• Eric J. Yetter

Private Equity is Investing in Retina Practices


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.


It’s no secret that vitreoretinal practice has drastically transformed over the past decade with the development of intravitreal injections for a variety of ophthalmic conditions. These injections have led to high success rates, minimal complications, and increased patient volumes for retina practices. Private equity investors understand the value of retina and seek to partner with sub-specialty physicians and groups.


PRIVATE EQUITY IS INVESTING IN RETINA SPECIALISTS


To reach an expanded patient base and offer more comprehensive care, many general ophthalmology practices have prioritized adding a retina specialist. Most in the industry understand that this is no easy task - specialists are in short supply and new investments are usually required.


For those seeking to add a single retina specialist, there will be large upfront costs for additional equipment, software and staffing. Injectable drugs are expensive, and so is their storage and documentation. The practice will need to hire ophthalmic technicians with the proper skill set to work alongside a retina specialist. Bottom line, these upfront expenses can be a barrier to entry for those trying to add retina, even when increased revenues and an expanded patient base make it a worthwhile long-term investment.


Private equity investors realize the capital constraints on ophthalmology practices and are committed to investing in the sub-specialties to drive practice growth. They see added value in practices with the physical capacity to immediately add retina and avoid sending those patients out the door.


PRIVATE EQUITY IS SEEKING INVESTMENTS IN RETINA-ONLY GROUPS


Private Equity’s interest in retina-only groups has evolved into two distinct categories. First, certain early private equity investments in ophthalmology were completed with retina-only groups, and that approach has continued with many more firms now interested in retina as a standalone investment. Second, we are seeing significant and increasing interest in retina-only practices as a complement to existing general ophthalmology investments, since they allow an investor to increase its exposure to the full continuum of care. Importantly, this doesn’t necessarily require a merger – just common investment.


VALUATION, TERMS, AND MANAGEMENT SERVICES


Private equity firms are currently offering generous valuations and physician-friendly terms. While most of the consideration is typically paid in cash, physicians often receive an equity stake in the global ophthalmology company. This allows retina-only practices to participate in the benefits of aggregation while maintaining their independence.


Finally, investors offer varying management services from hands-off to comprehensive. In addition to easing the administrative burden, retina practices may value assistance with drug administration and its associated complexity and risk. In the end, the goal is to reduce headaches and allow physicians to focus on patient care.


To learn more about private equity's investments in ophthalmology and how Physicians First can help you sell your practice, download our most recent report here.


This post is for informational purposes only and does not constitute an offer, invitation, solicitation, or recommendation to buy, sell, subscribe for, or issue any securities. While the information provided herein is believed to be accurate and reliable, 127 Capital, LLC (“Physicians First”) and Ashland Securities, LLC make no representations or warranties, expressed or implied, as to the accuracy or completeness of such information. All information contained herein is preliminary, limited and subject to completion, correction or amendment. It should not be construed as investment, legal, or tax advice and may not be reproduced or distributed to any person. Certain Principals of Physicians First are registered representatives of Ashland Securities, LLC Member FINRA, SIPC. Physicians First and Ashland Securities, LLC are separate and unaffiliated entities. Securities and Investment Banking Services are offered through Ashland Securities, LLC.