Cardiology is in the midst of one of the most rapid consolidation waves in modern medicine. As reimbursement tightens and operational costs climb, more independent groups are aligning with hospitals, health systems or private equity-backed platforms to stay competitive.
Here are five forces driving cardiology consolidation:
- Private equity’s expanding footprint: Private equity has quickly become one of the biggest forces behind cardiology consolidation. The number of PE-backed cardiology platforms has more than doubled since 2022, and now spans nearly 20 states — with particularly heavy activity in Florida, Texas and Arizona.
“Independent practices — 90% of them — have less than 10 physicians,” David Konur, CEO of Cardiovascular Logistics, told Becker’s. “Just the administrative burden of complying with the regulations that are out there is incredibly costly.”
For smaller groups, joining larger entities can offer capital, infrastructure and payer leverage that are increasingly difficult to sustain alone.
- The outpatient migration: Cardiology is steadily moving out of hospitals and into outpatient environments. As more complex cardiovascular procedures become approved for ASCs, practices need scale and infrastructure to meet patient demand and regulatory requirements.
The outpatient shift has accelerated investment from both hospital systems and private equity firms looking to capture market share in lower-cost care settings.
- Reimbursement and operational pressures: Cardiology practices face shrinking reimbursement, rising labor costs and mounting administrative demands — all of which make independent operation more difficult.
Ongoing Medicare physician pay cuts and inconsistent private-payer coverage are among the biggest hurdles slowing outpatient cardiology growth. These financial pressures are also fueling hospital acquisitions, as health systems seek to secure referral streams and capture more outpatient revenue.
- Geographic clustering and competitive dynamics: Consolidation is uneven across the U.S., with private equity-backed cardiology practices heavily concentrated in specific markets.
According to a 2024 JAMA Health Forum study, PE-acquired cardiology groups are now active in 22 states — with the highest concentration in Rhode Island at 37.1% of all cardiology practices, Nevada at 26.4% and Louisiana at 23.6%. In seven states overall, more than 10% of cardiology practices are PE-owned. This geographic clustering is raising new questions about competition, patient access and pricing transparency.
- Deal momentum and strategic growth: Deal activity in cardiology remains strong as investors and health systems expand their cardiovascular portfolios. Recent private equity–backed transactions include WindRose Health Investors’ acquisition of CardioOne and Pharos Capital’s purchase of RhythMedix.
At the same time, platforms such as Cardiovascular Logistics continue to grow through partnerships with leading independent groups — including Cardiology Consultants of Philadelphia, the nation’s largest private cardiology practice.
Industry leaders expect consolidation to accelerate over the next two years as site-of-service differentials narrow and reimbursement pressure persists.
“If site-of-service differential goes away, there is going to be a huge influx of cardiologists looking to join platforms like ours,” said Mr. Konur. “I would expect to see an increase in consolidation in the specialty.”
