Patient Care Experience Declines After Private Equity Hospital Acquisitions 

Patient care experience declined following private equity acquisition of US hospitals, according to a study published in JAMA.1Private equity acquisition has increased over the past decade in the US, attracting widespread scrutiny due to concerns that private equity firms’ financial incentives could have adverse implications for patient care.2 Evidence on quality and outcomes post-acquisition has been inconsistent; some studies have linked private equity acquisitions to lower mortality rates, while others have reported an increase in adverse events.1However, little is known about whether patient care experience has changed post-acquisition; poor patient experiences are associated with greater health care use, slower recovery from illness, and nonadherence to treatment regimens. Given these gaps in knowledge, the researchers sought to evaluate whether the acquisition of hospitals by private equity firms is associated with changes in patient-reported experience.Private equity hospital acquisitions in the US were associated with declines in patient care experience, particularly in overall hospital ratings, willingness to recommend, and staff responsiveness. | Image Credit: Spiroview Inc. – stock.adobe.comThey identified hospitals acquired by private equity firms through mergers and acquisitions data from Irving Levin Associates and Pitchbook, which they manually verified through news releases, hospital websites, and other online sources. Eligible private equity acquisitions occurred between 2008 and 2019; the researchers aimed to avoid overlap with the onset of the COVID-19 pandemic. Data from the American Hospital Association annual survey and CMS Impact Files were used to obtain hospital characteristics.Additionally, the researchers used the CMS Hospital Compare files to determine patient care experience measure scores for each hospital based on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results; HCAHPS is a 29-question survey that asks recently discharged patients about their care experiences during hospitalization. Over 2.5 million surveys are completed annually, with more than 7500 patients completing it daily.The primary outcomes were 2 global measures of patient care experience from HCAHPS: patients’ overall hospital rating and willingness to recommend the hospital. Respondents rated the hospitals on a scale of 1 to 10, with 10 being the best, and their recommendation options ranged from “definitely no,” to “definitely yes.”The researchers determined the percentage of patients reporting the top-box response for each measure. For the overall hospital rating, this was considered a response of 9 or 10, and for patients’ willingness to recommend the hospital, it was “definitely yes.”The secondary outcomes included 7 other HCAHPS measures, which focused on clinical processes (staff responsiveness and discharge information), communication (communication with nurses, doctors, and about medicati