Private equity hospital acquisitions in the United States worsen the quality of care for patients with asthma, COPD, or pneumonia. After being acquired by private equity, 30-day hospital revisits increased for patients with asthma and COPD, and in-hospital deaths increased among patients with pneumonia, a new study reports.
Private equity firms are rapidly acquiring US hospitals. Their incentive to generate short-term profits appears to compromise the quality of care patients receive, especially those who have chronic conditions, including many pulmonary diseases.
To learn more about the poorly understood impact of private equity hospital acquisitions on the clinical outcomes of patients with common pulmonary conditions, the researchers investigated outcomes at 41 private equity hospitals. They compared those outcomes to those at 192 matched control hospitals between 2010 and 2019.
Medicare Claims Data
They focused on Medicare fee-for-service claims data from beneficiaries aged 65 and older who had at least one hospital encounter: an emergency department visit, an observation stay, or an inpatient admission for asthma, COPD, or pneumonia.
The researchers analyzed 14,463 asthma encounters, 146,904 COPD encounters, and 194,993 pneumonia encounters in private-equity-held and matched control hospitals. They examined changes in clinical outcomes during the 3 years before and after acquisition. For clinical outcomes, the models adjusted for patient age, sex, race and ethnicity, clinical risk score, and dual eligibility status. The models also incorporated year fixed effects and hospital random effects and assessed parallel trends for each outcome.
They used multivariable linear regression models that included binary indicators for exposure (acquisition vs no acquisition; pre- vs post-acquisition), and an interaction term between these indicators (difference-in-differences estimate).
Following the private equity acquisition, no changes in patient age, sex, clinical risk scores, or dual-eligibility status were observed across all three diseases at private equity hospitals compared to control hospitals.
- Among patients who had a hospital encounter for asthma, 30-day hospital revisits increased at private equity hospitals vs control hospitals (difference-in-differences, +8.3 percentage points [95% CI, 4.0-12.7]), but in-hospital or 30-day mortality did not change.
- Patients with an encounter for COPD at private equity hospitals experienced an increase in 30-day hospital revisits vs patients at control hospitals (difference-in-differences, +0.9 percentage points [95% CI, 0.1-1.6]).
- Patients with pneumonia had higher in-hospital mortality at private equity hospitals than at control hospitals (difference-in-differences, +0.7 percentage points [95% CI, 0.2-1.2]), with no change in 30-day mortality or 30-day revisits.
“Our findings of worse outcomes among patients with pulmonary conditions following private equity acquisition of hospitals have critical policy and clinical implications. Given the increasing privatization of healthcare in the US, policymakers should consider stronger regulation of acquisitions,” the researchers advise in their abstract.
Reference
Mein S, Zheng Z, Duan K, et al. Clinical Outcomes for Pulmonary Conditions Worsened After Private Equity Acquisition of US Hospitals: A Difference-In-Differences Analysis. Presented at: CHEST 2025, October 19-22, 2025; Chicago.
