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HEALTHCARE MARKET REPORTFY2016
1
-10%-5%0%5%
10%15%20%25%30%35%
2014 - 2016 Market Performance
NASDAQ Composite Index S&P 500 Index Dow Jones Industrial Average
FY2016 OVERALL MARKET UPDATE AND ECONOMIC REVIEW
Empirically, M&A activity appears to be slowing. For the year, total transaction valuewas essentially flat at $1.5T while the number of deals declined ~15% from 3,329 in2015 to 2,829. Most of the gains achieved in volume and value of transactions earlier inthe year were erased by weak 4Q16 results. QoQ, transaction volume was down 15%and total deal value declined almost 20%.
FY2016 M&A UPDATE
Anecdotally, most sell-side advisors and strategic and financial buyers gathered at the2017 JPM Healthcare Conference complained about the dearth and quality of deal flow.Seller valuation expectations remain high, and buyers seem reluctant to pay theseprices, particularly this late in a business cycle. Many companies are deferring thelaunch of processes until they are confident financial results can clear the highoperating performance and diligence bar that justifies a premium valuation. Oncebuyers and sellers reach terms, hungry capital markets, particularly bank and non-banklenders, remain eager to finance deals.
Source: Capital IQ.
Amidst this undercurrent of scarce deal flow, investors remain intensely interested inthe healthcare sector, particularly outsourced physician services, behavioral healthcareand value-based healthcare. There was very little discussion of Trump’s pendingdismantling of Obamacare. Despite these sentiments, BCA’s deal flow remains fairlystrong. This month we launched ophthalmology, tech-enabled revenue cyclemanagement and SaaS value-based performance management analytics transactions.
STOCK MARKET
All major indices continue their upward climb fueled largely by historically low interestrates (ZIRP). YoY, the S&P 500 was up 11.2%; NASDAQ, 9.8%; and DJIA, 15.2%. Aftershaking off U.S. election night jitters and significant volatility, the “Trump Bump” hashelped all indices rebound strongly, hitting record highs and culminating with the DJIAcrossing through the 20,000 threshold in late January. Markets are rallying aroundoptimism for lower tax rates, fewer regulations and other pro-business initiativespromised by the new Trump administration.
Some of this optimism is grounded in better corporate earnings growth. If companiescontinue to report positive earnings for 4Q16, it will mark the first time in two yearsthat there have been two consecutive quarters of YoY earnings growth. However, withonly 3% earnings growth, these markets continue to be priced for perfection. U.S.equities have only been more expensive than current levels 10% of the time in thepost-WW2 period. To support current market levels, the U.S. economy must accelerateand put some wind in the sails of corporate earnings.
602
788
859 985
824 826 849 869
738 682
761 647
$0
$50
$100
$150
$200
$250
$300
$350
$400
$450
-100
100
300
500
700
900
1,100
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
2014 2015 2016
Total Transaction Value($ in billions)
Tran
sact
ion
Volu
me
Middle-Market Quarterly M&A Activity - All Sectors
$25 - $100 $101 - $250 $251 - $500
$501 - $750 Over $750 Total Transaction Value
2
FY2016 OVERALL MARKET UPDATE AND ECONOMIC REVIEW
Job growth remains subdued and may actually be slowing. Non-farm payroll growthaveraged 165K per month in 4Q16 versus 197K in 3Q16. Job growth has also trendeddownward over the last three years, averaging 258K per month in 2014, 210K in 2015 and182K in 2016. As a reference, non-farm payroll would have to average 300K per month toachieve 3% GDP growth and 400K per month for 4% GDP growth.
NON-FARM PAYROLL
Unemployment, as measured by U-3, finished 2016 at 4.7% and was below 5% for most ofthe year. U-6 unemployment finished the year at 9.2% and was below 10% for the entireyear. Both measures are near 10-year lows. A good part of the decline in unemployment hasbeen driven by a decline in the labor participation rate, which at 62.7% in Decemberrepresents one of the lowest levels since the mid 1970s. Although some of this decline canbe attributed to an aging population, 15 million people have left the workforce since early2009 and a significant percentage of these workers are discouraged and have either stoppedlooking for work or are underemployed.
GROSS DOMESTIC PRODUCTWith almost $20T in debt, achieving higher GDP growth is the biggest challenge facing theU.S. and the only way to right size its balance sheet. Entitlements spending now consumesapproximately 75% of the U.S.’ annual budget. When FDR introduced Social Security in1935 and LBJ enacted Medicare in 1965, the average beneficiaries’ life expectancy expiredprior to being eligible for benefit and represented a small cost to U.S. taxpayers. Now, withthe average life expectancy of 79 years old, these entitlements are consuming an everincreasing percentage of the budget. The only way to afford these entitlements is to eitherreduce benefits, raise taxes or grow the size of the economy.
