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More than a year ago, Kaiser Permanente made waves when it said it was creating a new, sprawling entity of nonprofit hospitals and doctors with Geisinger as its first takeover — the latest example of health care companies bulking up in an already highly consolidated industry.

Nothing has happened since then, at least publicly. Geisinger’s 10 hospitals and 1,700 employed physicians are now officially part of the group, known as Risant Health. Kaiser, which is both a health insurance company and a network of providers, said it wants to add at least five to six more health systems by 2028.

Those other organizations are still a mystery. But recent financial reports show a handful of systems that have been on the same shaky trajectory as Geisinger and could find themselves in Kaiser’s crosshairs. Patients and local communities have a lot at stake if their health system gets gobbled up by Kaiser; it’s still unclear how this unique structure will alter costs or quality of care.

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