Private Equity-Owned Physician Practices Decreased Access To Retinal Detachment Surgery, 2014-22

Private equity (PE) firms have increased their ownership stake across health care sectors in the US. PE's focus on short-term profitability may decrease the provision of unprofitable services, reducing access for patients in vulnerable populations. This is a particular concern for certain eye conditions such as retinal detachment, for which access to timely surgery is necessary to prevent irreversible vision loss and for which reimbursement is below cost for the fee-for-service Medicare population. Using a difference-in-differences approach, we examined changes in the provision of retinal detachment repair by 535 physicians in PE-acquired practices and 1,070 matched controls during the period 2014-22. Relative to matched controls, physicians in PE-acquired practices decreased the number of retinal detachment repairs by 19.6 percent after acquisition. These findings shed light on how PE acquisitions can affect the provision of services that do not present financial opportunities for investors. As nearly 30 percent of retina specialists are affiliated with PE firms nationally, further investigation into PE's impact on access for patients is warranted to determine whether PE acquisitions require patients to travel longer distances or have longer wait times, which could have serious effects on patient outcomes.