Consolidation Without Trust: Competing in Healthcare’s Asset-Class Era
DECEMBER 2025
Consolidation Without Trust: Competing in Healthcare’s Asset-Class Era
Angle: Hospitals, physician groups, MA plans, PBMs—the whole system is consolidating under financial intermediaries. The structural flaw? Scale has grown faster than trust, value, or access. The only durable advantage left for regional systems and plans may be local trust paired withplus transparent value.
The Signal
The effects of consolidation are evident in higher prices and mixed quality, alongside wage pressure and declining physician autonomy. MA enrollees typically access less than half of local physicians, with narrower networks in counties with more people of color. Price transparency files are riddled with conflicting rates. Physicians report eroding trust in leadership, even in nonprofit systems.
The Shift
Patients and employers increasingly see healthcare as Big Business first, community asset second. That’s a growth risk and a brand opportunity:
Narrow networks without clarity feel like rationing.
Consolidation without visible value feels like extraction.
Employed physicians who distrust leadership won’t be your best ambassadors.
The Move
Build a “Local Trust Advantage” strategy: transparent wait times, prices, and outcomes at the decision point.
Clean up your public data: ratings, reviews, and pricing where people actually choose care—not buried PDFs.
Involve physicians in designing access and network decisions, not just executing them.
Use consolidation to simplify the front door (fewer numbers, clearer pathways), not complicate it.
SPIRTO Insight: In an era when care is a financial asset class, trusted local access is your only moat that can’t be acquired or undercut overnight.
Closing Thought
If your growth story starts with size instead of trust, don’t be surprised when smaller players start winning the conversations that matter.