Between WW2 and 2008, U.S. GDP grew 3.1% per year on average. Post 2009’s GreatRecession, GDP growth has averaged 2.1% despite record levels of fiscal and monetarystimulus. Although the economy created 11.5 million jobs of various quality over this period,the number of new jobs required by population and immigration growth is 15 to 17 millionover the same period. The net effect is very little real job growth. Perhaps a more tellingstatistic is average household income, which remains stubbornly 2-3% below the 1999 peakof $57.9K.
Although 3Q16 GDP’s headline growth was 2.9%, most of the increase was due to asignificant, one-time increase in soybean exports to South America and China that accountedfor almost 1% of the quarter’s total. Baseline GDP growth remains mired at 2%. Without anyone-time increases in exports, 4Q16 GDP was 1.9% and 1.6% for the whole year.
UNEMPLOYMENT
Source: Bureau of Labor Statistics
Source: Bureau of Labor Statistics
050
100150200250300350400
Jan
Mar
May Ju
lSe
pN
ov Jan
Mar
May Ju
lSe
ptN
ov Jan
Mar
May Ju
lSe
pN
ov Jan
Mar
May Ju
lSe
pN
ov Jan
Mar
May Ju
lSe
pN
ov
2012 2013 2014 2015 2016
(in th
ousa
nds)
Historical Change in Non-Farm Payrolls
3%
6%
9%
12%
15%
18%
Jan
Apr
Jul
Oct Jan
Apr
Jul
Oct Jan
Apr
Jul
Oct Jan
Apr
Jul
Oct Jan
Apr
Jul
Oct Jan
Apr
Jul
Oct Jan
Apr
Jul
Oct Jan
Apr
Jul
Oct
2009 2010 2011 2012 2013 2014 2015 2016
Unemployment
U-6 Unemployment Traditional Unemployment
-10.0%-8.0%-6.0%-4.0%-2.0%0.0%2.0%4.0%6.0%
Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
GDP Growth
The Obama Administration has dealt President Trump a mediocre economic hand. The U.S.is in the seventh year of the worst economic recovery in the post-WW2 era. Our nationaldebt has nearly doubled, 15 million Americans have left the workforce and 43 million peopleare on food stamps. However, for the third time in the same period, Republicans nowcontrol both Houses of Congress and the Executive Branch. The pro-business TrumpAdministration will have a chance to enact real legislative and fiscal reform, and perhapseven attain their goal of 4% GDP growth and the creation of 25 million jobs over the nexteight years.
3
(dollars in millions)Announced Enterprise
Date Private Equity Firm Target Value(1)
12/21/16 BBH Capital Partners American Physician Partners $208.412/20/16 TPG Capital, L.P. Mediware Information Systems, Inc. N/A12/19/16 Bain Capital Private Equity Epic Health Services, Inc. N/A12/19/16 Thomas H. Lee Partners, L.P. Professional Physical Therapy N/A11/25/16 CC Capital Management, LLC Constellation Healthcare Technologies $273.010/31/16 The BlackStone Group Team Health Holdings, Inc. 6,020.110/14/16 GTCR, LLC Riverchase Dermatology N/A8/20/16 Summit Partners LLP HealthSun Health Plans Inc. 1,000.08/9/16 EQT Partners AB Press Ganey Holdings, Inc. 2,382.28/4/16 BBH Capital Partners Haven Behavioral Healthcare, Inc. 39.58/1/16 Pritzker Group Private Capital; Vesey
Street Capital Partners, L.L.C.PathGroup, Inc. N/A
7/13/16 ThomaBravo, LLC Imprivata, Inc. 496.95/18/16 Harvest Partners, LP Advanced Dermatology & Cosmetic Surgery
Inc.N/A
5/5/16 Hellman & Friedman LLC; Leonard Green & Partners, LP; GIC Pte.
MultiPlan, Inc. 7,500.0
4/25/16 Veritas Capital Verisk Health; MediConnect Global, Inc. 820.03/23/16 GI Partners, LLC Netsmart Technologies Inc. 950.0
(1) Data from SEC fi l ings and Capital IQ.
