Private Equity Investment in Private For-Profit Healthcare in Australia and New Zealand: A scoping review

OBJECTIVES Private Equity (PE) involvement in healthcare has been evident in the United States (US) for some time, with questionable benefits reported. There are significant differences in funding, health insurance and regulation in the US, when compared to Australia and New Zealand (NZ), so it is not clear whether existing US research can be generalised to these settings. This study aims to examine published information regarding PE involvement in the private-for-profit (PFP) healthcare sector in Australia and NZ, including evidence of PE shareholdings and its impacts. DESIGN This scoping review considers academic and grey literature, including academic research and commentary papers, media reports, corporate reports, PFP healthcare websites and government submissions. MAIN OUTCOME & RESULTS Thirty-three relevant sources were identified, but no specific information on the impacts of PE investment were discovered. The academic papers highlight an ongoing debate (but limited research evidence) about PFP healthcare, including the quality of clinical care, practice consolidation and a downward trend on clinician ownership. The grey literature offered more information on PE investment and growth of the PFP sector, but limited detail about shareholdings. CONCLUSION With little research on PE investment in Australia and NZ, it is difficult to know if continued PE growth will have a positive or negative affect on operational performance and outcomes, such as clinician engagement and clinical care. The authors conclude that there is a shifting landscape of PFP healthcare in Australia and NZ, to less clinician and greater PE ownership. Given the reports of negative impacts of PE involvement in the US, these trends pose significant immediate and long-term implications. This paper sets the agenda for further research to explore the organisational and system-level impacts of PE growth in Australia and NZ.