducible extracts and calculations: the preserved internal analysis package.