Private Equity In Dermatology: Effect On Price, Utilization, And Spending

Braun, Robert; Bond, Amelia M.; Qian, Yuting; Zhang, Manyao; Casalino, Lawrence P.

doi:10.1377/hlthaff.2020.02062

Cited by 45 publications

(59 citation statements)

References 13 publications

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“…However, PE firms usually sell acquired organizations within 3 to 7 years, so there were likely few exits during the 2013-2017 period used for our analyses. 43 Fourth, our study population included only residents participating in Medicare fee-for-service. As of 2018, 39% of all Medicare beneficiaries participated in Medicare Advantage, 44 although the participation rate of nursing home patients is estimated to be just over half the rate of the broader Medicare population.…”

Section: Discussionmentioning

confidence: 99%

Association of Private Equity Investment in US Nursing Homes With the Quality and Cost of Care for Long-Stay Residents

et al. 2021

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Key Points Question Is private equity acquisition of nursing homes associated with the quality or cost of care for long-stay nursing home residents? Findings In this cohort study with difference-in-differences analysis of 9864 US nursing homes, including 9632 residents in 302 nursing homes acquired by private equity firms and 249 771 residents in 9562 other for-profit nursing homes without private equity ownership, private equity acquisition of nursing homes was associated with higher costs and increases in emergency department visits and hospitalizations for ambulatory sensitive conditions. Meaning This study suggests that more stringent oversight and reporting on private equity ownership of nursing homes may be warranted.

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Section: Discussionmentioning

confidence: 99%

Association of Private Equity Investment in US Nursing Homes With the Quality and Cost of Care for Long-Stay Residents

et al. 2021

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“… 5 , 7 , 29 , 30 , 31 Critics assert that PE firms, unlike other for-profit institutions, have an inherent incentive to favor short-term returns rather than long-term investments (eg, information technologies and care redesign) that would otherwise meaningfully improve population health. 29 , 32 In certain aspects of health care services, the latter view has been bolstered by important research 13 , 14 , 33 , 34 in nursing homes and outpatient clinical practices. Private equity–owned nursing facilities performed comparably, both in terms of equipment shortages and resident outbreaks, during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Association Between Hospital Private Equity Acquisition and Outcomes of Acute Medical Conditions Among Medicare Beneficiaries

et al. 2022

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Key Points Question What is the association between private equity (PE) acquisition of short-term acute care hospitals and measures of comorbidity, mortality, readmission, length of stay, and spending among Medicare beneficiaries admitted to the hospital with 1 of 5 acute medical conditions? Findings In this cross-sectional study of more than 21 million Medicare beneficiaries with 5 different acute medical conditions who were hospitalized at short-term acute care hospitals, PE acquisition was associated with significantly lower inpatient mortality (−1.1 percentage points) and lower 30-day mortality (−1.4 percentage points) among patients admitted with acute myocardial infarction. However, PE acquisition was not associated with significant differences in other dimensions of quality and spending or with differences across other medical conditions. Meaning The study’s findings suggest that PE acquisition has mixed consequences for patient-level outcomes overall but is associated with moderate and consistent improvement in mortality among Medicare beneficiaries hospitalized with acute myocardial infarction.

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“…18 Consolidation by PE in these markets might improve a platform's purchasing and employing bargaining power, and could increase health care charges for commercially-insured payers. 21,22 Prior work has shown that physicians in concentrated markets charge commercial payers 14%e30% more than in unconcentrated markets. 22 Large platforms can benefit from economies of scale via centralization of administrative tasks and cost-spreading of medical and information infrastructure, making it more difficult for smaller, neighboring practices to compete.…”

Section: Discussionmentioning

confidence: 99%

Urology Practice Acquisitions by Private Equity Firms from 2011–2021

et al. 2022

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Introduction: Private equity firms have recently acquired several large urology practices in the United States. As little is known about these acquisitions, we sought to characterize trends in urology practice consolidation. Methods:We compiled urology practice acquisition data via financial databases, news outlets, practice websites, and Internet keyword search for the time period January 1, 2011 through March 15, 2021. For each acquisition, we determined the acquiring group, number of employed urologists, practice locations, and status of ancillary services (pathology, radiology, or surgery centers). We estimated workforce effects based on the 2019 American Urological Association workforce census.Results: We identified 69 independent practice acquisitions in the study period, including 19 (28.4%) by hospital systems, 7 (10.4%) by multispecialty physician groups, 23 (34.3%) by urology practices, and 20 (29.9%) by private equity-backed platforms. Private equity firms initially targeted large urology practices (mean of 60.8AE32.6 urologists) with ownership of ancillary services and consolidated local market share through acquisitions of smaller practices (mean of 15.9AE14.5 urologists). As of March 2021, we estimate that 7.2% of private practice urologists in the U.S. were employed by one of 5 private equity-backed platforms; over 25% of all urologists practicing in New Jersey and Maryland are employed by a private equity-backed platform.Conclusions: Private equity acquisitions have accelerated to become a dominant form of urology practice consolidation in recent years and have achieved significant market influence in certain regions. Future research should assess the impact of private equity investment on practice patterns, health outcomes, and expenditures.

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Private Equity In Dermatology: Effect On Price, Utilization, And Spending

Cited by 45 publications

References 13 publications

Association of Private Equity Investment in US Nursing Homes With the Quality and Cost of Care for Long-Stay Residents

Association of Private Equity Investment in US Nursing Homes With the Quality and Cost of Care for Long-Stay Residents

Association Between Hospital Private Equity Acquisition and Outcomes of Acute Medical Conditions Among Medicare Beneficiaries

Urology Practice Acquisitions by Private Equity Firms from 2011–2021

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