Healthcare as asset: Private equity investment and the changing geographies of care in the United States

Abstract

This article considers what private equity’s (PE) growing interest in the healthcare industry means for the geographies of healthcare provisioning in the United States. PE firms invest in healthcare providers and spaces, treating these investments similar to their traditional investment assets, which subjects healthcare, a vital service, to often austere management tactics and financial engineering. Our work builds on critiques emerging from the healthcare community about the negative effects – and even dangers - of this mode of funding. A geographical reading raises questions about this form of investment that are simultaneously political, ethical, and practical: whose sickness provides profit, where and how is care provisioned, and what impacts--if any-- does this form of investment have on the quality of care and life? To answer these questions, we mobilise feminist geographical approaches to finance and care to consider the impacts of PE investments on the provisioning of US healthcare. Specifically, this article examines urgent care centers (UCCs) and telehealth in the United State. We conduct a content and discourse analysis of investor, analyst, and industry documents, examining dealmaking in the sector and asking how PE investors understand the healthcare sector as a lucrative asset that they can subject to traditional PE investment strategies. In so doing, we illustrate how private equity both relies on old practices and reinvents itself as it seeks profits in the healthcare sector. Overall, we call for more attention to the effects of PE investment on the geographies and quality of healthcare.