Hospital Complications Rise After Private Equity Buyout — Medicare data point to additional reason for concern

Right and left seem to agree about private equity's dubious role in healthcare, and now the feds are chiming in.

From the right, "Private Medicine Trumps Private Equity" says it all. (Association of American Physicians & Surgeons)

The Left's UC Berkeley School of Public Health stated in a 2021 white paper:

Private equity companies seek to consolidate health care providers and companies not, primarily, to deliver higher quality healthcare more efficiently, but to engage in financial arbitrage and to gather leverage that can be used to bargain against suppliers, payors, and patients.
https://publichealth.berkeley.edu/wp-content/uploads/2021/05/Private-Equity-I-Healthcare-Report-FINAL.pdf

And last week, MedPage Today reported the CMS quality measurement differences between private-equity hospitals and the others.

CMS quality metrics are not the be-all and end-all. They're limited in many ways, especially being a rather short list of what can go wrong in healthcare. And of course, the study of CMS data may be flawed.

Still, it's a reason for a close look at personal health shopping and policies governing private equity practices.

https://www.medpagetoday.com/publichealthpolicy/practicemanagement/108014

Hospital Complications Rise After Private Equity Buyout
— Medicare data point to additional reason for concern
by Crystal Phend, Contributing Editor, MedPage Today December 26, 2023

After private equity acquisition, medical centers had an increase in hospital-acquired adverse events, despite a shift to a lower-risk case mix, a study of Medicare data showed.

Admission at a private equity hospital was associated with a 25.4% greater risk of hospital-acquired conditions compared with treatment at a non-private equity hospital, an absolute difference of 4.6 such conditions per 10,000 hospitalizations (P=0.004), Zirui Song, MD, PhD, of Harvard Medical School in Boston, and colleagues reported in JAMAopens in a new tab or window.

Driving the difference were more falls and central line-associated bloodstream infections along with a doubling in surgical site infections, despite fewer central lines placed and a younger and less dually (Medicare/Medicaid) eligible population compared with the controls.

The findings together "suggested poorer quality of inpatient care," wrote the researchers, and "heighten concerns about the implications of private equity on healthcare delivery."

Soaring rates of private equity buyouts of both physician practicesopens in a new tab or window and hospitals have drawn federal scrutinyopens in a new tab or window. The Federal Trade Commission recently sued one medical group and its private equity backersopens in a new tab or window, alleging anticompetitive practices that drove up healthcare costs.

The study from Song and colleagues utilized data from 100% Medicare Part A claims for hospital stays between 2009 and 2019 to compare 662,095 hospitalizations at 51 private equity-acquired hospitals against 4.2 million hospitalizations at 259 hospitals that were not acquired by private equity, matched by year, ownership types, teaching status, and U.S. Census region with "nearest neighbor matching" for total number of beds. The difference-in-differences were analyzed for events from 3 years before to 3 years after private equity acquisition.

Hospital-acquired conditions, considered preventable based on Centers for Medicare & Medicaid Services guidelines, included: foreign object retained after a surgery, air embolism, blood incompatibility, stage 3 or 4 pressure ulcers, falls and trauma, catheter-associated urinary tract infections, central line-associated infection, surgical site infections from coronary artery bypass grafting or bariatric surgery or certain orthopedic procedures, diabetic ketoacidosis or hypoglycemic coma, and deep vein thrombosis or pulmonary embolism after total knee and hip replacement procedures.

Results showed that private equity acquisition was associated with 27.3% more falls, an additional 1.9 falls per 10,000 hospitalizations (P=0.02); and 37.7% more central line-associated infections, an extra 1.5 per 10,000 hospitalizations (P=0.04). That occurred against a backdrop of placing 16.2% fewer central lines than non-private equity hospitals (37.1 per 10,000 hospitalizations).