Primary Problems, Healthcare Looters, Premiums Are Rising

Hey all,

Happy Tuesday! Health plans are buying up independent practices at a stunning pace, reshaping the front door of medicine into something that looks a lot more like a claims department. And if there’s one group we can count on to lead this transformation with empathy and patient-centered care, it’s obviously UnitedHealth—America’s largest health insurer and a company best known for denying care at scale. 

Enjoy the rundown! 

Jacob Brody (Co-Founder & CEO, ZorroRX)

(Modern Healthcare) Medicare Advantage Physician Practice Market Share Growth

Insurer-owned primary care practices have sharply expanded their presence, with national market share growing from under 1% in 2016 to 4.2% in 2023, led by Medicare Advantage plans. This shift, detailed in a study by Brookings Institution and Weill Cornell Medical College, highlights the growing influence of major insurers—particularly UnitedHealthcare’s Optum, which alone reached 2.7% market share—on primary care delivery, raising concerns about competition and care quality. But hey, maybe Optum will take a breather from buying up practices if the DOJ keeps poking around its risk adjustment playbook. Full Article.

(Versán Consulting) Steward Health Bankruptcy & Corporate Misconduct

A newly filed adversary complaint in the Steward Health Care bankruptcy case alleges a calculated scheme of corporate looting by former CEO Ralph de la Torre and insiders, who extracted hundreds of millions through fraudulent dividends, overpriced acquisitions, and self-dealing equity transfers while the company was insolvent. This 68-page legal action could become a landmark case in how courts address insider enrichment and private equity-style tactics in collapsing healthcare systems, raising questions about systemic failures among corporate boards, insurers, regulators, and financial partners—though perhaps the most shocking part is that private equity firms can own hospitals, but your doctor can’t. Full Article.

(KFF) ACA Marketplace Premium Increases in 2026

Health insurers on the individual ACA Marketplace are requesting their largest premium increases since 2018, with a median hike of 15% across 105 insurers in 20 markets. The increases are driven by rising healthcare costs, expected expiration of enhanced premium tax credits (which could raise subsidized premiums by over 75%), and cost pressures from tariffs and provider wage demands. If Congress does not renew the tax credits, a significant shift in the insurance risk pool toward sicker enrollees is expected, further raising costs. Full Article