As independent practices buckle under rising costs, administrative burdens and stagnant reimbursement, a new and unlikely cast of acquirers has entered the game, moving beyond the traditional hospital and health system playbook to stake claims across primary care and specialty medicine.
From insurers to pharmaceutical companies, here’s who is reshaping the physician acquisition landscape.
Payers
Payer-operated practices now account for 4.2% of the national Medicare primary care market by service volume, up from just 0.8% in 2016, according to a July 2025 study in Health Affairs Scholar. In counties with above-average Medicare Advantage enrollment, that share rises to 5.5%, suggesting payers are deliberately targeting markets where MA penetration gives them the greatest competitive advantage. Since 2019, insurers have accounted for 11% of all physician practice acquisitions, according to a 2023 American Hospital Association analysis, and over that same period, acquired 40% more physicians than hospitals did.
UnitedHealth Group, parent company of both UnitedHealthcare and Optum, is one of the biggest players. According to the Health Affairs study, Optum controlled 2.71% of the national primary care market by service volume, making it the largest payer-affiliated provider in this space.
“A bothersome trend we’re seeing is the insurance companies, such as Optum, acquiring physician practices. This is producing a conflict of interest; they’re trying to undercut physician payments, but they’re also acquiring their practices,” Udaya Padakandla, MD, former president of the Texas Society of Anesthesiologists, told Becker’s. “They’re both the payers and the payees in the insurance equation. I’m not sure they have the interest of the patients or the physicians at the heart of the matter, because insurance companies are always focused on their profits.”
Humana is another standout player in the space. In 2025, CenterWell Senior Primary Care added more than 100,000 patients, more than 25% year-over-year growth, including approximately 32,000 through the acquisition of The Villages Health, a Florida-based system serving a large retirement community. Then in early 2026, Humana acquired Sarasota, Fla.-based MaxHealth — a primary care network that Arsenal Capital Partners had spent four years building by rolling up three provider organizations and 13 independent practices — completing a PE-to-payer exit valued at approximately $1 billion.
Pharmaceutical companies
According to VMG Health, pharmaceutical companies are increasingly acquiring physician groups and management services organizations to build national, specialty-focused networks. Dublin, Ohio-based Cardinal Health, long known as a pharmaceutical and medical products distributor, has rapidly expanded into physician services with three billion-dollar acquisitions in the past two years. The strategy reflects a broader industry push toward physician-led, vertically integrated care platforms.
In August, Cardinal Health announced plans to acquire Solaris Health, a leading urology MSO, for $1.9 billion in cash. The transaction will occur through The Specialty Alliance, Cardinal Health’s multispecialty MSO platform. In April 2025, Cardinal Health also acquired Urology America and Potomac Urology, integrating them into its broader specialty care strategy.
Cardinal Health acquired a majority stake in GI Alliance for $2.8 billion in 2024, marking one of the largest deals ever in the gastroenterology space. The deal sparked criticism from Sen. Elizabeth Warren, D-Mass., who urged the FTC to investigate, noting Cardinal Health already controls 28% of the U.S. prescription drug wholesale market. She said the acquisition could restrict competition by incentivizing physician practices to rely on Cardinal’s supply chain rather than rival wholesalers.
With these acquisitions, Cardinal Health is also restructuring its strategy. In its July 2025 earnings report, Cardinal Health announced the official launch of The Specialty Alliance, a national multispecialty MSO platform. The platform now encompasses its newly acquired platforms. Together, The Specialty Alliance and the separately managed Navista Oncology Alliance support approximately 2,200 providers across 28 states and more than 450 sites of care.
PBMs
Pharmacy benefit managers have quietly evolved from drug pricing middlemen into physician practice acquirers. The three largest PBMs in the country — OptumRx, CVS Caremark and Cigna’s Express Scripts — are each embedded inside parent conglomerates that also own or employ physicians, creating an acquisition logic that extends well beyond pharmacy.
CVS Health, whose Caremark unit processes roughly a quarter of all U.S. prescription claims, has used that infrastructure as a springboard into care delivery. Its 2023 acquisition of Oak Street Health, a value-based primary care network with more than 600 physicians across 21 states, marked one of the largest physician practice acquisitions in recent history, valued at $10.6 billion. The deal gave CVS a direct employment relationship with primary care physicians at scale, something no standalone PBM had previously attempted.Cigna followed a parallel path through its Evernorth health services unit, which houses Express Scripts alongside care delivery and specialty pharmacy assets. In 2025, Cigna divested its Evernorth Care Group clinics, 18 primary care practices in the Phoenix market, to HonorHealth, signaling a strategic pullback from direct physician employment even as the broader PBM-to-acquirer trend accelerates among competitors.
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