Private equity investment in long-term care: The case of Ireland.

BACKGROUND

Private equity (PE) firms are key actors in the financialisation of health care systems. Yet, research rarely focuses directly on these firms and related private for-profit actors involved in financialisation. Moreover, existing work mostly concerns the United States, while several key health care sectors remain under-researched.

OBJECTIVE

This study examines the factors driving PE investment in long-term care (LTC) and the strategies PE firms use to enter and expand within the sector.

METHODS

We conduct a thematic analysis of 20 in-depth interviews with expert informants, including senior executives from PE firms, financial investors and private for-profit providers. These interviews shed light on the role of PE in Ireland's LTC sector, specifically within nursing homes and home care.

RESULTS

Five key factors attract PE investment in Irish LTC: demographic trends, market composition, risk diversification, and the characteristics of state funding and regulation. In nursing homes, PE uses the "OpCo/PropCo" (operating company/property company) model. In home care, PE enters via global investments in parent companies, direct acquisitions of Irish firms, and master franchise agreements.

CONCLUSIONS

Examining private for-profit actors through key officials central to PE growth in LTC provides valuable insights into the financialisation of health care systems. This approach enhances our understanding of business interests driving investment in European LTC.