Private Equity in Ophthalmology and Optometry

Chen, Evan M.; Cox, Jacob T.; Begaj, Tedi; Armstrong, Grayson W.; Khurana, Rahul N.; Parikh, Ravi

doi:10.1016/j.ophtha.2020.01.007

Cited by 47 publications

(52 citation statements)

References 19 publications

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“…A total of 228 ophthalmic and optometric practices were purchased between 2012 and 2019 which included 1466 clinical locations. 65,66 Covid-19 Pandemic and Telemedicine in LVC With forced closures for elective LVC centers due to Covid-19 pandemic from late March 2020 to slow reopening in early June 2020, the practice of LVC changed. 67 Teleophthalmology consultation during center closure went from minimal to nearly 80% with potential patients scheduling surgery without an examination.…”

Section: Consolidation and Buyouts In Ophthalmologymentioning

confidence: 99%

The 25th Anniversary of Laser Vision Correction in the United States

Joffe¹

2021

OPTH

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Laser Vision Correction (LVC) is an elective, self-pay and safe surgical procedure to correct myopia and hyperopia. Since FDA approval 25 years ago, there have been a progression of technological improvements leading to better outcomes and LVC is now one of the safest surgical procedures. With a potential pool of 50 million patients, 6000 trained ophthalmic surgeons regularly treating in over 1000 centers of which 65% are physician owned. Treatments remain low from an earlier peak of 1.4 million to less than 800,000 over last 10 years. The factors preventing patients undergoing surgery have not changed and include the cost of $2000 ± $1000 per eye and fear of laser surgery on their eyes. The latter is overcome by word of mouth referrals and positive social media messaging. In addition, press misinformation and lack of optometrists participating in co-management have not helped grow LVC procedures despite the positive results of the FDA's Patient Reported Outcomes with LASIK studies known as PROWL. The surgery is quick, and patients can be "in and out" in less than two hours with a rapid recovery, minimal postoperative restrictions and within 24 hours have 20/20 vision. Volume and price drives center and physician profitability with a scheduling capacity of two to four patients' treatments per hour. Laser vision correction and especially LASIK, remains the treatment of choice for myopic and hyperopic patients wanting to remove their dependency on glasses and contact lenses.

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Section: Consolidation and Buyouts In Ophthalmologymentioning

confidence: 99%

The 25th Anniversary of Laser Vision Correction in the United States

Joffe¹

2021

OPTH

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“…Chen et al previously identified a dramatically increased rate of acquisitions from 2017–2019 (186) compared to 2012–2016 (42). 1 A 2018 study found ophthalmology to be the specialty with the second most acquisitions by PE, behind only dermatology. 2 Important reasons for PE's focus on ophthalmology include its relative lack of dependence on hospital systems and its relative fragmentation with the presence of many small practices.…”

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confidence: 99%

“…2 Important reasons for PE's focus on ophthalmology include its relative lack of dependence on hospital systems and its relative fragmentation with the presence of many small practices. 1 2 3 And while the percentage of ophthalmology practices owned by PE remains small, estimated to be around 5% in 2020, its impact on the field appears to be growing. 1…”

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confidence: 99%

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Trainee Perspectives of Private Equity's Impact on Ophthalmology

Portney

Goldstein

Berkowitz

et al. 2023

Journal of Academic Ophthalmology

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Objective The accelerated involvement of private equity (PE) in ophthalmology has many potential implications for the future of the field. The aim of this study was to evaluate trainee perspectives on PE's impact on ophthalmology. Methods An electronic survey was sent to trainees via an online ophthalmology research newsletter. The survey assessed for career goals and perspectives on the involvement of PE and its impact across a variety of attributes. Results A total of 41 United States-based respondents responded to the survey, 68% were medical students and 32% were residents or fellows. Seventy-eight percent of respondents reported they would not consider working for a PE-owned practice. There was a negative perceived impact of PE for physician autonomy, long-term physician income, career advancement, and quality of care. There was a positive perceived impact for the number of physician extenders, more referral sources, financial support, bargaining with insurance companies, starting physician salary, and administrative burden. All respondents agreed (76% strongly agree, 24% somewhat agree) that education about practice options and ownership structures is important to include in residency program education, with preferred modalities of small group discussions and on-site learning. Conclusions Trainees broadly perceive PE to negatively impact the practice of ophthalmology. While there were attributes perceived to be positively impacted by PE, these were not felt to be as important as those which may be negatively affected. New modalities for education about practice ownership options are necessary, and small group discussions and on-site learning may be of the highest yield for trainees.

