Who Owns Medicaid?
Private equity is buying up Medicaid providers. Solo practices become aggregators become financial platforms. The system is consolidating — and nobody tracks who owns what.
Thursday, February 19, 2026|~11 min
“The Medicaid system isn't just healthcare. It's becoming a financial asset class.”
Key Findings
- Top 10 providers include 3 PE-backed aggregators
- 15+ major M&A transactions in personal care (2019-2024)
- Aggregators operate at 12-18% margins vs 3-5% for solo providers
Data Points
Top PE-backed provider: $3.2B in Medicaid spending
Provider count stable but ownership consolidating
NPI system has no ownership tracking capability