Private Equity Ownership and Artificial Intelligence Adoption by Hospitals in the United States

Abstract Introduction Private equity (PE) firms own a growing share of United States hospitals and claim that capital infusions support technology investment. We examined the association between PE hospital ownership and the likelihood of artificial intelligence (AI) technology adoption. Methods We linked the 2024 American Hospital Association Annual Survey to a database of PE acquisitions and exits. Mixed-effects logistic models estimated any, clinical, and operational AI adoption by hospital ownership type, adjusting for hospital and market characteristics. In secondary analyses, we examined challenges to AI implementation. Results PE-owned hospitals had higher adjusted adoption of any AI (difference, 24.5 percentage points; 95% confidence interval, 11.2 to 37.8) and clinical AI (difference, 27.5 percentage points; 95% confidence interval, 14.0 to 41.1) than other for-profit hospitals but did not differ from not-for-profit hospitals. Operational adoption did not differ by ownership. In secondary analyses, not-for-profit hospitals reported any, cost and resource, and regulatory and safety challenges more often than PE-owned hospitals; PE-owned hospitals reported staff-training challenges more often than other for-profit hospitals. Conclusion PE-owned and not-for-profit hospitals had similar adoption of any and clinical AI, and both exceeded other for-profit hospitals, consistent with a capital access advantage that does not extend to the broader for-profit sector.