Although hospitals in the U.S. acquired by private equity had a significant decline in the clinical risk of patients admitted, there was no improvement in outcomes among older adults with heart failure (HF), according to a study presented at AcademyHealth's 2025 Annual Research Meeting and simultaneously published June 9 in JACC.

Looking at 41 hospitals acquired by private equity between 2012 and 2019 in addition to 192 matched control hospitals, Daniel Y. Johnson, BA, et al., used a difference-in-differences (DiD) analysis to evaluate if clinical care and outcomes for HF patients changed with private equity acquisition.

The authors observed no change in 30-day mortality rates (DiD +0.7 percentage points) or 30-day hospital revisit rates (DiD –0.2 percentage points) when comparing acquired and nonacquired sites, despite a decline in the clinical risk of HF patients admitted to acquired facilities.

Results also showed that among HF patients at private equity-acquired facilities, there was a significant increase in cardiac catheterization rates when compared to control hospitals (DiD estimate +0.7 percentage points). "Our finding that cardiac catheterization rates increased among patients with [HF] at private equity-acquired hospitals – despite a decrease in clinical risk – may reflect an incentive to shift toward greater use of highly reimbursed procedures to maximize profits," write the authors.

"Notably, cardiac catheterization rates increased, and Black patients were significantly more likely to be transferred to another hospital following acquisition," adds JACC Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC. "These findings raise important questions about equity, care intensity, and broader implications of ownership trends in U.S. health care."