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Corporate Disrupters Are Moving Rapidly into Healthcare. Are We Watching?

April 2023, Vol 13, No 4
Dawn Holcombe, MBA, FACMPE, ACHE
President, DGH Consulting, South Windsor, CT

Healthcare is no longer the exclusive domain of the clinician’s office or the local hospital. Big business has been investing billions of dollars per year into healthcare, and, if successful, it may make private practices and community hospitals anachronistic. The dedicated professionals who work in these settings, who spend the majority of their time caring for patients, negotiating contracts, and navigating coverage and even medical-decision-making challenges from payers and specialty pharmacies, may not be aware of how their worlds are being transformed. A recent Avalere study found that in only 4 years—from 2019 to 2022—corporate-owned practices expanded 86%, while corporate employment of physicians increased by 43%.1

Corporations Are Spending Billions to Stake Out a Significant Healthcare Footprint

On its website, CVS Health ( covering,, and claims that it is the country’s largest health solutions company. It has invested in primary care, condition management, health and wellness, mental health, and even medical equipment. The company asserts that it delivers transformative healthcare with high-quality, physician-led primary care in local communities, at home and virtually.

Walgreens Boots Alliance’s (WBA;,, and US Healthcare segment is expanding into primary care, population health, home health, post-acute care, specialty pharmacy, retail pharmacy, VillageMD, Shields Health Solutions, CareCentrix, and Walgreens Health. WBA is an integrated healthcare, pharmacy, and retail brand, with international and national health services.

Amazon has been moving into pharmacy and medical care for several years. The recent acquisition of One Medical marked an aggressive move into primary care with a twist—an established network of employer relationships and healthcare.2

The largest employer of physicians in the United States is UnitedHealth Group’s Optum, with 70,000 employed or aligned physicians across more than 2200 national locations.3 Optum claims a differential advantage by bringing patients, payers, data, and physicians under the umbrella of 1 organization. It claims to reach the majority of the nation’s Medicare population through the acquisition of the home health business, LHC Group, and is expanding into primary, specialty, urgent, and surgical care, as well as mental health.

Following the Money

The more touches that an expanding corporation can make along the patient journey, the greater the opportunity to increase its revenue streams. Every stop along the way is billable or creates an opportunity to direct care to another revenue-generating internal component. There may be the potential for greater data analytics and the streamlining of care to reduce redundancy, but that case has yet to be made when it comes to these growing monopolies.

Is the retention of patients in 1 closed system more or less cost-effective? We have already witnessed an increase in costs when large hospital systems expand and enclose primary care (and those referrals) in their markets.

Who Will Control Healthcare Delivery and Decision-Making?

We know that healthcare tends to be local, but care cannot be provided in a vacuum. More and more, those that pay the healthcare bills (eg, state and local governments, employers, unions, etc) are deciding where and how care will be provided. The agendas at healthcare conferences are filled with topics such as interacting with employers, fighting prior authorizations, evaluating new value-based contracts, appealing denials, navigating step edits, and pharmacy redirection. What if these battles are masking a greater unrecognized transformation—one that cedes most of the control of healthcare delivery and decisions to corporate disrupters moving into the healthcare system and bypassing traditional channels and processes?

Consolidation and Acquisition Are Now Crossing Healthcare Silos

In the payer world, we have seen consolidation between health plans, pharmacy benefit managers, and specialty pharmacies. In the provider world, this consolidation has been characterized by the growth of integrated delivery networks and health systems that incorporate hospitals, primary and specialty physicians, and home healthcare. Now that consolidation is leading to the merger of the payer and provider worlds, where does that leave the remaining independent entities on both sides?

Are Local Providers Aware of These Intrusions?

Unless one of these corporate growth strategies affects the local market (eg, if a local practice is acquired by Optum, VillageMD, Amazon Health, or another national corporate physician acquisition model), it is unlikely that many physicians or hospitals will follow these trends, or they may think they will not be directly affected.

Primary care acquisitions can dramatically impact the referral patterns of specialists. Referrals for services or goods, such as equipment, medicine, and even care, can shift on a dime. Formularies for specific drugs and treatments can also narrow in a heartbeat, changing market shares and, in many cases, ignoring the patient’s individual needs. Technology solutions are already replacing and improving patient–provider interactions that previously relied on one of these parties to initiate a labor-intensive phone call. Testing and advances such as mRNA analytics can change the course of disease progression and move care and intervention far ahead of the specialist office, which waits to treat cancers once they have already been diagnosed.

What Steps Can Local Providers Take?

Awareness is the first challenge. Keeping a watchful eye on these companies and learning where they are expanding will help to guide your local plans. Set online searches for these organizations so you can be aware of the level of activity that may be nearing your markets.

Observe and track how healthcare changes. There may be valuable lessons and opportunities in more connected and even cost-effective ways to manage patient populations and transitions between disparate services. You may also see gaps that can be used as competitive leverage in discussions with your local legislators and regulators, who are often responsible for approving significant sales and mergers. Research technologic advances and integrate them into existing practices. Learn more about these companies so you can compare what they say they are bringing to healthcare versus the reality that unfolds. Make it part of your community dialogue and provide your insights whenever possible.

Most physicians and hospitals are deeply engaged in competition (friendly or otherwise) with each other, and they are frequently in negotiations with specific payers in a market. The activities of corporate disrupters will be more prevalent in some markets than in others. If you are in one of the active markets, as an observer or a participant, join the discussion. I would be interested to hear what is and is not working. Does breaking down our longstanding traditions and relationships in favor of more fluid, perhaps electronic driven ones, offer advantages?

As a mother, I can see some advantages to keeping a telehealth-based connection to my pediatrician, while also having supplies such as strep tests shipped to me overnight when my family history suggests that it would be useful. I can envision a world where routine laboratory workups and reporting to patients directly can be initiated by me and executed via a blood draw at my local grocery or pharmacy as part of preventive care. When people join Medicare, their insurance focus shifts from being prevention-based to being illness-based. Getting basic level-setting blood work or a hearing test becomes a challenge at a time when such barriers should be removed, not raised. Patients can be discouraged from having wellness discussions with their physicians. I am starting to seek out community health screenings myself, because I can no longer simply schedule annual checkups with my providers now that I use traditional Medicare insurance. I am being forced to seek alternatives to traditional physician care channels, and my primary care provider does not have a clue about that. I will not use Medicare Advantage under any circumstances.

Reach Out

I have been watching the growth of corporate disrupters in the healthcare space for years. However, I do not hear much discussion among local physicians and hospitals regarding the impact of the billions of dollars that are flooding into our domain. It is time to recognize this elephant in our backyard. Please share your comments, observations, and personal experiences with me at This email address is being protected from spambots. You need JavaScript enabled to view it..


  1. Physicians Advocacy Institute, Avalere Health. COVID-19’s impact on acquisitions of physician practices and physician employment 2019-2021. April 2022. Accessed April 5, 2023.
  2. American Hospital Association. 5 things to know about Amazon’s recent One Medical acquisition. Accessed April 5, 2023.
  3. Emerson J. Meet America’s largest employer of physicians: UnitedHealth Group. Updated February 16, 2023. Accessed April 5, 2023.

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