Health systems have spent nearly three decades acquiring provider practices on the premise that scale, technology, coordination, and better management would eventually offset the negative bottom line financial results. That premise has not held true. Employed medical groups do not run at a loss because of a fixable inefficiency. They run at a loss because the model is built in a manner that can only lead to losing money, and the forces widening that gap are accelerating.
The Myth of Breakeven Financial Performance
By Fred Horton, MHA, President, and Jill Powelson, DrPH, MPH, MBA, RN, CPC, CPPM, AMGA Consulting
October 15, 2026
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