A new study published by Harvard detailing higher patient mortality in private equity (PE) owned hospitals could cause public confidence in the institutions to flatline. (1)
Private equity–owned hospitals are medical facilities purchased by investment firms that use borrowed money to acquire, streamline and resell companies for profit — often within just a few years. In health care, that means hospitals once run by nonprofit boards or health systems are increasingly owned by financial entities seeking to maximize returns rather than improve patient outcomes.
That’s because the study — a joint effort by researchers at Harvard Medical School and the Universities of Chicago and Pittsburgh — found that “Medicare beneficiaries in the emergency departments of private equity hospitals experienced seven additional deaths per 10,000 visits” compared to non-PE hospitals.
The study added that this increase represents a 13.4% jump from the baseline mortality rate of 52.4 deaths per 10,000 visits. (2)
The research also found that ICU times decreased and patient transfers to other hospitals increased in PE facilities — all of which the study largely attributes to cuts in staff and salaries at the institutions.
“Staffing cuts are one of the common strategies used to generate financial returns for the firm and its investors,” Dr. Zirui Song, one of the study’s lead researchers and an associate professor of health care policy at Harvard Medical School, said on the school’s website. “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.”
This research, however, is only the latest in a series of studies that warn about the life-threatening failings of PE hospitals.
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The increased risks associated with PE hospitals
Last year, the Harvard T.H. Chan School of Public Health reported on the growth of PE investment in medical facilities, finding that they make up 22% of all for-profit hospitals and employed 5,779 doctors (as of 2021) — a number that jumped from 816 less than a decade earlier. (3) Yet numerous studies have raised the alarm about the level of care at PE hospitals.
For example, 2023 research also led by Dr. Song found that PE hospitals showed increased rates of “hospital-acquired adverse events” that include “falls and central line-associated bloodstream infections” as well as surgical site infections. (4) Follow-up research a year later focussed on PE hospitals purchased between 2005 and 2018 confirmed the findings, adding that PE hospitals saw a 25.4% increase in hospital-acquired events. (5)
Meanwhile, a joint American-Canadian 2002 study comparing for-profit hospitals in general with private hospitals in the U.S. between 1982 and 1995 found a 2% increase in deaths — or 14,000 more per year — in for-profit facilities. (6) And a Stamford Law Review article from last year warned that “The drive for quick revenue generation [at PE hospitals] threatens to increase costs, lower health care quality, and contribute to physician burnout and moral distress.” (7)
And the danger doesn’t stop at hospitals. A 2021 study showed that PE-owned nursing homes experienced an 11% increase in 90-day mortality rates over non-PE-owned facilities. (8)
“It’s for-profit business in its most aggressive form,” Harvard T.H. Chan School of Public Health professor John McDonough said of PE-owned hospitals. (9) He added that they, “seek returns on their investment as high as possible as quickly as possible, then rush to sell off that investment and go on to their next conquest.”
Steward Health Care, described by CBS News as “the nation’s largest for-profit hospital chain,” is a prime example of this. The chain filed for bankruptcy in 2024 and a CBS investigation found that by purchasing medical properties and then “forc[ing] the hospitals into costly lease-back arrangements” after selling the real estate, Steward’s PE investors raked in millions “while health care workers and patients struggled to get the life-saving supplies they needed.” (10)
Similarly, two Pennsylvania-based PE hospital chains filed for bankruptcy earlier this year. One of the PE owners, Prospect Medical Holdings, which ran Crozer Health System hospitals, “pillaged these hospitals for their own gain” according to Gov. Josh Shapiro. (11) He added that “their greed and mismanagement” resulted in the “closure and loss of critical health care services for the people of Delaware County.”
All of which explains why a bipartisan Senate committee set out to investigate “the harmful effects of private equity on the U.S. health care system.” (12) Sen. Sheldon Whitehouse, who co-led the investigation, told CBS that “Private equity has infected our health care system,” and that “these financial entities are putting their own profits over patients, leading to health and safety violations, chronic understaffing, and hospital closures.” (13)
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How to protect yourself during a hospital stay
If you’re concerned about the care you might receive in a PE facility, it’s important to prepare as much as possible ahead of time.
Many experts recommend bringing a family member or trusted friend to serve as a second pair of eyes and ears, ask questions, take notes and speak up on your behalf. In addition, keeping detailed records of your own medical history and individual doctor/hospital visits can help ensure that any concerns or important information regarding your health aren’t overlooked.
Others advise advocating for yourself during hospital visits, including asking questions when things are unclear and voicing concerns if they arise. It’s also important, they say, to know your rights as a patient.
Having someone on your side to advocate for you helps, too. A family member or friend can help monitor care, ask questions and take notes when staff are stretched thin.
If you do go in for surgery, the University of Rochester Medical Center says to speak with your surgeon so that you know exactly what the procedure entails, ask your nurse to outline the effects — and side effects — of any medications you’re given and be present and involved when details of your treatment or procedure are being discussed.
And, they add, perhaps most importantly, make sure you and your doctor have gone over everything about the procedure, and that you are fully informed and comfortable, before signing off on it.
As lawmakers investigate and health experts sound the alarm, patients can take small but meaningful steps to protect themselves: stay informed, ask questions, and never be afraid to demand clarity or compassion. In a system that’s driven by profit, your vigilance might be the most powerful safeguard of all.
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Article sources
We rely only on vetted sources and credible third-party reporting. For details, see our editorial ethics and guidelines.
Harvard Medical School (1); ACP (2); Harvard T. H. Chan School of Public Health (3), (9); JAMA (4), (5); PubMed Central (6); Stanford Law Review (7); NBER (8); CBS News (10), (13); Pensylvania Capital Star (11); Senate Budget Committee (12); University of Rochester Medical Center (13)
This article provides information only and should not be construed as advice. It is provided without warranty of any kind.