合作伙伴ing with a private equity firm can be a strategic decision for cardiology practitioners and leaders considering growing and advancing their practice. 但达成合作关系需要对几个关键领域进行深思熟虑.
受到其他医疗保健行业成功的推动, private equity (PE) firms began consolidating and investing in physician practices over two decades ago. 早期的私募股权投资主要集中在基于医院的专业领域, 后来转到初级保健和以程序为重点的专业(如.g.(皮肤科、眼科、泌尿科、骨科、胃肠病学).
最近, PE活动已经出现在心血管(CV)的实践中, 通常与CV流动外科中心(ASCs)的发展相吻合。. 对心血管护理需求的持续增长加剧了这一趋势, 财务利润率下降, 以及医院与云顶集团40011官网结盟的历史挑战.
私募股权公司通常是推动市场内医师业务整合的催化剂, 有一个支持的商业模式,旨在创造规模经济, 规范和改进操作流程, 利用技术来提高效率, 生产力, 和利润. 通过创造一个更高效的, 低成本的医疗云顶集团网络, 该模型提出了几个优点和注意事项,应该进行彻底评估.
市场因素可能促进心脏病学中的PE活动
心血管疾病患病率
预计到2060年,心血管疾病将增加30%以上. 需要获得心血管护理的大量患者确保了对云顶集团的持续需求. 早期发现策略, 远程监控, 人工智能算法, 新疗法和新技术, and expanded indications for treatment will all continue to broaden the opportunity to invest in CV care delivery.
心脏病学程序转移到门诊门诊设置
虽然在ASCs中管理CV程序的各州法规仍然存在差异, 医疗保险中心 & Medicaid 云顶集团 (CMS) has signaled an intent to shift low-risk interventional cardiology and electrophysiology procedures to this setting. 这一转变将给医院和医疗保健系统带来巨大的收入损失, 对私募股权投资者来说,这是一个巨大的潜在上行空间, 尽管与新CV ASCs的实践收购和开发相关的成本很高.
CV实践整合到医疗保健系统的持续挑战
过去20年,云顶集团40011官网拥有的CV诊所数量有所下降, 全国大多数心脏病专家现在都与云顶集团40011官网保持一致. The Medicare fee-for-service cuts to office-based diagnostic testing beginning in 2005 played a central role in this shift. A sharp decline in reimbursement made it difficult for independent physicians to maintain positive margins in their practice, 私人诊所的其他运营成本上升,而报销却停滞不前, the number of practices moving into a hospital or health system alignment model climbed at a steep rate.
回顾, we can recognize that many of the cardiology alignment models over the past 10 to 20 years were very transactional in nature. Health systems often sought to integrate cardiology practices using a traditional primary care practice model and assessing results through metrics designed to measure performance in primary care practices. 结果是, 文化和业务上的整合已经萎靡不振, 随着时间的推移, the decline in practice revenue and increases in overhead have escalated into sizable losses for health systems. This lack of integration has prompted some CV practitioners and programs to consider a PE partnership as a viable alternative to their current health system alignment model.
医院/云顶集团40011官网利润侵蚀
仍在从大流行病中恢复,并在通货膨胀的环境中进行管理, 美国的医院和云顶集团40011官网正经历着极其微薄的利润. 云顶集团40011官网拥有的心脏病学实践通常不能自我维持, and they generally do not create margins within a system-wide physician enterprise since most of the revenue generated by diagnostic testing is attributed to the organization’s hospital-based outpatient service. 由于其他实践的间接成本已经加速, 与心脏病学实践相关的总体损失在云顶集团40011官网的资产负债表上显得更大.
涉众的注意事项
与私募股权公司合作的决定需要相当的尽职调查, 鉴于伙伴关系可对提供护理产生重大影响. 这种视觉方式, 值, and economic incentives align is important to understand at the outset of any partnership conversation, 考虑各种利益相关者的观点是一个有益的起点.
云顶集团40011官网
Cardiologists who are aligned with a health system but want an alternative will find that reentry to independent practice is costly. 私募股权投资可以为资本和运营费用提供支持. 类似的, cardiologists in an independent employment model may turn to a PE firm for financial support to invest in overhead and capital, 最显著的是建立和操作CV ASCs.
当然, cardiologists who crave independence may fear a loss of autonomy by aligning with a PE investor (not unlike the health system employment they’re looking to escape). 但在不同市场量身定制模式的私募股权投资者将更具吸引力, 从MSO云顶集团到云顶集团40011官网就业的总所有权,提供一系列选择. Ultimately investors will be seeking to build a cardiology enterprise that can efficiently drive high volumes of CV encounters with some level of oversight in the operation of the practice and any affiliated ambulatory cath labs. 与私募股权投资者结盟的长期激励将取决于个人安排, 而是作为一种短期策略, 与私募股权公司的合作可能会为公司的强劲增长奠定基础, 通过投资更新设备和技术来维持财务业绩, 优化付款人合同, 提高运营效率.
