Tag Archives: Med Groups

50 largest US medical group parents

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https://www.beckershospitalreview.com/rankings-and-ratings/50-largest-u-s-medical-group-parents.html

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Oakland, Calif.-based Permanente Medical Groups ranked No. 1 in the nation’s 50 largest medical group parents, with over three times the number of unique physicians as the second ranked Veterans Health Administration, according to an annual report published by IQVIA.

The report uses data from OneKey, a database from IQVIA that includes nine million U.S. healthcare professionals and 680,000 organizations.

The report ranked these parent companies by total physician affiliations, unique physicians and medical group count. Total physician affiliations are defined as the number of physician bridges between providers and sites, unique physicians are defined as the number of unique physicians affiliated to an integrated delivery network and medical group count is defined as the number of physicians at the IDN’s outpatient center(s), which may be a single specialty or multispecialty business. Imaging centers and surgery centers are not included in this report.

Here are the 50 largest U.S. medical group parents, ranked according to total physician affiliations, unique physicians and medical group count.

No. 1 — Permanente Medical Groups (Oakland, Calif.)

  • Total physician affiliations: 19,179
  • Unique physicians: 14,757
  • Medical group count: 578

No. 2 — Veterans Health Administration (Washington, D.C.)

  • Total physician affiliations: 4,909
  • Unique physicians: 4,798
  • Medical group count: 690

No. 3 — Mayo Clinic (Rochester, Minn.)

  • Total physician affiliations: 5,137
  • Unique physicians: 4,733
  • Medical group count: 128

No. 4 — Ascension Health (St. Louis)

  • Total physician affiliations: 5,035
  • Unique physicians: 4,218
  • Medical group count: 1,136

No. 5 — UC Health (Oakland, Calif.)

  • Total physician affiliations: 4,797
  • Unique physicians: 4,124
  • Medical group count: 397

No. 6 — Fresenius Medical Care Holdings (Waltham, Mass.)

  • Total physician affiliations: 5,875
  • Unique physicians: 3,229
  • Medical group count: 2,479

No. 7 — Providence Saint Joseph Health (Renton, Wash.)

  • Total physician affiliations: 3,507
  • Unique physicians: 3,054
  • Medical group count: 573

No. 8 — DaVita (Denver)

  • Total physician affiliations: 3,676
  • Unique physicians: 2,737
  • Medical group count: 2,813

No. 9 — Trinity Health (Livonia, Mich.)

  • Total physician affiliations: 2,864
  • Unique physicians: 2,551
  • Medical group count: 607

No. 10 — Catholic Health Initiatives (Englewood, Colo.)

  • Total physician affiliations: 2,961
  • Unique physicians: 2,473
  • Medical group count: 766

No. 11 — Sutter Health (Sacramento, Calif.)

  • Total physician affiliations: 3,131
  • Unique physicians: 2,468
  • Medical group count: 436

No. 12 — HCA Healthcare (Nashville, Tenn.)

  • Total physician affiliations: 2,838
  • Unique physicians: 2,457
  • Medical group count: 641

No. 13 — Partners HealthCare System (Boston)

  • Total physician affiliations: 2,384
  • Unique physicians: 2,178
  • Medical group count: 218

No. 14 — UPMC (Pittsburgh)*

  • Total physician affiliations: 2,955
  • Unique physicians: 2,163
  • Medical group count: 642

No. 15 — Carolinas HealthCare System — now Atrium Health (Charlotte, N.C.)

  • Total physician affiliations: 2,235
  • Unique physicians: 1,885
  • Medical group count: 468

No. 16 — Cleveland Clinic

  • Total physician affiliations: 1,873
  • Unique physicians: 1,656
  • Medical group count: 195

No. 17 — Aurora Health Care (Milwaukee)

  • Total physician affiliations: 2,245
  • Unique physicians: 1,623
  • Medical group count: 258

No. 18 — Mercy Health (Chesterfield, Mo.)

