Dashboard Observations on 17 Niches and Specialties

G2 Group

The dashboard below highlights where we see expansion or slow down in different niches with healthcare. Of course, the success of a specific company or provider within an industry depends a great deal on its individual strengths, and the proficiency of its management team and its available resources.

Industry Status/Prospects
Hospitals and health systems
Slow erosion to stable. Political power in part offsets substantial reimbursement risk; reduced inpatient cases; increased risk on patient receivables and increased deductibles; serious pricing pressure if movement of patients to exchanges; continued consolidation across industry. Certain hospitals and health systems that have the best quality, that develop leadership in taking on risk, that have market dominance, or that treat a specialized niche and are very lean in their operations will thrive.
Ambulatory surgery centers Slow erosion. Reduced number of available physicians, core specialties remaining fairly independent, pressure on case numbers; reimbursement risk; some access to payor issues. Despite the slow erosion in the overall ASC industry, ASC business remains in the greater context a very good industry and business. It remains remarkable how different the revenue equation can be for ASCs from geographic market to market.
Dialysis facilities
Stable to growth. Continued increasing patient demand offsets some reimbursement risk; continued consolidation; reduced number of physician owned facilities.
Physician practices
Slow to moderate erosion. Reimbursement risk depending upon specialty (see below); pressure on referral base and payor access.
Medical device Slow erosion to stable. Political power in part offsets some pricing pressure (e.g., industry relationship with Sen. Orrin Hatch); better international opportunities; patient demand continues to increase; substantial mid- and long-term pressure on domestic pricing.
Health information technology

Urgent care
Stable to slow growth. Customer budget constraints (increased risk to customer available capital) offset by need to expand and improve systems in hospital and health systems.
Growth. Strong alignment with consumers and payors; slim margins.
Dental practice management Stable to growth. Growth dependent on payor mix, with pressure on Medicaid-dependent companies; increased state regulatory pressure.
Home health
Stable. Little political power; fragmented industry undergoing consolidation; some reimbursement risk.
Hospice Stable. Some political power; reimbursement risk; utilization risk constraints; consistent consumer demand.
Nursing homes
Slow erosion to stable. Reimbursement risks for Medicaid-dependent providers and timing of payment from states impacts cash flow.
Behavioral health
Growth. High patient demand for services; alignment with payors and consumers.
Anesthesia practice management
Stable to growth. Alignment with payors and hospital sector.
Pain management
Stable. Influx of physicians; increased reimbursement and utilization controls.

Slow erosion to stable. Reimbursement risk; Mature orthopedic practices seem to be very resilient in terms of their referral base and remain critical to the overall delivery of healthcare (i.e., as to the percentage of total dollars spent in orthopedics and the reliance on all facilities on orthopedics.
Spine care   Slow erosion to stable. Reimbursement risk; increased payor controls on surgery.
Stable. While some pressure on pricing at all levels, gastroenterologists in many areas remain in very high demand and remain very busy.

Article Source, Becker’s ASC Review