Here are five deals that show how health systems, corporate players and payer-backed platforms are competing within the physician workforce, often through acquisitions or deeper clinical integration.
1. Atrium Health + Carolina NeuroSurgery & Spine Associates
Charlotte, N.C.-based Carolina NeuroSurgery & Spine Associates, one of the nation’s largest independent neurosurgery groups, joined Atrium Health, also based in Charlotte, N.C., Oct. 1. Founded more than 80 years ago, CNSA includes more than 70 physicians and advanced practice providers and offers services ranging from nonoperative care and minimally invasive outpatient procedures to highly complex surgical interventions.
Atrium and CNSA have long partnered on neurosurgery and spine care in the Charlotte region, and the acquisition formalizes a relationship that has already been operationally intertwined for years. This is a hallmark of many system-physician deals today, where alignment begins well before ownership.
CNSA also isn’t the first large physician practice Atrium has absorbed. The system, which operates under the umbrella of Advocate Health, the nation’s third-largest nonprofit health system with $34.8 billion in annual revenue, previously added practices including Pediatric Surgical Associates and Georgia’s Harbin Clinic.
This deal underscores the continued shift toward system ownership of physician groups and the steady movement toward employed practice models. Between 2008 and 2016, the share of physician practices acquired by hospitals increased by 71.5%, according to a National Bureau of Economic Research study. Hospital ownership reached 47.2% of all physician practices by the end of that study period, and that trend has only accelerated as independent groups face reimbursement pressures, staffing costs and regulatory demands.
2. NYU Langone + Rothman Orthopaedics
New York City-based NYU Langone Health and NYU Langone Orthopedics announced the acquisition of Rothman Orthopaedics of Greater New York and Rothman Orthopaedics in New York City, expanding NYU’s orthopedic footprint across the city.
The move reflects a growing trend among large systems: acquiring premier specialty groups to add volume and expertise and to cement an orthopedic brand across a region. Orthopedics, with its high outpatient procedure volume and strong commercial reimbursement, remains among the most aggressively pursued specialties in physician dealmaking.
In a similar deal within the orthopedic specialty later in 2025, Baptist Health Medical Group acquired Louisville (Ky.) Orthopedic Clinic, adding more than 20 orthopedic providers to its network.
3. Brown Health + Brown Physicians
Providence, R.I.-based Brown Health finalized its merger with Brown Physicians after approvals from the Federal Trade Commission and Rhode Island Attorney General Peter Neronha. BPI is a multispecialty practice group founded and led by faculty at The Warren Alpert Medical School of Brown University. Its six foundations — dermatology, emergency medicine, medicine, neurology, surgery and urology — will now operate under Brown Health Medical Group, a physician-led division of the Brown University Health system.
The merger took effect Oct. 1 and brought 500 physicians into Brown Health Medical Group, expanding its network to more than 1,500 providers. Under the agreement, Brown Health also committed to expanding access to primary care for 30,000 new patients within three years, with the potential to reach 40,000 within four years.
The move highlights a broader trend among academic health systems to more fully integrate affiliated physician groups into system-employed medical group structures. A recent AAMC report, produced with ECG Management Consultants, describes the push to build a “unified physician enterprise” as a defining challenge for modern academic health systems, driven by consolidation, scale and value-based care.
The Brown Health-Brown Physicians merger mirrors a wider pattern of consolidation occurring across academic systems nationwide. Becker’s reported on 22 academic health systems that acquired hospitals in 2025. Kaufman Hall noted in a Jan. 12 analysis that community hospital networks that merge with academic medical centers can support a range of strategic goals — including extending the academic medical center’s specialty services into new markets, strengthening recruitment and branding, and shifting higher-acuity care to the main campus while building capacity across the broader network.
4. Cardinal Health + Solaris Health
Dublin, Ohio-based Cardinal Health acquired Solaris Health, a urology management services organization, for $1.9 billion in cash, gaining ownership of about 75% of The Specialty Alliance, also an MSO.
Cardinal Health — historically known for distributing pharmaceuticals and medical products — has accelerated its expansion into physician services with three major billion-dollar acquisitions in the past two years. Its strategy echoes a broader push among healthcare corporations to build physician-led, vertically integrated specialty care platforms. According to a VMG Health analysis, these moves are laying the groundwork for national, specialty-focused networks with centralized support and standardized operations.
In its July 2025 earnings report, Cardinal officially launched The Specialty Alliance, a national multispecialty MSO platform that includes its newly acquired physician services 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.
This deal highlights how nontraditional healthcare players are increasingly moving into care delivery, according to the VMG Health analysis. Instead of competing solely through supply chain or administrative services, companies like Cardinal are seeking sustainable growth through physician alignment and clinical platform ownership.
5. Optum + Holston Medical Group
Optum acquired Holston Medical Group, a 200-provider medical group based in Kingsport, Tenn., as part of its continued expansion in physician services.
The deal fits into a larger pattern of aggressive growth by Optum over the past several years. As of late 2024, Optum subsidiaries included 423 ASCs, more than 880 home health companies, and 335 administrative/support entities, according to the “Sunlight Report” by the Center for Health & Democracy, funded by Arnold Ventures.
It also reflects a broader trend of payers and payer-affiliated organizations becoming major physician acquirers. Optum, owned by UnitedHealthcare, controlled 2.71% of the national primary care market by service volume, making it the largest payer-affiliated provider in that space, according to a study published in Health Affairs Scholar.
However, Optum’s strategy may be entering a new phase. In an Oct. 29 earnings call, executives said the company is returning to its core value-based care model.
CEO Patrick Conway, MD, said the strategy had “strayed from the initial intent of the model,” resulting in an oversized provider network, operational inconsistencies and an overreliance on affiliated physicians who were not fully aligned with value-based care. Optum Health posted flat year-over-year revenue in the most recent quarter, and leadership tied the results to the network growing too large, misalignment with value-based care policies, and product and service drift away from Optum’s clinically oriented VBC foundation.
Optum’s continued acquisitions show how payer-backed physician platforms are still expanding — but the company’s recent commentary suggests that even the biggest consolidators are confronting the limits of growth without operational integration.
