Understanding private equity-owned HHAs in the U.S.: A performance comparison between pe-owned and non-pe-owned agencies

IF 3.6 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health Policy Pub Date : 2025-01-22 DOI:10.1016/j.healthpol.2025.105250

Mohammad Ishtiaque Rahman

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引用次数: 0

Abstract

Background

Private equity (PE) ownership in the healthcare sector has increased, raising concerns about its impact on care quality and patient outcomes. In the U.S., private equity-owned home health agencies (HHAs) make up a growing share of the market. This study aims to compare the performance of PE-owned HHAs with non-PE-owned agencies across several quality measures.

Objective

To assess the impact of PE ownership on care quality, patient outcomes, and operational efficiency in HHAs by comparing PE-owned and non-PE-owned agencies using data from Medicare-certified HHAs.

Methods

The study utilized data from the Centers for Medicare & Medicaid Services (CMS) Home Health Compare dataset, spanning 2017 to 2023. Fourteen quality and outcome measures were analyzed. Non-parametric tests, including the Mann-Whitney U test and Cliff's Delta, were used to identify significant differences between PE-owned and non-PE-owned HHAs.

Results

PE-owned HHAs generally outperformed non-PE-owned agencies in metrics such as timely care initiation and patient improvement in mobility and self-care. However, they underperformed in areas related to long-term outcomes, such as timely physician-recommended medication actions, preventable readmission rates, and discharge to the community.

Conclusions

PE-owned HHAs demonstrate greater efficiency and improvement in certain areas of patient care, but underperformance in critical long-term care outcomes raises concerns about the sustainability of care quality. Policymakers must carefully monitor the influence of PE ownership to ensure that improvements do not come at the expense of patient well-being.

查看原文本刊更多论文

了解美国私募股权拥有的医疗保健机构：私募股权拥有的机构与非私募股权拥有的机构之间的绩效比较。

背景：医疗保健行业的私募股权（PE）所有权有所增加，引发了人们对其对护理质量和患者预后影响的担忧。在美国，私人股本拥有的家庭健康机构（HHAs）占据了越来越大的市场份额。本研究旨在比较pe拥有的hha与非pe拥有的hha在几个质量指标上的表现。目的：利用医疗保险认证的HHAs的数据，通过比较PE拥有和非PE拥有的机构，评估PE所有权对HHAs护理质量、患者预后和运营效率的影响。方法：该研究利用了2017年至2023年医疗保险和医疗补助服务中心（CMS）家庭健康比较数据集的数据。分析了14项质量和结果指标。非参数检验，包括Mann-Whitney U检验和Cliff’s Delta检验，用于识别pe拥有和非pe拥有的hha之间的显著差异。结果：pe拥有的HHAs通常优于非pe拥有的机构在指标，如及时护理启动和患者的流动性和自我保健的改善。然而，他们在与长期结果相关的领域表现不佳，例如及时的医生推荐的药物行动，可预防的再入院率和出院到社区。结论：pe拥有的HHAs在患者护理的某些领域表现出更高的效率和改善，但在关键的长期护理结果中表现不佳，引起了对护理质量可持续性的关注。政策制定者必须仔细监控私人股本所有权的影响，以确保改善不会以牺牲患者福祉为代价。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.