Private equity investment in long-term care: The case of Ireland

IF 3.6 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health Policy Pub Date : 2025-06-14 DOI:10.1016/j.healthpol.2025.105378

Nicholas O’Neill , Julien Mercille

{"title":"Private equity investment in long-term care: The case of Ireland","authors":"Nicholas O’Neill , Julien Mercille","doi":"10.1016/j.healthpol.2025.105378","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Private equity (PE) firms are key actors in the financialisation of health care systems. Yet, research rarely focuses directly on these firms and related private for-profit actors involved in financialisation. Moreover, existing work mostly concerns the United States, while several key health care sectors remain under-researched.</div></div><div><h3>Objective</h3><div>This study examines the factors driving PE investment in long-term care (LTC) and the strategies PE firms use to enter and expand within the sector.</div></div><div><h3>Methods</h3><div>We conduct a thematic analysis of 20 in-depth interviews with expert informants, including senior executives from PE firms, financial investors and private for-profit providers. These interviews shed light on the role of PE in Ireland’s LTC sector, specifically within nursing homes and home care.</div></div><div><h3>Results</h3><div>Five key factors attract PE investment in Irish LTC: demographic trends, market composition, risk diversification, and the characteristics of state funding and regulation. In nursing homes, PE uses the “OpCo/PropCo” (operating company/property company) model. In home care, PE enters via global investments in parent companies, direct acquisitions of Irish firms, and master franchise agreements.</div></div><div><h3>Conclusions</h3><div>Examining private for-profit actors through key officials central to PE growth in LTC provides valuable insights into the financialisation of health care systems. This approach enhances our understanding of business interests driving investment in European LTC.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"159 ","pages":"Article 105378"},"PeriodicalIF":3.6000,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Policy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0168851025001344","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Private equity (PE) firms are key actors in the financialisation of health care systems. Yet, research rarely focuses directly on these firms and related private for-profit actors involved in financialisation. Moreover, existing work mostly concerns the United States, while several key health care sectors remain under-researched.

Objective

This study examines the factors driving PE investment in long-term care (LTC) and the strategies PE firms use to enter and expand within the sector.

Methods

We conduct a thematic analysis of 20 in-depth interviews with expert informants, including senior executives from PE firms, financial investors and private for-profit providers. These interviews shed light on the role of PE in Ireland’s LTC sector, specifically within nursing homes and home care.

Results

Five key factors attract PE investment in Irish LTC: demographic trends, market composition, risk diversification, and the characteristics of state funding and regulation. In nursing homes, PE uses the “OpCo/PropCo” (operating company/property company) model. In home care, PE enters via global investments in parent companies, direct acquisitions of Irish firms, and master franchise agreements.

Conclusions

Examining private for-profit actors through key officials central to PE growth in LTC provides valuable insights into the financialisation of health care systems. This approach enhances our understanding of business interests driving investment in European LTC.

查看原文本刊更多论文

私人股本投资于长期护理：以爱尔兰为例

背景私募股权（PE）公司是医疗保健系统金融化的关键角色。然而，研究很少直接关注这些公司和与金融化相关的私营营利性行为者。此外，现有的工作主要涉及美国，而几个关键的医疗保健部门仍未得到充分研究。目的本研究考察了长期护理（LTC）领域私募股权投资的驱动因素，以及私募股权公司进入和扩张该行业的策略。方法我们对20位专家线人进行了深度访谈，其中包括私募股权公司、金融投资者和私营营利性提供商的高管。这些访谈揭示了PE在爱尔兰LTC部门的作用，特别是在养老院和家庭护理中。结果爱尔兰LTC吸引私募股权投资的五个关键因素：人口趋势、市场构成、风险分散、国家资助和监管特征。在养老院，PE采用“OpCo/PropCo”（运营公司/物业公司）模式。在家庭护理领域，私募股权通过对母公司的全球投资、直接收购爱尔兰公司和特许经营协议进入。通过对长期医疗服务中心PE增长至关重要的关键官员考察私营营利性行为者，为医疗保健系统的金融化提供了有价值的见解。这种方法增强了我们对推动欧洲LTC投资的商业利益的理解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

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.