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Shining a light on PE ownership.

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HE

Heartland Dental

healthcare
PE-OWNED

Largest dental support organization in the United States.

PE-OWNED

Acquired by KKR2018-12-01

View PE Firm Profile

What Made It Great

“

Supporting independent dentists with business services while preserving clinical autonomy.

What PE Will Likely Do

Predictions

Heartland Dental will likely see an increase in the use of less experienced dental assistants and hygienists rather than licensed dentists to reduce labor costs

HIGH LIKELIHOODBased on: KKR's track record of aggressive cost-cutting, debt loading, and growth strategies in previous acquisitions

Heartland Dental may pursue a real estate sale-leaseback strategy, extracting equity from their office locations and passing the higher rental costs onto patients

HIGH LIKELIHOODBased on: The healthcare industry playbook that shows common PE tactics like staffing reductions, real estate sale-leasebacks, billing upcoding, and service line cuts

Heartland Dental could attempt to increase profits by aggressively upcoding dental procedures and billing for higher-reimbursement treatments, even if they are not medically necessary

HIGH LIKELIHOODBased on: The timeline of changes observed in similar past cases involving PE-backed healthcare companies

Heartland Dental may choose to eliminate or reduce access to certain specialized dental services like orthodontics, oral surgery, or pediatric dentistry in order to focus on more profitable procedures

HIGH LIKELIHOODBased on: The timeline of changes observed in similar past cases involving PE-backed healthcare companies

Expected Timeline

Phases
0-6 monthsCompleted

“0 to 6 months months”

Heartland Dental will likely announce 'optimization' initiatives, shuffle leadership, and make cosmetic changes to project an image of efficiency

6-12 monthsYOU ARE HERE

“6 to 12 months months”

Heartland Dental will begin cutting staffing levels, particularly by replacing dentists with less experienced personnel, and start reviewing service offerings

12-24 months

“12 to 24 months months”

Patients of Heartland Dental will likely experience longer wait times, reduced time with providers, and a noticeable decline in the quality of care

24-36 months

“24 to 36 months months”

Major issues could emerge at Heartland Dental, such as the closure of certain dental offices or clinics, and potential quality scandals related to improper billing or substandard treatment

36+ months

“36+ months months”

Heartland Dental could face the possibility of bankruptcy, fire sale to another operator, or significant contraction of its network of dental offices

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

  • Patients of Heartland Dental should closely monitor any changes in the quality of care, including the experience level of their providers, the time spent with them, and the availability of specialized services

  • Patients should be vigilant for any signs of improper billing or upcoding, and should seek second opinions if they are recommended treatments that seem excessive or unnecessary

  • Patients may want to consider seeking dental care from independent, locally-owned practices that are not part of a large, PE-backed dental support organization

Alternatives

Non-profit health systemsSAFE

Community-focused healthcare

Kaiser PermanenteSAFE

Integrated managed care consortium

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