Private Equity Investment in Ambulance & Medical Transportation, Part 1: Why Investors See Opportunity
As private equity investment in healthcare services has boomed over the past decade, select funds have turned an eye toward one of the most important and challenging areas of healthcare services: ambulance and medical transportation. Private equity’s foray into medical transportation has not been without controversy, but MHT Partners believes that private investment can be an agent of positive change in the industry and create value for a wide array of stakeholders with a vested interest in a reliable, high-quality medical transportation system. Over a series of blog posts in the coming weeks, we’ll delve into why private equity is interested in medical transportation, how private equity can help improve care, and what the future holds for the industry.
Big Business in Biologics
What are biologics? As the “bio” prefix suggests, biologics are drugs derived from living organisms, rather than traditional chemically synthesized drugs. They are also big business, representing six of the top eight drugs by total revenue and generating over $219 billion globally in 2016.
Considering that the first real biologic came to market with human insulin in 1982, these therapies’ rise has been nothing short of meteoric.
The Rise of Consumer IV Therapy Clinics
Intravenous (“IV”) therapies, which deliver medicines or fluids through a needle or tube inserted into a vein, a mainstay of hospitals and doctors’ offices globally, have entered American living rooms, strip malls, and hotel lobbies. On-demand IV infusions of saline, vitamins and prescription drugs can now easily be ordered to your home or accessed at ambulatory clinics – known as “drip bars” – across the country. Originally made popular as a quick hangover cure, the trend has been adopted by health-conscious consumers seeking a pick-me-up. While IV therapy can be a shortcut to hydration and can leave customers feeling great, the benefits may be limited. Nonetheless, demand for easily accessible drip therapy is rapidly growing, and the fragmented market presents vast opportunity for new entrants.
Private Equity Investment in ENT Practices
Private Equity’s love affair with specialty physician practices continues, as sponsors with an interest in healthcare investments seek opportunities to partner with leading otolaryngology practices.
Attractive Specialty – Large, Dynamic Market
Otolaryngology, or “ENT” is a medical specialty which is focused on the ears, nose, and throat. It is also called otolaryngology-head and neck surgery because specialists are trained in both medicine and surgery.
The otolaryngology industry is dynamic and expansive, covering a broad range of medical, surgical, and cosmetic procedures, such as tonsillectomy, head and neck cancer treatments, and rhinoplasties. Many of the procedures treated by otolaryngologists, such as asthma and seasonal allergies, hearing loss and tinnitus, and sleep apnea and snoring, affect multitudes of the U.S. population, resulting in a large, diverse potential patient base. Due to the wide range of procedures performed by ear, nose, and throat specialists, most practices report that no single class of procedures account for more than 10% of revenues. Industry growth is forecasted to be steady over the coming years; key catalysts of industry expansion include an increasing population of citizens age 65 and older (one in four Americans over age 65 suffer disabling hearing loss; the rate doubles to one in two by age 75), and expanding discretionary income, enabling more Americans to choose elective procedures.
Technology and Home Health Trends Impacting the Diagnostic Device Industry
The introduction of new technology in the healthcare industry has steadily improved patient care. Recently, increasing consumer demand for more convenient healthcare options is bringing a new wave of medical diagnostic devices that are more patient-friendly than ever before.
Taking Stock of Reimbursement Dynamics in Telehealth
In recent years, as technology and acceptance of telehealth solutions as a reliable, verified medium for the delivery of certain types of care have grown, demand for telehealth services has surged. Investment, innovation, and entrepreneurship in telehealth have kept pace, rapidly improving the quality of electronic healthcare delivery. Nevertheless, the ultimate facilitator of widespread adoption of telehealth as a means of care delivery are the twin gatekeepers of the healthcare dollar: commercial and government payors. Without buy-in from Centers for Medicare & Medicaid Services (“CMS”) and commercial insurers, the ability to deploy telehealth solutions to more cases will be limited. Therefore, as we survey the telehealth universe to identify new opportunities and emerging trends, it is imperative that we take stock of existing reimbursement dynamics for telehealth.
Long-Term Demographic Trends Impacting Home Health Care
There are currently 1.3 million Americans in long-term nursing facilities, but despite increases in demand for long-term nursing care, that number is shrinking. Between 2000 and 2009, the number of nursing facilities in the U.S. decreased by 9%, and in the years since, new construction of nursing home units has decreased by 33%. This decrease in nursing homes largely stems from modern reimbursement paradigms: on average, 90% of nursing home revenues come from Medicare and Medicaid, but at the current federal reimbursement rates for nursing home care, it is not profitable for nursing facilities to continue to operate. So what other option do senior citizens have when they need full-time care?
An estimated 51.9 million Americans (20.3% of the U.S. population) owned wearable technology (“wearables”) as of 2018 and that number is only expected to grow over the next several years.(1) The category spans AI-enabled glucose monitors to augmented reality glasses, but fitness trackers and smart watches are by far the most popular wearables, representing over half of the market. As wearables’ penetration continues to grow, so will the volume of data on individuals who adopt the technology—from physical activity, to sleep patterns, to heart rates. This level of data availability represents a major opportunity for technology-savvy companies who are able to effectively analyze the information and provide their customers actionable insights or valuable services.
The Potential of Care Coordination and Patient Communication to Improve U.S. Healthcare
The challenges facing the U.S. healthcare system are complex but boil down to two fundamental objectives: to lower the aggregate cost of care and to deliver improved outcomes. These dual objectives are oftentimes at odds under the existing industry construct. For many reasons, such as restricted access to care, legacy fee-for-service models, high drug prices, and imperfect implementation of public health initiatives, the incumbent regime is deeply rooted. To boot, many powerful participants within the industry are positioned to benefit from the status quo.
What’s on the Menu? Maximizing the Potential of Hospital Pricing Transparency Regulations
Beginning January 1st of this year, by order of the Trump administration, all hospitals in the U.S. are now required to publish master price lists – known as “chargemasters” – detailing all products and services offered to patients. According to the mandate, chargemasters must be readily available on the internet in a machine-readable format. While greater price transparency is a righteous goal, in practice, the pricing information is prohibitively difficult to find and utilize. The industry must take great strides in pricing data presentation and availability before the information can begin to positively impact affordability and patient care.