Consolidation trends in vascular surgery.
Terry P Gao1, Lawrence Oresanya1, Rebecca L Green1
1Department of General Surgery, Temple University Lewis Katz School of Medicine, Philadelphia, PA.
Journal of Vascular Surgery
|November 12, 2023
Summary
Vascular surgery practices are consolidating, with a significant decrease in small or solo practices and a rise in larger groups between 2015 and 2020. This trend indicates increased market concentration in vascular surgery.
Area of Science:
- Health Policy
- Surgical Practice Management
- Health Economics
Background:
- Practice consolidation is a growing trend across surgical specialties.
- The impact of this trend on vascular surgery has not been previously studied.
Purpose of the Study:
- To examine practice consolidation trends in United States vascular surgery.
- To analyze changes in practice size and market concentration from 2015 to 2020.
Main Methods:
- Utilized Medicare Provider Enrollment, Chain, and Ownership System data for 2015 and 2020.
- Categorized practices into solo, small, medium, and large groups.
- Calculated the Hirfendahl-Hirshman index (HHI) to measure market consolidation.
Main Results:
- Vascular providers increased by 7.7%, while the number of practices decreased by 19.3%.
- Large practices grew by 49.4%, whereas small or solo practices declined by 42.1%.
- Market consolidation, measured by HHI, significantly increased in both urban and rural areas.
Conclusions:
- Vascular surgery shows a clear trend towards larger practice groups.
- Market consolidation in vascular surgery has demonstrably increased between 2015 and 2020.
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