Financial environment, dry powder, and the dynamics of private equity valuations

Apples and Oranges: Benchmarking Games and the Illusion of Private Equity Outperformance

Currently, the Chinese economy is undergoing significant cyclical fluctuations, and the market environment is complex and ever-changing. In this context, non listed companies are facing many development difficulties, particularly in terms of financing difficulties and high financing costs. At the same time, information disclosure is opaque and difficult to obtain, which seriously restricts their further development. In the current critical period of economic development, scientific valuation of non listed companies has become an important issue that urgently needs to be addressed, and it is urgent to establish a comprehensive company value evaluation system. This article uses market analysis methods and carefully selects data from listed companies in 2023 to explore in depth the financing scale and structural characteristics during their initial public offering (IPO) period. And with the help of the Stata regression model, will carefully study the impact of the shareholding ratio of private equity institutions among non listed company shareholders on IPO valuation, striving to accurately evaluate the growth potential of enterprises and provide more targeted and practical decision-making recommendations for private equity investment institutions.

Private Equity Replication: A Survey

While early rounds of rental housing financialization were predominantly driven by private equity firms and other speculative landlords acquiring residential portfolios, in the wake of the global financial crisis, real estate investment trusts (REITs) and institutional investors marked their entry into the public and private rental sector. Although this transition from financialization 1.0 to financialization 2.0 is arguably still unfolding, the contributions to this special issue demonstrate that we are potentially experiencing the beginning of a new cycle. Financialization 3.0 is marked by intensifying—albeit not necessarily stable and coherent—state interventions and regulatory attempts to both constraint and facilitate institutional housing investment. For all its contradictions, I argue that financialization 3.0 contributes to shifting modes of governance, enabling global financial investors to (1) negotiate housing policy and urban planning arrangements, (2) develop market-oriented crossholdings and state-supported investment schemes, and (3) diversify portfolio holdings and rentier models across the real estate sector at large. Although an emergent state-finance nexus can thus be observed, the outcomes of financialization 3.0 are controversial at best. For that reason, I conclude that financialization 3.0 will not lead to a durable asset ecosystem where tensions between public housing needs and global investment priorities are reconciled.

Background: Private equity (PE) acquisitions of health care facilities have increased over the past decade, and growing evidence suggests this negatively affects patient outcomes. However, PE firms’ strategic priorities and operational approaches vary, raising the possibility that the effects on patient outcomes may differ across firms. Whether such heterogeneity exists remains unknown. Research Question: We evaluated 30-day hospital revisits and 30-day mortality for acute myocardial infarction (AMI) and stroke at PE-acquired hospitals, and determined whether these outcomes differed across firms. Methods: We identified US hospitals acquired by PE firms from 2013 to 2018. We compared the rates of 30-day revisits and 30-day mortality among Medicare fee-for-service beneficiaries aged 65 years and older with AMI or stroke between 2012 and 2019 at hospitals after PE acquisition. We excluded PE firms with less than 200 AMI or stroke hospitalizations. We then calculated median odds ratios (mOR) to quantify the variation in outcomes between PE firms. This represents the median increase in the odds of an outcome when an individual is switched from a with lower odds to a cluster with higher odds, holding all other factors constant. Results: We identified 40 PE-acquired hospitals that had Medicare data for AMI and stroke hospitalizations. There were 15 PE firm acquirers, 9 of which had more than 200 hospitalizations for AMI or stroke. The median AMI hospitalization rate across PE firms was 491 (IQR, 240-1105) and median stroke hospitalization rate was 530 (IQR, 223-914). Median 30-day revisit rate was 33.4% (IQR, 29.5%-36%) for AMI and 42.4% (IQR, 33.4%-45.6%) for stroke ( Figure 1 ). Median 30-day mortality was 10.7% (IQR, 8.7%-11.4%) for AMI and 12.0% (IQR, 10.1%-15.0%) for stroke ( Figure 2 ). After adjustment for age, sex, and clinical comorbidities, the mOR for 30-day revisits was 1.2 (CI, 1.09-1.35) for AMI and 1.28 (CI, 1.14-1.57) for stroke. In addition, the adjusted mOR for 30 day-mortality was 1.1 (CI, 1.00-1.93) for AMI and 1.17 (CI, 1.05-1.63) for stroke. Conclusions: These findings reveal substantial variation in 30-day revisit and mortality rates for acute myocardial infarction and stroke among hospitals acquired by different PE firms. This heterogeneity underscores the need for further research to elucidate the strategic, operational, or structural factors that enable some PE firms to achieve better patient outcomes, while others fall short.

