Exhibit 4.

Differential change in types of medication therapies offered associated with private equity (PE) acquisition of substance use disorder treatment facilities, 2009–22

Source/Notes: SOURCE Authors’ analysis of data from the National Survey of Substance Abuse Treatment Services paired with a data set of PE acquisitions. NOTES This exhibit plots event-time coefficients documenting the association between PE acquisition in relative year zero and three outcome indicators. All values are derived using the discussed modified difference-in-differences estimator. Establishment, year, and state-by-year fixed effects are included in all estimates. Outcome indicators distinguish whether a given form of medication treatment is offered at a substance use disorder treatment establishment. All coefficients are estimated in comparison with the year immediately before acquisition. Vertical bars indicate 95% confidence intervals calculated from standard errors clustered by establishment. Reported p values are from an F-test of the significance of all preacquisition coefficients: Naltrexone pre-period, p = 0.066; Methadone pre-period, p = 0.708; Buprenorphine pre-period, p < 0.001.