> "When health systems buy hospitals, they generally do not use borrowed money," said Song, who is also an internal medicine physician at Mass General. "In cont

> "When health systems buy hospitals, they generally do not use borrowed money," said Song, who is also an internal medicine physician at Mass General. "In contrast, the classic private equity buyout uses a small amount of cash, but a large amount of debt." This is a red herring. Health systems have different metrics for success than "the market". The former, ideally balances QoC with costs. The latter by definition only cares about ROI in terms of profits (either from revenue or from playing hot potato with other buyers). There's no reasonable argument why we should expect private equity to result in anything but a degradation of QoC if it doesn't have a considerable negative impact on profitability or resale value (and that's even ignoring situations in which a loss may be desirable or acceptable).