Where the math is defensible.
Long-form research on live enterprise decisions. Publication is selective. Every number traces to a named source. No takes without evidence.
US healthcare private equity rollup at the antitrust inflection: physician practices, hospital chapter 11, and the 2026 refi wall
PE healthcare deal value has settled into the 80 to 100 billion dollar a year band after the 2021 peak, even as Envision and Steward have proven the LBO model can break, and the FTC, DOJ, and a growing list of state attorneys general are now writing rules around physician rollups.
Private equity ownership in US healthcare reached an inflection point between 2023 and 2026. Pitchbook tallied roughly 1,049 PE healthcare deals in 2024 with disclosed value near 115 billion dollars, well below the 2021 peak. KKR backed Envision Healthcare filed for chapter 11 in May 2023, wiping out about 7 billion dollars of equity. Cer...
US State Pensions 2026: USD 5.5 Trillion of Trust Money, an 80 Percent Funded Aggregate, and the CalPERS, CalSTRS, Texas TRS Allocation Reset
Federal Reserve Z.1 puts US state and local defined benefit assets at roughly USD 5.5 trillion at end 2024, with Pew Charitable Trusts marking the aggregate funded ratio in the 80 to 85 percent band on a market value basis. The 2024 fiscal year delivered a median public plan return near 9.7 percent, but discount rate compression, a 25 percent and rising allocation to alternatives, and an anti ESG patchwork from Florida, Texas, and West Virginia have replaced the funded status story with an asset strategy story. CalPERS at USD 540 billion, CalSTRS at USD 358 billion, and Texas TRS at USD 211 billion are the marginal price setters.
US state and local pension assets stood at approximately USD 5.5 trillion at end Q4 2024 per Federal Reserve Z.1 table L.120.b, against accrued liabilities that the Public Plans Database and Pew Charitable Trusts mark in the USD 6.7 to 6.9 trillion range, leaving an aggregate unfunded liability near USD 1.4 trillion and an aggregate funde...