At least 17 (21%) of the 80 healthcare companies that filed for bankruptcy in 2023 were owned by private equity firms, including Envision Healthcare and Center for Autism and Related Disorders. During the first half of 2024, nine private equity-owned or recently PE-owned healthcare companies filed for bankruptcy, comprising 23% of all large US healthcare bankruptcies during that period.

Private equity’s excessive use of debt and aggressive financial strategies puts healthcare companies at risk, and in turn threatens the stability of critical healthcare resources across the country.


Steward Health Care’s bankruptcy represents a worst-case scenario for what can happen when private equity buys a healthcare business.

Steward Health Care was owned by private equity firm Cerberus Capital Management from 2010 to 2020; despite the private equity firm making at least $800 million from its investment in Steward, the multi-state health system has been financially struggling since before Cerberus divested. Under Cerberus’ ownership, many of Steward’s assets were sold off – including real estate, laboratory operations, and medical office buildings. In recent years, Steward’s financial situation worsened, and the health system declared bankruptcy in May 2024.

The pillaging of Steward that contributed to its financial distress was made possible by its partnership with Medical Properties Trust, a real estate investment trust (REIT), that helped finance investor payouts to Cerberus Capital Management through sale-leaseback deals and Steward’s national expansion.

In the months leading up to the bankruptcy, Steward closed two hospitals – one in Texas and one in Massachusetts. Since the bankruptcy, Steward has closed two more hospitals in Massachusetts, and is struggling to reach sale agreements for multiple others. The recent closures will result in the layoffs of 1,243 workers and decreased access to care for patients.

As of January 2024, private equity firms owned approximately 460 hospitals in the US, representing 8% of all private hospitals and 22% of all proprietary for-profit hospitals. But hospitals aren’t the only healthcare businesses in which private equity invests – private equity is invested in virtually every aspect of healthcare, including behavioral health, revenue cycle management, emergency medicine, travel nursing, clinical research, medical equipment, physician practice management, dental care, health IT, home health and hospice, and more.

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