South Carolina’s last major independent multispecialty physician group is no longer independent.
On March 3, Charleston-based MUSC Health finalized the $111 million acquisition of Palmetto Primary Care Physicians, the state’s largest independent multispecialty practice. The Medical University Hospital Authority board voted unanimously to purchase all membership interests in PPCP, effective March 3, with the group set to become a not-for-profit entity within MUSC Health.
PPCP includes 31 physicians, 95 advanced practitioners and 40 medical practices, spanning physical therapy, urgent care and specialty clinics. The group has operated since 1996 and held the distinction of being the largest independent physician group remaining in South Carolina.
Breaking the numbers down, the deal works out to roughly $3 million per physician, according to an op-ed published in News From The States.
MUSC Health CEO Patrick Cawley, MD, cited South Carolina’s physician shortage as the driving rationale.
“South Carolina faces a significant shortage of primary care physicians, and strengthening access to high-quality, community-based primary care is essential to MUSC Health’s mission,” Dr. Cawley said in a news release. “We have worked closely for years with PPCP’s outstanding providers, and their proven value-based care model makes them an ideal partner.”
PPCP board President Mark Redwine, MD, framed the deal as a stability play.
“This transaction ensures long-term stability for our physicians, specialists and staff while allowing us to expand the services our communities rely on,” he said in the release. “Joining MUSC Health provides the scale, infrastructure and academic partnership needed to expand access and deliver even stronger value-based care.”
The deal fits a pattern playing out nationally. Health systems have increasingly moved to acquire large independent physician groups as those groups struggle under rising administrative burden, reimbursement pressure, and the cost of sustaining operations without institutional backing. PPCP, which had operated independently since 1996, exemplifies that scale alone does not insulate a practice from the structural economics reshaping independent medicine.
MUSC recently announced plans to construct a $130 million hospital in Nexton, a rapidly growing development in Berkeley County. According to an op-ed in the Post and Courier, critics have noted the tension between that goal and MUSC’s identity as a publicly supported academic medical center. South Carolina ranks among the worst 10 states for several major chronic disease outcomes, including diabetes, kidney failure and stroke, raising questions about whether health system acquisition of community practices advances access or primarily advances referral flow.
The acquisition is one of dozens of independent-to-system deals completed in 2026 as consolidation continues at a pace that shows no signs of slowing.
Between 2019 and 2023, the share of independent physician practices owned by hospitals, health systems, or other corporate entities jumped from 39% to 59%, while physician employment by those entities rose from 62% to 78%, according to a December 2025 report from the Progressive Policy Institute.
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