Implications of Private Equity Acquisition of Otolaryngology Physician Practices

Miller, Lauren E.; Rathi, Vinay K.; Naunheim, Matthew R.

doi:10.1001/jamaoto.2019.3738

Cited by 8 publications

(18 citation statements)

References 6 publications

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“…Between 2017 and 2020, the number of clinicians participating in the AAO-HNSF clinical data registry nearly tripled from approximately 700 to more than 2000. 26 Third, otolaryngologists in solo or small group practices could seek employment by or affiliation with hospital-based health systems or large physician group organizations that are well positioned to deliver value-based care. 27 Organizations participating in APMs may be particularly attractive for otolaryngologists seeking to perform well in the MIPS.…”

Section: Discussionmentioning

confidence: 99%

“…26 Third, otolaryngologists in solo or small group practices could seek employment by or affiliation with hospital-based health systems or large physician group organizations that are well positioned to deliver value-based care. 27 Organizations participating in APMs may be particularly attractive for otolaryngologists seeking to perform well in the MIPS. These organizations already possess the care management infrastructure necessary to report quality data and satisfy requirements for promoting interoperability and improvement activities.…”

Section: Discussionmentioning

confidence: 99%

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Otolaryngologist Performance in the Merit-Based Incentive Payment System in 2017

Xiao

Rathi

Kondamuri

et al. 2020

JAMA Otolaryngol Head Neck Surg

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System (MIPS) for Medicare is the largest pay-for-performance program in the history of health care. Although the Centers for Medicare & Medicaid Services (CMS) launched the MIPS in 2017, the participation and performance of otolaryngologists in this program remain unclear.OBJECTIVE To characterize otolaryngologist participation and performance in the MIPS in 2017. DESIGN, SETTING, AND PARTICIPANTSRetrospective cross-sectional analysis of otolaryngologist participation and performance in the MIPS from January 1 through December 31, 2017, using the publicly available CMS Physician Compare 2017 eligible clinician public reporting database. MAIN OUTCOMES AND MEASURESThe number and proportion of active otolaryngologists who participated in the MIPS in 2017 were determined. Overall 2017 MIPS payment adjustments received by participants were determined and stratified by reporting affiliation (individual, group, or alternative payment model [APM]). Payment adjustments were categorized based on overall MIPS performance scores in accordance with CMS methodology: penalty (<3 points), no payment adjustment (3 points), positive adjustment (between 3 and 70 points), or bonus for exceptional performance (Ն70 points). RESULTSIn 2017, CMS required 6512 of 9526 (68.4%) of active otolaryngologists to participate in the MIPS. Among these otolaryngologists, 5840 (89.7%) participated; 672 (10.3%) abstained and thus incurred penalties (−4% payment adjustment). The 6512 participating otolaryngologists reported MIPS data as individuals (1990 [30.6%]), as groups (3033 [46.6%]), and through CMS-designated APMs (964 [14.8%]). The majority (4470 of 5840 [76.5%]) received bonuses (maximum payment adjustment, +1.9%) for exceptional performance, while a minority received only a positive payment adjustment (1006 of 5840 [17.2%]) or did not receive an adjustment (364 of 5840 [6.2%]). Whereas nearly all otolaryngologists reporting data via APMs (936 of 964 [97.1%]) earned bonuses for exceptional performance, fewer than 70% of otolaryngologists reporting data as individuals (1124 of 1990 [56.5%]) or groups (2050 of 3033 [67.6%]) earned such bonuses. Of note, nearly all otolaryngologists incurring penalties (658 of 672 [97.9%]) were affiliated with groups.CONCLUSIONS AND RELEVANCE Most otolaryngologists participating in the 2017 MIPS received performance bonuses, although variation exists within the field. As CMS continues to reform the MIPS and raise performance thresholds, otolaryngologists should consider adopting measures to succeed in the era of value-based care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Otolaryngologist Performance in the Merit-Based Incentive Payment System in 2017

