Private practices find themselves in challenging positions as the cost of operating medical facilities increases alongside insufficient reimbursement rates and other market pressures.
At the same time, emerging platforms and partnership models are giving physicians new avenues for maintaining their autonomy while securing financial sustainability for their practice.
Here are the developments that are helping and hurting physician practices in 2025:
Helping
1. Direct primary care is one of several new models for independent practice being explored by physicians in 2025. The practice model is gaining momentum as physicians seek more autonomy and patients seek more direct access to care. Some physicians are drawn to the DPC model as the patient structure allows for greater flexibility in determining which treatments or procedures are best for a patient, compared with the more rigid fee-for-service model.
While DPC is similar to concierge medicine and the terms are often conflated, it is generally considered to be less expensive than concierge medicine, which may offer more specialized or costly services. The One Big Beautiful Bill Act, signed into law in July, will allow people with high-deductible health plans and direct primary care arrangements to pay for concierge medicine through their health savings accounts.
“It’s a way to practice self-preservation in this field that is punishing patients and doctors alike,” internal medicine physician Shayne Taylor, MD, who recently opened a practice offering direct primary care in Northampton, Mass., told KFF Health News earlier this year. “It’s either we do something like this or we quit.”
2. There are also a number of consolidation models that avoid traditional acquisition practices that have become controversial in healthcare. For example, Charleston, S.C.-based Articularis Healthcare Group has built a model aimed at preserving the independence of community rheumatologists while providing the scale, infrastructure and resources needed to thrive in today’s complex healthcare environment.
Becker’s has reported on at least nine new platforms and MSOs in 2025 built around physician-ownership and autonomy. Another group, Franklin, Tenn.-based Regent Surgical Health, founded in 2001, partners with health systems and physician groups to develop, own and manage 26 ASCs across more than 13 states. The company has steadily grown over the last 20 years, steadily growing and adapting to the shifting demands of physicians and of the healthcare industry overall.
Healthcare technology start-up Meroka, which helps independent physician teams through a platform that supports practice operations, recently launched with $6 million in seed funding.
“Independent doctors are some of the most entrepreneurial and mission-driven professionals out there,” Alex Barrett, CEO of Meroka, said regarding the launch. “But too often, they are forced to spend more time managing vendors and paperwork than leading their teams and caring for patients. We built Meroka to give them the support and ownership structure they deserve, so they can keep building the kind of care they believe in and keep their practices in the hands of their teams and communities.”
3. Physicians are also increasingly seeking out dual MD/MBA programs or other leadership and business training opportunities to equip themselves with the knowledge and skills necessary to successfully step into private practice.
According to a 2025 report by the Association of American Medical Colleges, 9% of medical students are pursuing dual degrees and medical schools have also reported an increase in enrollment. Rochester, Minn.-based Mayo Clinic Alix School of Medicine reported about 16% of its students are in the dual program, and Los Angeles-based Keck School of Medicine of the University of Southern California found a 434% increase in the number of students pursuing dual MD-MPH degrees from 2010 to 2018.
Physician leaders have also told Becker’s that business skills are necessary for physicians looking to step into executive or leadership roles at healthcare organizations, but are rarely taught in traditional medical school environments.
“Getting an MD alone is practically worthless in today’s [leadership] environment,” Regis DeSilva, MD, a cardiologist and associate professor of medicine at Harvard Medical School in Boston told Becker’s. “The reason for that is that it’s been taken over by MBAs and business people, and they don’t pay any attention to garden-variety MDs.”
Hurting
1. On Oct. 31, CMS issued its final policy changes for Medicare payments under the Physician Fee Schedule — including a 3.77% increase from the current conversion factor.
Despite the increase, physicians told Becker’s that the update is not significant enough to make up for more than 20 years of reimbursement declines and the rising cost of operations.
“The 3.7% is a step in the right direction, but as a private primary care physician, it is hardly enough to offset increases in rent and employee salaries and will only reduce access by driving more of us into concierge practices,” Alan Falkoff, MD, a family medicine physician at Stamford (Conn.) Health, told Becker’s. “With respect to the decrease in specialist reimbursement, the same applies as more of them are also going concierge. You can’t reduce reimbursement by 6% to 7% and give back half of that and call it a raise. If medical care is determined to be a right, the government needs to pay for it.”
2. CMS’ recent update also included an “efficiency adjustment” of negative 2.5% work relative value units, sparking an outcry among physicians.
Dozens of physician organizations condemned the rule and the reduction, with the American Medical Association arguing that reimbursement under Medicare will shrink for more than 7,000 physician services. This represents 95% of all services provided by physicians, according to the AMA, which has advocated for an alternative payment structure.
“The ‘efficiency adjustment’ — cutting wRVU by 2.5% based on the broad assumption that surgery has become faster and more efficient — is perhaps the most egregious example of payment policy that flies in the face of data,” Margaret Tracci, MD, a vascular surgeon at the University of Virginia in Charlottesville, told Becker’s. “A recent study, based on high-quality registry data of over 1.7 million operations, found that between 2019 and 2023, cases have on balance taken longer — and patients being treated are sicker and more complex. Not to mention that ‘just operate faster’ doesn’t exactly resonate with surgeons or patients as a safe or wise solution!”
3. Other recent policy updates spell trouble for the physician workforce and independent practice leaders. A federal policy that went into effect Sept. 21 will require employers to pay a $100,000 fee to sponsor highly skilled workers from other countries. This policy, however, may disproportionately impact areas in the U.S. already facing severe healthcare shortages, according to an analysis published Oct. 29 in JAMA. Researchers said that their findings support the need for the Trump administration to exempt physicians and other healthcare workers from the fee.
The Medicare Payment Advisory Commission is also considering changes to Stark Law that could restrict how physician-owned distributorships operate, according to a September report from the commission. The proposed revisions aim to curb potential conflicts of interest in Medicare referrals without banning PODs outright.
