Five major physician practice deals in 2026 reveal an industry at an inflection point. Independent practices are becoming harder to sustain, academic partnerships are fracturing, and a new mix of buyers — from hospital giants to insurers — is racing to gain leverage over physicians and the flow of patients.
Here’s a breakdown of the deals, both finalized and pending, and what they mean for the industry:
South Carolina’s largest independent multispecialty group acquired
Austin, Texas-based St. David’s HealthCare acquired Cardiothoracic and Vascular Surgeons, the state’s largest independent multispecialty group, on Feb. 15. St. David’s comprises nine hospitals, 190 care sites and more than 12,600 employees, and operates as a partnership between Nashville-based HCA Healthcare and two local nonprofits, the St. David’s Foundation and the Georgetown Health Foundation. The acquisition brings the cardiothoracic and vascular physician group’s clinic operations under St. David’s management.
Cardiothoracic and vascular surgery is among the most capital-intensive specialties to sustain independently, with high overhead, expensive equipment, and heavy hospital dependency making these groups particularly vulnerable to acquisition. A 2022 analysis in the Annals of Thoracic Surgery found that rising practice costs combined with declining reimbursement were placing established independent cardiothoracic surgery practices “at risk for closure or purchase by hospital systems.”
The transaction reflects a broader pattern accelerating across the industry. As independent practices face rising costs and administrative burdens, hospital systems have steadily consolidated physician employment. Between 2019 and 2023, the share of physician practices owned by hospitals, health systems, or other corporate entities jumped from 39% to 59%, while physician employment by these entities rose from 62% to 78%, according to a December 2025 report from the Progressive Policy Institute. HCA has been among the most active players in physician practice M&A, with a network of more than 44,000 active and affiliated physicians.
U of Minnesota, Fairview and M Physicians reach 10-year agreement
After seven weeks of mediation, the University of Minnesota, Minneapolis-based Fairview Health Services and M Physicians reached a 10-year agreement extending and strengthening a partnership that was set to expire at the end of 2026. Under the agreement, Fairview will commit $1 billion in investments over 10 years to enhance medical facilities on the University of Minnesota campus, assume operations of the M Health Fairview Clinics and Surgery Center, negotiate a new lease with the university, forgive the center’s operating debt and absorb all annual operating losses.
The university publicly called an earlier side-deal between Fairview and M Physicians a “hostile takeover” of the medical school and called on the state Attorney General had to intervene. A collapse would have disrupted care for 1.2 million patients annually and threatened the training pipeline for 70% of Minnesota’s physicians.
This deal exemplifies the strain fracturing academic medical center partnerships nationwide and the trend toward renegotiating legacy physician-hospital relationships. The $1 billion commitment, debt forgiveness and operational assumption by Fairview mirror the structure of the Brown-Lifespan deal struck in 2024, in which Brown committed $150 million over seven years to stabilize its health system partner.
Fairview’s commitment may also represent a new template for how health systems fill the gap left by federal research funding instability. According to Strata’s Healthcare Performance Trends: Q3 2025, AMCs expanded research infrastructure and personnel in 2025 even as gross research operating revenue declined nearly 2%. The report attributes the gap to commitments made before more than $2 billion in NIH grants were cancelled in early 2025.
Universal Health Services moves to acquire Washington physician group
King of Prussia, Pa.-based Universal Health Services is planning to take control of the George Washington University Medical Faculty Associates, the physician practice that staffs George Washington University Hospital in Washington, D.C., and Cedar Hill Regional Medical Center. UHS plans to form a nonprofit physician group that would directly employ many MFA physicians while maintaining clinical coverage at both hospitals. The proposal, expected to close in the second quarter of 2026, would shift governance of the MFA and change how physicians are employed across the enterprise, though some MFA physicians may choose not to join the new UHS subsidiary.
By the end of fiscal year 2025, the group had accumulated more than $444 million in debt to GW and other lenders, with the university loaning it $98 million in that year alone. This arrangement could have left UHS in a position to absorb a 750-physician, 51-specialty practice that had long operated independently.
This follows a broader pattern of hospital operators moving to directly employ or control university faculty practice plans that have historically operated independently. Faculty practice plans are proving to be increasingly financially unsustainable as standalone entities, making them vulnerable to acquisition. A 2024 AAMC report produced with ECG Management Consultants identifies the push to build a “unified physician enterprise” as a defining challenge for modern academic health systems, driven by consolidation pressures, the need for scale and the shift toward value-based care.
Humana acquires MaxHealth
In February, 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.
Humana has been steadily expanding its owned and affiliated primary care footprint. In 2025, CenterWell Senior Primary Care, its provider services arm, 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 one of the country’s largest retirement communities. Insurers like Humana are building or buying primary care platforms to control the front door of care for Medicare Advantage members, reduce downstream utilization costs and capture margin across the care continuum. Notably, the MaxHealth acquisition comes even as CVS, Elevance and UnitedHealth have all announced plans to scale back Medicare Advantage offerings in 2026 amid rising medical costs.
The acquisition also reflects a broader shift in who is acquiring physician practices. 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.
Surgery Partners acquires vascular ASC operator
Brentwood, Tenn.-based Surgery Partners acquired Preferred Vascular Group, an operator of ASCs focused on specialty dialysis access procedures. Preferred Vascular Group operates eight ASCs in Georgia and Ohio with a team of 16 physicians. The acquisition gives Surgery Partners a foothold in the $6 billion dialysis access market, which sees more than 2 million procedures annually, and signals the continued migration of high-acuity vascular procedures into the ambulatory setting. PVG’s management team will continue to lead the operating entity with support from Surgery Partners for expansion.
Cardiovascular care has been shifting to the outpatient setting for years, a transition recently accelerated by technology improvements and payer incentive alignment toward ASCs. In its 2026 final rule published Nov. 21, CMS approved four cardiovascular codes for electrophysiology studies and ablations and three codes for percutaneous coronary intervention, in addition to hundreds of other procedures added to the ASC Covered Procedures List.
