Higher adverse-event rates; mixed mortality results
Sneha Kannan, Joseph Dov Bruch, Zirui Song. JAMA, 2023.
Compared 662,095 hospitalizations at 51 PE-acquired hospitals with 4,160,720 at 259 matched controls. Acquisition was associated with 25.4% more hospital-acquired adverse events relative to controls, equivalent to 4.6 additional events per 10,000 hospitalizations. In-hospital mortality decreased slightly; mortality by 30 days after discharge showed no differential change.
Scope: Observational Medicare claims study, 2009–2019. Changes in patient mix and transfers complicate mortality comparisons.
Lower patient experience ratings relative to controls
Anjali Bhatla, Victoria L. Bartlett, Michael Liu, ZhaoNian Zheng, Rishi K. Wadhera. JAMA, 2025.
Compared 73 PE-acquired hospitals with 293 matched controls using 2008–2019 survey data. Acquisition was associated with relative declines of 2.4 percentage points in top hospital ratings and 2.1 percentage points in willingness to recommend the hospital.
Scope: Measures patient-reported experience. This article does not measure hospital asset sales or establish that asset sales caused care changes.
Effects depend on competition
Ashvin D. Gandhi, YoungJun Song, Prabhava Upadrashta. Management Science, 2026.
Finds that PE-owned nursing homes respond more strongly to competition: consumers benefit in competitive markets but are harmed in concentrated markets. PE-owned facilities also respond more to a policy helping consumers compare quality.
Scope: Nursing-home evidence; effects vary with local market conditions. The linked publication supersedes the previously listed 2025 working-paper citation.
Improved restaurant operations
Shai Bernstein, Albert Sheen. Review of Financial Studies, 2016.
Health inspection records show cleaner, safer, better-maintained restaurants after buyouts. Improvements are stronger in chain-owned locations than franchises and when PE partners have prior industry experience.
Scope: Restaurant-chain operational outcomes. The summary does not extend the finding to every sector or ownership period.
Improved workplace safety
Jonathan Cohn, Nicole Nestoriak, Malcolm Wardlaw. Review of Financial Studies, 2021.
Finds persistent declines in workplace injury rates and fewer OSHA violations after buyouts of publicly traded U.S. firms. Larger injury-rate declines are associated with a greater probability of an IPO exit.
Scope: Results concern buyouts of publicly traded firms. The link is the coauthor’s publication page, which provides the abstract and journal link.
Sales growth; small price increases
Cesare Fracassi, Alessandro Previtero, Albert Sheen. Journal of Finance, 2022.
Acquired firms increase product retail sales 50% more than matched controls. New products and geographic expansion account for the growth; existing-product prices rise about 1%. Competitors reduce product offerings and raise prices slightly.
Scope: Consumer-product price and sales data. Sales growth is not a measure of every effect on workers or consumers.
No significant acquisition-related change in low-value care
Yashaswini Singh, Qi Lei, Meehir Dixit, Christopher M. Whaley. Medical Care Research and Review, 2026.
The Medicare study found no statistically significant change in low-value care following acquisition. Higher baseline use in PE-affiliated practices is not an estimated effect of acquisition.
Scope: Difference-in-differences analysis of primary-care acquisitions. A null result for measured low-value services does not establish that every dimension of care was unchanged.
More services and patients; workforce expansion
Yashaswini Singh, Meehir N. Dixit, Amal N. Trivedi, Christopher M. Whaley. Health Affairs, 2026.
A study of 225 primary-care acquisitions during 2016–2022 reports 30% more services billed, 11% more patients seen, and 12.9% more services per patient after acquisition. The workforce expanded, particularly advanced-practice providers.
Scope: Publisher-supplied abstract only; full publisher text was inaccessible. Utilization and staffing changes do not establish a clinical benefit; unverified spending and turnover details are omitted.
Higher quoted prices in a facility comparison
John L. Havlik, Susan Busch, Kalea Hidalgo, Kimberly Mercado, David Zhu, Samuel Jensen, Jane M. Zhu. JAMA Health Forum, 2026.
A secret-shopper study compared 127 PE-acquired residential substance-use treatment facilities with 214 other for-profit facilities. PE facilities quoted higher daily prices, with a geography-adjusted difference of $127.73 (95% CI $29.57–$225.87), and less often offered detoxification or private rooms.
Scope: Cross-sectional comparison, not an estimate of changes caused by acquisition. The study did not measure patient outcomes.
Higher submitted charges; no significant negotiated-price change
Kamyar Nasseh, Anthony T. LoSasso, Marko Vujicic, Tim Downey. Health Services Research, 2026.
After acquisition, submitted dental charges increased 3.3% (95% CI 2.3–4.4%), while negotiated allowed prices did not change significantly. Procedure mix shifted toward restorative, specialty, and surgical care.
Scope: Summary limited to the publisher-supplied abstract of a 2015–2021 difference-in-differences study. Higher submitted charges are not evidence of a measured cost transfer to every uninsured patient.
Narrower within-firm pay gaps; composition matters
Lily Fang, Jim Goldman, Alexandra Roulet. Journal of Finance, 2026.
French administrative data show narrower pay gaps after buyouts: the 90th-to-10th-percentile ratio falls 3%, the gender gap 9%, the age gap 21%, and the manager/non-manager gap 4%. Manager turnover and changes in workforce composition contribute to these differences.
Scope: Publisher abstract only. Narrower within-firm ratios do not mean every worker received a raise or that economy-wide inequality declined.
No overall increase in measured low-value cancer care
Aaron P. Mitchell et al.. Journal of the National Cancer Institute, 2026.
The study found no overall increase across five measured low-value cancer treatments in 2015–2021 Medicare data. The estimate for biologics with available biosimilars was −2.9 percentage points (95% CI −6.0 to 0.2), not a statistically significant increase.
Scope: Results vary by treatment endpoint; some estimates indicate reductions and others are inconclusive. These five measures do not capture every dimension of cancer care.
No significant change in measured hospitalization rates
Meehir N. Dixit, Alexander P. Philips, Amal N. Trivedi, Christopher Whaley, Yashaswini Singh. JAMA Health Forum, 2026.
A matched Medicare analysis compared 24,397 patients at PE-acquired primary-care practices with 121,939 controls during 2016–2022. It found no statistically significant change in all-cause or potentially preventable hospitalizations after acquisition.
Scope: Observational difference-in-differences analysis. Null findings for these hospitalization measures are not proof of no harm across all outcomes or longer follow-up.
Systematic review: worse surgical outcomes in several cohorts
Angad S. Sidhu, Nikola S. Vuckovic et al.. Journal of Hospital Medicine, 2026.
A review of eight US studies reports worse surgical outcomes in several cohorts after PE acquisition. Readmission and length-of-stay findings varied across studies.
Scope: Systematic review of observational and quasi-experimental studies, not randomized evidence or a universal pooled causal estimate. Surgical and nonsurgical findings differ, and individual estimates retain uncertainty.