Objectives/Goals: Private equity (PE) investment in Medicare Home Health Care (HH) is rising, raising concerns that PE’s profit focus may reduce spending on staff, training, and care quality. Objective: Examine the growth and regional trends of PE involvement in HH across the USA. Methods/Study Population: Background: PE investment in Medicare Home Health Care (HH) is becoming increasingly common, and HH is among the top healthcare sectors attracting interest from PE investors. This is potentially concerning given that PE’s focus on maximizing short-term returns may come at the expense of investments in staffing, training, and other agency operations that enhance care quality. Methods: We linked an investor targeted dataset (LevinPro HC), typically used by investment banks to track mergers and acquisitions, with Medicare administrative data on HH agencies. We then tracked PE deals to HH agencies and mapped deals to HH agency states. Results/Anticipated Results: Results: By combining the LevinPro HC and Medicare Provider of services data sources, we created a novel dataset of PE transactions in HH from 2006 through 2024. We found that there were 796 HH agencies (532 unique) acquired in 117 PE deals. Overall, HH acquisition by PE has been increasing over time with the majority of deals taking place between 2016 and 2022. Deals ranged in size from 1 to 115 HH agencies. Texas led the nation in PE activity in the HH sector with over 50% more deals than California, the state with the next higher number of acquisitions. Discussion/Significance of Impact: This study is the first to document the growth of PE involvement in HH across the USA by linking HH PE industry data with CMS data. Using these linked data will be essential for examining complex patterns of ownership and affiliation that were previously difficult to capture and that influence HH care delivery, competition, and regulatory oversight.
Jones et al. (2026) studied this question.