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Category: ROLL-UP

FTC Chair Discusses Anticompetitive Concerns at AVMA Forum

November 12, 2023 Admin

Lina Khan, chairman of the U.S. Federal Trade Commission (FTC), delivered REMARKS in a keynote address at the 2023 Veterinary…

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Posted in: FTC, PRIVATE EQUITY, ROLL-UP, Veterinary

Rarebreed Veterinary Partners Announces Acquisition of Hospital Group with 47 Practice Locations

July 8, 2022 Admin

Rarebreed Veterinary Partners, a growing veterinary hospital group, recently ANNOUNCED the acquisition of Massachusetts-based veterinary group Vet’s Best Friend (VBF).…

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Posted in: Consolidation, Hospital Groups, PRIVATE EQUITY, Rarebreed, ROLL-UP, Veterinary

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THE CORPORATIZATION OF VETERINARY MEDICINE

The acquisition of private-owned animal hospitals by corporate entities such as veterinary consolidators has grown exponentially since 2011, and accelerated in 2017 -- market share has tripled in the last 6 years. Its largely invisible to most pet owners because consolidators view the corporatization of a practice as a marketing liability. Today, nearly 1 out of 3 general practices in the U.S. are owned by consolidators -- operate larger practices and account for 50% of all client visits. Corporate practices will not return to being independently owned again -- irreversible unless consumers push back against industry consolidation.
Are Consolidators Helping or Hurting Veterinary Medicine?

MAJORITY OF CORPORATE PRACTICES LED BY NON-VETERINARIANS
Study conducted by CARE for Pets™ reveals that the majority of consolidators are led by non-veterinarians. Doctors are more often managed by non-veterinary professionals with no experience in the pet medical world. Consolidators require significantly greater revenue to be profitable due to its large infrastructure of managers and support teams -- multiple levels of management that are highly incentivized. The support center is often located in a different state, far from its individual practices -- support staff often lack industry experience.
CEOs of Veterinary Consolidators and Hospital Groups

 

IS PATIENT CARE IMPACTED BY COMMISSION-BASED PAY?
Today, approximately 2 out of 3 full time associate veterinarians are paid on "production" -- how much revenue they bring into the practice. Compensation models for veterinarians consist either of a fixed salary, salary plus commission, or 100% commission -- doctor pay up to 25% of sales. A new full market investigation abroad will focus on incentive-based compensation of veterinary professionals.

 

IS INDUSTRY CONSOLIDATION THE ROOT CAUSE OF THE PROBLEM?
In the next decade, less than 10 large corporate groups will own, operate and control 6 out of 10 general practices based on current u.s. trends and abroad -- reaching at least 70 to 80% without opposition. A consolidated market with many complaints of higher prices and lower quality of care. Major consolidators plan merger to create giant network of more than 730 veterinary hospitals -- industry expert says it’s unlikely that the Federal Trade Commission would block the merger.

 

AFFORDABILITY CRISIS: VETERINARY CARE PRICES RISING RAPIDLY
Today, the news media reports the cost of vet care has increased 8% in the past year -- historically 3%. Many practices have raised prices 20 to 40% year over year. Insurance companies are seeking premium increases up to 56% -- provider drops coverage for 100,000 pets citing high vet costs. Corporate practices typically offer higher salaries, benefits and signing bonuses to employees -- retention bonus up to $250k to veterinarians.
What's Behind the High Cost of Veterinary Care?

 

IS PRIVATE EQUITY SADDLING VETERINARY SECTOR WITH DEBT?
Since 2017, private equity firms have invested more than $60 billion in the u.s. veterinary sector. Consolidators use high levels of debt to acquire as many hospitals as possible -- "serial acquisitions." The use of financial leverage and valuation arbitrage have caused sale prices to more than double over the past five years -- outbid independent doctors paying 2 or 3 times more. Several consolidators each have billions of outstanding debt in a high interest rate environment which makes it harder to cash out their investments -- may jeopardize their ability to navigate a downturn.

 

FIND THE BEST CARE FOR YOUR PET - COMPANION PLATFORM™
CARE for Pets™ officially launches the Companion Platform™ (COMPANION™) -- a pet health platform to help pet owners find the best possible care for all companion animals.

