A group of emergency physicians and consumer advocates in multiple states are pushing for stiffer enforcement of decades-old statutes that prohibit the ownership of medical practices by corporations not owned by licensed doctors.
Thirty-three states plus the District of Columbia have rules on their books against the so-called corporate practice of medicine. But over the years, critics say, companies have successfully sidestepped bans on owning medical practices by buying or establishing local staffing groups that are nominally owned by doctors and restricting the physicians’ authority so they have no direct control.
These laws and regulations, which started appearing nearly a century ago, were meant to fight the commercialization of medicine, maintain the independence and authority of physicians, and prioritize the doctor-patient relationship over the interests of investors and shareholders.
Those campaigning for stiffer enforcement of the laws say that physician-staffing firms owned by private equity investors are the most egregious offenders. Private equity-backed staffing companies manage a quarter of the nation’s emergency rooms, according to a Raleigh, North Carolina-based doctor who runs a job site for ER physicians. The two largest are Nashville, Tennessee-based Envision Healthcare, owned by investment giant KKR & Co., and Knoxville, Tennessee-based TeamHealth, owned by Blackstone.
Author(s): Bernard J. Wolfson
Publication Date: 22 Dec 2022
Publication Site: Kaiser Health News, California HEalthline
To compensate for the ongoing pressure on interest rates, CIOs participating in our survey have made substantive, structural shifts in their asset allocations. Why did they make this transition? We believe that CIOs are embracing complexity and the thoughtful use of illiquidity, as public market assets roll off and excess cash builds up. Improved asset-liability matching and more robust risk management have also helped, we believe. Reflective of these shifts, non-traditional investments, including Real Estate Credit and Structured Credit, collectively experienced almost a 1,200 basis point increase in market share. As a result, total
non-traditional investments now account for 31.8% of total portfolios surveyed, compared to 20.3% in 2017. As we detail below and in Exhibit 21, our work shows that 100% of the gain came at the expense of traditional public credit, which fell to 48.5% of portfolios surveyed, compared to 60.7% in 2017. Meanwhile, the allocation to Liquid Equities (predominantly by Property & Casualty and Reinsurers that typically favor Public Equities for liquidity) slipped to 5.5% from 9.1% over the same period. Cash as a percentage of assets is now at 4.9%, which is almost double the level it was the last time we did the survey. See below for full details on this increase but we think high cash balances are fueling thoughtful moves into longer duration assets. However, there is obviously more work to be done, as the supply of yielding, long-term assets remains limited.