Opinion: The decline and fall of elite multispecialty medical groups
The failure of Geisinger Health System, which lost $842 million in 2022 and disappeared into a new Kaiser subsidiary called Risant, sent shockwaves through the health care community in the spring of 2023. Founded in 1919, Geisinger was in the vanguard of the so-called “value-based care” movement. It sponsored a regionally significant 600,000-member health plan and served as the home of an exceptionally high-quality 1,600-person multispecialty medical group. While Covid-related financial pressures, fateful management decisions, and troubled regional economic conditions all contributed to Geisinger’s demise, federal health policy may have played a crucial role — and it could bring down other multispecialty groups in 2024 and beyond.
Geisinger is only the latest member of an elite group of large regional multispecialty medical groups to lose their independence and join large hospital systems or corporations. Virginia Mason in Seattle was fatally damaged by the sad end of its decades-long partnership with Group Health in 2016 and is now part of CommonSpirit. Wisconsin’s Marshfield Clinic agreed to merge with Duluth-based Essentia Health in October 2022 after a lengthy string of operating losses, though the merger fell apart recently. Central Texas’ Scott and White was absorbed into Baylor in 2013. Everett Clinic in Seattle, Atrius, and Reliant (formerly Fallon) in Massachusetts, HealthCare Partners (with the Everett Clinic, both part of DaVita Medical Group), Kelsey-Seybold in Houston, and a host of others are now part of UnitedHealth Group’s vast Optum Health physician network. Billings Clinic in Montana, Carle Health in central Illinois, and Guthrie Clinic in north central Pennsylvania are all struggling financially and may not survive as independent organizations.
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