It’s no secret that ophthalmology practice mergers & acquisitions exploded in 2017 and the investment momentum has carried into 2018. At PhysiciansFirst Healthcare Partners, we represent ophthalmology practices in all geographic regions of the country. For our clients, it is valuable to know where ophthalmology acquisitions are happening, which private equity groups are behind the portfolio companies, and how their platforms are expanding. In this four-part series, we share our knowledge by focusing on key ophthalmology investments in specific geographic regions. We’ll start with a region experiencing significant private equity activity, The Northeast, as defined by the United States Census Bureau.
Over the past six months, our Advisory Resources writings have focused heavily on private equity investments in ophthalmology practices across the United States. During that time, we have received a growing number of inquiries about private equity’s interest in retina – either as part of a total ophthalmology group or sub-specialty practice. Bottom line, we are seeing increased interest for retina practices from private equity.
As mentioned in our previous post, there are many questions swirling around private equity investments in ophthalmology practices. Some particularly important ones relate to how a transaction will alter the career trajectory of associate ophthalmologists – particularly those with an interest in partnership. Is there upside for physicians who did not participate in the initial equity transaction? Will they ever have an opportunity to gain an equity position in the practice? The answer is yes, and here’s why.
These days, many ophthalmology practices are faced with the challenge of securing their next generation of physician partners. Historically, practices brought in ophthalmology “associates” soon after residency or fellowship, and these associates immediately set their sights on the path to partnership. Although partnership was never guaranteed, it was expected to both reward physician loyalty and, more importantly, ensure practice continuity.
As a physician-owner of an ophthalmology practice, you are probably trying to make sense of the acquisition and outside investment inquiries you’ve received over the past year. Where did all of these potential buyers come from? Who are they, and how do you separate the legitimate acquirers from the tire-kickers?
As more physician-owners continue to capitalize on the value they’ve created within their practices, selling is understandably a tougher decision for younger physicians, who are often decades away from retirement age. Financially, today’s private equity transactions in ophthalmology are once-in-a-lifetime opportunities, but physicians with long career runways are hesitant to pursue a transaction, fearing they will be “stuck” as an employed physician without upside incentivization for the rest of their career. Quite the dilemma.
Private equity interest in buying ophthalmology practices is accelerating across the US. This interest has created a fundamental shift in how practice owners should think about the future of their businesses. As a result, many physicians are unclear or even confused about how these partnerships unfold and what makes a strong candidate for private equity investment. As this ophthalmology acquisition wave continues to build, we seek to dispel some of the common myths surrounding the new M&A landscape.
As 2018 begins, physician-owners are developing strategic plans and examining their long-term options. More and more, the importance of private equity’s interest in specialty medical practices and surgery centers is being considered and discussed by physicians throughout the United States. What is going to happen in 2018? Should I consider a sale to private equity? How do these transactions work? Is private equity my best long-term option? Is this the best time to make a deal?
Many interested physicians ask me how private equity investments in ophthalmology will play out over the coming years. We now know that consolidation is happening, but how will it work? Why are PE firms interested? What kind of return on investment are they looking for? And what will it take to achieve that objective? This article will look at those items in detail and explore the financial mechanics from a PE firm's perspective.
The current consolidation wave in ophthalmology is still in its very early stages, but something changed in 2017. This year’s accelerated private equity investments confirmed our predictions of far-reaching, immediate impact across the specialty. The year 2017 has seen the heaviest investment to date, with eight major acquisitions completed as of November 1st.