Surge in private equity acquisitions of cardiology clinics raises concerns over quality and patient outcomes

A study published in the Journal of the American College of Cardiology and presented at the AcademyHealth 2024 Annual Research Meeting in Baltimore found a dramatic rise in the acquisition of cardiology clinics by private equity firms over the past decade.

The research indicates that from January 2013 to September 2023, private equity firms acquired 41 outpatient cardiology practices, encompassing 342 clinic sites. More than 94% of these acquisitions occurred between 2021 and 2023, marking a significant uptick in recent years. The annual number of acquired clinic sites skyrocketed from zero in 2013 to 215 in 2023. The acquisitions spanned 20 states, with Florida, Texas, and Arizona leading the list, and 64 of these clinics changed hands more than once.

Senior author Rishi K. Wadhera, MD, a cardiologist at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School, expressed concern about the trend. "Policymakers and clinicians have raised concern about the growing presence of private equity in other medical specialties. Although cardiology is an attractive target for private equity firms, little is known about the number and types of practices that are being acquired," he said in a statement. "Private equity acquisitions in other specialties have been shown to decrease quality and increase costs, so it is critical to understand the impact on cardiology."

Private equity in health care involves acquiring medical practices through pooled investments from various sources, including individual and institutional investors, pension funds, and endowments. The goal is to improve operations, financially support innovation and technology, drive growth through additional acquisitions, and ultimately, increase profitability.

The study found a concentration of acquisitions in affluent areas, while clinics in high-poverty communities were less likely to be acquired. The study raises questions about the equitable distribution of health care resources and access to quality care across different socio-economic groups.

In an editorial comment accompanying the study, ACC Past President Edward Fry, MD, emphasized the importance of understanding the motivations behind cardiologists' decisions to sell their practices to private equity firms. “Is it just about the money or is the move to private equity a symptom of more foundational problems with the current practice of medicine and cardiology?” he said. “Clinicians, health system administrators, policymakers, and the public need to define the elements of clinical practice that encourage a growing number of cardiologists to seek out alternative employment models. Addressing them will be necessary to truly transform care and promote equity and value.”