Key Takeaways
- • Private equity healthcare deals nationwide fell 18.5% over the year through Q2 2026, according to a PitchBook report published the prior week.
- • Deals giving private equity control of clinical practice management services dropped nearly 36%, from 111 to 71 over the same period.
- • PitchBook attributed the slowdown partly to state laws, including Oregon's 2025 law that bars management services organizations from controlling local clinics and took effect in January 2026.
- • Enforcement remains unresolved: the Oregon law is privately enforced through clinic lawsuits, and Rep. Nancy Nathanson is pushing for stronger attorney general authority.
Summary
A new industry report finds that Oregon's 2025 corporate practice of medicine law is part of a broader wave of state restrictions making it harder for private equity firms to acquire healthcare services. According to a report published last week by PitchBook, private equity deals for health care services nationwide declined 18.5% comparing the second quarter of 2025 with the second quarter of 2026. Deals allowing private equity firms to take control of the management services of a clinical practice fell nearly 36%, from 111 to 71 over the same period.
PitchBook partially attributed these developments to heightened state scrutiny, citing "tighter regulations slowing deal processes." The report pointed to Oregon's law, which prohibits management services organizations from owning local clinics or holding majority control over a practice, and which restricts reliance on out-of-state physicians who own the clinical side while investors control administrative or billing functions. The report stated that Oregon's restrictions, effective January 2026, target the "friendly physician" model and, combined with other state developments, are "lengthening transaction timelines, increasing deal costs and complexity and making serial roll-up strategies more complicated to execute."
The Oregon Medical Association welcomed the findings. Courtni Dresser, the association's vice president of government relations, said in a statement that it is "a positive development if it means that PE-backed deals that edge out clinical decision making in favor of corporate interests are becoming harder to put in place."
The law gained support in the 2025 session following Optum's takeover of Oregon Medical Group in the Eugene-Springfield area, which led to the departure of dozens of doctors bound by agreements restricting them from joining other local practices. Optum reversed course after lawmakers applied pressure in May 2024, and the Oregon law rendered such agreements largely unenforceable. However, the law is enforced through legal action by medical clinics rather than state agencies, and lawmakers and the Oregon Medical Association have called for stronger enforcement provisions in a future session. Democrats have not made an explicit commitment to do so. Rep. Nancy Nathanson, D-Eugene, argued that the attorney general and Department of Justice need tools to enforce the laws.
The law has not yet been used to block a private equity deal. It was, however, central to a federal case in which emergency physicians in Lane County reached a settlement with PeaceHealth earlier this year over a potential replacement by ApolloMD, an Atlanta-based staffing company. PeaceHealth said its arrangement complied with state law. U.S. District Judge Mustafa Kasubhai described ApolloMD's arrangement with a local emergency physician firm as a "handshake and a wink" that allowed the company to conceal its influence over the firm's decisions.
PitchBook partially attributed these developments to heightened state scrutiny, citing "tighter regulations slowing deal processes." The report pointed to Oregon's law, which prohibits management services organizations from owning local clinics or holding majority control over a practice, and which restricts reliance on out-of-state physicians who own the clinical side while investors control administrative or billing functions. The report stated that Oregon's restrictions, effective January 2026, target the "friendly physician" model and, combined with other state developments, are "lengthening transaction timelines, increasing deal costs and complexity and making serial roll-up strategies more complicated to execute."
The Oregon Medical Association welcomed the findings. Courtni Dresser, the association's vice president of government relations, said in a statement that it is "a positive development if it means that PE-backed deals that edge out clinical decision making in favor of corporate interests are becoming harder to put in place."
The law gained support in the 2025 session following Optum's takeover of Oregon Medical Group in the Eugene-Springfield area, which led to the departure of dozens of doctors bound by agreements restricting them from joining other local practices. Optum reversed course after lawmakers applied pressure in May 2024, and the Oregon law rendered such agreements largely unenforceable. However, the law is enforced through legal action by medical clinics rather than state agencies, and lawmakers and the Oregon Medical Association have called for stronger enforcement provisions in a future session. Democrats have not made an explicit commitment to do so. Rep. Nancy Nathanson, D-Eugene, argued that the attorney general and Department of Justice need tools to enforce the laws.
The law has not yet been used to block a private equity deal. It was, however, central to a federal case in which emergency physicians in Lane County reached a settlement with PeaceHealth earlier this year over a potential replacement by ApolloMD, an Atlanta-based staffing company. PeaceHealth said its arrangement complied with state law. U.S. District Judge Mustafa Kasubhai described ApolloMD's arrangement with a local emergency physician firm as a "handshake and a wink" that allowed the company to conceal its influence over the firm's decisions.
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