Private Equity Acquisition Of Primary Care Practices: Modest Growth In Clinicians Offset By Increased Clinician Exits

Private equity (PE) acquisition of primary care practices has raised questions about the effect on the clinician workforce, a key determinant of care continuity and access. We examined workforce changes after PE acquisition of 451 US primary care practices during the period 2018-22, using a difference-in-differences design with 2,241 matched independent control practices. Outcomes included the number of clinicians per practice and clinician exits, stratified by physician and advanced practice provider status. After acquisition, practices experienced a relative increase of 0.39 clinicians per practice, a 12.2 percent rise from the preacquisition mean of 3.2 clinicians per practice. Growth was observed for both the number of physicians (0.21) and the number of advanced practice providers (0.18). Exits increased by 0.22 clinicians per practice, largely driven by turnover among advanced practice providers. PE acquisition was associated with modest growth and higher advanced practice provider turnover, raising important questions about how ownership influences staffing dynamics in primary care, where workforce stability is critical to patient-centered delivery of care.