It’s Time to Rethink Your Physician Alignment Strategy

The health care landscape has evolved significantly over the past few decades, prompting health systems to adopt a range of physician alignment models. Yet, as highlighted in a recent Sg2 survey of strategy leaders, many of these models have been tried but have yielded limited results.

One of the most significant shifts has been in physician employment trends. In the 1980s, approximately 75% of physicians were independent. Today, that figure is reversed, with three-quarters now employed by health care systems. This reflects the growing dominance of employment-based alignment strategies and the continued push by health systems to pursue them.

CIN = clinically integrated network; MSA = managed services agreement; MSO = management services organization; PHSO = population health services organization; PSA = professional services agreement. Source: Sg2 Survey of Vizient CFO and CSO Networks, 2025.

However, the traditional employment model must evolve to meet today’s challenges. Systems should diversify their alignment strategies—especially to support value-based care—and implement them with greater intentionality than in the past.

Download the Synopsis of the Sg2 Executive Briefing to learn more about current alignment models and the optimal path forward.

Sg2 members can access the full Sg2 Executive Briefing: Optimize Physician Alignment Efforts to Drive Sustainability, which examines commonly used physician alignment models and how they must evolve to stay relevant and effective in the changing health care landscape.