The growth of the Civica Rx health care utility model of addressing shortages of pharmaceutical supplies for hospitals has been gathering momentum since its launch in 2018. The concept is to bypass the major drug makers and to manufacture or subcontract for generic pharmaceuticals that its 1,400-plus member hospitals need. What’s unique about the venture is that it is established as a nonstock, nonprofit 501(c)(4) social welfare organization. The money to run the operation comes from the customers (the hospitals) and philanthropic organizations, not banks or investors in need of a healthy return. The aim is to combine the efficiency of a pro-competitive private enterprise with the equitable mission of a pro–social welfare organization. This new organizational construct represents an opportunity that could be adapted and implemented in other areas of the health care landscape