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Shining a light on PE ownership.

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AM

American Renal Associates

healthcare
PE-OWNED

Dialysis services provider operating outpatient kidney dialysis centers.

PE-OWNED

Acquired by Golden Gate Capital2017-11-28

View PE Firm Profile

What Made It Great

“

Community-based dialysis centers with physician-centric care model

What PE Will Likely Do

Predictions

Reduction in nursing staff, with more LPNs and aides replacing RNs at dialysis centers

HIGH LIKELIHOODBased on: Golden Gate Capital's history of cost-cutting, debt loading, and outsourcing tactics

Aggressive coding for higher-reimbursement procedures and diagnoses to boost revenue

HIGH LIKELIHOODBased on: The healthcare industry playbook of common PE strategies like staffing reductions, billing upcoding, and service line cuts

Elimination of unprofitable but essential services like psychiatric care or home dialysis

HIGH LIKELIHOODBased on: The negative consumer impact score associated with Golden Gate Capital's past acquisitions

Extraction of large management and consulting fees, reducing resources for patient care

HIGH LIKELIHOODBased on: The negative consumer impact score associated with Golden Gate Capital's past acquisitions

Expected Timeline

Phases
0-6 monthsCompleted

“0 to 6 months months”

Announcements of 'optimizing' operations and a leadership shuffle

6-12 monthsYOU ARE HERE

“6 to 12 months months”

Staffing cuts begin, with fewer RNs per patient and longer wait times

12-24 months

“12 to 24 months months”

Noticeable decline in service quality, with rushed appointments and reduced access to specialized care

24-36 months

“24 to 36 months months”

Potential closure of less profitable dialysis centers, leading to reduced access for patients

36+ months

“36+ months months”

Possibility of bankruptcy or a fire sale to another operator, further disrupting patient care

Similar Cases

Other companies that followed a similar path after PE acquisition

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Steward Health Care

Cerberus Capital Management·2010

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Envision Healthcare

KKR·2018

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US Dermatology Partners

Ares Management·2016

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Hahnemann University Hospital

Cerberus Capital Management·2018

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Sound Physicians

Summit Partners·2019

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What You Can Do

Take Action

Actions

  • Closely monitor wait times, staff-to-patient ratios, and access to specialized care at your local dialysis center

  • Be aware of any changes in billing practices or a sudden increase in higher-reimbursement procedures

  • Advocate for the preservation of essential services like home dialysis and psychiatric care

  • Stay informed about any potential center closures or disruptions to your care, and be prepared to switch providers if necessary

Alternatives

Non-profit health systemsSAFE

Community-focused healthcare

Kaiser PermanenteSAFE

Integrated managed care consortium

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"American Renal Associates is now PE-owned. Here's what that means for you."