Three Facts about Private Equity in the U.S. Hospital Sector

With Mark Naslund, Sungil Kim, Ambar La Forgia, Ryan McDevitt, Xingzhi Wang, and Kelly Kaili Yang
Published in Health Affairs Scholar, 2026
Open access article available here. BibTeX citation available here. Data for this paper available here.

Abstract: Private equity (PE) ownership of U.S. hospitals has grown over the past twenty-five years, attracting substantial academic and policy attention. Despite this interest, fragmented and incomplete transaction data have made it difficult to establish basic facts critical to an informed debate about PE’s effects on hospitals, patients, and payers. Using a harmonized, publicly available PE acquisition dataset, supplemented with verified exit transactions, we identify PE ownership spells for all short-term acute care hospitals from 2000 to 2024. We identify three key facts: (1) PE ownership has never exceeded 7 percent of short-term acute care hospitals and was below 4 percent in 2024, (2) most PE firms exit within five years, typically through a sale to another PE firm or strategic acquirer, with bankruptcy and closure representing a small share, and (3) most Americans live in hospital referral regions that have no PE-owned hospitals. These findings indicate that PE ownership continues to represent a small share of hospitals.