Private equity hospitals admit healthier patients, perform more procedures, transfer Black patients.
Private equity firms have been buying up hospitals around the country, and new research shows those changes may be affecting the kind of care patients get, especially those with heart failure. In hospitals taken over by private equity, doctors are seeing patients who are less sick on paper but are performing more procedures and moving some patients to other hospitals more often. In particular, the number of Black patients being transferred elsewhere after admission has gone up in these hospitals, raising flags about how decisions are being made and who is being treated where.
The study looked at heart failure hospitalizations before and after hospitals were bought by private equity and compared them to hospitals that didn’t go through these kinds of ownership changes. The number of deaths and repeat visits didn’t change much between the two groups, but patients at the private equity-owned hospitals showed lower risk scores. That means the patients who were admitted were healthier overall, yet there was no matching improvement in how well they did. This raises the question of whether these hospitals are choosing to admit people who are easier and cheaper to treat.
Heart failure is known to be a tough and expensive condition for hospitals. Patients are usually older and have other medical problems. They often stay in the hospital longer and come back more often after discharge. That’s why some doctors believe these hospitals may be turning away the more complex cases in favor of patients who cost less to care for but can still be billed at profitable rates, especially when certain procedures are added.
One of those procedures is cardiac catheterization. It’s not normally done in most heart failure cases unless there’s another pressing reason. In the hospitals owned by private equity, use of this procedure went up, while nothing changed at the hospitals used for comparison. This shift could suggest that doctors are being nudged—directly or indirectly—toward doing procedures that bring in more money even when they might not be needed.
Another troubling detail from the research is the increase in Black patients being sent out to other hospitals. While the overall number of patients transferred didn’t rise much, the number of Black patients moved to other hospitals did go up. Since these patients are more likely to be on Medicaid, which pays less than private insurance, it raises concerns about whether money is playing too big a role in deciding who gets care and who doesn’t.
The study didn’t track exactly why all of this is happening, and it’s possible that some of the choices being made are medically sound. But the patterns found in the data don’t show up in hospitals that weren’t bought by private equity. That difference points toward a change in how decisions are being made once profit-focused companies take over. The worry is that decisions that should be based on what’s best for the patient may be increasingly influenced by what brings in more money or what costs less.
Doctors and policy experts are speaking up about what they see as a trend. This isn’t the first study to suggest that private equity ownership changes how care is delivered. Other reports have linked these takeovers to more hospital errors and worse patient satisfaction. With this new evidence around heart failure, there’s growing pressure to look more closely at how these ownership deals affect the people who rely on hospitals to care for them.
Questions are now being raised about how closely these deals should be watched and whether rules need to be changed so the government can track what kinds of hospitals are being bought and what happens to patients afterward. For now, the data continue to build, and the message is becoming harder to ignore: when private equity steps in, patient care might not stay the same.
Sources:
Private Equity-Backed Hospitals Appear to ‘Cherry-Pick’ HF Patients
Heart Failure Care and Outcomes After Private Equity Acquisition of U.S. Hospitals
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