Roll-Ups and Surprise Billing: Collisions at the Intersection of Private Equity and Patient Care

This case describes the increasing investment by private equity (PE) firms in patient care and other healthcare services. The case focuses on investments in physician staffing firms and roll-up strategy investments in physician practice management (PPM). Included in the case is discussion of the practice of surprise billing, i.e., when staffing firms and insurance companies fail to reach agreement on adequate reimbursement for physician services, resulting in patients’ being responsible for paying the entire bill. The case includes material on the debate over whether surprise billing is part of a deliberate strategy on the part of the staffing companies and their PE owners. The case also includes discussion of PE firms’ fiduciary duty to generate returns for their LPs and how that might affect the cost of care to patients and insurers.