Steward Health Care quickly became a lesson for healthcare leaders about what can happen when private equity (PE) controls a system—specifically, what can go wrong. PE has become increasingly popular in healthcare in the last few decades, with investments growing from $5 billion annually in 2000 to an estimated $104 billion in 2024, according to accounting firm Cherry Bekaert. As of April 2025, PE firms owned 488 US hospitals, however, studies have shown PE can worsen quality of care, as we’ve previously reported. The downfall of Steward inspired lawmakers to create more regulations to keep hospitals operational, spurring an ongoing debate about whether PE has a place in healthcare’s future. History of Steward. Before Steward was Steward, it was a Catholic health system called Caritas Christi Health Care. But in late 2010, leaders agreed to sell the six-hospital system to New York PE firm Cerberus Capital Management for nearly $900 million. Caritas Christi, which was previously run by the Boston Archdiocese, had been facing financial complications amid the Catholic church’s child sex abuse scandal, which ultimately cost $3 billion in settlements across the US. See our final Quarter Century Project story here.—CM | 