ABSTRACT Pre‐IPO tokens offer a new way for individual investors to access the private equity markets. However, without access to the private firm or to regulated public disclosures, token traders operate under extreme information asymmetry. This paper examines the behavior of the pre‐IPO token market around private funding events, such as venture capital rounds, which often offer a rare glimpse into the private firm. We find that investor attention spikes around funding announcements, and token prices decline—particularly when valuation information is disclosed and pre‐event token prices are loftier. These findings suggest that information released around funding events tempers speculative fervor in a market that otherwise trades in the dark. This study may interest accountants and auditors evaluating tokenized securities and their underlying assets. It also contributes to the discussion on expanding individual investors' access to the private markets while ensuring appropriate safeguards. JEL Classification: G1, G4

Global biodiversity decreased by 69% from 1970 to 2022, representing a key risk to economic activity. However, the link between nature, biodiversity and finance has received little attention within the field of sustainable finance. This paper attempts to fill this gap. Nature finance aims to avoid biodiversity loss and promote nature-positive activities, such as the conservation and protection of biodiversity through market-based solutions with the proper measurement of impact. Measuring biodiversity impact remains a challenge for most companies and banks, with a fragmented landscape of nature frameworks. We conduct a bibliometric analysis of the literature on biodiversity finance and analyze a unique market dataset of five global investment funds as well as all corporate bonds issued in Brazil, the country with the largest biodiversity assets. First, we find that the literature on nature finance is recent with a tipping point in 2020, with the three most common concepts being ecosystem services, nature-based solutions and circular economy. Second, we find that sovereigns and two corporate sectors (food production, pulp & paper) represent the vast majority of issuers that currently incorporate biodiversity considerations into funding structures, suggesting an opportunity to expand accountability for biodiversity impacts across a greater number of sectors. Third, we find a disconnect between science and finance. Out of a catalogue of 158 biodiversity metrics proposed by the IFC, just 33 have been used in bond issuances and 32 by fund managers, suggesting an opportunity for technical assistance for companies and to simplify catalogs to create a common language. Lack of consensus around metrics, complexity, and cost explain this gap. Fourth, we identify a distinction between liquid markets and illiquid markets in their application of biodiversity impact management and measurement. Illiquid markets, such as private equity, bilateral lending, voluntary carbon markets or investment funds can develop complex bespoke mechanisms to measure nature, leveraging detailed catalogues of metrics. Liquid markets, including bonds, exhibit a preference for simpler metrics such as preserved areas or forest cover.

Association of Private Equity and Hospital Consolidation and Negotiated Prices of Radiologic Services.

Private equity (PE) firms have actively acquired substance use disorder treatment facilities in the past decade. Evidence on whether these acquisitions affect establishments' operations is limited. Using a novel catalog of treatment facilities acquired by PE firms and a difference-in-differences research design, we identified a relative increase in the probability that establishments accepted public health insurance after PE acquisition. We did not observe a differential change in the probability that the facility offered common forms of medication treatment. Our results suggest that PE acquisitions may increase participation in public insurance programs to expand the revenue sources at acquired facilities without necessarily changing the scope of service lines available.

The effects of private equity ownership in U.S. nursing homes quality and financial performance: A systematic review.

The role of private equity in the German outpatient sector.

In this episode of SoundPractice, host Mike Sacopulos interviews Ron Howrigon, President and CEO of Fulcrum Strategies, who has decades of experience in healthcare and managed care organizations. Howrigon discusses his career transition from negotiating provider contracts for major insurance companies to advocating for physicians and hospitals. He critiques the current U.S. healthcare system, highlighting its inherent flaws due to for-profit incentives, bureaucratic hurdles, and the declining autonomy of physicians. Howrigon also addresses pressing issues such as physician retirements, inadequate training pipelines, and the challenges posed by private equity in healthcare. He proposes reforms, such as holding insurance medical directors accountable, as practicing physicians, to improve patient care and reduce administrative burdens. The conversation concludes with insights into Fulcrum Strategies’ mission to help doctors achieve equitable reimbursement and navigate the complexities of managed care.

Very Large Group Private Practices/Management Organizations.

During the past several decades, physicians have transitioned from small, physician-owned practices to larger practices owned by corporations such as hospitals, private equity firms, and health insurers. UnitedHealth Group, the largest US health care company by revenue, sells insurance products under the UnitedHealthcare brand while providing health care services under the Optum brand, which has more than 90,000 aligned physicians. Although there are benefits to insurer-physician integration, potential concerns include regulatory gaming of the medical loss ratio and partial foreclosure of rival physician practices. This descriptive study used Centers for Medicare and Medicaid Services payer transparency data for the employer-sponsored and individual markets to show that when the relative price paid to Optum versus non-Optum providers is analyzed, UnitedHealthcare's payments are 17percent higher than the relative price of its competitors. In markets where UnitedHealthcare has 25percent or more market share, this percentage increases to 61percent. The results suggest that intercompany transactions within health care conglomerates may warrant scrutiny, as they may be signals of regulatory gaming or attempted foreclosure.

