Oregon’s 2025 Corporate Practice of Medicine (CPOM) reform law is a first-in-the-nation, bipartisan solution to a growing public problem: the rapid corporatization of medical practices that compromises care quality and disrupts community health systems.
The Corporate Practice of Medicine (CPOM) doctrine exists in most states to ensure that only licensed medical professionals—not corporations—control clinical decision-making. In Oregon, the law has required since 1947 that physicians own at least 51% of a clinic. For decades, this safeguard helped preserve independent medical practice and patient-centered care.
In recent years, however, large corporate interests—especially private equity firms, insurance companies, and national healthcare conglomerates—have circumvented the law through shell companies called Management Services Organizations (MSOs). These MSOs use “paper owners” (physicians in name only) to satisfy technical ownership requirements while retaining actual control over clinical operations. Research shows that corporate takeovers of medical practices drive up costs, worsen patient outcomes, and increase physician burnout due to profit pressures.
The 2025 reform law updates the CPOM framework to close this loophole and :
Affirms that clinical decisions must remain under the authority of independently practicing, licensed providers.
Prohibits MSOs from influencing care-related matters such as staffing, visit length, or pricing models.
Limits restrictive employment practices (e.g., non-compete agreements) that undermine clinical independence.
Allows MSOs to provide non-clinical administrative support without overstepping into medical decision-making.
By targeting the corporate practices that have led to a loss of trust and continuity in patient care, SB 951 protects the physician–patient relationship and offers a replicable model for other states grappling with similar issues.
Impact or how it will be measured:
Because of the widespread interest in this issue, policy outcomes are being tracked by a variety of entities, including independent academic sources. Additionally, the policymaker put together a workgroup of more than 150 stakeholders, who came together to craft a legislative solution that works for entities across the industry.
In addition to monitoring publicly available expert data, their office will work closely with these organizations to track:
Provider and Ownership Structures: Monitoring the percentage of clinics where licensed physicians retain at least 51% ownership. Tracking shifts away from “paper doctor” arrangements and identifying the arrangements used to restructure.
Patient outcomes: measuring access, satisfaction, and care quality, especially during transitions from corporate control. Much of this work is being done by researchers at the New England Journal of Medicine
Physician retention and burnout: surveying providers for improvements in workplace autonomy and morale.
MSO compliance: review administrative reports and audits to confirm that MSOs provide only non-clinical support, with physicians maintaining veto power over any decision affecting patient care.
Access to care: analyze trends in primary care availability, particularly in underserved and rural areas, to determine whether reform helps reduce patient abandonment issues witnessed in previous corporate takeovers.