The investment community is moving “up the acuity curve” as they seek novel opportunities to deploy capital, with Cardiology a specialty ripe for consolidation, according to an industry report released by the Healthcare Provider Services investment banking team at Brown Gibbons Lang & Company (BGL). Favorable secular trends, fragmentation, and the opportunity for platform growth through practice consolidation and service line expansion are draws.
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Inside the report, BGL highlights a number of growth catalysts driving outside capital investment in the specialty:
- Demographic trends that support sustained demand for cardiovascular care;
- Regulatory tailwinds driving ongoing shift in site-of-service to the ambulatory environment, with reimbursement trends incentivizing such shifts;
- Continued technological advancements facilitating delivery of advanced procedures in the outpatient setting, coupled with preventive trends like remote patient monitoring; and
- Market fragmentation lending to consolidation opportunities.
The report also features an exclusive executive roundtable which discusses the current state of the market, as well as future outlook.
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Dave Alpern, founding partner of Varsity Healthcare Partners, an investor in Partners First Cardiology, spoke to the attractiveness of cardiovascular services as an investment area: “Cardiology is a ripe category for investment. First, it’s a big space – 30,000-plus licensed cardiology providers in the U.S., where the hospital systems have been the only source of capital in cardiovascular medicine and currently roughly 70% of that population is employed by a hospital. Secondly, the secular trends in the cardiology/cardiovascular space are just undeniably good… along with what feels like sustainable Medicare support for reimbursement of cardiac interventions in the ambulatory environment … there’s a strong investment thesis there.” Alpern characterizes the recent approvals by Medicare for outpatient reimbursement in cardiology as the catalyst… “that will/is driving an outmigration of procedures from the hospital.”
“There’s clearly been a real appetite for moving to outpatient cardiovascular care. But…there is plenty of runway left,” observed Holly Stokes, a Health Policy Consultant at Farragut Square and report participant.
Sponsors are actively seeking complementary acquisitions to build size and scale through geographic and service line expansion; significant fragmentation presents the opportunity to pursue various growth strategies. Varsity Healthcare Partners (Partners First Cardiology), Ashlar Capital (Cardiothoracic & Vascular Surgical Associates), Athyrium/Comvest Partners (Sunset Cardiology), Alvarez & Marsal Capital (Nevada Heart & Vascular), Silversmith Capital (USHP), Webster Equity Partners (Cardiovascular Medicine), Deerfield Management Company (Novocardia), and Assured Healthcare Partners (Cardiovascular Health Partners) are among the private equity funds to announce new investments in the space.
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