Patient deaths have been found to increase in U.S. hospitals after being acquired by private equity firms, according to one study.
The death rates rose in the emergency departments of these hospitals, in comparison to similar hospitals not acquired by private equity, the study says.
This nationwide study of hundreds of hospitals by researchers at Harvard Medical School, the University of Pittsburgh and the University of Chicago builds on previous evidence demonstrating the link.
“Among Medicare patients, who are often older and more vulnerable, this study shows that those financial strategies may lead to potentially dangerous, even deadly consequences,” study author Dr. Zirui Song, professor of healthcare policy at Harvard and general internist at Massachusetts General Hospital, said in a statement.
The new study said that after U.S. hospitals were acquired by private equity firms, mortality among Medicare beneficiaries in the emergency departments increased by 13 percent on average (seven additional deaths per 10,000 emergency department (ED) visits, from a baseline of 52 deaths per 10,000), as compared with non-private equity, control hospitals.
“This occurred after an increase in ED patients transferred to other hospitals, who are typically sicker,” Song told Newsweek.
Private equity hospitals have also been found to experience large cuts in staffing and salaries, which may be among common strategies to generate financial returns for firms and investors, according to the study authors.
“We also found an average 18 percent reduction in ED salary expenditures after acquisition relative to control hospitals, which likely reduced the capacity and bandwidth to deliver care, and may have explained the increased mortality,” Song explained.
“In the ICUs [intensive care units], salaries were cut by 16 percent. ICU mortality did not change, but sicker ICU patients were similarly transferred to other hospitals more—notably patients who were intubated, on dialysis and who needed blood transfusions—with the remaining, healthier, ICU patients experiencing shorter ICU stays, which was also consistent with reduced staffing and bandwidth.”
Researchers compared more than 1 million emergency department visits and 121,000 ICU hospitalizations across 49 private equity hospitals from 2009 through 2019 to more than 6 million emergency department visits and 760,000 ICU hospitalizations across 293 control hospitals. The data used involved traditional Medicare claims and cost reports.
Research in 2023 revealed a 25 percent increase in preventable adverse events, including infections, in hospital inpatient wards after private equity acquisition, also likely related to staffing cuts.
“In theory, the infusion of private equity capital and management expertise into a financially struggling healthcare facility can help turn around the facility,” said Song. However, he pointed out previous research and other recent research suggests other intentions.
In a 2024 study, Song and colleagues said they they found private equity firms were more likely to buy financially healthier hospitals that are more capable of taking on the new debt while still generating revenue, despite these acquisitions often being presented as an effort to help struggling hospitals grow.
While purchasing a struggling facility for the purpose of turning it around can happen, private equity has on average targeted more financially stable hospitals, Song said.
The study team noted several limitations to their work, including private equity acquisitions not being monolithic and their sample of acquired hospitals potentially not representing other acquisitions.
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References
Kannan, S., Bruch, J. D., Zubizarreta, J. R., Stevens, J., & Song, Z. (2025). Hospital staffing and patient outcomes after private equity acquisition. Annals of Internal Medicine, 178(11). https://doi.org/10.7326/ANNALS-24-03471
