I live in Washington too, and the practices here are being swallowed up by hospital mergers. That is not the case for the midwest, or the south.
You probably live in the Puget Sound area and are affected by the mergers we read about in the Seattle Times. Here in the Tr-Cities, with three basically independent hospitals (although one of them has an affilition with the large Catholic group), the issue of mergers has nothing whatsoever to do with independent practices closing and the providers joining hospitals.