Physician practice deals drew pushback this year from regulators, lawmakers and researchers. Here are five controversies that shaped the conversation:
1. USAP settles FTC roll-up case. On April 23, the FTC announced an agreement in principle with Houston-based U.S. Anesthesia Partners. The deal would resolve the agency’s 2023 lawsuit, which alleged that USAP built a monopoly over anesthesia services in Texas through a decade-long roll-up of more than a dozen practices, backed by private equity firm Welsh, Carson, Anderson & Stowe. The FTC said USAP’s market share reached about 44% to 70% in Houston, Dallas and Austin. The terms are confidential for now. The FTC said the settlement will “restore a competitive market structure” in Texas if fully implemented, and that it will return to court if USAP does not follow through. USAP denies wrongdoing, according to a May 1 analysis from law firm Brach Eichler. A federal court stayed the case May 26 while USAP carries out the settlement over 180 days. The deal still needs approval from both the FTC and the court.
2. Optum moves to sell New York specialty practices. In June, Optum confirmed to Becker’s that it plans to sell orthopedics, general surgery and urology services across New York. The services are part of Optum Medical Care and Crystal Run Healthcare, a Hudson Valley multispecialty group Optum acquired in 2023. Optum said it has signed or is negotiating letters of intent with several large health systems in the state, and it aims to close the deals by Dec. 31. The move followed scrutiny from New York lawmakers in December and remarks from Optum CEO Patrick Conway that the care services division had “strayed from the initial intent.”
3. Democrats push a federal corporate practice of medicine ban. In September, Sens. Elizabeth Warren (D-Mass.), Ron Wyden (D-Ore.) and Jeff Merkley (D-Ore.) introduced the Stop Corporate Takeovers of Physicians Act, along with Reps. Val Hoyle (D-Ore.), Alexandria Ocasio-Cortez (D-N.Y.) and Suhas Subramanyam (D-Va.). The bill would generally bar entities that are not majority-owned and controlled by licensed clinicians from owning or controlling medical practices. Hospitals and certain nonprofit and public providers would be exempt. It would also prohibit MSOs from owning practice interests or financing acquisitions, ban most physician noncompetes and allow FTC, state attorney general and private enforcement, according to a Sept. 17 analysis from law firm Holland & Knight.
4. State MSO laws, including Oregon’s, slow PE deals. Private equity deals for healthcare services fell 18.5% nationwide in the second quarter of 2026 compared with the same period in 2025, according to PitchBook’s Q2 2026 Healthcare Services Report. Deals giving PE firms control of a practice’s management services dropped nearly 36%, from 111 to 71. PitchBook said the decline was partly due to “tighter regulations slowing deal processes” and pointed to Oregon’s 2025 law restricting MSO ownership and control of clinics, which took effect in January, according to an Aug. 18 report from the Oregon Capital Chronicle. The Oregon Medical Association welcomed the findings.
5. White House report ties practice takeovers to higher prices. In April, the White House Council of Economic Advisers released the 2026 Economic Report of the President. One chapter argues that the shift away from independent practice was “driven in part by rising regulatory and administrative burdens and government-designed financial incentives.” The share of physicians employed by hospitals rose from 23.4% in 2012 to 34.5% in 2024, and nearly 80% of physicians worked for hospitals, health systems or corporations in 2024, the report said.
“This consolidation led to higher prices paid by Americans for the same services,” the report said. Citing prior studies, it said commercially insured patients pay about 20% less in the least concentrated physician markets than in the most concentrated ones. The chapter said a CMS rule extending site-neutral payment to drug administration at off-campus hospital departments “will reduce the financial incentives for hospitals to acquire independent practices.” It also noted the FTC has warned large healthcare employers that their noncompetes with employed physicians will be scrutinized.
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