A study published June 9 in the Journal of the American College of Cardiology evaluated 30-day outcomes for patients treated at hospitals acquired by private equity firms.
Here are five key findings:
1. The study analyzed more than 35,000 heart failure hospitalizations at private equity-acquired hospitals and over 178,000 at matched control hospitals between 2012 and 2019. Researchers examined changes in clinical outcomes, the case mix of admissions and transfers, and cardiac procedure utilization among Medicare fee-for-service beneficiaries aged 65 and older with heart failure.
2. The researchers found no significant difference in 30-day mortality or rehospitalization rates for heart failure patients treated at private equity-acquired hospitals compared with control hospitals.
3. Rates of right heart catheterization doubled at private equity-acquired hospitals, rising from 0.6% to 1.2%. This trend was not observed in left heart catheterizations.
4. Van Walraven-Elixhauser scores — a metric used to measure a patient’s total disease burden — were lower at private equity-acquired hospitals, suggesting those patients had fewer clinical risks.
“One might expect outcomes (eg, mortality, revisits) to improve at PE-acquired hospitals, given the decrease in the clinical risk scores of patients with heart failure at these sites when compared with control hospitals,” the authors wrote. “However, we observed no changes in 30-day mortality or hospital revisit rates after PE acquisition. In addition, our finding that cardiac catheterization rates increased among patients with heart failure at PE-acquired hospitals—despite a decrease in clinical risk—may reflect an incentive to shift toward greater use of highly reimbursed procedures to maximize profits. These findings build upon prior studies, which have shown an increase in hospital adverse events and decrease in patient care experience at PE-acquired hospitals.”
5. The study also found that Black patients were significantly more likely to be transferred to another facility at private equity-acquired hospitals than at control hospitals.
“Although it is possible that this shift reflects an attempt to ensure that some patients receive appropriate care (eg, transferring higher-acuity patients to a tertiary care facility), we did not observe similar changes across other racial groups,” the authors wrote. “More concerning is the possibility that this shift in transfer patterns reflects implicit or explicit bias, potentially because Black adults tend to have lower incomes and are more likely to be insured by Medicaid, a pattern that has also been observed in one prior study that evaluated heart failure admissions to specialized cardiology services.”
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