BackgroundThe fast-food industry has transformed substantially in recent decades – from diverse, locally rooted providers into a globalised, and increasingly corporate-led industry. Corporate fast-food retailers (FFRs) represent a key retail channel through which both ultra-processed foods and intensively produced animal source foods are consumed and normalised within corporate-industrial food systems. These dietary patterns are strongly associated with increased risks of diet-related diseases and contribute significantly to environmental degradation, including greenhouse gas emissions, land use change, and biodiversity loss. Despite the growing significance of FFRs, there has been limited analysis of their financial strategies and implications for global food system transformation.ResultsWe conducted a global analysis of market data from 54 countries and financial data of publicly listed FFRs, examining trends in FFR sales (2009–2023), market dominance, and the financial performance of leading publicly listed firms (1980–2023). We found that while sales in high-income countries were stagnating, leading firms maintained stable net profit margins and delivered relatively high shareholder returns, facilitated by financial strategies such as franchising and private equity ownership. U.S.-based corporations dominated the global market, with substantial expansion into countries outside the global North. These trends reflect the consolidation of power within the corporate food regime.ConclusionsThe global expansion of corporate FFRs underscore their growing influence over diets and food systems, with critical implications for public health, ecological sustainability, and social justice. Policies targeting structural leverage points, for example, democratising corporate governance, reducing the influence of private equity, and re-orienting agri-food subsidies, are essential to countering the entrenchment of this model and supporting more democratic and sustainable food systems.Clinical trial numberNot applicable.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12992-025-01158-9.

Building on the strategic entrepreneurship perspective and upper echelon theory, we examine the importance of private equity (PE) functional human capital and socio-demographic diversity for the success of the acquisitive growth strategy. Our focus is on the buyout lead partner team rather than on human capital at the collective PE firm (or fund) level. The results of our panel data survival models suggest that gender and age diversity, as well as the financial background, significantly accelerate both first and subsequent add-on acquisitions. The results are robust to alternative proxies, model specifications, and endogeneity checks. JEL Codes: G24, G34, J10, L26

Private equity firms directly employ 13 million people in the United States alone. With less transparency and regulation than publicly traded companies or government employers, private equity is rarely held accountable for poor labor practices. This paper offers an overview of teaching and learning resource by the Private Equity Stakeholder Project (PESP) on the role of private equity in the United States economy and its impact on the workforce. PESP resources that use government agency data, corporate documents, and examples from worker campaigns can help support a case for strengthening policy, legislation, and investment standards for private equity managers to protect workers.

The volume of percutaneous coronary intervention (PCI) at ambulatory surgical centers (ASC) is expected to increase. We surveyed US interventional cardiologists with a 58-question, anonymous online survey to evaluate their knowledge of and perspectives on ASC PCI. A total of 114 interventional cardiologists (9 fellows) responded. Participants were most commonly between 45 and 54 years old (33%). Most participants identified as male (95%), white (58%), non-Hispanic (95%), and with an academic affiliation (61%); 13 participants (11%) were PCI operators at an ASC. Most participants (59%) were in support of ASC PCI, 63% were very confident in their ability to decide if a patient is well-suited for ASC PCI, and 43% were not familiar with national and state-level laws/regulations of ASC PCI. Perceived benefits of ASC PCI included positive patient experience (69%), greater efficiency (79%), and lower costs for patients (50%) and institutions (53%). Participants reported a high level of concern about private equity involvement in ASC PCI (58%), occurrence of adverse events away from the hospital (47%), lower quality of care (39%), inappropriate patient selection (40%), inadequate regulatory standards (35%), and institutional pressures (47%). Supporters of ASC PCI reported a better self-assessed knowledge of it and perceived more benefits with fewer concerns. Most survey participants expressed support for ASC PCI, citing benefits such as improved patient experience, greater efficiency, and reduced costs. However, participants expressed concern for private equity involvement and the risk of adverse events occurring away from the hospital setting.

ABSTRACT This article investigates the sectors of housing and residential care in Austria regarding the extent of privatisation and exposure to financialisation through real estate investment, private equity or shareholder value orientation to ascertain reasons for Austria's comparatively low levels of financialisation. We argue that country-specific welfare regimes give rise to different degrees of financialisation of social provisioning. We refer to the regulatory frameworks and institutional arrangements enabling and/or restricting this process as bulwarks against or conduits for financialisation. At the more general level, we identify the conservative-corporatist welfare model with its emphasis on continuity and preference for incremental over drastic change as a key reason for the stability in welfare provision. Further, our sectoral analysis reveals three key bulwarks across both sectors, namely (1) path-dependent institutions that have developed out of Austrian social partnership; (2) widely (although not exclusively) upheld common-good stipulations for publicly funded goods and services; (3) strong frameworks of tenant, service users and workers' protection. However, we also see that financial investment opportunities are sought around the fringes by (1) taking advantage of fragmented regulations; (2) exploiting sectoral variation, for example, by investing in care homes as real estate.