As veterinary costs climb, private equity ownership of clinics draws scrutiny

Geoff Bennett:

If you have a furry friend, you might have noticed that veterinary care is becoming increasingly expensive. And as prices rise, attention is turning to a major shift in the industry, private equity firms and large corporations buying up veterinary practices across the country.

Paul Solman has the story.

Paul Solman:

Clyde, a 9-year-old boxer who lived in California with pet parent Kylie.

Kylie, Dog Owner:

I adopted him in April of 2020. So he's a pandemic baby. He was in mostly good health for about a year, and then he started vomiting pretty regularly.

Paul Solman:

After a year plus of vet visits, sweet potato Clyde's diagnosis, cancer.

Kylie:

We started him on chemo pretty early on.

Paul Solman:

Costing how much?

Kylie:

In 2026 alone and just for my one dog Clyde, I have spent $3,500.

Jennifer Tirnauer, Cat Owner:

At what point do you say, enough?

Paul Solman:

Jennifer Tirnauer has spent some 20 grand on her daughter's beloved 14-year-old Balinese cat, Jupiter.

Jennifer Tirnauer:

If it was $20,000 all at once, I might have said no, but because it was a few thousand, a few thousand, a few thousand, then a few years past, then a few thousand, it's really hard to draw a clear line.

Paul Solman:

Look, we can bombard you with stories like these because veterinary care costs have risen by roughly 60 percent since 2014, far outpacing overall inflation. The mission of this story, to examine the role of corporate ownership by private equity in particular.

Matt Salois, President, Veterinary Management Groups:

Rising prices are partly a story of inflation. They're partly a story of better medicine, partly a story of labor scarcity, and then it's partly a story of ownership and market structure.

Paul Solman:

Economist Matt Salois studies the industry.

Matt Salois:

And so the private equity component is a piece of that story.

Paul Solman:

Salois says it's hard to precisely quantify private equity's share of these costs, but they are real enough. And, in fact, Clyde and Juniper (ph) have something in common besides their pathologies. They were treated by vets owned by the same private equity firm.

Now, as we and others have reported, private equity buys businesses to hike their value, usually with a loan that's loaded onto the acquisition. The goal? Increase profits and sell at a higher price.

Helaine Olen, Financial Journalist:

Private equity has started to move in very aggressively into the veterinary space.

Paul Solman:

Financial journalist Helaine Olen.

Helaine Olen:

And what often happens is everyone from the customers to the employees get the short end of the stick. There is a lot of evidence out there now that what they do is, they put a lot of pressure on the veterinary clinics themselves to increase revenue. They raise prices quickly and often.

Paul Solman:

Salois says, that can happen, but in the vet world, so much depends on how the acquirers operate and how many practices they own.

Matt Salois:

The entry of private equity into a veterinary practice in and itself is not good or bad. It's, what kind of operating model? I think the problem here is one of size. It's easier for a smaller enterprise to maintain that level of trust between the veterinary team and the pet owner because the distance between decision-maker and decision-implementer is closer.

And that becomes harder as an enterprise grows, as can happen in a corporate veterinary practice.

Paul Solman:

In other words, the practice can wind up putting profits over pets. A government-backed investigation of vet clinics in the U.K. estimated that corporate ownership added more than a billion dollars in costs for consumers over a five-year period.

Back here across the pond, corporations owned only 10 percent of vet practices a decade ago. Today, it's estimated from about 30 to as much as 50 percent and, in specialty care, emergency medicine, oncology, and cardiology, 75 percent. Why? Because vet practices can be cash cows, given the emotional bonds between man and beast.

(SINGING)

Kylie:

If you're a pet owner that loves your pet, you're going to want to keep that pet alive. They're my babies. They're my kids.

Jennifer Tirnauer:

It's very hard to say no when something might extend their life.

Helaine Olen:

The status of pets at our society has gone up by a huge degree over the course of our lifetimes. These private equity places, shops see this and they think this is a guaranteed way to make money, because just keep spending money on their pets.

Paul Solman:

Michele Forbes is a veterinarian who runs an independent vet practice in Ann Arbor, Michigan.

Michele Forbes, Owner, Compassionate Care Animal Hospital:

When I started 22 years ago, it was you had to be a veterinarian to own your practice. It was a more locally functioning, connected, sort of we make decisions here in the moment in the hospital. And now it is -- it's just much more business. It's a business venture.

Paul Solman:

Vets like Forbes are increasingly getting offers to sell their practices to private equity firms. Here's a recent bid she got and posted on TikTok.

Michele Forbes:

Initial corporate offer, $8.5 million.

I, on a daily basis, will get requests from private equity companies to purchase my practice, and the numbers are so hard to walk away from.

Paul Solman:

And she has walked away from every offer.

Michele Forbes:

That's what we think of selling to corporate.

Paul Solman:

Even so, she says, the rise of corporate-owned practices has made it harder for her to compete.

Michele Forbes:

There are certain medications that for, every dollar I spend, a corporate hospital spends 30 cents. So when I charge a client the same amount as a private equity, my profit margin is so slim that it's hard to stay alive.

Paul Solman:

That's because she can't get the same huge volume discounts that come with size. But when vets like her sell or close up shop, the community may pay the price.

Matt Salois:

Private equity, consolidation in general has the potential to reduce competition in local markets. And so, if that happens, that pressure does contribute to higher prices. Independent practices, they're not just nostalgic. They are an important competitive force.

Paul Solman:

We contacted some of the largest corporate-owned veterinary groups in the U.S.

Mars, the candy folks, now a conglomerate, which owns three of those groups, and about 2,000 U.S. practices in all, responded -- quote -- "Diagnostics, treatments, and specialty care that did not exist a generation ago are helping pets live longer, healthier lives. Those advances, along with industry-wide pressures, such as a national shortage of veterinary professionals and rising costs for medical supplies and equipment, have affected the cost of care. Our veterinarians have clinical autonomy."

Mars rebrands its vet practices, but that's not usual for private equity owners. So consumers often assume local ownership.

Francis Wong's dachshund, Pluto, was sideswiped by a car, rushed to a local clinic.

Francis Wong, Dog Owner:

And we were just really disappointed in the way he was cared for. There didn't seem to be any continuity of care. The vets that he saw were relief vets, so they were coming in and out. And so they missed the internal bleeding that he had, and that's ultimately what led to his death.

And the other thing that was really torturous for us was just the way in which they were continually asking for additional authorization for payment, including after he had passed.

Paul Solman:

Did you know it was private equity?

Francis Wong:

So we didn't, we complained. We didn't really hear anything back. And at that point I started researching who owns the practice.

Paul Solman:

The local vet had been acquired by a private equity firm, KKR. Wong appealed, was offered a refund of his $13,000 bill, but:

Francis Wong:

That was in return for an NDA.

Paul Solman:

A nondisclosure agreement.

Francis Wong:

Meaning that we wouldn't be able to share anything about our experience. And so, instead, what I decided to do was to try and honor Pluto in some way by setting up this Web site that actually has the goal of bringing transparency to the ownership of veterinary practices across the U.S.

Paul Solman:

His Web site, PrivateEquityVet.org, features a searchable map of corporate-owned practices, something he wishes he had had when he lost Pluto, just a pet, some might say, but, like so many, a priceless member of the family.

For the "PBS News Hour," Paul Solman.