Singh Yashaswini, Song Zirui, Polsky Daniel, Zhu Jane M
Yashaswini Singh (
Zirui Song, Harvard University and Massachusetts General Hospital, Boston, Massachusetts.
Health Aff (Millwood). 2025 Feb;44(2):215-223. doi: 10.1377/hlthaff.2024.00190.
Consolidation of physician practices, largely driven by health systems, has motivated policy efforts to move care toward lower-price, non-health system settings. At the same time, however, private equity (PE) firms are increasingly acquiring those non-health system practices, potentially negating the prior price advantages of those practices. We used novel ownership data on gastroenterology practices linked to commercial claims for the period 2015-20 to study how PE acquisitions affect the prices and volume of care relative to both health system-affiliated practices and independent practices. We examined both professional fees and facility fees. After PE acquisition, prices increased by $92 per claim, or 28.4 percent, driven by a 78.1 percent increase in professional fees. Facility fees did not exhibit a statistically significant change. Meanwhile, utilization also increased. These findings suggest that PE firms have multiple avenues for raising prices-in this case, primarily via professional fees. For policy makers, although moving care out of higher-price health system settings remains a key strategy to lower spending, unchecked growth in professional fees in PE-acquired outpatient settings may nullify some of the intended effects.
在很大程度上由医疗系统推动的医生执业机构合并，促使政策努力将医疗服务转向价格更低的非医疗系统机构。然而，与此同时，私募股权（PE）公司越来越多地收购那些非医疗系统的执业机构，这可能会抵消这些机构先前的价格优势。我们利用2015年至2020年期间与商业索赔相关的胃肠病学执业机构的新所有权数据，研究私募股权收购相对于医疗系统附属执业机构和独立执业机构如何影响医疗服务的价格和数量。我们研究了专业费用和设施费用。私募股权收购后，每项索赔的价格上涨了92美元，即28.4%，这是由专业费用上涨78.1%推动的。设施费用没有显示出统计学上的显著变化。与此同时，利用率也有所提高。这些发现表明，私募股权公司有多种提高价格的途径——在这种情况下，主要是通过专业费用。对于政策制定者来说，虽然将医疗服务从价格较高的医疗系统机构转移出去仍然是降低支出的关键策略，但私募股权收购的门诊机构中专业费用不受控制的增长可能会抵消一些预期效果。
