Becker's ASC Review

45 HEALTHCARE NEWS 45 4 physician practice deals that are shaping industry By Patsy Newitt P hysician groups are increasingly consolidating – acquisitions jumped 145 percent in 2021, according to a report from VMG Health. Here are four big deals since the beginning of 2021 that point to a consolidating industry. 1. UnitedHealth Group subsidiary Optum, which owns and operates ASC management company Surgical Care Affiliates, acquired Houston-based Kelsey-Seybold for around $2 billion. Optum has yet to confirm the terms of the deal, which closed earlier this year. Kelsey-Seybold is a multispecialty physician group with cancer and women's health centers, two ASCs and a sleep center. The group is building another ASC on a campus that will eventually have space for 82 providers. 2. Optum also agreed to acquire Atrius Health, which employs 645 physicians and primary care providers, for $236 million in March 2021. Although the acquisition came under scrutiny by the Massachusetts attorney general, the deal was confirmed in 2022. Atrius Health employs 645 physicians and primary care providers, along with 421 additional clinicians. 3. Mednax acquired nine physician practices for a total of $34.9 million in 2021, according to VMG — this included a pediatric orthopedic practice, a multilocation pediatric primary and urgent care practice, a pediatric cardiology practice, two pediatric neurology practices, one maternal medicine practice, an OB-GYN practice, a pediatric intensivist practice and a neonatology practice. 4. Babylon, a digital health company in London, acquired Novato, Calif.-based medical group Meritage Medical Network and its 700 physicians in 2021. n Arizona health system files $10M breach of contract suit against physician group By Patsy Newitt C ommunity Health has filed a suit to recover nearly $10 million from Fresno, Ariz.-based physician group Santé Health System, e Sun reported Oct. 5. Community Health, which entered an agreement with Santé in October 2017 to provide millions in grant money, alleges an independent audit revealed the group did not distribute or account for various grants. According to the report, Santé asked the health system in 2019 to increase the grant to cover management service fees. Community Health then solicited an independent audit for fiscal year 2020 and found the group allegedly misappropriated $9.89 million of grant funds. e suit alleges the grant money was "distributed for unincurred expenses, disbursed in excess of permitted expenditures and dispersed or retained by Santé aer the grant periods expired," the report said. Santé has allegedly admitted it has possession of grant funds due but is refusing to return the funds, Community said in a statement, according to e Sun. e lawsuit also states that Santé is not operating medical clinics, enrolled in Medicare nor offering genuine financial assistance. "In the last month of the grant period alone, Santé disbursed $6.8 million in grant funds to medical providers before expenses were incurred in order to avoid having to return those funds to Community when the grant period expired on Aug. 31, 2020," the statement reads, according to e Sun. Santé, which has a portfolio of more than 1,500 providers who serve more than 120,000 people, has claimed in response that Community severed their agreement more than two years ago and "breached the exclusivity provision in the contract in a way that Community is obligated to pay $5 million in liquidated damages," the report said. n Market share of the 10 largest payers By Patsy Newitt UnitedHealth Group is the insurer with the largest market share, according to a September report from ValuePenguin. Here is the market share of the 10 largest payers: • UnitedHealth Group:12 percent • Anthem: 11 percent • Centene: 10 percent • Humana: 7 percent • HCSC: 6 percent • CVS Health: 5 percent • Molina Healthcare: 2 percent • Cigna: 2 percent • Kaiser Permanente: 2 percent • Guidewell: 2 percent n

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