Healthcare markets

Petris Center Leadership Recognized for Top-Cited Article in Health Services Research

Posted on By jordan-wolf

The Petris Center is proud to announce that Richard Scheffler, Brent Fulton, and Daniel Arnold have been recognized by Wiley as authors of a Top Cited Article (2025) in Health Services Research.

Their paper, “New evidence on the impacts of cross-market hospital mergers on commercial prices and measures of quality, examines how “cross-market” hospital mergers, where hospitals in different geographic areas combine, affect prices and quality of care. Using national commercial claims data and an event study design, the research finds that such mergers are associated with significant increases in hospital prices over time, with prices rising by nearly 13% six years after acquisition, and provides new insights into serial acquisitions. Notably, the study finds no corresponding improvements in quality, as measured by mortality and readmission rates for major conditions.

Read the full article here

Wiley Top Cited Article CertificateDownload

Private equity investments in health care in OECD countries: an exploratory analysis

Posted on By crystal-haryanto

By Yashaswini Singh, Megha Reddy, Irene Papanicolas, and Richard Scheffler | Published January 28, 2026 in Cambridge University Press | Link to Full Paper

Private equity (PE) firms are increasingly investing in healthcare, seeking short-term returns through market consolidation, price increases, asset sales, and financial engineering. Although PE is transforming the healthcare sector, many countries lack systematic data to determine whether a regulatory response is warranted. Using data from PitchBook, we document substantial and growing PE investment in health care across 25 of 38 Organization of Economic Cooperation and Development (OECD) countries, totalling over 8,400 reported deals and $1.4 trillion in capital between 2013 and 2023. Outpatient clinics represent the dominant target of investment, while hospital and elder care sectors have attracted investments in select countries. Exploratory regression analyses suggest that PE firms are less likely to invest in countries with a social health insurance system and that PE deal volume is positively associated with health expenditures. Country-specific deviations from model predictions underscore the importance of unmeasured country-specific factors such as regulation, payment policy, and market competition. Eight case studies illustrate the operational, financial, and social implications of PE investments, as well as diverse regulatory contexts. Given the lack of disclosure requirements, a key policy priority for governments is to enhance transparency to enable effective monitoring of the financialisation of health care delivery.

When profit kills: How private equity is eroding health care

Posted on By crystal-haryanto

In a U.S. Right to Know Healthwire article, Pamela Ferdinand examines how private equity ownership in health care prioritizes aggressive profit maximization, often at the expense of patient care. The article highlights how financial incentives can conflict with the delivery of high-quality care, contributing to higher mortality rates and raising concerns about the long-term impact of private equity’s role in the U.S. health system. Richard Scheffler told U.S. Right to Know, “The empirical studies are now overwhelming: Private equity puts profits above the well-being of patients.”

Read the full article here.

Reducing Spending And Enhancing Value In US Health Care: Reflections On The GAO Report

Posted on By crystal-haryanto

Federal health spending plays a central role in the nation’s long-term fiscal outlook. Medicare, Medicaid, the Children’s Health Insurance Program, and private health insurance spending are projected to increase in the coming years. These unsustainable trends—occurring without commensurate improvements in population health— create a burning need for reform: Without meaningful change, rising health care costs will increasingly strain household budgets, crowd out other federal and state priorities, and undermine the nation’s long-term fiscal stability.

Against this urgent backdrop, the United States Government Accountability Office issued its 2024 report, “Highlights of a Forum: Reducing Spending and Enhancing Value in the U.S. Health Care System”. The report summarizes the discussions of an expert forum convened in October 2024. Dr. Papanicolas and Dr. Scheffler, the director of the Petris Center, highlight below the areas the group believes are most critical for policymakers to consider and offer new insights that have gained salience given shifts in the policy landscape since the forum was conducted.

Please view the report linked here.

New Evidence about the Heterogeneity of Indiana’s Healthcare Markets: Competition, Costs, and the Impacts of Market Structure

Posted on By crystal-haryanto

By Brent D. Fulton, Daniel R. Arnold, Ola A. Abdelhadi, and Richard M. Scheffler | Published October 2022 | Link to Full Report

On April 29, 2021, Indiana enacted HB 1405, directing a study to be conducted on the market concentration in Indiana’s healthcare sector. This study focuses on the health insurance, hospital, and physician industries. The healthcare sector in Indiana is a microcosm of the healthcare sector in the United States, consisting of dominant health insurers and a delivery system that has evolved into a patchwork of hospital systems that have grown in size and geographic scope via mergers and acquisitions, including vertical acquisitions of physician organizations. This study shows that the healthcare sector in Indiana is not monolithic, neither across the industries we analyzed—health insurance, hospitals, and physicians—nor across its MSAs. Therefore, policies aimed at improving healthcare competition, affordability, and quality need to account for this heterogeneity.

