The Rise of Equity Buyouts in Cardiology: Study

Over the past decade, 342 cardiology clinics have been acquired by private equity firms, with more than 94% of those acquisitions occurring between 2021 and 2023, according to a study published today in JACC, the flagship journal of the American College of Cardiology, and presented at AcademyHealth 2024 Annual Research Meeting in Baltimore. As the practice grows, the study underscores the critical need to monitor the impact of private equity acquisitions on quality of care and outcomes for cardiovascular patients, as well as procedure utilization.

Private capital in healthcare occurs when a medical practice and its service providers are acquired through aggregate investment from multiple sources, including individual and institutional investors, pension funds, foundations, etc., to improve operations, financial support for innovation and technology , increasing growth through additional acquisitions and ultimately increasing profitability.

“Policymakers and clinicians have expressed 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 being acquired,” said senior author Rishi K. Wadhera, MD, MPP, MPhil, a cardiologist at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School in Boston. “Private equity acquisitions in other specialties have been shown to reduce quality and increase costs, so understanding the impact on cardiology is critical.”

The researchers found that between January 2013 and September 2023, private equity firms acquired 41 outpatient cardiology practices, representing 342 clinic locations. The number of clinic acquisitions per year increased from zero in 2013 to 215 in 2023, with 324 of those acquisitions occurring between 2021 and 2023, and 64 of those clinics were acquired more than once. The acquisitions occurred in 20 states, with the most in Florida, followed by Texas and Arizona. The study also found that acquisitions tended to be heavily concentrated in the same areas, with communities with the highest levels of poverty being less likely to be acquired than the wealthiest.

In an accompanying editorial comment, former ACC president Edward Fry, MD, MACC, said it was equally important to understand what drives cardiologists to pursue knowledge in these endeavors.

“Is it just about money, or is the move to private equity a symptom of more fundamental problems with current medical and cardiology practice?” – he said. “Clinicians, health care administrators, policymakers, and society must define the elements of clinical practice that encourage more cardiologists to seek alternative employment models. Addressing them will be necessary to truly transform care and promote equity and value.”