Key Takeaways
- • Private equity firms own roughly 447 U.S. hospitals, about 7 percent of all hospitals, according to a 2026 report by the Private Equity Stakeholder Project.
- • A 2024 study co-authored by Atul Gupta of more than 18,000 nursing homes found residents were 10 percent more likely to die within 90 days of discharge from a private-equity-owned facility, and 50 percent more likely to take antipsychotic medication.
- • A 2023 JAMA study of Medicare recipients found private-equity-owned hospitals were associated with more patient falls and higher infection rates, including central line infections.
- • Private equity typically holds companies for five to seven years, and experts say ownership most reliably raises prices, while quality effects are less clear.
- • Experts advise patients not to abandon a good doctor because a practice is acquired, but to check referrals, cosmetic upselling, nursing staffing, and Medicare.gov star ratings when choosing a facility.
Summary
Private equity firms are expanding into U.S. health care, and according to AARP, that expansion has direct implications for patient care. Atul Gupta, assistant professor of health care management at the Wharton School, says private equity differs from other for-profit owners because its investors are focused on returns rather than health care, and the typical ownership period of five to seven years creates pressure to cut costs, raise prices, and sell. Researchers do not agree that private equity is necessarily worse than other profit-focused owners, but the business model can lead to staff reductions, higher prices, and a shift toward privately insured patients.
Nursing homes are the sector where experts most strongly warn against private equity ownership. Gupta, who co-authored a 2024 study of more than 18,000 nursing homes, found residents were 10 percent more likely to die within 90 days of discharge from a private-equity-owned facility and 50 percent more likely to take antipsychotic medication. An older 2014 Florida study found higher rates of pressure ulcers and less staff walking of patients, with problems growing the longer a firm owned the facility. Because these facilities typically employ fewer nurses, and nurse availability correlates with better outcomes, staffing is a central concern. Lynn Unruh, professor emerita at the University of Central Florida, advised patients to avoid such facilities. Gupta and Unruh recommend checking Medicare.gov's five-star ratings, focusing first on staffing, and researching violations, lawsuits, and corporate parent names.
According to the Private Equity Stakeholder Project's 2026 report, 447 U.S. hospitals are private-equity owned. A 2023 JAMA study of Medicare recipients found patients were more likely to fall in these hospitals, and that patients undergoing operations were more likely to develop infections, including life-threatening central line infections. Researchers linked these outcomes to broader institutional problems, including reduced nurse staffing. Unruh noted that older adults are particularly vulnerable to staffing-related errors.
Private equity has also acquired physician practices, particularly in dermatology, gastroenterology, ophthalmology, anesthesiology, urology, oncology, and obstetrics and gynecology. Experts, including Laura Alexander of Ohio State University, say patients should not necessarily leave a doctor they trust after an acquisition, since results vary. Alexander states that pricing impacts are "pretty conclusive," with increases ultimately passed to consumers through higher premiums. Quality effects are less clear, according to Daniel Arnold of Brown University. Patients should watch for referrals to affiliated practices and upselling of cosmetic procedures, and should consider alternatives where available, as Arnold advised. Lauren Roth of Pace University noted that clinic closures can occur when sites are unprofitable, particularly those serving high-risk patients with low reimbursement.
Nursing homes are the sector where experts most strongly warn against private equity ownership. Gupta, who co-authored a 2024 study of more than 18,000 nursing homes, found residents were 10 percent more likely to die within 90 days of discharge from a private-equity-owned facility and 50 percent more likely to take antipsychotic medication. An older 2014 Florida study found higher rates of pressure ulcers and less staff walking of patients, with problems growing the longer a firm owned the facility. Because these facilities typically employ fewer nurses, and nurse availability correlates with better outcomes, staffing is a central concern. Lynn Unruh, professor emerita at the University of Central Florida, advised patients to avoid such facilities. Gupta and Unruh recommend checking Medicare.gov's five-star ratings, focusing first on staffing, and researching violations, lawsuits, and corporate parent names.
According to the Private Equity Stakeholder Project's 2026 report, 447 U.S. hospitals are private-equity owned. A 2023 JAMA study of Medicare recipients found patients were more likely to fall in these hospitals, and that patients undergoing operations were more likely to develop infections, including life-threatening central line infections. Researchers linked these outcomes to broader institutional problems, including reduced nurse staffing. Unruh noted that older adults are particularly vulnerable to staffing-related errors.
Private equity has also acquired physician practices, particularly in dermatology, gastroenterology, ophthalmology, anesthesiology, urology, oncology, and obstetrics and gynecology. Experts, including Laura Alexander of Ohio State University, say patients should not necessarily leave a doctor they trust after an acquisition, since results vary. Alexander states that pricing impacts are "pretty conclusive," with increases ultimately passed to consumers through higher premiums. Quality effects are less clear, according to Daniel Arnold of Brown University. Patients should watch for referrals to affiliated practices and upselling of cosmetic procedures, and should consider alternatives where available, as Arnold advised. Lauren Roth of Pace University noted that clinic closures can occur when sites are unprofitable, particularly those serving high-risk patients with low reimbursement.
Go deeper than the headline
Research every firm in this story, track the ones that matter and get the daily briefing — free for 7 days.