Tenet Reclaims Full Control of Conifer as CommonSpirit Exits Stake, Eyes AI Expansion
This analysis was developed from reporting originally published by Healthcare Dive. For daily healthcare industry news, subscribe to the free Healthcare Dive newsletter.
DALLAS – In a strategic shift that consolidates its hold on a key subsidiary, Tenet Healthcare has acquired the remaining 23.8% stake in Conifer Health Solutions from CommonSpirit Health. The transaction, announced Monday, effectively ends CommonSpirit’s decade-long role as both client and part-owner, and is projected to unlock approximately $2.7 billion in value for Tenet.
Conifer, founded in 2008, is a major force in healthcare’s back-office operations. It provides revenue cycle management and value-based care services, processing about $25 billion in net patient revenue annually for over 600 hospitals, physician groups, and other clients.
The buyout concludes a period of uncertainty for Conifer within Tenet’s portfolio. After exploring a sale in 2017 and a potential spinoff in 2019 due to margin concerns, Tenet reversed course in 2022, deciding to retain the subsidiary citing improved operations. Now, with full ownership, Tenet’s leadership is signaling a bold, forward-looking investment strategy.
"This agreement is mutually beneficial and provides us with enhanced strategic flexibility," said Tenet CEO Dr. Saum Sutaria. On an investor call, he outlined plans to ramp up investments in Conifer’s artificial intelligence and automation capabilities. Key focuses include refining algorithms to process millions of claims with greater speed and reliability, and deploying AI to manage complex disputes with insurers over claim denials.
For CommonSpirit, the exit aligns with its broader initiative to internalize its revenue cycle management functions. The nonprofit system will terminate its service contract with Conifer by year-end, a full six years ahead of the original 2032 expiration.
The deal underscores Tenet’s evolution from a traditional hospital operator into a diversified healthcare services company. Beyond its 50 hospitals and 130+ urgent care and outpatient sites, Tenet’s portfolio includes the country’s largest ambulatory platform, United Surgical Partners International.
Financially, Tenet appears on solid footing, recently raising its capital spending budget and forecasting adjusted EBITDA at the high end of its $4.47-$4.57 billion guidance for the year. However, analysts note looming headwinds. Like its peers, Tenet faces potential volume pressure in 2026 related to the sunsetting of enhanced Affordable Care Act subsidies, which could lead to more uninsured patients. In Q3 2025, over 8% of Tenet’s hospital admissions came from ACA enrollees.
The company is scheduled to report its Q4 and full-year 2025 results on February 11.
Industry Reaction
Michael Torres, Healthcare Analyst at Brighton Capital: "This is a clean, value-accretive move for Tenet. Full control allows them to fully integrate and scale Conifer's tech stack across their other assets without a minority partner's consent. The AI focus isn't just buzz—it's a necessary arms race in the fight against administrative bloat."
Lisa Chen, CFO of a regional hospital network: "As a former Conifer client, I'm watching closely. CommonSpirit's move to insource gives me pause. If a system that large believes it can do RCM better internally, it asks the question: is the outsourced model losing its edge? Tenet's AI promises need to translate to tangible client savings."
David R. Miller, Policy Director at the Coalition for Affordable Care: "This is corporate maneuvering while the house burns. Tenet talks about billions in 'value' from financial engineering, but what about the patients? They're preparing for more uninsured Americans in 2026 due to policy failures. Investing in AI to fight insurance denials is an admission our system is broken—it's a tool to win a war against payers, not to heal people."
Priya Sharma, Healthcare IT Consultant: "The timing is strategic. Consolidating Conifer now gives Tenet a unified data and AI asset before the expected regulatory push for greater price transparency and billing simplification. They're building the plumbing for the next era of healthcare administration."
Recommended Reading