My wife is a provider in the health care industry who is licensed to provide primary care in two different states. I pay close attention to the industry, and how it functions locally, regionally, and nationally.
The best model I've found for trying to understand health care is the Tri-dimensional Chess game that is a recurring prop in Star Trek The Original Series, https://en.wikipedia.org/wiki/Three-dimensional_chess#Star_T.... Different arrangements and alignments of chess boards exist in each regional market in the United States, with the chess boards representing integrated health care systems, city, county, or state-owned hospitals and care facilities, and public and private hospital groups.
As the Wikipedia article suggests, careful observation of Star Trek TOS episodes shows "boards are sometimes not even aligned consistently from one scene to the next within a single episode." This is akin to different dominant health care systems co-existing in the Philadelphia area, in Central New Jersey, in the western part of northern New Jersey, in the eastern part of northern New Jersey, and in several different areas in Downstate New York. In addition to these existing realities, in certain cases two dominant health care entities from adjacent areas collaborate to deliver services in certain hospitals and practices in areas where their respective markets meet each other.
Creating a business at scale that would be disruptive across multiple regional markets even within a 100 to 200-mile radius in certain parts of the U.S. would be extremely difficult.