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Abstract

Between 2013 and 2023, private-equity-sponsored investment funds spent one trillion dollars on healthcare acquisitions, targeting hospitals, physician practices, and specialty providers. This Note examines the growing role of private equity in the US healthcare system and its implications for cost, quality, and competition.

ring struggling hospitals and medical practices much-needed capital and managerial expertise. In practice, however, prevalent private equity practices often create moral hazards by prioritizing short-term financial gains over long-term community health. Their reliance on debt, short investment horizons, and consolidation strategies can translate into higher prices, compromised care, and anticompetitive behavior. Mounting empirical studies reinforce these concerns, linking private equity ownership to higher costs and increased hospital-acquired adverse events.

This Note situates private equity’s rise in healthcare within the broader story of financialization and analyzes how existing legal frameworks, particularly antitrust law, struggle to address its consequences. It reviews emerging state and federal legislative responses, as well as the Federal Trade Commission’s evolving enforcement strategies, highlighting both opportunities and limitations.

Ultimately, the Note argues that lack of transparency is the greatest obstacle to effective antitrust enforcement of private equity activity in healthcare and proposes robust premerger notification programs targeting private equity sponsors as a politically viable and legally effective first step toward aligning healthcare finance with the public interest. These programs would provide regulators with the tools needed to identify harmful transactions earlier, deter practices that undermine healthcare access and quality, and help ensure that patient care, rather than financial engineering, remains at the center of American healthcare.

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