Private equity hospital ownership nearly 1 in 8 private hospitals

Chicago, IL — A single $3.9 billion acquisition has pushed the share of private equity-owned hospitals in the United States nearly one in eight private hospitals (12%), according to an updated Private Equity Hospital Tracker from the Private Equity Stakeholder Project (PESP).

The acquisition of Select Medical by a consortium that includes private equity firm Welsh, Carson, Anderson & Stowe was significant enough to prompt PESP to update its hospital tracker for the second time in 2026, just months after its July release. The deal demonstrates that private equity firms continue to make major acquisitions of hospitals despite growing scrutiny of the industry.

Key findings from the updated tracker include:

• 561 private equity-owned hospitals nationwide, up from 447 in July 2026.
• 11.9% of all private hospitals are now private equity-owned, compared to 9.5% in July.
• 33.6% of proprietary for-profit hospitals are private equity-owned, up from 26.8%.
• Welsh, Carson, Anderson & Stowe is now the second-largest private equity hospital owner identified in the tracker, with 124 hospitals through Select Medical and Emerus Hospital Partners.

“Anyone who thinks private equity is done buying hospitals should think again,” said Jim Baker, executive director of PESP. “The industry is still placing multi-billion-dollar bets on hospitals, even after the devastating failures at systems like Steward Health Care, and Prospect Medical Holdings/Crozer Health. Patients and healthcare workers are the ones who suffer when those bets go wrong, and policymakers need to take that risk seriously.”

Massachusetts regulators review late-filed transaction notice
The Select Medical acquisition has also raised concerns about compliance with state healthcare oversight requirements. Massachusetts requires advance notice of certain healthcare transactions, generally at least 60 days before they take effect. Massachusetts enacted its healthcare transaction oversight law in early 2025 in response to the collapse of Steward Health Care, which led to multiple hospital closures in the state.

After PESP contacted the Massachusetts Health Policy Commission (HPC) about the Select Medical acquisition in August, the commission contacted Select Medical and determined that a notice of material change should have been filed. Select Medical subsequently filed its notice on October 15, more than three months after the July 1 acquisition. As of October 27, the notice was under review. No further information about the status of that review is publicly available.

The delayed filing highlights the challenges regulators face in monitoring private equity healthcare acquisitions, particularly when transactions involve large companies operating across multiple states.

PESP’s tracker also documents how private equity-backed hospital systems use complex ownership arrangements, including real estate investment trusts (REITs) and joint ventures with nonprofit health systems. The updated tracker finds that at least 144 private equity-owned hospitals have REIT-owned real estate, while 23% operate through joint ventures with nonprofit health systems.

With a new Congress and new state legislators taking office post-midterms, the continued acquisition of hospitals by private equity firms underscores the need for lawmakers to address hospital ownership transparency and oversight of transactions that can affect healthcare access and quality.

The updated PESP Private Equity Hospital Tracker is available at: pestakeholder.org/pesp-private-equity-hospital-tracker