  • Total physician affiliations: 1,840
  • Unique physicians: 1,570
  • Medical group count: 515

No. 19 —New York Presbyterian Healthcare System (New York City)

  • Total physician affiliations: 1,617
  • Unique physicians: 1,506
  • Medical group count: 168

No. 20 — NYU Langone Health (New York City)

  • Total physician affiliations: 1,743
  • Unique physicians: 1,500
  • Medical group count: 221

No. 21 — Indiana University Health (Indianapolis)

  • Total physician affiliations: 1,671
  • Unique physicians: 1,462
  • Medical group count: 244

No. 22 — SSM Health (Saint Louis)

  • Total physician affiliations: 1,824
  • Unique physicians: 1,455
  • Medical group count: 274

No. 23 — Penn Medicine (Philadelphia)

  • Total physician affiliations: 1,746
  • Unique physicians: 1,443
  • Medical group count: 210

No. 24 — Advocate Health Care (Downers Grove, Ill.)

  • Total physician affiliations: 1,777
  • Unique physicians: 1,398
  • Medical group count: 284

No. 25 — Baylor Scott & White Health (Dallas)

  • Total physician affiliations: 1,596
  • Unique physicians: 1,362
  • Medical group count: 290

No. 26 — Dignity Health (San Francisco)

  • Total physician affiliations: 1,519
  • Unique physicians: 1,342
  • Medical group count: 396

No. 27 — Northwell Health (New Hyde Park, N.Y.)*

  • Total physician affiliations: 1,528
  • Unique physicians: 1,337
  • Medical group count: 308

No. 28 — Mount Sinai Health System (New York City)

  • Total physician affiliations: 1,522
  • Unique physicians: 1,326
  • Medical group count: 215

No. 29 — Community Health Systems (Franklin, Tenn.)

  • Total physician affiliations: 1,497
  • Unique physicians: 1,312
  • Medical group count: 586

No. 30 — Yale New Haven (Conn.) Health System

  • Total physician affiliations: 1,516
  • Unique physicians: 1,311
  • Medical group count: 202

No. 31 — Emory Healthcare (Atlanta)

  • Total physician affiliations: 1,523
  • Unique physicians: 1,282
  • Medical group count: 119

No. 32 — Stanford (Calif.) Health Care

  • Total physician affiliations: 1,403
  • Unique physicians: 1,254
  • Medical group count: 110

No. 33 — HealthPartners (Minneapolis)

  • Total physician affiliations: 1,508
  • Unique physicians: 1,254
  • Medical group count: 117

No. 34 — Johns Hopkins Health System (Baltimore)

  • Total physician affiliations: 1,515
  • Unique physicians: 1,251
  • Medical group count: 166

No. 35 — Vanderbilt University Medical Center (Nashville, Tenn.)

  • Total physician affiliations: 1,655
  • Unique physicians: 1,248
  • Medical group count: 109

No. 36 — Duke University Health System (Durham, N.C.)

  • Total physician affiliations: 1,549
  • Unique physicians: 1,229
  • Medical group count: 231

No. 37 — Intermountain Healthcare (Salt Lake City)

  • Total physician affiliations: 1,452
  • Unique physicians: 1,197
  • Medical group count: 241

No. 38 — Jefferson Health (Radnor, Pa.)

  • Total physician affiliations: 1,372
  • Unique physicians: 1,153
  • Medical group count: 173

No. 39 — UW Medicine (Seattle)

  • Total physician affiliations: 1,459
  • Unique physicians: 1,093
  • Medical group count: 178

No. 40 — Northwestern Medicine (Chicago)

  • Total physician affiliations: 1,370
  • Unique physicians: 1,083
  • Medical group count: 135

No. 41 — Fairview Health Services (Minneapolis)

  • Total physician affiliations: 1,291
  • Unique physicians: 1,070
  • Medical group count: 139

No. 42 — Novant Health (Winston-Salem, N.C.)

