Private Equity Acquisition in Ophthalmology and Optometry: A Time Series Analysis of the Pre-COVID, COVID Pre-Vaccine, and COVID Post-Vaccine Eras

ObjectiveTo identify temporal and geographic trends in private equity (PE) backed acquisitions of ophthalmology and optometry practices in the United States from 2012 to 2021. DesignCross-sectional time series analysis using acquisition data from 10/21/2019 to 9/1/2021 compared to previously published data from 1/1/2012-10/20/2019. Acquisition data was compiled from 6 financial databases, 5 industry news outlets, and publicly available press releases. Linear regression models were used to compare rates of acquisition. Subjects245 PE acquisitions of ophthalmology and optometry practices in the United States between 10/21/2019 and 9/1/2021. MeasuresNumber of total acquisitions, practice type, locations, provider details, and geographic footprint. Results245 practices associated with 614 clinical locations and 948 ophthalmologists or optometrists were acquired by 30 PE-backed platform companies. 18 of 30 platform companies were new compared to our prior study. Of these acquisitions from 10/21/2019 - 9/1/2021, 127, 29, and 89 were comprehensive, retina, and optometry practices, respectively. From 2012 to 2021, monthly acquisitions increased by 0.947 acquisitions per year (p<0.001*). Texas, Florida, Michigan, and New Jersey were the states with the greatest number of PE acquisitions with 55, 48, 29, 28 clinic acquisitions, respectively. Average monthly PE acquisitions were 5.71 per month from 1/1/2019 - 2/29/2020 (pre-COVID), 5.30 per month 3/1/2020-12/31/2020 (COVID pre-vaccine, p=0.8072), and were 8.78/month 1/1/2021-9/1/2021 (COVID post-vaccine, p=0.1971). ConclusionPE acquisitions increased from 2012-2021 as companies continue to utilize both regionally focused and multi-state models of add-on acquisitions.