Health System Lawyers Work Outside New York, Often at Mid-Size Firms

A hospital system or health plan recruiting healthcare in-house counsel is looking for lawyers who mostly work outside New York. Sartori & Partners data show 323 lateral moves by lawyers with a healthcare provider and payor focus in the 12 months to October 2026. Only 9.0% of them joined a firm in New York, against 14.8% of all lateral moves: an index of 61 against the market. Firms of 150-399 lawyers took 23.1% of these moves, against 13.3% in the market. Health care lawyers carry most of the flow, appearing in 63.8% of it. Moves between firms are not in-house hires, but they show where these lawyers practice and which of them are open to a change. For an in-house search, the map points away from the usual New York shortlist and toward Washington, Chicago, Nashville and mid-size firms.

New York is still the largest single destination in the 12-month list, with 29 moves, yet its share sits well below the market's. Washington runs the other way: 7.1% of these lawyers joined a firm there, an index of 127 against the market's 5.6%. The 36-month record shows this is not a one-year swing. Over that window New York took 9.7% of moves by lawyers with this focus against 14.2% market-wide, while Chicago took 6.2% against 4.0%, Philadelphia 4.9% against 1.8% and Atlanta 3.4% against 1.8%.

Neighboring life-science sectors look different. Among lawyers with a pharma and biotech focus who changed firms, New York carries an index of 107 and Boston 718. For a medical device focus, New York sits at 94 and Washington at 278. Of the three, only the hospital and health plan group leans clearly away from New York. A health system should draw its search map from where these lawyers already work: Washington first, then Chicago, Philadelphia and Atlanta, with New York as one market among several rather than the default.

Sartori & Partners deal records, a different measure from moves, point the same way. Lawyers in Chicago worked on 14.7% of hospital and health plan deals, against 6.8% of pharma and biotech deals and 9.1% of medical device deals. Lawyers in Nashville worked on 12.4%, and Nashville does not reach the top 10 cities of either neighboring sector. New York, at 27.3%, carries less of the work here than in pharma and biotech (45.9%) or medical devices (37.3%). These shares show where the work is done: one deal can count in several cities, so the shares add to more than the whole.

The lateral record, counted separately, lines up. Over 36 months, Chicago took 6.2% of moves by lawyers with this focus and Nashville 3.7%. Most of these lawyers stay put when they move: 19.2% changed city, close to the market's 20.5%. A hospital operator or plan based in the Midwest or the South can therefore recruit lawyers who already staff the sector's transactions and disputes, without asking them to relocate.

Firm size is where this group departs most from the market. Firms of 150-399 lawyers took 23.1% of moves by lawyers with this focus, 9.8 points above the market's 13.3%. Firms of 1,000+ lawyers took 44.2%, against 53.6%, and firms of 400-999 lawyers 28.3% against 23.4%. The 36-month figures keep the same shape: 22.4% at firms of 150-399 lawyers, against 13.9% for the market and 12.0% for lawyers with a pharma and biotech focus.

Companies in every sector recruit the other way. Of the lawyers who moved from a law firm to a company between May and October 2026, 59.3% left a firm of 1,000+ lawyers and 12.3% a firm of 150-399 lawyers. A search confined to the largest firms misses much of where health care lawyers work. Firms of 150-399 lawyers with health care groups belong on the target list from the first week, and the firms below hired the most lawyers with this focus over 36 months.

The practice mix is narrow and specialist. Health care lawyers appear in 63.8% of moves by lawyers with this focus, against 3.0% of all lateral moves, an index of 2,146. Over 36 months the share was 62.4%, so this is the normal pattern. Litigators appear in 39.0%, an index of 98, close to the market. Product liability and torts lawyers over-index at 191, while corporate lawyers sit at 84. One lawyer can carry more than one practice, so these shares overlap.

In the Sartori & Partners record of moves from firms to companies, health care is a small line. Across all sectors, health care lawyers made 4.6% of the 953 moves from law firms to companies between May and October 2026, against 37.7% for litigators and 33.2% for corporate lawyers.

Across the market, 86.1% of lawyers who left a firm between May and October 2026 joined another firm, and health care specialists are a small share of those who went to companies. A hospital system therefore competes for them mainly with other law firms. The offer has to beat a lateral partnership or a place in a mid-size firm's health care group, not another company's role, and the brief should say plainly which regulatory areas the job covers.

Seniority tilts upward. Partners made 41.2% of moves by lawyers with this focus, against 27.7% market-wide, and associates 47.4% against 58.5%. Moves from firms to companies lean hard the other way: across all sectors, associates made 76.7% of them and partners 11.0%.

The count of these moves held flat (+0.0%), 344 in the latest settled 12 months against 344 the year before, and partner moves held steady at 139 against 144. Lateral moves are one hiring channel only, so a flat count says nothing about how many health care lawyers a company can approach. A health plan hiring a senior lawyer will meet more partners in this flow than in the market as a whole; one hiring a junior lawyer should expect firms to compete for the same associates.

Start outside New York. With New York at an index of 61 and Washington at 127, a search that opens in Manhattan begins in the wrong place. Put Washington, Chicago and Nashville on the first list, and add Philadelphia and Atlanta for regional systems.

Add mid-size firms by name. Firms of 150-399 lawyers took 23.1% of these moves, so a list built only from firms of 1,000+ lawyers leaves out a large share of candidates. Health care groups at those firms also train lawyers on reimbursement, licensing and payor contracts, the daily work of an in-house role.

Plan to compete with law firms. Health care lawyers made only 4.6% of moves from firms to companies, and partners were 41.2% of the lateral flow in this sector. Budget pay and title against a lateral partnership offer, and allow time for a candidate who is not looking to be approached directly.