The Blubber

Medicare patients who have surgery at hospitals owned by private-equity firms are 42% more likely to die within 30 days compared to those treated at hospitals without private-equity ownership, according to new research published in the journal Health Affairs. The findings add to growing concerns that private-equity involvement in healthcare may be prioritizing profit over patient outcomes, particularly for elderly Americans.

The study comes as private-equity firms continue to expand their presence in the healthcare sector, raising alarms about the impact on quality of care.

Researchers analyzed data from 298,000 surgeries performed on Medicare beneficiaries at 701 hospitals nationwide between 2011 and 2020. Patients had a median age of 74, with 46% being male and 86% white. The study focused on four common major surgeries: appendectomies, gall bladder removals, colon resections, and hernia repairs. After adjusting for various factors such as age and underlying health conditions, researchers found a notable difference in post-surgery mortality rates.

At hospitals not owned by private equity, the 30-day risk-adjusted death rate was 6.4%. But at private-equity-owned hospitals, the rate rose to 9.1%—a 2.7 percentage point difference, or a 42% relative increase in mortality.

“That’s certainly been the case in our study, and other studies have also found that,” said Dr. Adrian Diaz, a surgical oncology fellow at the University of Chicago and the study’s lead author. “When you compare private equity and non-private equity, it does seem that outcomes do get a little bit worse, at least in the short term.”

Although the increase in deaths may seem modest in absolute terms, the relative rise is significant. Diaz noted that the elevated mortality risk was largely concentrated among patients undergoing emergency surgeries, suggesting cost-cutting in emergency departments might be a contributing factor. For elective surgeries, the difference in outcomes was smaller.

This isn’t the first study to link private-equity ownership with worse patient outcomes. Two separate studies published in the Journal of the American Medical Association (JAMA) in the past 18 months reported similar findings.

One JAMA study examined nearly 5 million hospitalizations at over 300 facilities and found that Medicare patients in private-equity-owned hospitals were 25% more likely to suffer hospital-acquired conditions, such as falls and bloodstream infections—despite being, on average, healthier than other patients in the study.

Another study found that patients at private-equity-owned hospitals reported poorer care and less responsive staff.

Concerns about private equity in healthcare aren’t new. Prior research has shown that nursing homes owned by private-equity firms had higher mortality rates than those not under private-equity control—an early signal of the risks posed when financial firms prioritize cost-cutting in care environments.