Envision Healthcare
One of the largest physician staffing companies in the US.
PE-OWNED
Acquired by KKR2018-10-01
What Made It Great
Providing emergency room and hospital-based physician staffing.
What PE Will Likely Do
Envision Healthcare will likely experience significant staffing reductions, with a focus on replacing registered nurses (RNs) with lower-cost licensed practical nurses (LPNs) or nursing aides to reduce labor costs.
Envision may sell and lease back its hospital real estate to extract equity for investors, leading to potential disruptions in service delivery and increased costs passed on to patients.
The company will likely engage in aggressive billing practices, such as upcoding procedures and diagnoses to maximize reimbursements, which could lead to inflated healthcare costs for patients.
Envision may eliminate or significantly reduce essential but less profitable services, such as maternity care, psychiatric care, or rural healthcare, leading to reduced access and quality of care for certain patient populations.
Expected Timeline
“0 to 6 months months”
Cosmetic changes, 'optimization' announcements, and leadership shuffle as KKR takes over Envision Healthcare
“6 to 12 months months”
Staffing cuts begin under 'efficiency' programs, and service line reviews are conducted
“12 to 24 months months”
Service quality noticeably declines, with longer wait times for patients, reduced time spent with healthcare providers, and potential equipment maintenance issues
“24 to 36 months months”
Major issues emerge, such as department closures and quality scandals, as the cost-cutting measures take a toll on patient care
“36+ months months”
Potential bankruptcy, hospital closures, or a fire sale to another operator as the long-term effects of KKR's tactics become apparent
Similar Cases
Other companies that followed a similar path after PE acquisition
What You Can Do
Actions
Closely monitor any changes in the availability and quality of healthcare services provided by Envision Healthcare, such as longer wait times, reduced appointment lengths, or the elimination of certain services
Be vigilant about billing practices and carefully review any medical bills or insurance claims to ensure that you are not being overcharged or billed for unnecessary procedures
Stay informed about any major issues or quality scandals that may arise and consider seeking care from alternative healthcare providers if the quality of Envision's services deteriorates significantly
Alternatives
Community-focused healthcare
Integrated managed care consortium