Xiao

Rathi

Kondamuri

et al. 2020

JAMA Otolaryngol Head Neck Surg

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“…The general tone in the literature reviewed was of a critical nature related to concerns about the demise of professional medical and self-employed managerial autonomy, and decision-making power being detached from physicians with PE involvement [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Correspondingly, Novice et al [ 36 ] found that physician autonomy was the most common concern expressed by 81% of 137 residents from dermatology residency programs in the US.…”

Section: Resultsmentioning

confidence: 99%

“…Notably, the predominant perception was of a critical nature. Physicians feared the demise of their professional medical and self-employed managerial autonomy [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ] and subsequently a potential deterioration of quality of care due to profit-oriented treatment choices. Thereby, an ideal image of the self-determined medical profession shapes the physicians and builds a root cause for their concerns when they encounter external economic interests in their profession [ 27 , 69 ].…”

Section: Discussionmentioning

confidence: 99%

Physicians’ Perspectives Regarding Private Equity Transactions in Outpatient Health Care—A Scoping Review and Qualitative Analysis

Nolte

Miedaner

Sülz

2022

IJERPH

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Private equity (PE) investments in health care have increased drastically over the last decade, and the profit interests of these companies have triggered a vivid discussion among medical professions. However, what are the key underlying perceptions among physicians regarding this trend? Unravelling the argumentative structure of this debate is the purpose of this paper. With physicians being a major stakeholder group in the outpatient health care setting, this paper explores physicians’ perspectives regarding increasing PE activities. We systematically searched, selected, and synthesized existing knowledge in a scoping review and complemented the findings through 14 semi-structured interviews with physicians working in the outpatient health care sector in Germany. The results outline a complex network of arguments, concerns, and fears whereby the first intuitive perception of physicians is of critical nature. Arguments cluster around central perceptions of how PE involvement affects the individual autonomy of physicians in their daily work and decision-making, the impact on quality of care, work-life balance considerations, PE investment strategies, lack of medical vs. managerial expertise, and taxation issues. The high number of opinion papers among the literature underlines the actuality of the topic and emphasizes the need for empirical research.

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“…1 While private equity has been explored in other specialties, the extent of private equity engagement in plastic surgery is unknown. 2,3 This study characterizes trends in private equity deals from 2011 to 2019. We hypothesized that there would be greater private equity investment toward companies with scalable business models, which include cosmetic products and retail clinics, as opposed to companies with a focus in regenerative medicine or devices that require extensive research and development efforts.…”

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confidence: 99%

Private Equity in Plastic Surgery: A Nine-Year Analysis

Khetpal

Lopez

Steinbacher

2021

Plastic &Amp; Reconstructive Surgery

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Plastic and Reconstructive Surgery • December 2021 private equity has been explored in other specialties, the extent of private equity engagement in plastic surgery is unknown. 2,3 This study characterizes trends in private equity deals from 2011 to 2019. We hypothesized that there would be greater private equity investment toward companies with scalable business models, which include cosmetic products and retail clinics, as opposed to companies with a focus in regenerative medicine or devices that require extensive research and development efforts.A retrospective review of private equity deals was performed using Pitchbook (PitchBook, Seattle, Wash.), a market database comprising public information on companies and investors. Data were analyzed from deals posted in January 1, 2011, through December 31, 2019. 4 The total amount (U.S. dollars) of private equity investment made to plastic surgeryrelated companies was identified. Six therapeutic areas were identified: cosmetic products (over-the-counter skincare products), dermatology (nonsurgical) physician practices, plastic surgeon physician practices, devices/lasers, retail clinics (including medical spas and franchise clinics), and regenerative medicine/ biotechnology companies (composed of companies that offer tissue engineering and wound-healing solutions).

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Implications of Private Equity Acquisition of Otolaryngology Physician Practices

Cited by 8 publications

References 6 publications

Otolaryngologist Performance in the Merit-Based Incentive Payment System in 2017

Otolaryngologist Performance in the Merit-Based Incentive Payment System in 2017

Physicians’ Perspectives Regarding Private Equity Transactions in Outpatient Health Care—A Scoping Review and Qualitative Analysis

Private Equity in Plastic Surgery: A Nine-Year Analysis

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