When national headlines focus on healthcare consolidation—hospital systems acquiring physician practices, private equity buying clinics, insurers merging into ever-larger entities—it’s easy to assume this is simply how healthcare works now.
But in Southern Oregon, a quieter and more instructive model has been operating for decades.
AllCare Health, the coordinated care organization serving roughly 70,000 people across Jackson, Josephine, Curry, and southern Douglas counties, is structured around a simple but consequential idea: who owns healthcare determines how healthcare decisions get made.
Nearly 50 physicians and nurse practitioners who actively practice in the region own and govern the organization. They set priorities. They allocate resources. And when the organization generates surplus revenue, those dollars are reinvested locally rather than distributed to distant shareholders.
This isn’t a feel-good footnote. It’s a structural choice that shapes outcomes.
For families, employers, and community leaders navigating rising healthcare costs and fragmented care, ownership models like this one matter more than most people realize—because they quietly determine incentives long before any clinical decision is made.
Why Ownership Is a Decision Issue—Not an Ideological One
Most healthcare organizations in the U.S. fall into one of three ownership categories:
For-profit corporations, accountable to shareholders and quarterly earnings
Private equity-backed groups, optimized for short-term value extraction
Large nonprofit systems, tax-exempt but often operating with for-profit behaviors
Each structure creates predictable incentives. Growth targets matter. Cost centers are scrutinized. Investments are evaluated based on financial return.
AllCare represents a fourth approach: physician-owned, community-accountable governance.
The physicians who own AllCare aren’t passive investors. They are clinicians who see the downstream effects of organizational decisions every day—in exam rooms, in emergency departments, and in long-term patient outcomes.
That proximity changes how decisions get made.
When investments go toward transportation access, housing stability for people leaving psychiatric hospitalization, or early childhood programs that reduce long-term health risks, those choices aren’t abstract. The owners experience the results directly.
The structure aligns incentives in a way most healthcare systems cannot.
The Role of the B Corp Structure: Permission to Think Long-Term
In 2018, AllCare became an Oregon Benefit Company and earned B Corporation certification through B Lab, scoring 136.5 on the B Impact Assessment—nearly three times the median score for companies completing the evaluation.
The number itself isn’t the point. The legal framework is.
As a Benefit Company, AllCare is formally obligated to consider the impact of its decisions on patients, workers, communities, and the environment—not just financial performance. This matters because traditional corporate law often constrains leadership to prioritize profit maximization, even when leaders personally value broader outcomes.
“AllCare’s structure gives us the freedom to find and fund creative ways to address health needs,” says CEO Max Janasik. “That freedom leads to better problem-solving.”
Chief Medical Officer Dr. Kelley Burnett adds a practical dimension: “Each community has different needs. You have to be on the ground to understand how to make a system work.”
This combination—local ownership plus legal permission to prioritize community outcomes—creates space for decisions that don’t fit neatly into quarterly spreadsheets but make sense over years or decades.
How Structure Becomes Strategy
AllCare operates at significant scale: approximately $472 million in annual revenue across Medicaid, Medicare Advantage, and other programs. Yet unlike similarly sized systems, it has no external shareholders.
That difference shows up in several ways:
Physician-led governance
Board decisions are made by clinicians practicing in the communities served, not executives managing portfolios across states.
Local reinvestment
Surplus revenue funds programs addressing real barriers to care—transportation, housing transitions, language access—identified through direct patient experience.
Long-term planning
Physician-owners expect to live and work in these communities for decades. That enables investments in prevention, early intervention, and upstream health initiatives that won’t show immediate financial returns.
Provider support over acquisition
Rather than buying practices to consolidate market share, AllCare supports independent providers, maintaining its roots as an Independent Physician Association while contracting with more than 1,500 local specialists and hospitals.
For employers and families, these aren’t philosophical distinctions—they shape access, continuity, and stability over time.
What This Looks Like in Practice
The effects of these decisions are often quiet but meaningful.
