New interactive tool tracks private equity investments in healthcare across U.S.

PROVIDENCE, R.I. [Brown University] - A new interactive tool launched on Tuesday, Sept. 8, offers policymakers, researchers, journalists and the public a state-by-state look at private equity investments in U.S. healthcare.

Created by researchers at Brown University's Center for Advancing Health Policy through Research, the Private Equity State Tracker maps the growth of more than 6,000 private equity investments in healthcare across all 50 states from 2015 to 2023, including acquisitions of physician practices and hospitals.

Yashaswini Singh, an assistant professor of health services, policy and practice at Brown who helped develop the tracker, said the tool fills a crucial need: Private equity deals are generally not disclosed due to the private nature of the transactions and a lack of regulatory oversight, and researchers and policymakers often rely on commercial databases and extensive manual research to piece together where investments are occurring.

"Our goal for the tracker is to move the conversation from ideological debate about whether private equity is good or bad toward evidence-based policymaking that addresses healthcare corporatization as a whole," Singh said. "If you only look at private equity in isolation, you miss that bigger picture, and you risk regulating one channel of corporatization while the other expands to fill the gap."

Users can explore private equity transactions by state, county and ZIP code and see how that activity has changed over time. Users can also examine investments within physician specialties, such as primary care, orthopedics or oncology, as a way to understand private equity's presence within physician markets.

For example, the tracker shows that states where more doctors work for hospitals tend to have less private equity involvements, and states where fewer doctors work for hospitals tend to have more. In Indiana, the majority of oncologists are employed by hospitals and health systems, so private equity firms have fewer opportunities to roll up independent doctors, Singh said. In contrast, fewer than half of all oncologists in Texas are affiliated with hospitals, and private equity-backed entities have successfully employed one-third of independent doctors.

The tracker was designed with policymakers in mind but is free and open to researchers, journalists and the public. The tracker's underlying data are also available for download.

The team at Brown developed the project with support from the Commonwealth Fund and in collaboration with the National Academy for State Health Policy. The researchers say the tracker may not capture every private equity investment in U.S. healthcare, but it provides a starting point for identifying broader patterns and trends in where and how private equity firms are investing.

Singh and colleagues at the Center for Advancing Health Policy through Research believe that by making more information available about the rapid growth of private equity investments in health care, the tool will help policymakers and the public better understand what is happening in their own states as they consider policies addressing healthcare ownership and consolidation.

"This year I testified before half a dozen state legislatures debating policies to address healthcare corporatization," Singh said. "One thing that was remarkably consistent across all of them was that lawmakers and the public were genuinely surprised by how much private equity was already active in their state's health care system. That reaction, over and over, is what convinced me this tracker needed to exist."