IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v91y2023ics0167629623000784.html
   My bibliography  Save this article

Private equity and healthcare firm behavior: Evidence from ambulatory surgery centers

Author

Listed:
  • Lin, Haizhen
  • Munnich, Elizabeth L.
  • Richards, Michael R.
  • Whaley, Christopher M.
  • Zhao, Xiaoxi

Abstract

Healthcare firms regularly seek outside capital; yet, we have an incomplete understanding of external investor influence on provider behavior. We investigate the effects of private equity investment, divestment, and an initial public offering (IPO) on ambulatory surgery centers (ASCs). Throughput is unchanged while charges grow by up to 50% for the same service mix. Affected ASCs witness declines in privately insured cases and rely more on Medicare business. Private equity increases physician ASC ownership stakes, and both simultaneously divest when the ASC is sold. Our findings appear more consistent with private equity influencing the financing of ASCs, rather than treatment approaches.

Suggested Citation

  • Lin, Haizhen & Munnich, Elizabeth L. & Richards, Michael R. & Whaley, Christopher M. & Zhao, Xiaoxi, 2023. "Private equity and healthcare firm behavior: Evidence from ambulatory surgery centers," Journal of Health Economics, Elsevier, vol. 91(C).
    • Handle: RePEc:eee:jhecon:v:91:y:2023:i:c:s0167629623000784
    DOI: 10.1016/j.jhealeco.2023.102801
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167629623000784
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.jhealeco.2023.102801?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Ashwini Agrawal & Prasanna Tambe, 2016. "Private Equity and Workers’ Career Paths: The Role of Technological Change," The Review of Financial Studies, Society for Financial Studies, vol. 29(9), pages 2455-2489.
    2. Kathleen Carey & James F. Burgess & Gary J. Young, 2011. "Hospital competition and financial performance: the effects of ambulatory surgery centers," Health Economics, John Wiley & Sons, Ltd., vol. 20(5), pages 571-581, May.
    3. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Richards, Michael R. & Whaley, Christopher M., 2024. "Hospital behavior over the private equity life cycle," Journal of Health Economics, Elsevier, vol. 97(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Barth, Erling & Davis, James C. & Freeman, Richard B. & McElheran, Kristina, 2023. "Twisting the demand curve: Digitalization and the older workforce," Journal of Econometrics, Elsevier, vol. 233(2), pages 443-467.
    2. Bas Scheer & Wiljan van den Berge & Maarten Goos & Alan Manning & Anna Salomons, 2022. "Alternative Work Arrangements and Worker Outcomes: Evidence from Payrolling," CPB Discussion Paper 435, CPB Netherlands Bureau for Economic Policy Analysis.
    3. Ichev, Riste & Valentinčič, Aljoša, 2025. "The effect of impact investing on performance of private firms," Research in International Business and Finance, Elsevier, vol. 73(PA).
    4. Mac Clay, Pablo & Börner, Jan & Sellare, Jorge, 2023. "Institutional and macroeconomic stability mediate the effect of auctions on renewable energy capacity," Energy Policy, Elsevier, vol. 180(C).
    5. Katrin Huber & Geske Rolvering, 2023. "Public child care and mothers’ career trajectories," Working Papers 228, Bavarian Graduate Program in Economics (BGPE).
    6. Shun-Yang Lee & Julian Runge & Daniel Yoo & Yakov Bart & Anett Gyurak & J. W. Schneider, 2023. "COVID-19 Demand Shocks Revisited: Did Advertising Technology Help Mitigate Adverse Consequences for Small and Midsize Businesses?," Papers 2307.09035, arXiv.org, revised Jan 2024.
    7. Coury, Michael & Falconer, Liam & La Nauze, Andrea, 2024. "Wildfire smoke and private provision of public air-quality monitoring," Journal of Environmental Economics and Management, Elsevier, vol. 127(C).
    8. Catalina Amuedo‐Dorantes & Francisca M. Antman, 2022. "De facto immigration enforcement, ICE raid awareness, and worker engagement," Economic Inquiry, Western Economic Association International, vol. 60(1), pages 373-391, January.
    9. Steven J. Davis & John C. Haltiwanger & Kyle Handley & Ben Lipsius & Josh Lerner & Javier Miranda, 2021. "The economic effects of private equity buyouts," Jena Economics Research Papers 2021-013, Friedrich-Schiller-University Jena.
    10. Anderson, D. Mark & Liang, Yang & Sabia, Joseph J., 2022. "Mandatory Seatbelt Laws and Traffic Fatalities: A Reassessment," IZA Discussion Papers 15843, Institute of Labor Economics (IZA).
    11. Arne Henningsen & Guy Low & David Wuepper & Tobias Dalhaus & Hugo Storm & Dagim Belay & Stefan Hirsch, 2024. "Estimating Causal Effects with Observational Data: Guidelines for Agricultural and Applied Economists," IFRO Working Paper 2024/03, University of Copenhagen, Department of Food and Resource Economics.
    12. Yang Haodong & Liu Jialin & Wang Gaofeng, 2025. "Knowledge Innovation Effect of University Computing Power in China: Evidence from the top500 Supercomputers," Research in Higher Education, Springer;Association for Institutional Research, vol. 66(1), pages 1-30, February.
    13. Stefan Bauernschuster & Michael Grimm & Cathy M. Hajo, 2023. "The Impact of Margaret Sanger’s Birth Control Clinics on Early 20th Century U.S. Fertility and Mortality," CESifo Working Paper Series 10421, CESifo.
    14. Lan, Xiujuan & Hu, Zheneng & Wen, Chuanhao, 2023. "Does the opening of high-speed rail enhance urban entrepreneurial activity? Evidence from China," Socio-Economic Planning Sciences, Elsevier, vol. 88(C).
    15. Fabio Bothner & Annette Elisabeth Töller & Paul Philipp Schnase, 2022. "Do Lawsuits by ENGOs Improve Environmental Quality? Results from the Field of Air Pollution Policy in Germany," Sustainability, MDPI, vol. 14(11), pages 1-18, May.
    16. Li, Qianqian & Zhao, Zhengtang & Chen, Tingting, 2024. "The effect of public pension insurance integration on income disparities between urban-rural households: Evidence from a quasi-experiment in China," Finance Research Letters, Elsevier, vol. 66(C).
    17. Goda, Gopi Shah & Levy, Matthew R. & Flaherty Manchester, Colleen & Sojourner, Aaron & Tasoff, Joshua & Xiao, Jiusi, 2023. "Are retirement planning tools substitutes or complements to financial capability?," Journal of Economic Behavior & Organization, Elsevier, vol. 214(C), pages 561-573.
    18. DeMalach, Elad & Schlosser, Analia, 2024. "Short- and Long-Term Effects of Universal Preschool: Evidence from the Arab Population in Israel," CEPR Discussion Papers 18781, C.E.P.R. Discussion Papers.
    19. Bhalotra, Sonia & Clarke, Damian & Mühlrad, Hanna & Palme, Mårten, 2021. "Health and Labor Market Impacts of Twin Birth : Evidence from a Swedish IVF Policy Mandate," The Warwick Economics Research Paper Series (TWERPS) 1391, University of Warwick, Department of Economics.
    20. Shang, Longfei & Saffar, Walid, 2023. "Employment Protection and Household Mortgage Debt," Journal of Banking & Finance, Elsevier, vol. 149(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:91:y:2023:i:c:s0167629623000784. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.