Changes in Patient Volume, Billing After Private Equity Acquires Physician Practices – ScienceDaily

Changes in Patient Volume, Billing After Private Equity Acquires Physician Practices – ScienceDaily

Changes in Patient Volume, Billing After Private Equity Acquires Physician Practices – ScienceDaily

New research shows that private equity firms that take over doctors’ medical practices appear to be imposing measures to squeeze out more profits.

After being acquired by private equity firms, the clinics saw more patients and billed more for visits among a large, commercially insured population, according to a study published today in JAMA Health Forum by researchers at Oregon Health & Science University and other institutions.

Researchers examined a total of 578 physician practices specializing in dermatology, gastroenterology and ophthalmology acquired by private equity firms in the US between 2016 and 2020.

“The reason patients and policymakers are concerned about this is that private equity is often driven by profit margins of 20% or more,” said senior author Jane M. Zhu, MD, assistant professor of medicine (general internal medicine and geriatrics) in the OHSU School of Medicine. “To do that, they have to generate more revenue or reduce costs. Increasing private equity in these doctors’ practices could be a symptom of the continuing privatization of health care.”

It is not clear whether these practices harm clinical outcomes for patients. However, the findings suggest parallels to the rapid growth of private equity acquisition of nursing homes and hospital systems.

“Private equity investment in nursing homes has been associated with an increase in near-term mortality and changes in workforce,” the authors write, citing previous research.

In the new study, researchers found an increase in the total number of patients seen in these clinics. The study also reviewed data on commercial insurance claims that showed a higher proportion of visits lasting more than 30 minutes, although the complexity of the cases remained comparable to the cases before the acquisition.

“These billing patterns could mean more efficient documentation of services provided, or it could mean updating or increasing insurance companies to make more money,” Zhu said.

She believes more evidence is needed about the impact of private equity on practices.

Policy makers are taking note of these trends.

In Oregon, for example, lawmakers have established a Health Care Market Oversight program to review proposed mergers, acquisitions and other business deals to ensure they meet the state’s goals of health equity, lower consumer costs, better access and better health. concern.

A recent estimate by the same research team found that approximately 5% of physicians are currently employed by private equity-owned practices. Researchers cited quality of care and patient satisfaction as important areas for future research as this trend continues.

“Private equity ownership of physician practices has added a distinctly private and market-driven influence to broader trends in physician business consolidation by health systems and insurers,” they concluded. “This study provides evidence for potential overuse and higher health care expenditures, which will be important for policymakers to monitor.”

In addition to Zhu, co-authors include Yashaswini Singh, MPA, and Daniel Polsky, Ph.D., MPP, of Johns Hopkins University; and Zirui Song, MD, Ph.D., and Joseph D. Bruch, Ph.D., of Harvard Medical School.

The study was supported by the National Institute for Healthcare Management Foundation and the NIH Director’s Early Independence Award, DPS-ODO24564. The content is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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