Abhinav Gupta of Kenan-Flagler Business School, UNC Chapel Hill reviews “The Market Power of Technology: Understanding the Second Gilded Age” by Mordecai Kurz. The Econlit abstract of this book begins: “Examines the relationship between economic inequality and the technological market power of firms, considering its policy implications in light of the history of income and wealth inequality since 1889.”

Amid an aging population and a growing role for private equity (PE) in the care of older adults, this paper studies how PE ownership affects U.S. nursing homes using patient-level Medicare data. We show that PE ownership leads to a patient cohort with lower health risk. However, after instrumenting for the patient-nursing home match, we find that PE ownership increases mortality by 11%. Declines in measures of patient well-being, nurse staffing, and compliance with care standards help to explain the mortality effect. Overall, we conclude that PE has nuanced effects with adverse outcomes for a subset of patients.