Private Equity Acquisition and Buprenorphine Prescribing

Area of Science:

• Health Services Research
• Addiction Medicine
• Health Economics

Background:

• Private equity investment in US healthcare, particularly substance use disorder (SUD) treatment, is rising.
• The impact of private equity (PE) acquisition on buprenorphine access and care quality in SUD facilities remains unclear.

Purpose of the Study:

• To investigate the association between PE acquisition of SUD treatment facilities and buprenorphine prescribing patterns.
• To analyze changes in patient volume, prescription volume, payer mix, and treatment retention following PE acquisition.

Main Methods:

• A cross-sectional study utilizing difference-in-differences analysis compared buprenorphine prescription claims from acquired vs. non-acquired SUD facilities.
• Data spanned from Q3 2019 to Q2 2021, including adult patients (>18 years).
• An event study design assessed changes from 4 quarters pre- to 4 quarters post-acquisition using adjusted linear models.

Main Results:

• PE acquisition correlated with increased patient volume (mean increase of 65.66 patients per facility quarter) and buprenorphine prescriptions (mean increase of 163.90 per facility quarter).
• A slight increase in cash-paid prescriptions was observed post-acquisition (0.73 percentage points).
• Treatment retention decreased significantly, with 90-day retention dropping by 6.24 and 180-day retention by 7.91 percentage points.

Conclusions:

• PE acquisition in SUD treatment facilities leads to higher buprenorphine patient volumes but is associated with reduced treatment quality, indicated by shorter retention durations.
• These findings highlight the need for oversight to ensure PE investment in addiction care supports evidence-based treatment quality.