Charles Lyons-Burt 
- Private equity owns 447 U.S. hospitals, with Apollo alone controlling 200
- CMS rule would extend PE ownership disclosure to hospitals and physician groups
- CMS, NIH and Walter Reed leaders will headline the 2026 Healthcare Summit on Dec. 3!
Private equity firms own 447 U.S. hospitals, which is 9.5 percent of all private hospitals and 26.8 percent of for-profit ones, according to the 2026 update of the Private Equity Stakeholder Project’s hospital tracker. PESP is a watchdog group that monitors the deals. Apollo Global Management is the largest owner, running 200 hospitals through Lifepoint Health and ScionHealth. New Mexico has the densest concentration, with 42.1 percent of its private hospitals under private equity ownership.
Federal regulators are moving to get a clearer picture of who owns the facilities Medicare pays for. On July 6, the Centers for Medicare and Medicaid Services published a proposed rule that would extend ownership disclosure requirements for private equity firms and real estate investment trusts, or REITs, well beyond home health agencies, reaching hospitals, physician organizations and other Medicare participants, Holland & Knight noted. REITs often buy hospital property and lease it back to operators, a common feature of private equity deals.
Leaders from HHS, CMS, the National Institutes of Health and the military health enterprise will take the stage at the Potomac Officers Club’s 2026 Healthcare Summit on Dec. 3. Register now to hear how federal health agencies are adapting to a fast-consolidating provider market.
Why Is Private Equity Buying Hospitals?
To investors, hospitals and physician practices look like durable assets. Demand is steady and recession-resistant, an aging population keeps patient volume rising, and a historically fragmented field of independent operators offers room to consolidate. Facilities also need large, recurring infusions of capital, which private equity can supply along with operational and technology expertise that many independent providers lack.
The model relies on leverage. Buyers typically finance acquisitions mostly with debt that the acquired provider carries, then aim to sell the improved asset within several years. Research suggests that efficiency push has tradeoffs. A study of Medicare claims data published in the Annals of Internal Medicine in September 2025 found that newly acquired hospitals reduced staffing by nearly 12 percent and hospital-wide salaries by nearly 17 percent, HealthDay reported. The cuts were concentrated in emergency departments and ICUs, and emergency department mortality rose.
The market is also maturing. Larger orthopedic groups are increasingly funding growth through internal cash flow or bank loans instead of private equity, and investor activity in that specialty has shifted toward add-on acquisitions and recapitalizations, Becker’s Spine Review reported.
How Is CMS Tracking Private Equity Ownership?
Nursing homes were the proving ground. Since January 2024, Medicare- and Medicaid-billing nursing facilities have had to state whether each direct or indirect owner or managing entity is a private equity company or a REIT, using definitions CMS finalized for that purpose. The calendar year 2027 proposal would carry that visibility across a far broader swath of Medicare providers and suppliers. CMS typically finalizes its annual home health payment rule in the fall, according to Learningsignal.
Lawmakers have floated stronger measures. A bicameral bill introduced in March would bar private equity-owned hospitals and nursing homes from Medicare certification, LeadingAge reported, though industry groups have opposed an outright ban.
For contractors, the expanding disclosure regime means more ownership data flowing through provider enrollment, more analytics to connect ownership with cost and quality outcomes, and new program integrity work across CMS systems.
What Does Hospital Ownership Mean for Military Health?
The Department of War’s health enterprise has a direct stake in the civilian hospital market. The Pentagon buys more than 65 percent of TRICARE care from civilian providers, Military.com reported, so the financial health of private hospitals bears directly on beneficiary access.
The Defense Health Agency is also working to shrink that dependence. Its fiscal 2026 plan made care reattraction, which aims to bring patients back to military treatment facilities after years of shifting care to the private sector, one of three lines of effort, alongside combat support and enterprise services optimization. A December 2023 directive set a goal to recapture at least 7% of available private sector care for military treatment facilities by Dec. 31, 2026.
Why Should GovCons Attend the 2026 Healthcare Summit?
The 2026 Healthcare Summit will take place Dec. 3 at the Hilton McLean in McLean, Virginia. Featured speakers include:
- CMS Deputy Administrator and Chief Operating Officer Kimberly Brandt, who may discuss Medicare program integrity, provider ownership transparency and CMS modernization priorities
- Dr. Matthew Memoli, principal deputy director of NIH, who will deliver the afternoon keynote
- Melissa Austin, director of Walter Reed National Military Medical Center, a panelist for Readiness Over Everything: Combat Support, Care Reattraction and MHS’s FY26 Pivot
- Tria Federal CEO Tim Borchert, who will moderate Navigating the Healthcare Trilemma: Cost, Quality and Access to Care
- James Perkins, acting program executive officer of the Program Executive Office, Defense Healthcare Management Systems (pending confirmation), who may discuss health records interoperability between military and civilian care networks
Many more speakers from across federal health will be announced in the coming weeks. Secure your spot at the 2026 Healthcare Summit today!
