Gary M. Kirsh, MD, presented “Future Options for Urology Practice Ownership” during the 29th Annual International Prostate Cancer Update on January 25, 2019 in Beaver Creek, Colorado.

How to cite: Kirsh, Gary M. “Future Options for Urology Practice Ownership” January 25, 2019. Accessed Apr 2024.

Future Options for Urology Practice Ownership – Summary:

Gary M. Kirsh, MD, discusses the challenges that independent urology practices face from complexities in the constantly-evolving healthcare industry. He then describes the benefits of adopting configurations of independent urology groups in which physicians have equity ownership.


Healthcare is changing, and as a result, urologists are asking if they can continue to thrive in their current practice configurations. The healthcare industry has seen changes in reimbursement complexity and opportunity due to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the value-based payment programs it implemented, namely the Merit Based Incentive Payments System (MIPS) and Alternative Payment Models (APMs). This complexity necessitates increasingly sophisticated business models, such as professional, legal, and accounting management.

Whether or not urologists are seeking out new practice ownership opportunities, they often receive offers for these arrangements. While most industries in the United States have consolidated, healthcare remains a fragmented industry. However, according to recent trends in health system mergers, consolidation in the industry has already begun. A 2018 AUA survey demonstrated the consolidation of physicians, as 50% of urologists are currently hospital-employed.

One key action independent practices can take in order to navigate this atmosphere of healthcare changes is to acquire scale. Unfortunately, many practitioners equate scale with a loss of independence and confinement to policies and procedures of a larger structure. Because of this, the urologic community should adopt a new concept of independence in which physicians have equity ownership.

Options for achieving this structure include investor-driven consolidation; or in other words, “private equity,” and “organic” consolidation. Private equity can help to achieve scale, bring outside capital infusion and expertise from the equity partner, as well as obtain liquidity from the initial sale of a portion of a practice. Organic consolidation can also achieve scale, allowing physicians to maintain all decision-making in the practice. Regardless of the method used, the successful urology group of the future will offer meaningful scale while maintaining physician equity ownership.

About the International Prostate Cancer Update

The International Prostate Cancer Update (IPCU) is an annual, multi-day CME conference focused on prostate cancer treatment updates. The conference’s faculty consists of international experts, and the event caters to urologists, medical oncologists, radiation oncologists, and other healthcare professionals. Topics encompass prostate cancer management, from diagnosis to treating advanced and metastatic disease. Dr. Kirsh presented this lecture during the 29th IPCU in 2019. Please visit this page in order to learn more about future IPCU meetings.