Access to Urological Care for Medicaid-Insured Patients at Private Equity-Owned Urology Practices

MM Curator summary

[MM Curator Summary]: Clinics funded by private equity do not prioritize patients whose insurance pays less and is harder to deal with.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


In light of current national trends in practice consolidation, researchers sought to define appointment availability for Medicaid-insured patients seeking care at urological practices linked with private equity companies.

They found 214 private equity-affiliated urology offices that were geographically matched with 231 non-private equity-affiliated urological offices. Investigators posed as an adult patient with either Medicaid or commercial insurance in the clinical scenario of new-onset, painless hematuria using a standardized script. The main result was whether or not the patient’s insurance was accepted for an appointment. The appointment wait time was a secondary consequence.

In 12 states, we made 815 appointment inquiry calls to 214 private equity (PE) and 231 non-PE-affiliated urology practices. Appointment availability was greater for commercially insured patients (99.0%; 95% [CI]: 98.1%-99.9%) than for Medicaid-insured patients (59.8 %; 95 % CI: 55.0%-64.6%) (P<.0001). Medicaid acceptance was greater in non-PE associated practices (66.8%; 95% CI 60.4%-73.2%) than in PE affiliated practices (52.1%; 95% CI 45.0%-59.2%) (P=.003). On multivariable logistic regression analysis, state Medicaid expansion status was independently associated with Medicaid appointment availability (odds ratio [OR] 2.20; CI 1.14-4.28; P=.020), whereas PE-affiliation was independently associated with lower Medicaid access (OR 0.55; CI 0.37-0.83; P=.004). Appointment wait times did not differ substantially between commercially and Medicaid-insured patients (19.2 vs. 20.1 days; P=.59), while PE-affiliated practices had shorter mean wait times than non-PE offices (17.5 vs. 21.4 days; P=.017).

Access discrepancies for urologic assessment were more evident in patients with Medicaid insurance at urology offices bought by private equity.



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