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Owner Incentives and Performance in Healthcare: Private Equity Investment in Nursing Homes

Author

Listed:
  • Atul Gupta
  • Sabrina T. Howell
  • Constantine Yannelis
  • Abhinav Gupta

Abstract

Amid an aging population and a growing role for private equity (PE) in elder care, this paper studies how PE ownership affects U.S. nursing homes using patient-level Medicare data. We show that PE ownership leads to lower-risk patients and increases mortality. After instrumenting for the patient-nursing home match, we recover a local average treatment effect on mortality of 11%. Declines in measures of patient well-being, nurse staffing, and compliance with care standards help to explain the mortality effect. Overall, we conclude that PE has nuanced effects, with adverse outcomes for a subset of patients.

Suggested Citation

  • Atul Gupta & Sabrina T. Howell & Constantine Yannelis & Abhinav Gupta, 2021. "Owner Incentives and Performance in Healthcare: Private Equity Investment in Nursing Homes," NBER Working Papers 28474, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:28474
    Note: CF EH PR TWP
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    JEL classification:

    • G3 - Financial Economics - - Corporate Finance and Governance
    • G32 - Financial Economics - - Corporate Finance and Governance - - - Financing Policy; Financial Risk and Risk Management; Capital and Ownership Structure; Value of Firms; Goodwill
    • G34 - Financial Economics - - Corporate Finance and Governance - - - Mergers; Acquisitions; Restructuring; Corporate Governance
    • G38 - Financial Economics - - Corporate Finance and Governance - - - Government Policy and Regulation
    • I1 - Health, Education, and Welfare - - Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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