• Posted September 24, 2025

ER Deaths Increase After Hospitals Are Purchased By Private Equity Firms

WEDNESDAY, Sept. 24, 2025 (HealthDay News) — More people appear to die in emergency rooms (ER) after hospitals have been bought by private equity firms, a new study says.

About 13% more deaths occur among Medicare patients in the emergency rooms of hospitals after their acquisition by private equity, researchers estimate in the Annals of Internal Medicine.

Hospitals purchased by a private equity firm tend to cut salaries and staff following acquisition, under pressure to reduce debt and boost profits, researchers found.

These cut corners cost lives, researchers said.

“Staffing cuts are one of the common strategies used to generate financial returns for the firm and its investors,” said senior researcher Dr. Zirui Song, an associate professor of health care policy in the Blavatnik Institute at Harvard Medical School.

“Among Medicare patients, who are often older and more vulnerable, this study shows that those financial strategies may lead to potentially dangerous, even deadly consequences,” Song said in a news release.

Around 488 U.S. hospitals are owned by private equity firms, and at least 1 in 4 (28%) serve rural populations, according to the non-profit watchdog group Private Equity Stakeholder Project (PESP).

Private equity firms use funds from investors and lenders to buy health care facilities, with the acquired hospitals taking on the obligation to repay the new debt used for the purchase, researchers said in background notes.

Some of the private equity firms that own for-profit hospitals include Apollo Global Management (Lifepoint Health, ScionHealth); Equity Group Investments (Ardent Health Services); One Equity Partners (Ernest Health); GoldenTree Asset Management and Davidson Kempner (Quorum Health); Surgery Partners (Bain Capital); and Webster Equity Partners (Oceans Healthcare), according to the PESP.

For the new study, researchers used Medicare claims data from 2009 to 2019 to compare outcomes at hospitals recently purchased by private equity firms against those of other hospitals.

The data included more than 1 million ER visits and 121,000 intensive care unit hospitalizations at 49 private equity hospitals. This information was compared with nearly 6.2 million ER visits and 760,000 ICU hospitalizations at 293 other matched hospitals.

Results showed there were seven additional deaths per 10,000 visits in the ERs of hospitals recently purchased by private equity firms.

That represents a 13% increase from the rate of 52 deaths per 10,000 ER visits that the hospitals had prior to their acquisition, researchers said.

At the same time, death rates in hospitals not acquired by private equity declined from 49 deaths per 10,000 ER visits to 44 deaths per 10,000 visits, a rate that reflects national trends, researchers said.

Data also showed that private equity hospitals cut ER salaries by 18% and ICU salaries by 16% following their acquisition, compared to other hospitals.

Those cuts came alongside a nearly 12% reduction in overall staffing and nearly 17% cut in hospital-wide salaries among newly aquired private equity hospitals.

“These are places where cutting staffing often means cutting the capacity to take care of people,” Song said.

In a previous study published in the Journal of the American Medical Association, Song and colleagues found a 25% increase in preventable adverse events like infections in hospitals after private equity acquisition.

This new study also found that ER transfers increased by 4% and ICU transfers by 10% after hospitals were acquired by private equity firms. There also was a nearly 5% decrease in patients’ length of stay in the ICU.

The transferred patients tended to be sicker on average, and researchers noted their care required more staff attention as a result.

Those findings suggest that staffing cuts led to reduced capacity to care for high-risk patients, researchers said.

“Among those patients remaining in the ED, who were likely on average healthier, mortality increased,” researchers concluded.

More information

The Private Equity Stakeholder Project has more on private equity hospitals, including a list of hospitals owned by the firms.

SOURCES: Harvard Medical School, news release, Sept. 22, 2025; Annals of Internal Medicine, Sept. 22, 2025