Project Grant R01AG097947

Federal Grant Award Summary

The National Institute on Aging (NIA) awarded Harvard Medical School a Project Grant totaling $683,924 on February 1, 2026, under the Aging Research program (CFDA 93.866) to conduct rigorous empirical research examining the effects of private equity (PE) acquisitions on patient outcomes and healthcare utilization in U.S. hospices. The five-year project, scheduled for completion on January 31, 2031, will deliver a comprehensive analysis of how PE-driven ownership changes in hospice facilities influence patient selection, service delivery patterns, and Medicare spending, utilizing a novel dataset linking hospice PE acquisitions to 100% Centers for Medicare & Medicaid Services Medicare claims data spanning 2016-2018. The research employs a quasi-experimental hypothesis-driven approach to investigate key mechanisms through which PE firms may alter hospice operations, including patient risk selection, length of stay patterns, discharge rates, and shifts toward lower-cost care modalities.

This work addresses a critical evidence gap in healthcare policy, as approximately half of U.S. hospices have transitioned from nonprofit to for-profit status over the past two decades with PE driving recent increases, yet rigorous evidence on PE's clinical and economic effects in hospice remains sparse. The project's findings are intended to inform policymakers and healthcare administrators regarding the consequences of PE acquisitions in a sector serving 67 million Medicare beneficiaries and accounting for approximately one-quarter of Medicare spending, leveraging existing evidence from other healthcare delivery settings demonstrating that PE acquisitions frequently correlate with increased mortality, adverse events, and healthcare expenditures.