전망·동향
Rising and Disparate Trends in the Private/For-Profit Acquisition of Nonprofit Substance Use Treatment Facilities, US, 2019-2024
[Background]
- Private acquisition of public and nonprofit healthcare facilities is increasing throughout the United States (US). While privatization can be beneficial, growing evidence has demonstrated higher costs, larger patient volumes, and worsening outcomes. These trends are also apparent in substance use disorder (SUD) treatment facilities at a time when overdose and treatment demand are at an all time high. This study was designed to measure whether increases in private acquisitions of nonprofit substance use treatment facilities are happening faster in underrepresented and underresourced communities.
[Methods]
- We used the Mental health and Addiction Treatment Tracking Repository (MATTR) to identify SUD treatment facilities that were nonprofit/public owned in 2019 (N？=？2826 facilities). Our outcome was whether a facility became privatized and owned by a for-profit company by 2024. We linked MATTR to demographic census data and modeled privatization using a generalized estimating equation with a modified Poisson distribution, log link function, and robust standard errors.
[Results]
- Twenty percent (n？=？572) of public/nonprofit SUD treatment facilities were privatized between 2019 and 2024. Privatization of nonprofit/public facilities was more common in communities with lower household incomes (p？<？0.01).
[Conclusion]
- Private acquisition of nonprofit/public SUD treatment facilities increased between 2019 and 2024. Acquisitions were disproportionately located in communities with higher rates of low-income households. Private acquisition can be beneficial for some facilities, but a growing evidence base is demonstrating how privatization is generally followed by worsening health outcomes in the process of restructuring and reselling at a profit. Treatment systems must not be extractive. Oversight and community involvement may help ensure mutual beneficence.
- Private acquisition of public and nonprofit healthcare facilities is increasing throughout the United States (US). While privatization can be beneficial, growing evidence has demonstrated higher costs, larger patient volumes, and worsening outcomes. These trends are also apparent in substance use disorder (SUD) treatment facilities at a time when overdose and treatment demand are at an all time high. This study was designed to measure whether increases in private acquisitions of nonprofit substance use treatment facilities are happening faster in underrepresented and underresourced communities.
[Methods]
- We used the Mental health and Addiction Treatment Tracking Repository (MATTR) to identify SUD treatment facilities that were nonprofit/public owned in 2019 (N？=？2826 facilities). Our outcome was whether a facility became privatized and owned by a for-profit company by 2024. We linked MATTR to demographic census data and modeled privatization using a generalized estimating equation with a modified Poisson distribution, log link function, and robust standard errors.
[Results]
- Twenty percent (n？=？572) of public/nonprofit SUD treatment facilities were privatized between 2019 and 2024. Privatization of nonprofit/public facilities was more common in communities with lower household incomes (p？<？0.01).
[Conclusion]
- Private acquisition of nonprofit/public SUD treatment facilities increased between 2019 and 2024. Acquisitions were disproportionately located in communities with higher rates of low-income households. Private acquisition can be beneficial for some facilities, but a growing evidence base is demonstrating how privatization is generally followed by worsening health outcomes in the process of restructuring and reselling at a profit. Treatment systems must not be extractive. Oversight and community involvement may help ensure mutual beneficence.
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