PRIVATE equity hospitals were associated with worse clinical outcomes for older adults hospitalized with pulmonary conditions, according to a difference-in-differences analysis of Medicare fee-for-service claims.
The analysis evaluated 41 private equity hospitals and 192 matched control hospitals from 2010–2019, focusing on Medicare beneficiaries aged 65 years or older who had at least one hospital encounter for asthma, chronic obstructive pulmonary disease (COPD), or pneumonia. Outcomes included patient characteristics, in-hospital mortality, 30-day mortality, and 30-day hospital revisit rates.
Asthma and COPD Revisit Rates Increased
Across 14,463 asthma encounters, 146,904 COPD encounters, and 194,993 pneumonia encounters, private equity acquisition was not associated with changes in patient age, sex, clinical risk score, or dual-eligibility status compared with control hospitals. This suggests that shifts in outcomes were not explained by measurable changes in baseline patient mix.
Among patients with asthma, 30-day hospital revisits increased at private equity hospitals compared with matched controls, with a difference-in-differences estimate of 8.3 percentage points (95% CI, 4.0–12.7). No corresponding change was observed in in-hospital mortality or 30-day mortality for asthma.
A smaller but statistically significant increase in 30-day hospital revisits was also seen among patients with COPD. Private equity hospitals had a 0.9 percentage point relative increase in revisits compared with control hospitals (95% CI, 0.1–1.6), pointing to a potential decline in continuity, discharge planning, or post-acute support for patients with chronic respiratory disease.
Pneumonia Mortality Signal Raises Concern
For pneumonia, private equity acquisition was associated with increased in-hospital mortality. The difference-in-differences estimate was 0.7 percentage points higher at private equity hospitals than at control hospitals (95% CI, 0.2–1.2). No significant changes were reported for 30-day mortality or hospital revisits in this group.
The findings suggest that private equity hospitals may experience measurable declines in care quality for pulmonary conditions after acquisition. With hospital privatization continuing to expand, the data support calls for closer scrutiny of acquisition models and stronger oversight focused on patient outcomes.
Reference
Mein S et al. Clinical Outcomes for Pulmonary Conditions Worsened After Private Equity Acquisition of US Hospitals: A Difference-In-Differences Analysis. ATS International Conference, May 15-20, 2026.
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