  • Total physician affiliations: 1,324
  • Unique physicians: 1,063
  • Medical group count: 305

No. 43 — Tenet Healthcare (Dallas)

  • Total physician affiliations: 1,161
  • Unique physicians: 1,052
  • Medical group count: 347

No. 44 — Banner Health (Phoenix)

  • Total physician affiliations: 1,303
  • Unique physicians: 1,043
  • Medical group count: 239

No. 45 — University of Michigan Health System (Ann Arbor)

  • Total physician affiliations: 1,285
  • Unique physicians: 1,039
  • Medical group count: 84

No. 46 — Adventist Health System (Altamonte Springs, Fla.)

  • Total physician affiliations: 1,180
  • Unique physicians: 1,033
  • Medical group count: 312

No. 47 — UNC Health Care System (Chapel Hill, N.C.)

  • Total physician affiliations: 1,162
  • Unique physicians: 1,013
  • Medical group count: 211

No. 48 — PeaceHealth (Vancouver, Wash.)

  • Total physician affiliations: 1,137
  • Unique physicians: 1,006
  • Medical group count: 165

No. 49 — Allina Health System (Minneapolis)

  • Total physician affiliations: 1,259
  • Unique physicians: 999
  • Medical group count: 120

No. 50 — Sanford Health (Sioux Falls, S.D.)

  • Total physician affiliations: 1,212
  • Unique physicians: 964
  • Medical group count: 198

To download IQVIA’s full report, click here.

Health-Care Transactions Update: Deals Significantly Up in Third Quarter

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https://www.bna.com/healthcare-transactions-update-n73014471384/?utm_campaign=LEGAL_NWSLTR_Health%20Care%20Update_102717&utm_medium=email&utm_source=Eloqua&elqTrackId=25bb35a21f7f4ee09f31a5e908020cf8&elq=3924f09b80454e158ead21b0e1788481&elqaid=9961&elqat=1&elqCampaignId=7532

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Stay ahead of developments in federal and state health care law, regulation and transactions with timely, expert news and analysis.

July, August, and September have been the most active deal months in 2017 so far, with over 299 recorded deals. That can be contrasted with the same quarter in 2016, during which only 167 deals were recorded, making it the slowest quarter that year.

The three most active sectors in summer 2017 were long-term care, health-care information technology, and physician practices, as strategic and financial buyers continued to actively shop for assets. The much-discussed market uncertainty—stemming from the political environment, regulatory uncertainty, and other factors—doesn’t seem to be hindering transaction activity.

Long-Term Care Has Been Most Active

Long-term care, including home health, continues to outpace the industry, with 215 transactions year to date. The sector remains attractive for many investors looking to position their portfolios for future growth, predominantly due to demand fundamentals such as an aging U.S. population and shifting preferences of seniors.

It is estimated that 10,000 U.S. residents turn 65 each day, adding to an already sizable population demographic that historically utilizes the vast majority of health-care spending. In particular, as the U.S. health-care system increasingly places emphasis on efficient outcomes and lowering cost of care, long-term care will offer a critical value proposition as an effective means of reducing the number of acute-care hospital visits and maintaining the overall health of seniors.

Of note in the third quarter was BlueMountain’s $700 million purchase of skilled nursing and assisted living assets from Kindred Healthcare. Continued interest and heightened activity are expected in this sector.

Physicians Have More Buyer Options for Transactions

Historically, large independent physician networks looking to partner with either a strategic or financial sponsor were limited in their options—mainly larger physician groups and local health systems. The landscape has quickly evolved as more organizations are seeing the value in controlling large patient populations.

Private equity buyers and insurance giants are increasingly interested in physician groups and are willing to purchase partial or complete interests at a premium. In the third quarter, Ares Capital invested $1.45 billion in DuPage Medical Group, a multi-specialty practice in Illinois previously owned by the private equity group Summit Partners.

Financial sponsors see an opportunity to leverage size and scale through acquisition and de novo growth, to increase patient populations and capture added revenues in a changing reimbursement environment. In April, Optum, a subsidiary of UnitedHealth Group, purchased American Health Network, a 300-physician practice in Indiana for $184 million. The insurer’s strategy is to control the delivery and cost of health care in all settings outside of the hospital.