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“…This conclusion is supported by developments in private equity-owned child day care in the U.S. and the United Kingdom (Roosenboom 2019), as well as by recent research on private equity in other care sectors, such as U.S. dermatology practices (Resneck 2018), U.S. physician practices (Gondi & Song 2019), U.S. ophthalmology and optometry practices (Chen et al 2020), and residential care for children and youth in Sweden (Meagher et al 2016). The rise of large care organizations might affect 'the mix of institutional logics that organize a field' (Meagher et al 2016: 808).…”

Section: Conclusion 1 -Private Equity Owners Increase the Size Of Care Organizationsmentioning

confidence: 89%

Corporate Kangaroos in Care Strategy and performance of for-profit and private equity-owned care organizations

Bos¹

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Table of contents 5 tABle of Contents 1 introduction 1.1 Study background: neoliberalism 1.2 Commercialization of public service delivery 1.3 Multidimensional performance and strategy 1.4 Research questions and study outline 2 financial performance, employee well-being, and client wellbeing in for-profit and not-for-profit nursing homes: A systematic review Abstract 2.1 Introduction 2.2 Theoretical framework 2.3 Method 2.4 Results 2.5 Conclusions and implications 3 Just another business? Private equity in health services Abstract 3.1 Introduction 3.2 Conceptual framework 3.3 What we (do not) know about private equity in health services 3.4 Conclusions and future research opportunities 4 For-profit nursing homes in the Netherlands: what factors explain their rise? Abstract 4.1 Introduction 4.2 Theoretical framework 4.3 Institutional background 4.4 Methods and data 4.5 Results 4.6 Discussion and conclusions 5 What Happens to a nursing Home Chain when Private equity takes over? A longitudinal Case study Abstract 5.1 Introduction 6 Table of contents 5.2 Methods 5.3 Results 5.4 Conclusion 6 What happens when private equity takes over? two case studies in social care organizations Abstract 6.1 Introduction 6.2 Literature 6.3 Methods 6.4 Results 6.5 Conclusions and discussion 7 Conclusions and discussion 7.1 Introduction 7.2 Research model and study background 7.3 Answering the research questions 7.4 Main conclusions 7.5 Limitations of the study 7.6 Implications for theory and practicereferences Appendices Appendix A -Quality assessment of the studies (chapter 2) Appendix B -PRISMA checklist (chapter 2) Appendix C -Systematic review private equity literature (chapter 4) Appendix D -Golden Living chart (chapter 5) Appendix E -Operationalization performance dimensions Appendix F -Author contributions per chapter nederlandse samenvatting (Dutch summary) Dankwoord (acknowledgements in Dutch) About the author Public organizations acting business-likeFor public services, New Public Management (NPM) ideas became relevant in the 1980s. Neoliberalism formed the ideological and theoretical foundation for this NPM paradigm (Petersen & Hjelmar 2014). Efficiency, results orientation, customer orientation and value for money were placed on the agenda of administrative reform (e.g. Hood 1991;Hood & Peters 2004;Pollitt 2000). The traditional paradigm of public administration was regarded too weak and bureaucratic in its service provision (O'Flynn 2007;Pollitt & Bouckaert 2004). In their bestseller Reinventing Government. How the Entrepreneurial Spirit is Transforming the Public Sector, Osborne and Gaebler (1992) introduced a new style of government organizations using apparently universal business techniques.

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Private Equity in Ophthalmology and Optometry

Cited by 47 publications

References 19 publications

The 25th Anniversary of Laser Vision Correction in the United States

The 25th Anniversary of Laser Vision Correction in the United States

Trainee Perspectives of Private Equity's Impact on Ophthalmology

Corporate Kangaroos in Care Strategy and performance of for-profit and private equity-owned care organizations

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