Welsh Carson FTC Order

[Mad Jack]

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FTC Approves Final Order with Welsh Carson

The Federal Trade Commission finalized a consent order with Welsh, Carson, Anderson & Stowe and its affiliates (collectively referred to as Welsh Carson) that resolves a potential administrativ

www.ftc.gov

Looks like the FTC is finally actually doing something about these PE companies trying to create anesthesia monopolies

 

[aneftp]

FTC Approves Final Order with Welsh Carson

The Federal Trade Commission finalized a consent order with Welsh, Carson, Anderson & Stowe and its affiliates (collectively referred to as Welsh Carson) that resolves a potential administrativ

www.ftc.gov

Looks like the FTC is finally actually doing something about these PE companies trying to create anesthesia monopolies

Does it really matter to welsh Carson at this point?

Welsh Carson made their killing between 2015-2020. It’s no longer a highly profitable business

Notice the ftc didn’t say Welsh Carson to give Back their always taking 20% profit of every usap center. I see ko mention of that.

So they will Confinue to take 20% of profits in Dallas Houston orlando and other places.

The ftc ruling means nothing in 2025.

 

[Mad Jack]

Does it really matter to welsh Carson at this point?

Welsh Carson made their killing between 2015-2020. It’s no longer a highly profitable business

Notice the ftc didn’t say Welsh Carson to give Back their always taking 20% profit of every usap center. I see ko mention of that.

So they will Confinue to take 20% of profits in Dallas Houston orlando and other places.

The ftc ruling means nothing in 2025.

True. But at least they're doing *something.* Hopefully if they get enough orders in place it will put PE off of anesthesia altogether

 

[NicholasPavona]

True. But at least they're doing *something.* Hopefully if they get enough orders in place it will put PE off of anesthesia altogether

🤣

 

[centdoc]

From what I recall, it’s a slap on the wrist. No monetary penalties. All it really says (which is better than nothing) is that WC (via USAP) cannot buy any more groups in Texas without FTC approval. What I would like to know is does this order prevent USAP from getting any new exclusive contracts? Since that is what the lawsuit was initially about.

 

[amyl]

No. I heard WC/usap just got an exclusive contract w a facility in the N dallas suburbs. It’s not my old division - it’s a different one - so not sure of details.
I don’t think they can buy any more physician groups though.

 

[kidthor]

FTC Approves Final Order with Welsh Carson

The Federal Trade Commission finalized a consent order with Welsh, Carson, Anderson & Stowe and its affiliates (collectively referred to as Welsh Carson) that resolves a potential administrativ

www.ftc.gov

Looks like the FTC is finally actually doing something about these PE companies trying to create anesthesia monopolies

In my opinion the FTC is actually doing nothing about PE in healthcare now. The orange administration loves private equity - a ton of the current cabinet members came from private equity (Vance, Bessent, Feinberg, Burgum, Sacks, Wright, Lutnick, Kushner, Ramaswamy - just to name a select few!).

In my opinion this Welsh Carson order is even less than a mere slap on the wrist. Welsh Carson extracted tons of cash from USAP while the getting was good (pre no-surprises-act) and this FTC order basically pats them on the back and tells them to calm it down next time. WC keeps all the profits and the order settles the matter with them fully to seal the deal.

Even worse the FTC is still suing USAP. In my opinion USAP acted at WC's direction and if anything is the more innocent actor.

In my opinion USAP got pumped and dumped by WC and now USAP is still in legal jeopardy. I'm no fan of USAP, but I think they got screwed here.

Also of note the FTC only has 3 voting members instead of the normal 5 because the orange team expelled the democrat members (normally there are 3 from the party in power and 2 from the other - no president has ever expelled everyone from the other party).

 

[nimbus]

In my opinion the FTC is actually doing nothing about PE in healthcare now. The orange administration loves private equity - a ton of the current cabinet members came from private equity (Vance, Bessent, Feinberg, Burgum, Sacks, Wright, Lutnick, Kushner, Ramaswamy - just to name a select few!).

In my opinion this Welsh Carson order is even less than a mere slap on the wrist. Welsh Carson extracted tons of cash from USAP while the getting was good (pre no-surprises-act) and this FTC order basically pats them on the back and tells them to calm it down next time. WC keeps all the profits and the order settles the matter with them fully to seal the deal.

Even worse the FTC is still suing USAP. In my opinion USAP acted at WC's direction and if anything is the more innocent actor.

In my opinion USAP got pumped and dumped by WC and now USAP is still in legal jeopardy. I'm no fan of USAP, but I think they got screwed here.

Also of note the FTC only has 3 voting members instead of the normal 5 because the orange team expelled the democrat members (normally there are 3 from the party in power and 2 from the other - no president has ever expelled everyone from the other party).

USAP could have been an HVAC contractor or a concrete castings manufacturer. Wouldn’t have made any difference to Welsh Carson. Of course they would have loved to flip USAP or go public with it but they are basically done with USAP.

