PESP’s Mary Bugbee Presents at “Risky Business: Profitizing Home Care” Webinar
June 5, 2025
On April 3, 2025, Mary Bugbee, Healthcare Director at the Private Equity Stakeholder Project (PESP), participated in the webinar “Risky Business: Profitizing Home Care,” organized by The Care Economy. This important event brought together experts from the United States and Canada to discuss the growing trends in the home care sector that are driving profitization.
The webinar was facilitated by Canadian economist Armine Yalnizyan, and Dr. Cynthia Crawford, a University of Toronto professor and researcher, and Kenyon Wallace, a reporter in the Toronto Star’s business department, also presented.
During her presentation, Mary shared valuable insights from PESP’s research on the influence of private equity in home care in the U.S. While acknowledging the differences between the U.S. and Canadian healthcare contexts, she emphasized the core issue of putting profit ahead of care.
Private equity firms have invested nearly $70 billion in U.S. home care companies over the past five years. Mary explained how private equity’s drive to produce outsized returns over short time horizons can result in financial tactics that can negatively impact the quality and affordability of home care. These tactics include high-leverage, debt-funded dividends, roll-up strategies, and management fees.
These financial strategies can generate risks, such as consolidation that can drive up costs for payers and clients, as well as cost-cutting, which can translate to understaffing, low wages, and inadequate training for caregivers.
Mary outlined several potential solutions, including policy changes to 1) ban or limit debt-based financial strategies, 2) attach strict conditions to companies receiving public funds and contracts, 3) raise the minimum wage for direct care workers, and 4) enhance antitrust enforcement. She also emphasized the importance of building people power through organizing and cross-border coalitions.
PESP is committed to monitoring and analyzing the impact of private equity on the care economy and advocating for policies that prioritize quality care and fair treatment of workers.
The entire virtual presentation is available here.
