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In 2009, when President Barack Obama was touring the country and ginning up support for what would eventually become the Affordable Care Act, Geisinger entered the mainstream.

Obama praised Geisinger, the rural Pennsylvania hospital system and health insurer “where high-quality care is being provided at a cost well below the national average.” Its image as the archetype of local, integrated care seemed peerless.


Now, 14 years later, that sheen has worn off. Failed acquisitions, antitrust scrutiny, leadership changes, growing competition from local players, and a pandemic that temporarily upended how patients got care have forced Geisinger to abandon its independence. The system is coming off a year in which it lost $240 million from its patient care and insurance operations, and it decided to run into the arms of what is essentially a bigger version of itself — Kaiser Permanente.

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