Private Equity in 2021: Pragmatic recommendations for eye care practice owners and providers


One year ago, as the number of COVID-19 cases surged, the avid interest of private equity (PE) investors in the US health care sector suddenly came to a halt as they watched the industry mobilize against SARS-CoV-2. Emerging transactions came to a standstill; mergers, acquisitions, and PE deals were placed on hold indefinitely or fell apart; and the courtships between practice owners across all health care specialties, PE funds, strategic buyers, and investment bankers largely stopped. All stakeholders wondered if, when, and how the health care industry would rebound. The halt of PE’s interest in health care was brief and confined mostly to the second quarter of 2020, but it had consequences for the eye care sector at multiple levels.


Unlike in dermatology, consolidation in the eye care sector had just started heating up in early 2020 (Figures 1 and 2). Following the temporary halt in elective surgeries in the second quarter of 2020, most ophthalmologists had returned to operating by the third quarter of that year. Deal-making quickly rebounded after the halt in the second quarter and lasted into the end of the year. Several transactions that had been put on hold at the start of the COVID-19 pandemic resumed, some of which closed by the year’s end, ahead of concerns over future tax changes (personal communication with N. Johnson, Lawrence, Evans and Co, February 2021).

The number of eye care deals that closed in 2020—a total of 31—indicates that the COVID-19 pandemic has affected the consolidation in eye care only minimally (Figures 2 and 3). Merger and acquisitions professionals report an uptick in deals nearing pre–COVID-19 levels. This is in part because eye care enterprises, more than other specialties, have demonstrated extraordinary resistance to COVID-19 and velocity in recapturing pre–COVID-19 productivity levels during the pandemic.

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