This study was funded by the Indiana Legislative Services Agency (Grant no. 22021).

The report will be presented at the Interim Study Committee on Financial Institutions and Insurance hearing on October 20, 2022.

Physician Compensation In Physician-Owned and Hospital-Owned Practices

Posted on By crystal-haryanto

By Christopher M. Waley, Daniel R. Arnold, Nate Gross, and Anupam B. Jena | Published December 8, 2021 in Health Affairs | Link to Full Article

Physician practices are increasingly being acquired by hospitals and health systems. Despite evidence that this type of vertical integration is profitable for hospitals, the association between these acquisitions and the incomes of physicians in the acquired practices is unknown. We combined national survey data on physician practice ownership with data on physician income to examine whether hospital or health system ownership of physician practices was associated with differences in physician income during 2014–18. During the study period, hospital and health system ownership of physician practices increased by 89.2 percent, from 24.1 percent to 45.6 percent of all physicians in our sample. Among physician practices overall, vertical integration with hospitals or health systems was associated with, on average, 0.8 percent lower income compared with independent physicians after multivariable adjustment. In analyses by physician specialty, vertical integration of physician practices with hospitals or health systems was associated with lower income for nonsurgical specialists, no difference in income for primary care physicians, and slightly higher income for surgical specialists. Although vertical integration of physician practices is a rapidly growing trend, physicians might not directly benefit financially.

Richard Scheffler Speaks in PEPC Competition Webinar

Posted on By crystal-haryanto

Richard Scheffler acted as a panelist at a webinar hosted by the Partnership to Empower Physician-Led Care, an advocacy group promoting value-based care as a path to sustainability for independent physicians and practices. The webinar discussed provider consolidation’s impact on health outcomes and how best to ensure provider competitive behavior instead. Specifically, Dr. Scheffler touched on issues related to increasing private equity investments and vertical integration in healthcare, effects on prices, and next steps at the legislative level.

The title is “Addressing Consolidation in Health Care Markets: The Impact of Provider Consolidation on Cost and Quality.” Take a look here — 10:10 to 27:20.

Consolidation of Hospitals During the COVID-19 Pandemic: Government Bailouts and Private Equity

Posted on By alyssa-birchfield

By Richard M. Scheffler and Laura M. Alexander | Published July 20, 2021 in The Milbank Quarterly | Link to Full Article

On May 19, 2021, Senator Amy Klobuchar (D-MN), chair of the US Senate Subcommittee on Competition Policy, Antitrust, and Consumer Rights, held a hearing on hospital consolidation and the subsequent increase in hospital prices observed across the U.S. Most hospital markets meet the FTC/DOJ guidelines definition of being highly concentrated and, as a result, are not likely to exhibit competitive levels of prices, quality, or innovation. Yet, the COVID-19 pandemic is shaping the financial outlooks of large and small hospital systems in a manner that is expected to further fuel this consolidation trend. Coming out of the COVID-19 pandemic, private equity funds are sitting on enormous stores of “dry powder,” money they have amassed from investors and are required to spend or return within the next several years. Widespread expectations are that much of that dry powder will be deployed in health care, ultimately leading to vertical integration.

The article explores the harmful effects of post-COVID-19 consolidation through private equity in the healthcare space, emphasizing the damaging effects on local health care markets.

Modern Healthcare Features Richard Scheffler in Article on Blue Cross NC Independent Physician Initiative

Posted on By alyssa-birchfield

Blue Cross and Blue Shield of North Carolina has partnered with investment firm Deerfield Management Company in a joint venture aimed at helping independent physicians grow and strengthen their practices. The company will offer management infrastructure, technology support and marketplace information. Modern Healthcare sought comments from Dr. Richard Scheffler on the effects of this joint venture on independent physician practices, with Scheffler noting that this could help these physicians “ease the difficulty of managing their own small practice in today’s healthcare environment.”

Read the full article and all of Dr. Scheffler’s insights here.

Modern Healthcare Interviews Richard Scheffler Regarding Growing Private Equity Investment in Healthcare

Posted on By alyssa-birchfield

Modern Healthcare interviewed Richard Scheffler for an article discussing the growing trend of private equity investment in the healthcare sector. They also cite his recent report on the topic. The interview took place after the noteworthy buyout of medical supply company Medline by a trio of private equity firms—Blackstone Group, Carlyle and Hellman & Friedman. As Dr. Scheffler puts it, this may be “the start of an explosion of private equity deals in healthcare.”

Read the full article here.