Private Equity Hospital Acquisitions Tied to Higher ED Deaths

A study published in Annals of Internal Medicine analyzed Medicare claims from 2009–2019 across 49 hospitals acquired by private equity firms and 293 matched control hospitals and found a 13.4% increase in emergency-department mortality after acquisition (about seven additional deaths per 10,000 ED visits). The researchers documented substantial cost-cutting after acquisition — an average 11.6% reduction in full-time employees and a 16.6% drop in salary expenditures hospital-wide, with ED salary spending down roughly 18% and ICU salary spending down roughly 16%. ICU mortality did not change significantly, but transfers to other acute-care hospitals increased (ED transfers +4.2%, ICU transfers about +10%) and ICU length-of-stay fell, suggesting capacity or acuity-shifting after acquisition. The authors conclude these staffing and spending reductions plausibly help explain the rise in ED deaths. The findings reinforce prior peer-reviewed evidence, including a 2023 JAMA study, and raise policy concerns as private equity expands in hospitals.