Private Equity Descends on Rural Healthcare

January 25, 2023

Rural healthcare in America has hit a crisis point. Millions of Americans living in rural communities do not have access to critical healthcare services.

NEW REPORT: Private Equity Descends on Rural Healthcare

By most measures, the health of people living in rural areas is significantly worse than in non-rural areas. Compared to urban residents, rural residents generally experience poorer health outcomes and a higher prevalence of chronic conditions. An estimated one in three rural adults lives with a disability, impacting their hearing, vision, cognition, mobility, self-care, or independent living. Americans in rural areas more likely to die by suicide.

These disparities are pronounced for people of color. According to CMS, people of racial and ethnic minorities are “more likely to report not having primary care practitioners, not having accessed healthcare appointments due to cost, and having fair or poor health status. In general, Black, American Indian, and Alaska Native women experience worse maternal health outcomes compared to non-Hispanic White women, and these disparities are compounded by limited access to high quality obstetric care in rural communities.”

A new report by the Private Equity Stakeholder Project (PESP), “Private Equity Descends on Rural Healthcare,” provides an unprecedented look at the private equity industry’s incursion into rural healthcare.

Find the press release for the report announcement HERE.

This three-part survey examines the extent to which private equity (PE) has invested in rural health, as well as key financial drivers of significant investment activity in this uniquely distressed part of our health system. The new report also examines case studies of PE-owned companies in several rural healthcare sectors that highlight some of the risks posed by private equity’s incursion into rural healthcare.


  • Part I: Private Equity in Rural Hospitals
    • Overview of PE in rural hospitals
    • Case studies:
      • Apollo Global Management – LifePoint Health and ScionHealth
      • Lateral Investment Management – Santa Cruz Valley Regional Hospital
      • Riverside Capital, Monroe Capital – Little River Healthcare and True Health Group
      • Nueterra Capital – Noble Health
      • Equity Group Investments – Ardent Health Services
      • Cerberus Capital Management – Steward Healthcare
    • Part II: Private Equity Looks to Other Rural Health Services
      • Emergency department staffing
      • Emergency transport
      • Travel nursing, medical staffing
      • Behavioral health
      • Hospital Management and consulting
      • List of PE-owned rural healthcare companies
    • Part III: Safeguarding Rural Health from Private Equity
      • Why might PE invest in rural healthcare?
      • Policy recommendations

For a high resolution version of the report, download here.



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