Private equity is buying up more methadone clinics – access to the lifesaving drug isn’t getting easier - Cobb Courier

Private equity firms have acquired a large share of the U.S. methadone clinic market, a development that bears directly on patient access to the medication. Writing in The Conversation (republished by the Cobb Courier), Brown University healthcare economist Yashaswini Singh reports that PE investors now control more than one-third of U.S. methadone clinics. As of October 2026, 1,572 methadone clinics were registered with the Centers for Medicare & Medicaid Services, 35% of opioid treatment providers were affiliated with PE firms, and in 19 states and the District of Columbia more than half had PE owners.

Singh's research, co-authored with researchers from the University of Pittsburgh and RAND, examined acquisitions from 2011 to 2019. It found that within two years of a PE firm entering a county, the firm typically controlled 67% of the local methadone market, and in more than a quarter of counties a single firm controlled all of it. Despite this concentration, the acquisitions generally did not produce new clinics or more treatment. Methadone shipments and opioid-related deaths were unchanged over the study period. Singh characterizes the pattern as firms buying existing capacity rather than building new capacity. The article notes that federal methadone rules, which restrict dispensing to licensed opioid treatment programs, create a government-sanctioned market structure in which controlling clinics means controlling access.

The article also presents the counterview. Operator Community Medical Services (CMS), led by CEO Nick Stavros, says it grew from 14 clinics in four states before PE investment to 79 clinics in 14 states, with 49 of those added as new sites and the remainder acquired. Stavros said building a new clinic costs about $2.5 million. Research cited in the piece found PE-acquired clinics became significantly more likely to accept Medicare and Medicaid, though a separate study found that buprenorphine patient volume at PE-acquired facilities rose about 22% while 180-day continuous treatment rates fell by nearly 8 percentage points.

The issue is tied to the Modernizing Opioid Treatment Access Act 2.0, which would permit prescribing by regular doctors and dispensing by pharmacies. The original bill, introduced in 2023, did not receive a floor vote. The 2.0 version is in committee with no markup scheduled. The Hassan investigation is ongoing. The American Association for the Treatment of Opioid Dependence (AATOD), a trade group representing methadone clinics, opposes the bill, citing concerns about diversion, overdose risk and the HHS secretary's role in qualifying prescribers. AATOD president Mark Parrino also raised concerns about dispersible tablets. Stavros, who serves as AATOD's Arizona representative, said he would support a gradual transition to pharmacy prescribing.