# Substance use disorder treatment centers and facility ownership changes

> **NIH NIH R01** · YALE UNIVERSITY · 2024 · $747,956

## Abstract

Project Summary
An estimated 40.3 million adults and adolescents needed treatment for substance use disorders in 2020. Yet
only 6.5% of those needing treatment received it. Access to high-quality care remains a significant challenge.
In the past decade, private equity (PE) firms have acquired numerous substance use disorder (SUD) treatment
facilities, although evidence on the extent of these acquisitions is scarce. SUD treatment centers are attractive
targets for private equity acquisition due to increased need for SUD treatment, increased health insurance
coverage, and expansions in coverage of SUD treatments, all of which increase demand for treatment.
Opportunities for efficiencies due to the fragmented nature of the market and changes to regulations regarding
buprenorphine prescribing have the potential to increase profits. Commentators have raised concerns that a
focus on short term profits may lead to quality declines in private equity-acquired facilities. Similar acquisitions
in other areas of health care have resulted in declines in quality and increases in mortality. In this proposal, we
will, for the first time, comprehensively catalog and describe SUD facility acquisitions by private equity
investors from 2010-2022. We will we use a quasi-experimental difference in differences research design that
leverages differences in the timing of ownership changes to study changes in the delivery of care and patient
outcomes. Our interdisciplinary team consisting of faculty from the Yale Schools of Medicine, Management,
and Public Health is uniquely suited to study this issue with the methodological and substantive expertise to
assess the complex treatment and policy implications. Our specific aims are: (1) To catalog and describe
changes in private equity ownership of SUD treatment facilities (2010-2022) and the predictors of such
changes; (2) To determine whether private equity acquisition is associated with changes at the organization
level including changes in treatments offered (more facilities offering medication for opioid use disorder
(MOUD) treatment; fewer facilities offering primary care services or services attractive to complex patients) and
changes in the types of insurance accepted; (3) To determine whether private equity acquisition is associated
with changes in MOUD use, quality and patient insurance type in acquired facilities. Pressure to increase the
volume of commercially insured patients given the significantly higher reimbursement rates may lead to
reductions in the number of Medicaid patients treated; (4) To determine whether private equity acquisition is
associated with changes in OUD treatment quality and opioid-related adverse events in communities with
acquisitions. Ultimately, a goal of an SUD treatment facility is to improve health outcomes. Using commercial
insurance data, we will examine changes in treatment quality and health outcomes (OUD-related emergency
department visits). To our knowledge no information about...

## Key facts

- **NIH application ID:** 10811749
- **Project number:** 5R01DA057789-02
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Susan H Busch
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $747,956
- **Award type:** 5
- **Project period:** 2023-04-01 → 2027-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10811749

## Citation

> US National Institutes of Health, RePORTER application 10811749, Substance use disorder treatment centers and facility ownership changes (5R01DA057789-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10811749. Licensed CC0.

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