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Cardiology Transactions

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Baker Donelson's Health Care Transactions team delivers the insight and experience that cardiology practices need to thrive.

Overview


The cardiology sector is undergoing transformational changes. Fueled by rising demand for outpatient care, ongoing reimbursement pressures, and the prevalence of cardiovascular disease, the market is seeing unprecedented private equity and health system interest. In the 2008-2016 timeframe, many cardiology groups sold to or partnered with hospital systems, but since 2019, private equity consolidations of cardiology practices have risen sharply from a handful to more than 50 transactions by 2023, driven by Medicare's rules allowing interventional cardiac procedures to be performed in ambulatory surgery centers (ASCs).

Many independent cardiology practices are now exploring affiliation options as administrative complexity, staffing shortages, and revenue cycle challenges mount. As consolidation accelerates, private equity platforms have more than doubled in the last several years, and competition and deal activity remain elevated, while state-level regulations add complexity.

Strategic transactions with private equity, health systems, and national physician and ASC platforms are reshaping the industry, creating new avenues for innovation and value creation. In this environment, having the right legal partner is essential.

Baker Donelson's Health Care Transactions team delivers the insight and experience that cardiology practices need to thrive. We have represented dozens of cardiology groups in complex transactions nationwide – with private equity platforms and hospitals – guiding clients through every stage of the deal process. Our attorneys understand the unique opportunities available to cardiology groups, including the development and optimization of ancillary services such as:

  • Ambulatory surgery centers (ASCs) for a growing number of interventional cardiology procedures
  • Office-based laboratories (OBLs) for a wide range of cardiology procedures
  • Advanced imaging (nuclear medicine, PET-CT, MRI, X-ray, ultrasound)
  • Cardiac rehabilitation programs
  • Remote patient monitoring
  • Cardiology urgent care

We regularly advise clients on a full spectrum of transactional matters, including strategic affiliations with health systems and private equity sponsors, practice sales, mergers, acquisitions, and joint ventures. Further, we have advised on several transactions involving "extractions" of dissatisfied cardiologists from hospital employment and professional service arrangements. Our team also assists with the structuring and scaling of ancillary service lines, managed care arrangements, regulatory compliance, and post-transaction integration. Our approach is collaborative and business minded.

Results may vary depending on your particular facts and legal circumstances. Some of these matters were handled by a current Baker Donelson professional while associated with a prior firm.

  • Closed the sale of the country's largest independent cardiology practice to private equity. The sale added 90 cardiologists and 50 advanced practice providers specializing in all areas of cardiovascular care, as well as 30 locations, to a platform primarily based in the Southern U.S.

  • Advised a cardiology group located in Texas in the sale of their practice and ASC to a large Texas health system.

  • Advised a large cardiology practice in Colorado on its extraction from a purchase and sale agreement (PSA) with a large health system and its subsequent strategic private equity investment transaction.

  • Represented a cardiology group in its sale to a large New Jersey health system.

  • Represented a cardiology group in Colorado in its negotiation of a PSA with a large Colorado health system.

  • Represented a cardiology practice in the mid-Atlantic region in connection with a sale transaction with a private equity sponsor.

  • Represented a cardiology practice and its office-based labs and ambulatory surgery centers (ASCs) in connection with a sale to a regional health system.

  • Represented a large Midwestern cardiovascular group in a transaction with a private equity-backed platform.

  • Represented a cardiology group in an affiliation with a large New York health system.

  • Represented a large cardiology group in Maryland in the renewal and amendment of its affiliation with a Maryland health system.

  • Represented a cardiology group in an extraction from a national practice and a new affiliation with a health system.

  • Represented a cardiology group in an extraction from hospital employment and return to private practice.

  • Events Relevant to All Physician Specialties

  • "The Intersection of PE and MSOs, Part 1: Benefits and Pre-Transaction Considerations," CV Transforum Fall '24 Conference (October 2024)
  • "Private Equity Physician Deals: What Investors, Physicians, and Hospitals Need to Know in 2023," American Health Law Association (AHLA) Health Care Transactions 2023 Conference (April 2023)
  • "The Anatomy of a Private Equity Transaction and Process," 6th Annual Physician Transactions Conference: The Future of Healthcare Conference Series™ (March 2023)
  • "The (Still) Robust Market for Physician Groups," 6th Annual Physician Transactions Conference, The Future of Healthcare Conference Series™ (March 2023)
  • "The Anatomy of a Physician Group Transaction with Private Equity," 2022 Physician Transactions Conference (March 2022)
  • "Key Terms and Protections for Physicians in Sale Transactions," Physician Transactions Conference, The Future of Healthcare Conference Series® (February 2022)
  • "The Process of Undergoing a Strategic Medical Practice Transaction," 2021 Physician Transactions Conference (April 2021)
  • "Assessing Strategic Options and Practice Value in the Wake of the Pandemic," 2021 Physician Transactions Conference (April 2021)
  • "Exit Planning and Strategic Transactions for Physician Groups," AllianceBernstein (June 2020)
  • "Part 3: The Transaction Process, Key Protections for Physicians, and How to Prepare," Physician Group Transactions 2020 (May 2020)
  • "Part 2: Beyond the First Partnership – Second Bites and More," Physician Group Transactions 2020 (April 2020)
  • "Part 1: What's Going On, and What Do You Need to Know?," Physician Group Transactions 2020 (April 2020)
  • Cardiology & Vascular

  • "Anatomy of a Partnership Transaction: What to Expect at Each Stage," 2025 Physician Transactions Conference: Cardiology, The Future of Healthcare Conference Series® (March 2025)
  • "A New Strategic Option to Consider – ESOPs for Medical Groups," 2025 Physician Transactions Conference: Cardiology, The Future of Healthcare Conference Series® (March 2025)
  • "Keynote Panel: 'Life After Closing' of a Partnership Transaction from the Perspective of Cardiologists Who Pursued Different Strategic Options," 2025 Physician Transactions Conference: Cardiology, The Future of Healthcare Conference Series® (March 2025)
  • "How to 'Extricate' from a Hospital PSA or Employment Agreement that is Not 'Working Out' to Participate in a Strategic Transaction," 2025 Physician Transactions Conference: Cardiology, The Future of Healthcare Conference Series® (March 2025)
  • "How Cardiology Groups Are Valued and How to Maximize Practice Value by Getting Your House in Order," 2025 Physician Transactions Conference: Cardiology, The Future of Healthcare Conference Series® (March 2025)
  • "Maximizing Value and Protecting Physicians in Strategic Partnerships," MedAxiom, an American College of Cardiology Company (September 2024)
  • "Private Equity Partnerships with Physicians in Hospital Relationships – Navigating the Waters," MedAxiom, an American College of Cardiology Company (July 2024)

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