Private equity acquisitions of hospitals and the changing landscape of care for patients with gastrointestinal cancer.

Background: The growing presence of private equity (PE) in the United States (U.S.) healthcare raises concern about access, costs, care quality, and outcomes. This study explores the specific impact of PE-owned hospitals on gastrointestinal (GI) cancer care. Methods: Patients undergoing GI cancer surgery were identified from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2012-2020). Propensity score matching compared PE and non-PE hospitals. Difference-in-difference and multivariable models evaluated GI surgical outcomes, adjusting for patient and hospital-level characteristics. Results: Among 1,887 GI cancer patients (hepatopancreatic: n=127, 6.7%; colorectal: n=1,760, 93.3%), the majority were male (n=1,030, 54.6%), White (n=1,526, 80.9%), with early-stage disease (stage I/II: n=1,009, 54%) and a median age of 75 [interquartile range (IQR), 70-82] years. Surgeries at PE-owned hospitals comprised 31.7% (n=599). Compared to non-PE hospitals, patients treated at PE-owned centers were more often Black (18.7% Conclusions: PE hospital acquisitions reduce staffing, limit Medicaid patient's access, and increase infection risks-underlining the need to protect equity and quality in GI cancer care.