Dive Brief:
- The House Energy and Commerce Committee is launching an investigation into private equity firms and their role in the fight over surprise billing legislation, lawmakers said Monday.
- The committee sent letters to three of the biggest private equity firms, requesting documents relating to the policies and practices of the medical providers they own. The letters also seek ownership and financial performance information.
- Responses from KKR, Blackstone Group and Welsh, Carson, Anderson & Stowe are due no later than Sept. 30.
Dive Insight:
As lawmakers work to draft a bill to snuff surprise bills, private-equity owned firms have gone on defense, worried that regulation (in particular, a set rate for out-of-network charges) may hamper their bottom line.
Two physician staffing companies, both owned by private equity firms, have funneled more than $28 million into ads opposing potential legislation looking to curb surprise bills, according to the New York Times.
The issue has caught fire as academic studies and anecdotes from press reports illustrate how some patients, through no fault of their own, are stuck with unexpected and exorbitant medical bills.
Research indicates the practice is relatively common. As many as one in five emergency room visits results in a surprise bill, according to Health Affairs. Nearly 70% of air ambulances were out-of-network in 2017, according to a separate government report.
"We are concerned about the increasing role that private equity firms appear to be playing in physician staffing in our nation's hospitals, and the potential impact these firms are having on our rising health care costs," Committee Chairman Frank Pallone, D-N.J., and Ranking Member Greg Walden, R-Ore., said in a statement.
Within its vast portfolio, KKR owns physician practice Envision Healthcare and Global Medical Response, which operates air and ground ambulances. Blackstone owns TeamHealth, another physician practice.
Welsh, Carson, Anderson & Stowe's portfolio currently includes Concentra, an urgent care chain, Kindred Healthcare, a long-term care provider, and U.S. Anesthesia Partners.
The committee wants information on the financial performance of the companies within private equity groups' portfolios both past and present. For example, lawmakers seeking return on investment and periodic financial evaluations of the healthcare companies they back.
The panel is also seeking revenue information related to out-of-network and in-network services and to learn more about how the negotiating process works with insurers.