(HealthDay News) — After private equity acquisition of U.S. hospitals, global measures of patient care experience worsened, according to a study published online Jan. 9 in the Journal of the American Medical Association.
Anjali Bhatla, M.D., from the Beth Israel Deaconess Medical Center in Boston, and colleagues examined whether the acquisition of hospitals by private equity firms was associated with changes in measures of patient-reported experience. Seventy-three U.S. hospitals newly acquired by private equity firms and 293 matched control U.S. hospitals were identified in the study from 2008 through 2019. Changes in patient experience measures three years before to three years after private acquisition were assessed.
The researchers found that during the post-acquisition period versus the pre-acquisition period, the percentage of patients rating hospitals as a 9 or 10 decreased at private equity hospitals (65.0 to 65.2 percent) compared with control hospitals (66.2 to 69.2 percent), with a difference-in-differences estimate of −2.4 percentage points. At private equity-acquired versus control hospitals, the percentage of patients who would definitely recommend the hospital also decreased (66.9 to 65.5 percent versus 68.2 to 69.3 percent; difference-in-differences estimate of −2.1 percentage points). The difference between private equity-acquired and control hospitals in these global measures increased over time and was largest in year 3 after acquisition (−5.2 percentage points and −4.4 percentage points, respectively).
“Improving patient-centered care is a major policy priority, and these findings raise concerns about the implications of private equity acquisitions on patient care experience at U.S. hospitals,” the authors write.
One author disclosed ties to Abbott Vascular and Chambercardio.
How does private equity acquisition affect hospitals?
The impact of private equity (PE) acquisition of hospitals on patient care is a complex and often debated topic. Studies show a mixed bag of results, with some suggesting potential benefits and others highlighting significant concerns.
Potential Benefits
- Improved Efficiency and Management: PE firms often bring in experienced management teams and implement cost-cutting measures that can streamline operations and improve the hospital’s financial health. This could potentially lead to better resource allocation and improved patient care.
- Access to Capital: PE investment can provide hospitals with much-needed capital for infrastructure upgrades, new technology, and expansion of services, potentially benefiting patients with enhanced facilities and treatment options.
Concerns and Negative Impacts
- Profit Maximization: PE firms prioritize profit generation for their investors. This focus on profitability can lead to cost-cutting measures that negatively affect patient care, such as:
- Reduced staffing levels: Lower nurse-to-patient ratios can compromise the quality of care and lead to adverse patient outcomes.
- Service cuts: Closure of essential departments or reduction in specialized services can limit patient access to care.
- Increased Costs: Studies have shown that PE-owned hospitals tend to charge higher prices for services, increasing the financial burden on patients.
- Focus on Short-Term Gains: PE firms typically have a shorter investment horizon compared to traditional hospital ownership. This can lead to a focus on quick profits rather than long-term investments in quality improvement and patient-centered care.
- Debt Accumulation: PE acquisitions often involve significant debt financing, which can strain the hospital’s finances and limit its ability to reinvest in patient care initiatives.
- Potential for Market Consolidation: PE acquisitions can lead to hospital consolidation, reducing competition and potentially increasing healthcare costs for patients.
Studies and Evidence
Research on the impact of PE acquisitions on hospitals yields mixed results:
- Some studies suggest that PE ownership can lead to improved efficiency and financial performance.
- Others indicate a decline in quality of care, increased costs, and reduced access to services.
- A 2023 study in JAMA Health Forum found that PE acquisitions of physician practices were associated with a small but significant increase in patient mortality.
The impact of private equity acquisition of hospitals on patient care is multifaceted and requires careful consideration. While PE investment can bring potential benefits like improved efficiency and access to capital, there are significant concerns about profit maximization, cost-cutting measures, and the potential for negative impacts on patient care. Further research is needed to fully understand the long-term consequences of this trend.
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