CommonSpirit Health Ended Partnership With Conifer

The health system has completed a transition to an insourced model for revenue cycle operations.

Updated on Oct. 5, 2026 in Healthcare

Isometric editorial illustration of a modern white clinical corridor intersection with structural support columns in muted teal and cream. — CommonSpirit Health has finalized its transition to an insourced revenue cycle model, ending a longstanding partnership with vendor Conifer Health Solutions. AI Illustration. Upload story photo >

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CommonSpirit Health has finalized its departure from revenue cycle vendor Conifer Health Solutions. The transition involved moving 1,900 employees to the health system and finalizing a $1.9 billion payment agreement with Tenet Healthcare.

Why it matters

CommonSpirit pursued the shift to an insourced model after finding that incremental fixes were insufficient to optimize patient experience and lower the cost to collect. The health system expects this change to improve operational efficiency and revenue yield over the coming years.

CommonSpirit Health will pay Tenet Healthcare $1.9 billion over three years, while Conifer will pay $540 million to redeem the system's 23.8% equity stake. The system targets a reduction in cost to collect from 6% to under 5% by the end of fiscal 2027.

The players

CommonSpirit Health

This is one of the largest nonprofit health systems in the United States and is headquartered in Chicago.

Tenet Healthcare

Based in Dallas, this diversified healthcare services company manages a network of hospitals and related health care facilities.

Conifer Health Solutions

This organization provides revenue cycle management and value-based care services to healthcare providers.

The details

CommonSpirit is shifting its revenue operations toward a hybrid insourced model, moving away from its reliance on external vendors like Conifer. The system has already completed revenue cycle conversions in its Central and Pacific Northwest regions as it seeks to solve persistent revenue yield challenges.

Tenet Healthcare announced it would regain full control of Conifer in February 2026.
CommonSpirit ended its fiscal 2026 fourth quarter on June 30, 2026.
A total of 1,900 employees transitioned from Conifer to CommonSpirit on August 3, 2026.
The Central and Pacific Northwest regions finished their revenue conversions on August 28, 2026.
The South region revenue cycle conversion is scheduled for October 30, 2026.

Market Landscape

This move reflects a growing industry trend where large health systems are moving away from third-party revenue cycle management to gain greater operational control. By insourcing these functions, CommonSpirit aims to achieve better financial stability than could be attained through external vendors.

The transition to an insourced model is designed to optimize the cost to collect and improve overall patient experience for those served by CommonSpirit hospitals. Patients should not expect immediate changes to their billing or care but may see long-term benefits in administrative efficiency.

The takeaway

Large health systems are increasingly prioritizing direct control over financial operations to mitigate revenue volatility. This shift demonstrates the ongoing challenge of managing complex billing cycles within the current national healthcare environment.