Re: Concerns Regarding Private Equity in Healthcare

Deborah McKnight PhD ANP-C

1912 Spinnaker Ln

Azle Tx, 76020

(214) 900-8569

June 5, 2024

Federal Trade Commission

600 Pennsylvania Avenue, NW

Washington, DC 20580

Department of Health and Human Services

200 Independence Avenue, SW

Washington, DC 20201

Re: Concerns Regarding Private Equity in Healthcare

Dear Mr. Kanter, Mr. Becerra, and Ms. Khan,

I’m reaching out to share my deep concerns about the growing involvement of private equity firms in the healthcare sector and how it’s negatively affecting patient care, healthcare costs, and the quality of services overall.

As a small practice owner, I’ve seen firsthand how these changes impact both patients and providers. Over the past few years, Medicare Advantage (MA) plans have lured many of our patients away from traditional Medicare with promises like paying for groceries or utility bills. But once these patients switch, they often face denials for services that would have been covered under traditional Medicare. This bait-and-switch tactic not only jeopardizes patient care but also strains the financial stability of small practices like mine.

Please review these relevant excerpts and their citations of wanton profit over patients abuses of our healthcare system.

  1. The Office of Inspector General (OIG) has highlighted issues with MA plans, noting that some plans deny or delay services that beneficiaries are entitled to, which has a direct negative impact on patient health. This kind of behavior is unacceptable and underscores the need for stricter oversight and regulation.
  1. Hospitals and doctors are increasingly dropping out of private Medicare plans due to the administrative burdens and financial pressures these plans impose . This exodus further limits patient access to necessary care and highlights the detrimental impact of prioritizing profit over patient welfare.
  1. Private equity-owned physician practices are frequently resold within a few years, leading to instability and inconsistent patient care . This frequent turnover disrupts the continuity of care that is crucial for effective treatment and patient trust.
  1. A study in the Journal of Health Economics found that private equity acquisitions often lead to higher prices and reduced quality of care, disadvantaging patients. This is particularly troubling for small practices struggling to compete with larger, profit-driven entities.
  1. An opinion piece in The Hill pointed out that while private equity investments might bring much-needed capital, they often result in cost-cutting measures that undermine the quality of care and place undue stress on medical professionals. Maintaining the integrity and focus of healthcare on patient well-being rather than shareholder profits is critical.
  1. Additionally, extensive lobbying by Medicare Advantage plans has influenced Congress to make policy decisions that favor the financial interests of these plans over the healthcare needs of beneficiaries. This is evident in the findings reported by the Center for Public Integrity.
  1. An antitrust investigation into UnitedHealth Group by the U.S. government highlights the need for competitive healthcare markets and preventing domination by a few powerful entities.
  1. The significant financial influence of the healthcare industry on political campaigns and policymakers, as documented by OpenSecrets, can lead to policies prioritizing industry profits over patient care and public health.
  1. A report from Penn Medicine showed that over one-third of Congressional members hold significant healthcare-related financial assets, raising concerns about potential conflicts of interest in policymaking.
  1. Insurance lobbyists for Medicare Advantage exert considerable influence over policy decisions, often resulting in regulations that benefit insurers at the expense of patients. This is detailed in The American Prospect.
  1. The Texas Public Policy Foundation has discussed the issue of prior authorization, where insurers effectively practice medicine by requiring approvals for treatments and medications, delaying necessary care and undermining healthcare professionals’ judgment .
  1. Moreover, articles from various sources have highlighted fraud within UnitedHealth’s Medicare Advantage plans, described Medicare Advantage as a scam that exploits beneficiaries while overcharging taxpayers, reported that MA plans often reject claims affecting rural hospitals’ ability to provide care, and revealed how these plans overcharged taxpayers and dodged auditors.

Based on these observations, I urge the FTC and HHS to consider the following actions:

1. Strengthen Regulations on Private Equity Ownership in Healthcare: Implement stricter guidelines to ensure that private equity firms do not prioritize profits over patient care. This includes enhanced scrutiny of acquisitions and resales of healthcare practices.

2. Enhance Oversight of Medicare Advantage Plans: Increase monitoring and enforcement to prevent inappropriate practices by MA plans, ensuring that beneficiaries receive the services they are entitled to without undue delays or denials.

3. Promote Transparency in Healthcare Transactions: Require detailed disclosures of financial transactions and ownership changes in healthcare organizations to maintain accountability and transparency.

4. Support Non-Profit Healthcare Models: Encourage and support healthcare models that prioritize patient care over profit, potentially through incentives or regulatory frameworks that favor non-profit ownership structures.

The ongoing trend of private equity in healthcare poses significant risks to patient care and the integrity of our healthcare system. It is imperative that the FTC and HHS take decisive action to address these issues and protect the well-being of patients nationwide.

Thank you for considering my concerns. I look forward to your response and any actions you may take to mitigate these challenges.


Deborah McKnight PhD ANP-C


  1. U.S. Department of Health and Human Services. Office of Inspector General. Medicare Advantage Compliance Audit of Specific Plans. Available at: Accessed June 5, 2024.
  2. Whyte L. Hospitals and doctors drop private Medicare plans. Yahoo News. Available at: Accessed June 5, 2024.
  3. Anderson E. Half of private equity-owned physician practices are resold within 3 years. RevCycle Intelligence. Available at: Accessed June 5, 2024.
  4. Bruch JD, et al. Effects of private equity acquisitions on healthcare quality and costs. Journal of Health Economics. 2023; Available at: Accessed June 5, 2024.
  5. Bernstein L. Private equity in healthcare: Why doctors are selling. The Hill. Available at: Accessed June 5, 2024.
  6. Arnsdorf I. Medicare Advantage lobbying machine steamrolls Congress. Center for Public Integrity. Available at: Accessed June 5, 2024.
  7. Mathews AW, Evans M. U.S. launches antitrust investigation of UnitedHealth. Wall Street Journal. Available at: Accessed June 5, 2024.
  8. OpenSecrets. Healthcare industry financial influence. Available at: Accessed June 5, 2024.
  9. Penn Medicine News. Over one-third of congressional members held significant healthcare-related financial assets. Available at: Accessed June 5, 2024.
  10. Dayen D. Insurance lobbyists and Medicare Advantage. The American Prospect. Available at: Accessed June 5, 2024.
  11. Atlas S. Prior authorization: When insurers practice medicine. Texas Public Policy Foundation. Available at: Accessed June 5, 2024.
  12. Whistleblower Attorneys. UnitedHealth Medicare Advantage fraud. Available at: Accessed June 5, 2024.