Strategic buyers such as hospitals continue to actively recruit independent physicians, but are increasingly disadvantaged when forced to compete with the deep pockets of private equity investors and large insurers. Further compounding the problem for hospitals are the fair market value requirements that, by regulation, limit physician compensation options.

The single specialty provider space has experienced some of the highest activity in all of health-care services. With over 100 single specialty practices completing or announcing a transaction so far in 2017, independent physician groups are viewing an active mergers and acquisitions marketplace as an opportunity to secure future growth and viability.

A growing shift away from a hospital setting has increased the negotiating power of private practitioners and many are turning to private equity partners as a way to further increase their geographic footprint through aggressive growth strategies.

More and more groups are expected to pursue partnership and sale options as physicians continue to witness these large transaction values.

Size Is Attractive for Hospital Buyers

Bigger isn’t always better, but when it comes to hospital transactions, there is a market for sizable assets. In this quarter, Ascension Health, the country’s largest health system, emerged as the buyer of the struggling Presence Health in the Chicago area.

Despite Presence’s poor operations, it was able to align with a financially strong provider because it offered immediate scale in the Chicago market. With this transaction, Ascension, through its Amita Health joint venture with Adventist, vaulted up the market-share list from number four (8.1 percent) to number one (18.8 percent), according to Presence Health’s 2016 official statement. Acquiring and maintaining strong market share will continue to be a significant driver of financial success, thus the opportunity to immediately acquire scale through an acquisition will always be attractive.

Health-Care IT Remains Active

For many years, experts have thought that technology would be the key to driving value (high quality at a low cost). The activity in this space demonstrates the truth of that belief as there have been 133 transactions year to date. Notably, large private equity players have been active.

Clayton, Dubilier & Rice Inc., a private equity firm, acquired Carestream Dental in the third quarter, purchasing the dental imaging and practice management company with an eye toward growth, and expecting to leverage the technological expertise to grow the business.

Final Thoughts

While the summer months remained active, we believe the market will stay strong through the end of the year. Activity spawns more activity, and sellers are undoubtedly attracted to the high valuation multiples offered by buyers with tremendous access to capital and few investment options more attractive than health care.

Survey: 70% of medical groups worried about MACRA implementation

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http://www.beckershospitalreview.com/finance/survey-70-of-medical-groups-worried-about-macra-implementation.html

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Almost three-quarters of employed medical groups are concerned about implementation of the final Medicare Access and CHIP Reauthorization Act rule, according to The Advisory Board’s survey of the Medical Group Strategy Council.

The Advisory Board said it recently surveyed a group of 30 employed medical groups to determine their concern about MACRA and see how they’re adjusting to the changes MACRA will cause.

Here are five survey findings.

1. Seventy percent of respondents are “concerned” or “totally freaked out” by MACRA. Of the remaining respondents, 20 percent are “confident,” while 10 percent are “ambivalent,” the survey found.

2. The MACRA final rule, a landmark payment system for Medicare physician fees that replaces the sustainable growth rate formula, includes two pathways for provider participation: the Merit-Based Incentive Payment System and the Advanced Alternative Payment Model. According to the survey, 70 percent of respondents anticipate participating in MIPS, while the remaining 25 percent predict they will fall into the APM category.

3. Only half of the medical groups that believe they will participate in MIPS expect to be prepared to report data for the entirety of 2017, according to the survey. Another 21 percent anticipate choosing the partial-year option to be eligible for the smaller positive payment adjustment, and 29 percent of respondents planning to “test the program” by reporting nominal data to avoid the negative payment adjustment.

4. The Advisory Board said 58 percent of survey respondents identified MACRA as the driving force for consolidation efforts in their markets.

5. However, the other 42 percent of respondents have not observed MACRA affecting consolidation decisions in their markets, The Advisory Board said. “This could be a result of the additional support for small practices CMS included in the final rule. But we’re still in the early stages of MACRA implementation, so this may change during the coming year,” The Advisory Board added.

Empire Building by the Bay: Consolidating Control of Hospitals and Physician Organizations in the Bay Area

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http://www.chcf.org/publications/2016/01/empire-building?county=san_francisco

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