 

[aneftp]

USAP could have been an HVAC contractor or a concrete castings manufacturer. Wouldn’t have made any difference to Welsh Carson. Of course they would have loved to flip USAP or go public with it but they are basically done with USAP.

Usap fails the same way mednax American anesthesiology failed. History repeats itself.

Cherry pick the best practices. Make tons of money. Just no room for growth after a while.

Mednax American anesthesiology 2007-2014 growth. In trouble 2017 with charlotte practice. Dead by 2020 some for Pennies to Napa.

Usap suffers the same fate. Or will suffer.

Sure they will remain in some capacity. Just like Sheridan Amsurg Envison. (They were saddle with debt). I don’t think usap is in that bad of a shape. But they will shed money losing contracts. Keep the ones who make money.

Welsh Carson likely divest their control in the next 2 years is my guess. I don’t think they even want the 20% management fees they are charging. Too much liability to the parent company.

 

[HemeOncHopeful19]

Usap fails the same way mednax American anesthesiology failed. History repeats itself.

Cherry pick the best practices. Make tons of money. Just no room for growth after a while.

Mednax American anesthesiology 2007-2014 growth. In trouble 2017 with charlotte practice. Dead by 2020 some for Pennies to Napa.

Usap suffers the same fate. Or will suffer.

Sure they will remain in some capacity. Just like Sheridan Amsurg Envison. (They were saddle with debt). I don’t think usap is in that bad of a shape. But they will shed money losing contracts. Keep the ones who make money.

Welsh Carson likely divest their control in the next 2 years is my guess. I don’t think they even want the 20% management fees they are charging. Too much liability to the parent company.

How did you guys as a field beat Mednax?

My spouse's field is completely overtaken by it, just curious what the history lesson was.

 

[Gern Blansten]

How did you guys as a field beat Mednax?

My spouse's field is completely overtaken by it, just curious what the history lesson was.

I always thought that they just sold out after they had bled groups dry of as much as they could get and sold while they still could find a buyer. They sold to NAPA, didn't they?

 

[Shimmy8]

The field itself is cannibalizing PE...no one defeated anyone in particular.

Higher labor costs, decreased CMS reimbursement, NSA created even more ability for private insurers to fight groups...people just trying to get their money back or keep management fees at the moment. No one buying anyone now.

 

[aneftp]

I always thought that they just sold out after they had bled groups dry of as much as they could get and sold while they still could find a buyer. They sold to NAPA, didn't they?

No. Mednax was losing money on American anesthesiology and radiology divisions and covid was the final nail in the coffin for them. But they were struggling about usap formed. So less lucrative contracts to go after.

Mednax was the original mega anesthesia buyout company in 2007-2014 they charged insurers higher rates also. Like $120/unit. Almost double what our cigna smaller practice paid out ($80/unit). Florida blue cross was even worst at $70/unit. Mednax got paid like $90-100/unit with Florida blue cross.

Usap took it up another level with strangleholds in many cities. Charging $140-unit

 

[amyl]

I agree most of you esp w kid thors take but I think WC still wants the fees…. And it’s lots more than 20% in some markets.

This anesthesia market is a stress test for practices - high salaries, less reimbursement and no ability to “corner the market” and drive up prices - the only thing keeping them going is the non competes and that hospital admins are often stupid. The business model just doesn’t work anymore.
I’m sure WC will ride USAP until they can’t anymore - the horse is dying but not dead yet.
WC maybe more guilty than USAP in the ftc thing - idk… but WC definitely knows how to out maneuver USAP.

 

[aneftp]

I agree most of you esp w kid thors take but I think WC still wants the fees…. And it’s lots more than 20% in some markets.

This anesthesia market is a stress test for practices - high salaries, less reimbursement and no ability to “corner the market” and drive up prices - the only thing keeping them going is the non competes and that hospital admins are often stupid. The business model just doesn’t work anymore.
I’m sure WC will ride USAP until they can’t anymore - the horse is dying but not dead yet.
WC maybe more guilty than USAP in the ftc thing - idk… but WC definitely knows how to out maneuver USAP.

Envision charges as little as 12% in some markets their management fees and Hca even dumps them to take things in house hospital employees

The only people in denial are the “partners left at usap. More work for the “partners” means more “profits” for welsh Carson.

It’s like the tables have turned. The partnership tracks employees who in the past are asked to keep working on extra and the “partners “ collect profits while sleeping in their own bed doing nothing.

So usap partners these days are asked to work extra and WC collects an easy 20%

What if the partners refuse to work post call? And there are no more employees willing to work extra either.

Than you got huge issues.
As soon as people realize it. The sooner we can come to an end to these PE games

 

[amyl]

Yup…. Agree totally. You know it and I lived it. But at least I’m not part of the problem any more.