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Shining a light on PE ownership.

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AM

AmSurg

healthcare
PE-OWNED

Operates ambulatory surgery centers and provides physician services in various specialties.

PE-OWNED

Acquired by KKR2016-12-01

View PE Firm Profile

What Made It Great

“

Leading operator of outpatient surgery centers with cost-effective procedures

What PE Will Likely Do

Predictions

Reduction in nursing staff and replacement with less-qualified LPNs or aides, leading to longer wait times and potentially lower-quality care for patients undergoing outpatient procedures

HIGH LIKELIHOODBased on: KKR's track record of cost-cutting and debt-loading tactics in acquired companies

Sale-leaseback of AmSurg's surgery center real estate, extracting equity for KKR but potentially leading to higher rents and overhead costs that get passed on to patients

HIGH LIKELIHOODBased on: The healthcare industry playbook of common PE tactics, including staffing reductions, real estate transactions, billing upcoding, and service line cuts

Aggressive coding and billing practices to maximize reimbursements, potentially resulting in patients being billed for higher-cost procedures or diagnoses than necessary

HIGH LIKELIHOODBased on: The timeline of impacts seen in similar past cases of PE-backed healthcare companies

Elimination of certain less-profitable but essential service lines like maternity care or psychiatric services, reducing access to comprehensive healthcare for the local community

HIGH LIKELIHOODBased on: The timeline of impacts seen in similar past cases of PE-backed healthcare companies

Expected Timeline

Phases
0-6 monthsCompleted

“0 to 6 months months”

Announcements of 'operational optimization' and leadership changes, but no immediately visible impact on patients

6-12 monthsYOU ARE HERE

“6 to 12 months months”

Gradual staffing reductions and service line reviews begin, leading to slightly longer wait times and fewer available appointment slots

12-24 months

“12 to 24 months months”

Noticeable decline in service quality, with longer wait times, higher patient loads, and potential equipment maintenance issues

24-36 months

“24 to 36 months months”

Significant problems emerge, such as department closures, quality scandals, and potential financial distress for the company

Similar Cases

Other companies that followed a similar path after PE acquisition

Operating

Steward Health Care

Cerberus Capital Management·2010

See full case study
Operating

Envision Healthcare

KKR·2018

See full case study
Operating

US Dermatology Partners

Ares Management·2016

See full case study
Operating

Hahnemann University Hospital

Cerberus Capital Management·2018

See full case study
Operating

Sound Physicians

Summit Partners·2019

See full case study

What You Can Do

Take Action

Actions

  • Monitor for any changes in the availability of specific healthcare services at AmSurg centers, as well as any increases in wait times or billing practices

  • Be vigilant for any potential declines in the quality of care, such as shorter appointments, higher patient loads, or equipment maintenance issues

  • Consider alternative outpatient surgery options in the local community that may not be affected by the PE acquisition

Alternatives

Non-profit health systemsSAFE

Community-focused healthcare

Kaiser PermanenteSAFE

Integrated managed care consortium

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"AmSurg is now PE-owned. Here's what that means for you."