Over the last 20 years, the presence of independent practices in medicine has declined drastically as reimbursement rates fail to keep up with the rising cost of infrastructure and operations—and cardiology is no exception.
In an analysis published March 11 in the American Journal of Managed Care, researchers outline the evolving dynamics of private cardiology practice, including the challenges imposed by heightened private equity ownership and its impacts on physician independence and patient care.
Here are 10 takeaways from the analysis:
1. There are more than 2,500 active cardiology group practices across the U.S., including physician-owned, hospital-owned and PE-owned.
2. Only about 350 of those remain independent and “sizable,” according to the report, defined as employing 5 to 10 cardiologists.
3. By 2022, nearly 90% of cardiology practices were hospital integrated, leaving only 10% to 12% independent.
4. Hospital employment of cardiologists rose from approximately 26% in 2008 to nearly 63% by 2019, and by 2024, only 30.7% of cardiologists worked in physician-owned practices
5. Of the nation’s approximately 33,000 cardiologists, only 10,000 remain in independent practice, and nearly 80% of them work in groups of fewer than 10.
6. Large independent practices, those with more than 50 cardiologists, are rare, with only 30 nationwide.
7. Solo and 2-physician practices, once dominant, accounted for just 16.1% of the field in 2017.
8. Interventional cardiology and electrophysiology, with capital-intensive catheterization and electrophysiology labs, remain closely tied to hospitals.
9. In contrast, general cardiology remains more prevalent in physician-owned settings that focus on longitudinal care and diagnostics, and as a result, it has been a stronghold for private practice, attracting PE acquisitions.
10. From 2005 to 2021, Medicare payments for cardiology have fallen by approximately 29%, and physician pay across all specialties declined 26% after adjusting for inflation.