A routine outreach call for colorectal cancer screening led one local resident to early detection and successful treatment. Integrated care models combine physical, behavioral, and dental health with attention to social determinants that influence outcomes long before medical intervention is required.
Because AllCare serves a defined geographic region rather than millions across multiple states, there’s incentive to keep everyone healthy—including residents of small, rural communities that are often overlooked in national models.
As Vice President of Health Policy Josh Balloch notes, “Since we’re locally based and locally engaged, we make sure care is available where people actually live.”
The Broader Context Decision-Makers Should Notice
Nationally, healthcare ownership is moving rapidly in the opposite direction.
Private equity investment in healthcare has surged, correlating with higher costs and poorer outcomes. Physician ownership has declined steadily for decades. Consolidation has shifted decision-making further away from patients, clinicians, and communities.
Against that backdrop, AllCare’s durability—more than 30 years of operation—offers an instructive counterexample.
It suggests that scale alone isn’t the answer. Structure matters. Incentives matter. Governance matters.
And for local communities, there may be an optimal size for healthcare organizations—large enough to be efficient, small enough to remain responsive.
Why This Matters to Reimagine Healthcare
At Reimagine Healthcare, we focus on helping people make clearer healthcare decisions—not by promoting specific organizations, but by examining how systems actually work.
AllCare’s model illustrates several principles relevant to anyone navigating healthcare choices:
- Ownership shapes incentives
- Legal structure expands or limits decision-making
- Local control increases responsiveness
- Prevention requires long-term alignment, not short-term pressure
This isn’t about declaring winners or villains. It’s about understanding the frameworks that quietly influence outcomes long before care is delivered.
A Practical Takeaway
Healthcare doesn’t just function through treatments and technology. It functions through governance, incentives, and ownership.
For families choosing plans, employers evaluating benefits, clinicians considering career paths, and community leaders thinking about long-term health resilience, these structural questions deserve more attention.
AllCare won’t solve every healthcare challenge. But it demonstrates that alternative ownership and governance models are possible—and that they produce measurably different priorities.
In a system where decisions often feel opaque and reactive, clarity starts by asking better questions.
One of the most important is simply this:
Who owns the system making your healthcare decisions?
This article is part of The Reimagine Healthcare Brief, where we examine healthcare structures, trends, and decision frameworks relevant to Jackson County and Southern Oregon.
In an era of relentless healthcare consolidation, rising costs, and increasing distance between those who own healthcare organizations and those who deliver or receive care, AllCare Health’s model offers a different path.
Nearly 50 physicians and nurse practitioners who practice in Southern Oregon own the organization that serves 70,000 community members. When they invest in housing, transportation, language access, and upstream prevention, they’re not being charitable—they’re being strategic about long-term community health in ways that corporate incentive structures actively prevent.
The B Corp certification and Oregon Benefit Company structure aren’t awards; they’re legal frameworks that permit healthcare to function as a community benefit rather than an extraction mechanism.
This model won’t solve all of American healthcare’s problems. It exists within a broader system shaped by insurance structures, pharmaceutical pricing, federal regulations, and state policies. But it demonstrates that ownership matters, that legal structure shapes possibilities, and that healthcare can be locally controlled, physician-governed, and community-focused rather than corporatized, profit-driven, and extractive.
For families in Jackson County and beyond wondering whether healthcare can work differently—whether it can prioritize prevention over procedures, invest in community health over shareholder returns, and make decisions locally rather than in distant corporate headquarters—AllCare provides an answer: yes, when the structure is right and the owners are the physicians who see the consequences every day in their exam rooms.
That’s reimagining healthcare: not through new technology or treatments, but through fundamentally different answers to the question of who owns healthcare and who it serves.
Learn more about AllCare Health at allcarehealth.com and their B Corp certification at bcorporation.net.
This article is part of our ongoing series highlighting innovative healthcare initiatives in the Rogue Valley.