Profits, Providers, and Private Companies: What Happens When Wall Street Owns Your Neonatal Care

The study by Yu et al in this issue of Pediatrics¹ is the first study to explore the consequences of physician management companies (PMCs) on costs and outcomes of neonatal care. As the proportion of the economy devoted to health care has continued to expand in the United States to 18.3% of the gross domestic product in 2021, private equity funds and PMCs have increased their involvement in the health care market. First seen in the 1990s, both private equity firms, which are private or publicly owned companies that purchase or invest in hospitals or physician practices; and PMCs, which are companies that both purchase and run the business side of a physician practice including negotiating fee structures with insurance companies, have substantially increased their involvement in the health care system since 2010. Specialties particularly affected include dermatology,² fertility and obstetric care,^3,4 ophthalmology,⁵ and...