Editor’s note: This article reflects comments shared by industry experts and is not legal, tax, or valuation advice.

Joint ventures (JVs) have reemerged as one of the most flexible tools for medical groups and health systems navigating today’s margin pressure, workforce constraints, and shifting payer dynamics. When designed well, they let partners unlock value, share risk, and retain strategic autonomy — without the “all or nothing” trade-offs of a full acquisition.

That was the central theme of a 2025 MGMA Summit session led by David Lo and Jordan Zoeller of Stout, who walked through the building blocks of JV design — from asset contributions and valuation to due diligence and deal risks.

“At a very high level, what we’re really talking about with JVs is really any type of agreement or arrangement in which multiple parties are coming together to bring either assets or skills that they have to enter into another commercial operation,” Zoeller said.

Why JVs are on the rise

Reimbursement headwinds — most notably, Medicare physician payment that has fallen by about 33% since 2001 (after adjusting for inflation)¹ — have widened the gap between practice costs and fee-for-service revenues, while recruitment costs have increased for clinicians as significant physician shortfalls are projected in the years to come.²

“This kind of continued financial pressure has really hurt margins, and it really calls for, you know, players in the in the healthcare space to try to achieve as much efficiency as they possibly can, which JVs are well suited to do,” Zoeller said.

When a JV makes strategic sense

Lo and Zoeller highlighted several scenarios where a JV can deliver outsized benefits for outpatient organizations: