Private equity bets big on outpatient cardiology as CMS boosts reimbursements

Editor's Note

Private equity firms are accelerating their push into outpatient cardiology, lured by reimbursement trends and a fragmented market but shadowed by concerns about patient outcomes and financial motives, Modern Healthcare October 16 reports. Investor activity in cardiology has surged alongside the Centers for Medicare & Medicaid Services (CMS) expansion of cardiac procedure reimbursement in ambulatory settings.

The financial potential is substantial. Cardiology practices are facing rising demand from an aging population and increasing operational costs, while CMS’s move to pay for more procedures outside hospitals has opened new revenue streams. Investors see opportunities to consolidate independent practices, streamline operations, and profit from shifting cardiac care to lower-cost outpatient sites. More than 340 cardiology clinics have been acquired by private equity in the past decade, with 94% of those deals occurring between 2021 and 2023, the Journal of the American College of Cardiology reported last year. 

Backers argue investment supports physician independence and patient care. Tim Attebery, CEO of Cardiovascular Services of America, said private equity has helped expand capacity and technology, noting his network has tripled imaging units, doubled ambulatory surgery centers, and recruited dozens of new cardiologists since being acquired by Webster Equity Partners. He said practices under the company’s umbrella are not held to patient quotas, though financial results were not disclosed.

Some investors, such as WindRose Health Investors, focus on management service companies like CardioOne that provide administrative and technological support to independent cardiologists. Partner Oliver Moses said these services aim to promote more efficient and higher-quality care without sacrificing patient outcomes.

Still, skepticism persists. Research from Beth Israel Deaconess Medical Center found patient experience and staff responsiveness declined following hospital takeovers by private equity firms. A Senate investigation earlier this year accused major firms, including Apollo Global Management and Leonard Green & Partners, of prioritizing profits over patients. High-profile bankruptcies at Steward Health Care and Prospect Medical Holdings have heightened concerns about financial instability and workforce impacts.

Despite the controversy, experts say cardiology will remain a magnet for private equity. High reimbursement rates, strong procedural demand, and fewer regulatory barriers in some states continue to make the specialty an attractive investment target.