 

THE VETERINARY HEALTHCARE SYSTEM IS UNDER-REGULATED
First-of-its-kind study conducted by CARE for Pets™ reveals 2 out of 3 independent practices sold are acquired by corporate consolidators -- consolidation continues unabated with minimal federal and no state regulatory scrutiny.

 

CASE STUDY: Lack of Ownership Transparency in Veterinary Practices

Study conducted by CARE for Pets™ reveals many veterinary consolidators communicate misleading statements about ownership information on their individual practice websites which is most likely to create a false impression to pet owners that the practice is independently owned and locally operated. Most veterinary practices acquired by corporate consolidators often retain their original company name and may purposely avoid corporate ownership identification -- hide ownership.
Is Your 'Local' Animal Hospital Corporate-Owned?

COMMON PERCEPTIONS ABOUT CORPORATE PRACTICES
There is a common perception in the pet care industry that many corporate-owned veterinary practices prioritize profits over patient care -- doctors feel more pressure to generate revenue and see more clients per shift. A common strategy for consolidators is to increase revenue by raising prices after an acquisition -- increase in upselling to clients. Studies in human medicine show that private equity takeovers are linked to rising costs for patients and sinking quality of care. Understanding private equity investments in human medicine will provide insight into its potential impact to veterinary medicine.
Common Perceptions of Corporate Veterinary Practices

WHO OWNS, OPERATES AND CONTROLS THE PRACTICE?
CARE for Pets™ officially launches VERIFIED,™ the first and only veterinary practice ownership verification online tool for the pet care industry -- do you know who owns your vet? Consolidators buying hospitals often require the selling doctor to stay at the veterinary practice for 1 to 4 years post-sale and may fail to disclose change of ownership to pet owners -- "golden handcuffs." Advertising is ethical when there are no false, deceptive, or misleading statements or claims.

 

HEIGHTENED SCRUTINY OF PRIVATE EQUITY M&A DEALS
Today, 3 out of 4 specialty and emergency hospitals in the U.S. are owned by corporate consolidators -- state legislator asks Federal Trade Commission (FTC) to scrutinize closure of emergency hospital. Private equity firms increasingly engage in roll up strategies that allow them to accrue market power off the commission’s radar -- senators urged the FTC and congress to take stronger action against consolidation in the veterinary care industry.
FTC Intervenes PE Acquisition Citing Antitrust Concerns

 

EXIT-DRIVEN STRATEGY: BUYING UP HOSPITALS TO SELL
Roll-ups, a common strategy for consolidators, buys many veterinary practices and combines them into a larger organization to obtain a higher valuation -- grow rapidly. The entity is typically resold within 3 to 5 years to another consolidator for a substantial profit. Hospital groups sell for 100s of millions of dollars -- many times over $1 billion.
Flipping Hospitals Reap Large Profits for Consolidators

CONSOLIDATORS PRIORITIZING PROFITS OVER PATIENTS
Our research shows that common complaints among employees of corporate-owned veterinary practices say their employers prioritize short-term profits -- numerous red flags. Reading company reviews at popular job websites about the corporate consolidator that owns the individual practice can provide greater insight into the company's true priorities, work conditions, culture, and leadership. However, gag clauses are on the rise which may silence doctors and staff -- stifle public debate about the effects of rapid veterinary consolidation.
Common Employee Complaints of Veterinary Consolidators

 

ARE CONSOLIDATORS EXACERBATING VET SHORTAGE?
First-of-its-kind study reveals that veterinarians working in corporate practices reported feeling more pressure than those in private practice to generate revenue and see more clients per shift. There is a large mismatch between employees' purpose and consolidators -- employees and clients blindsided by abrupt closure of hospital. Consolidators primary focus on profits is negatively impacting the workplace culture -- cause burnout and drives workers away from the profession.

 

CONSOLIDATORS ENDLESS PURSUIT OF PROFITS
Large consolidators often make hundreds of millions of dollars a year while many of its employees struggle to earn a livable wage and owners deal with high vet bills -- consolidator launches sale process. The prioritization of profits will continue indefinitely unless workers and consumers pushback.

 

ACCELERATE POSITIVE CHANGE IN PET CARE INDUSTRY
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