Mon. Apr 22nd, 2024

Senate investigating whether ER care has been harmed by growing role of private-equity firms

By 37ci3 Apr1,2024



The Senate committee made three main demands private capital to learn about how firms operate, or to see if a private equity firm working in hospital emergency departments is harming patients in a large portion of the nation’s emergency departments.

The Homeland Security and Governmental Affairs Committee’s inquiry, led by its chairman, Sen. Gary Peters, D.-Mich., includes three of the nation’s largest private equity firms: Apollo Global Management, Blackstone Group and KKR. According to data requests, Peters’ staff interviewed more than 40 emergency department physicians who expressed “significant concerns” about patient safety and care resulting from aggressive practices by private equity firms in the arena. The committee’s letters to the companies said the practices included improper billing, retaliation and anti-competitive practices.

Those who received the letters sent on Monday were asked to submit documents and information by April 17, and to arrange a meeting with the committee no later than May 3.

Recently, NBC News is estimated 40% of US hospital emergency departments were controlled, staffed or managed by companies owned by private equity firms.

The Homeland Security Committee investigation is the second Senate inquiry to focus on the impact of private capital on patient care. In December, the Budget Committee began its bipartisan activities investigation to two hospital systems linked to private equity firms trying to assess the profits they made in their deals and whether those deals hurt patients and clinicians. Sen. Sheldon Whitehouse, D.R.I., who chairs the committee, and Chuck Grassley, R-Iowa, are leading the examination.

New letters from the National Security Committee seeking information about emergency department operations have also been sent to four companies backed by private equity firms. The three hospital staffing companies are: Apollo-funded US Acute Care Solutions; Envision Healthcare, formerly owned by KKR; and TeamHealth, a Blackstone company. Another buyer is Apollo-owned LifePoint Health, which operates 62 acute care hospitals in 16 states and the largest rural hospital network in the U.S. LifePoint Health is also the subject of a Senate Budget Committee investigation.

In recent years, private equity firms have invested $1 trillion and become significant players in many sectors of the healthcare industry, including hospitals, nursing homes, physician practices, mental health facilities and emergency department staffing companies. Private equity owners typically load up the companies they buy with debt to finance their health takeovers, then cut company costs to boost earnings and appeal to new buyers a few years later.

Those cost-saving practices are central to the new Senate investigation, Peters said in a statement. “I am concerned that our nation’s largest EMS companies may engage in austerity measures at the expense of patient safety and care, which could put our nation’s emergency preparedness at risk,” Peters said in a statement. “I press these companies and their private equity owners for the necessary transparency so we can better understand how their business practices can affect patient safety, quality care, and physicians’ abilities to exercise independent judgment in providing patient care.”

This was announced by Apollo’s spokesperson. We continue to welcome all discussions with senators regarding our foundations’ health investment practices.” An Envision spokesperson said: “Envision intends to work transparently with Senator Peters at his request. Our clinicians provide care to patients and communities when they need it most. Our number one priority is always the well-being of our clinicians and the patients they serve.” A Lifepoint spokeswoman said the company “looks forward to responding to Chairman Peters’ inquiry today and continuing any conversations with senators who have an interest in our operations and a commitment to our communities.”

KKR and Blackstone declined to comment.

As interest rates have risen recently, the costs associated with some of these companies’ debt burdens have become burdensome, creating financial difficulties. Last year, for example, staffing firm Envision Healthcare, formerly owned by KKR, filed for bankruptcy. It continued to operate during the bankruptcy period and re-emerged. Another emergency department company collapsed last year — American Physician Partners — leaving hospitals struggling for replacement staff.

Academic studies shows that the involvement of private equity firms in health care is associated with significant cost increases for patients and payers such as Medicare. Low quality of care is also associated with firms’ investments in health care, including a 10% increase in mortality in Azerbaijan. nursing homes owned by private capital. A to learn last year showed that patients in privately owned hospitals had more frequent falls and more infections.

A TeamHealth spokeswoman said the company is reviewing the letter from Peters. “The top priority for TeamHealth and our clinicians is always to provide high-quality, safe patient care,” he said. “We look forward to engaging with the Committee and demonstrating our uncompromising commitment to our clinicians and communities.”

Health-care deals by private equity firms are also under the microscope of the Federal Trade Commission, which screens overseas corporate mergers for potential anti-competitive practices. Last fall, the FTC sued US Anesthesia Partners Inc., one of the nation’s top anesthesia staffing companies. and its private equity backer, Welsh, Carson, Anderson & Stowe, have accused the institutions of conspiring to acquire them for more than a decade. anesthesia practices Monopolize the market in Texas, raise prices for patients and make a profit. Both companies are fighting the claim, saying it is “false” and “without merit”.

Mitchell Lee is one of the emergency room doctors interviewed by Homeland Security Committee investigators. founder of Take the medicine backAn organization trying to reclaim the medical profession from corporate control, Lee said in an interview, “The emergency department is the canary in the coal mine for the entire US health care system. We are the first to see the breaking point and we are beyond it. “Private capital and corporate medicine put our nations’ ability to respond to disaster at risk.”



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