11/14/2025
https://www.theregreview.org/2025/11/08/seminar-when-wall-street-owns-the-hospital/
“Private equity’s health care footprint has expanded dramatically. As of 2023, private equity firms owned or operated approximately 11 percent of U.S. hospitals and 30 percent of for-profit hospitals. These firms also control significant portions of emergency physician staffing companies, anesthesiology practices, and specialty care facilities.
“Existing regulatory framework on health care—designed for traditional nonprofit and community hospitals—lacks the tools to address private equity’s extraction strategies. The Affordable Care Act, Medicare conditions of participation (federal requirements that hospitals must meet to receive Medicare and Medicaid reimbursements), and state licensure requirements focus primarily on quality metrics and operational standards rather than ownership structures or financial engineering practices that can undermine patient care.
“Recent state efforts signal growing recognition of this regulatory gap. Massachusetts enacted groundbreaking legislation in 2025 requiring enhanced scrutiny of private equity health care transactions, including 60-day advance notice, disclosure of debt levels and management fees, and ongoing reporting of quality metrics. Similarly, Massachusetts Senator Edward Markey has proposed federal legislation that would increase transparency requirements and limit certain extraction practices.”
Private equity exploits regulatory gaps to extract billions from healthcare while patients suffer.