Drop in Hospital Salaries, Staffing Reported After Private Equity Acquisitions
FRIDAY, Sept. 26, 2025 -- U.S. hospitals that undergo private equity acquisition may reduce salaries and staffing after acquisition, especially in emergency departments (EDs) and intensive care units (ICUs), according to a study published online Sept. 23 in the Annals of Internal Medicine.
Sneha Kannan, M.D., from the University of Pittsburgh, and colleagues examined hospital staffing and patient outcomes in EDs and ICUs before and after hospitals were acquired by private equity in a matched difference-in-differences analysis. The comparison included 1,007,529 ED visits and 121,080 ICU hospitalizations across 49 private equity hospitals and 6,179,854 ED visits and 760,377 ICU hospitalizations across 293 matched control hospitals.
The researchers found that private equity hospitals reduced ED and ICU salary expenditures by 18.2 and 15.9 percent per inpatient bed day after acquisition, respectively, relative to control hospitals. In addition, average hospital-wide reductions of 11.6 and 16.6 percent were seen in full-time employees and salary expenditures, respectively, relative to controls. After acquisition, there were 7.0 additional deaths per 10,000 visits among beneficiaries in EDs of private equity hospitals relative to controls, while no difference was seen in ICU mortality. Relative to controls, after acquisition, patients in private equity EDs and ICUs experienced a 4.2 and 10.6 percent increase in transfers, respectively, to other acute care hospitals. ICU length of stay was shortened by 0.2 days on average.
"Staffing cuts are one of the common strategies used to generate financial returns for the firm and its investors,” senior author Zirui Song, M.D., Ph.D., from Harvard Medical School and Massachusetts General Hospital in Boston, said in a statement. “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."
Several authors disclosed ties to relevant organizations.
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