Private Equity Ownership Increases Mortality

Written by Chris Thom

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In this study examining outcomes before and after private equity hospital acquisitions, both emergency department and intensive care unit mortality increased following acquisition, while healthcare worker staffing declined.

Our patients deserve better than private equity 
This study looked at a three-year time period before and after private equity acquisition of 49 separate hospitals in the United States. Each private equity hospital was matched up to 8 non-private equity hospitals to serve as controls. Variables examined included hospital staffing levels, salary expenses, and patient outcomes pertaining specifically to emergency departments (EDs) and intensive care units (ICUs).

The analysis included 1,007,529 ED visits at private equity hospitals and 6,197,854 ED visits at control hospitals. For ICU patients, there were 121,080 in the private equity hospitals and 760,377 at control hospitals. On average, ED salary expenditures fell by an adjusted 18.2% after private equity acquisition and ICU salary expenditures fell by 15.9%. Private equity acquisition was associated with a reduction in average full-time employees from 13.9 to 13.1 per 1000 available inpatient bed days. In adjusted analyses, private equity hospitals experienced a 13.4% increase in mortality, with a differential increase of 7.0 additional deaths per 10,000 visits (p=0.009). ED transfers at private equity hospitals also increased from 2.7% to 3.7% after acquisition. 

How will this change my practice?
As physicians, our primary mission is to care for our patients. This study serves as a reminder that private equity involvement in healthcare creates inevitable barriers to fulfilling that mission. The financial incentives to degrade patient care in the private equity model are simply too irresistible for the folks at the top of those companies. This model fails in healthcare, leaving frontline clinicians and patients to suffer while a privileged few at the top extract millions in personal wealth. Those of us in EM understand this well, as physician staffing rates are invariably cut in an effort to reduce labor costs and pay back debtors or amorphous financial backers. The closure of Crozer and Hahnemann hospitals are tangible examples of what happens when these organizations are allowed through the healthcare door.

Source
Hospital Staffing and Patient Outcomes After Private Equity Acquisition. Ann Intern Med. 2025 Nov;178(11):1529-1538. doi: 10.7326/ANNALS-24-03471. Epub 2025 Sep 23. PMID: 40982974.