Private Equity in Primary Care: Just Another Inflationary Business Model? What Does the Data Actually Show, With Yashaswini Singh, PhD (EP528)
Private equity has been buying up primary care practices for years, promising the capital that chronically underfunded clinicians badly need. But does the money actually make care better? Yashaswini Singh, PhD, MPA, the Thomas J. and Alice M. Tisch Assistant Professor of Health Services, Policy, and Practice at Brown University, has spent years studying that question — and her newest research, published in Health Affairs and JAMA Health Forum, finds PE-affiliated primary care physicians negotiate prices 8% to 10% higher than independent doctors, while patient outcomes barely budge.
WHAT YOU'LL LEARN
✅ Why negotiated prices for PE-affiliated primary care physicians run 8% to 10% higher than independent doctors — and why hospital-affiliated physicians still command the highest prices of all
✅ How a national study of roughly 200 PE-acquired primary care practices found a 20% increase in preventive services, including the Medicare Annual Wellness Visit, with no evidence of low-value care
✅ Why "cognitive atrophy" — deskilling from rigid, box-checking visits — isn't inevitable under PE ownership, but why the "best case scenario" often isn't what's actually happening
✅ How opaque common ownership — the same investors owning primary care, GI, orthopedic, and oncology practices — can create hidden referral incentives current data can't detect
✅ Why site-of-care payment arbitrage — a hospital-owned MRI can cost double or triple an independent one — drives referral-machine incentives regardless of who owns the practice
✅ Why PE's promise to reduce fragmentation through consolidation has instead produced physician turnover that undermines the patient-doctor relationship
WHY THIS MATTERS
Primary care clinicians are chronically underpaid, and private equity promises the capital to fix that. But Dr. Singh's research shows a real tradeoff: costs rise 8% to 10% while quality barely moves. Whether professional capital builds sustainable, whole-person care or becomes, as Stacey puts it, corporate arbitrage in a different Halloween costume depends on realigning payment incentives around outcomes rather than throughput — something no ownership model, PE included, is yet built to do.
MENTIONED IN THIS EPISODE
EP519 with Lisa Rosenbaum, MD: Apple Podcasts | Spotify | Other Apps
LinkedIn Post by Yashaswini Singh, PhD
EP474 with Yashaswini Singh, PhD: Apple Podcasts | Spotify | Other Apps
Study: "Private Equity Acquisitions in Primary Care" (Health Affairs)
Study: "Private Equity Acquisition in Primary Care and Avoidable Hospitalizations" (JAMA Health Forum)
LinkedIn Comment by Andrea DeSantis, DO, FAAFP
EP521 with Andrew Tsang: Apple Podcasts | Spotify | Other Apps
EP523 with Suhas Gondi, MD, MBA: Apple Podcasts | Spotify | Other Apps
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🔗 Show Notes with all mentioned links: Show Notes
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00:00 Introduction to this episode.
04:16 The three categories covered in today's episode.
05:36 The conversation with Dr. Singh.
07:02 Findings these private equity studies have found about primary care.
12:00 Does private equity make cognitive atrophy inevitable?
14:49 In PE-backed, single-specialty primary care, is it easier for PCPs to have full-spectrum clinical scope?
17:14 Why perverse financial incentives cause problems but aren't necessarily an inevitability.
22:17 Fragmentation and private equity in primary care.
25:46 Indie primary care versus PE-backed primary care versus hospital system–backed primary care.
32:22 What Dr. Singh is thinking about and looking to solve for next.
34:30 Inspiring physician-led work and a reason for hope.
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