医院和云顶集团40011官网
低风险的, 选择性门诊导管室病例是医院收入的重要来源, 通常占CV云顶集团线中实验室程序总数的一半. 现在ASC已经批准了很多这样的程序, CV leaders must thoughtfully assess the potential impact of losing them to PE investor-backed cardiology groups and related ventures that are highly focused on developing de novo CV ASCs or multispecialty ASCs with cath labs. Additional potential impacts may be felt in the decanting of cath lab staffing and even in the availability of cardiology resources to cover other higher-acuity clinical areas, 例如急诊科的覆盖面和住院云顶集团.
尽管基于asc的程序的收入差异很大, embracing this shift in procedures to ASC—and the associated financial loss—may be better than a total loss of revenue. 策略可能包括发展医院附属或自有的ASC, 与当地心脏病专家合作, 或者与私募股权投资者合作.
但是,尽管策略会根据许多市场层面的因素而有所不同, it is important to evaluate longer-term tactics to ensure the financial well-being of the CV program. 这应包括扩大对增长的关注, 增加市场份额, 以及整个CV云顶集团线的财务和运营寿命, 急性, 以及急性后护理环境.
病人
从病人的角度来看, 谁拥有和经营一个设施或实践很少成为焦点, 除非与健康保险有关. 尽管我们看到医疗保健领域的消费主义在持续增长, patients largely continue to rely on their established physician or provider to advise them on what treatments are appropriate for them, 以及何时何地寻求这些治疗.
将程序性护理转移到流动环境是私募股权投资者的主要目标, 这样做有可能改善患者的整体体验. 方便使用, 病人的经验, 需要支付的费用, and total length of stay in an ASC is often much better in the ASC setting than in traditional hospital outpatient departments.
纳税人
付款人将继续寻求机会,引导低风险患者到低成本的环境. 这一转变与付款人越来越注重纵向管理健康结果相一致, 确保在适当的环境中提供护理, 以最有效和最具成本效益的方式. PE investors recognize the opportunity to drive high volumes of CV encounters to the ambulatory setting and can provide the platform and resources necessary to support efficient, guideline-driven保健. 除了寻找具有大量动态心血管护理潜力的市场之外, investors are likely to focus on the geographies where broad or even limited networks of care can strengthen managed care contracting opportunities.
上述每种情况都需要对当前和未来状态有透彻的了解. 预估分析, 其中可能包括管理医疗和关键费用假设, 在评估对外部资本和战略合作伙伴的需求时是否应该考虑.
简历领导者的关键要点
对CV治疗的投资兴趣增加, 特别是流动诊所和CV ASCs, is emerging at a time when physicians and healthcare systems are reevaluating how alignment partnerships need to evolve, 大多数云顶集团40011官网和CV做法都在努力管理及时获取, 在利润率承受巨大压力的环境下. 临床指南支持将许多CV程序转移到门诊环境, and many payers—including CMS—are signaling their intent to push low-risk procedures out of hospitals to lower-cost ASC settings. 有适当的监管保障, ASC的设置可以为患者和提供者提供更好的体验, bypassing many of the burdensome requirements that are slowing down hospital outpatient cath lab services.
As more CV procedures become approved for the ASC setting and site payment neutrality continues to present a challenge for health systems, 简历领导者应该仔细评估所有的合作机会, 包括私募股权公司提出的建议. 进一步, 因为新的所有权模式出现在CV护理中, it will be important for CV leaders to act as patient advocates to ensure goals and motivation link to a patient-centric mission and remain founded in clinical practice guidelines, 提供正确的护理, 在适当的时候, 在正确的位置, 由最合格的护理团队以合理的成本获得最好的结果.
关于心电图的心血管咨询云顶集团
心电图’s cardiovascular consulting team is passionate about improving CV care delivery and since 2010 has conducted nearly 300 CV engagements across more than 100 parent companies. 我们的简历专家专注于为全国领先的简历项目提供执行咨询云顶集团. 我们的米&A专家专注于为医师团体提供财务和合作咨询云顶集团, 正在评估现有平台和潜在机会的私募股权公司和医疗系统.
如果您想了解更多关于心电图咨询云顶集团的信息,
请 云顶集团.
编辑: 马特杂粮面包
2023年10月25日出版