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Evidence review suggests that costs rise and quality falls at acquired healthcare providers Private equity investment in healthcare provider institutions reached record highs in recent years in both the US and Europe, with US acquisitions accounting for three quarters of the combined $100bn (£78bn; €91bn) in investment in 2021.12 The US Medicare Payment Advisory Commission recently estimated that private equity firms own 11% of US skilled nursing facilities and 4% of US hospitals.3 Private equity firms use capital supplied by wealthy individuals to buy companies, and, after a relatively brief period of ownership, sell them at a large profit. Private equity involvement in healthcare, which receives limited oversight from either financial or public health regulators, has drawn considerable criticism from patient advocacy groups, academic researchers, and journalists, for draining financial resources from healthcare institutions.12456 Such involvement also receives considerable atten

Rhode islandUnited statesMerrill gooznerUs medicare payment advisory commissionDepartment of healthPayment advisory commissionAttorney general