Abstract

Abstract Currently and globally, the majority of ART treatments are performed either fully in the private medical sector or are partially subsidized in the public sector but with common treatments spill-over to the private sector; countries where there is sufficient public coverage of ART are in fact rare. While private clinics and hospital have been the norm in ART for decades, in recent years the field has undergone significant consolidation, and this has resulted in an influx of large financial players such as private equity (PE) firms. The results are a series of mergers and acquisitions that are shaping the geography of ART provision. In this debate, I will take on the “pro” side and I will highlight the scholarship around the changes in care brought about by PE ownership of medical practices, bringing examples from branches of medicine such as dermatology, dentistry, long term care or Ob&Gyn that have experienced market consolidation in the last decades. I will show that available evidence indicate that the change in ownership to PE of private medical practices is associated with an increase in the number of patients treated and a net increase in payments to clinicians. Moreover, PE ownership has been repeatedly associated with a perception of higher quality care by patients, while clinical KPIs have not gotten worse and, if anything, have improved. This is usually due to greater intentional focus on standardization and quality control, streamline and protocolization of treatments, and centralization of certain administrative areas. I will further argue that, in large PE owned networks, best practices tend to be enhanced by peer to peer sharing and central medical boards, while centralization and digitalization of patient data collection favors research and development in a field that sorely lacks public funding for reproductive research.

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