BCA Proprietary Data
BCA Proprietary Data
$422 $477
$512
$650
$737
$649 3,036
3,423 3,321
4,098 4,131
3,538
0
600
1,200
1,800
2,400
3,000
3,600
4,200
$0
$200
$400
$600
$800
2011 2012 2013 2014 2015 2016
# of Transactions
($ in
bill
ions
)
Capital Invested # of Deals Closed
$87 $104
$205 $195 $193 $180
190 204
295 311
287 252
0
50
100
150
200
250
300
350
$0
$50
$100
$150
$200
$250
$300
2011 2012 2013 2014 2015 2016
# of Transactions
($ in
bill
ions
)
Capital Raised # of Funds Closed
PRIVATE EQUITY ACTIVITY
TOTAL PRIVATE EQUITY FUNDRAISING ACTIVITYTOTAL PRIVATE EQUITY ACQUISITION ACTIVITY
Source: Pitchbook Source: Pitchbook
SELECT PRIVATE EQUITY TRANSACTIONS Private equity funds invested $649 billion in 3,538 transactions in 2016,
significantly down from $737 billion invested in 4,131 transactions in 2015.
− Transaction volume declined 14.4% in 2016 compared to 2015.
The decline in PE-backed transactions is accelerating due to continued highvaluations, market uncertainty and a lack of quality acquisition targets.
Many sponsors are unable to justify paying the high valuation multiples that sellersare demanding when growth prospects are low, further fueling the activity decline.
Exit activity continues to decrease as PE firms garnered $316 billion in proceedsfrom 1,097 transactions in 2016, representing a 22.1% YoY decrease in value and a18.0% decrease in the number of exits.
Total PE fundraising decreased in 2016 with $180 billion in capital raised across252 funds. A majority of the activity continues to be from LPs committing to mega-funds. In 2016, 89% of funds hit their stated fundraising target, marking thehighest point in the last decade.
4
$0$3$6$9
$12$15$18$21$24
Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3
2011 2012 2013 2014 2015 2016Loan
Vol
ume
by Q
uart
er ($
billi
ons)
Institutional Pro Rata
L+
L+ 100
L+ 200
L+ 300
L+ 400
L+ 500
2011 2012 2013 2014 2015 YTD 2016
Aver
age
Spre
ad O
ver L
IBO
R
Revolving Credit / Term Loan A Weighted-Average Institutional
LEVERAGED LOAN MARKET
SELECT RECENT HEALTHCARE DEBT DEALS
RECENT LEVERAGED LOAN STATISTICS (1) The capital markets remain hungry and competitive for high quality transaction acrossa broad range of industries.
Opportunistic loan activity (i.e. refinancings and dividend recapitalizations) accountedfor 55% of market volume in 3Q16, marking the highest level in over three years.
Refinancing activity drove 2H16 new business, representing approximately 70% of allnew issuances in the 2nd half of the year. Middle market sponsored loan volumeremains light due to the slowdown in M&A activity.
Unitranche loans continue to gain popularity as the structure provides more flexibilityand greater certainty to close.
The Fed announced a 0.25% rate increase at its December FOMC meeting, only thesecond time in a decade that the Fed has raised rates. The rate hike signifies the Fed’sconfidence in the improving domestic economy. The Fed signaled that there are likelyto be three rate increases in 2017.
Low transaction volume relative to lender demand is expected to sustain favorablemiddle market credit conditions in 2017.
Healthcare ServicesHealthcare ITNon-Healthcare
Debt as a Multiple of EBITDASenior Debt Total Debt
3.0x5.0x3.5x
4.0x6.0x4.5x
PricingFloorUpfront FeesUnused
Leverage Pricing and Fees
25 - 37.5 bps25 - 37.5 bps50 bps
-L + (4.0 - 4.75%)
Bank Non - Bank
L + (5.0 - 6.0%)-
100 bps
(1) Indicative debt multiples are for borrowers with at least $10 million of EBITDA.
AVERAGE SPREAD ON HEALTHCARE LOANSQUARTERLY HEALTHCARE LOAN VOLUME
Date Borrower Industry Tranche Type Rating Spread11/30/2016 Acadia Healthcare Psychiatric hospitals 900$ Term Loan A NR / NR L+40011/4/2016 Valley Stream Operator I LLC Skilled nursing care facilities 106 Term Loan NR / NR NA10/19/2016 Community Care Health Network Inc. Hospital/medical services plan 208 Term Loan B NR / NR L+55010/17/2016 Select Rehabilitation Inc Home health care services 156 Term Loan A NR / NR L+3759/28/2016 Providence Health & Services General med'l/surgical hospitals 550 Revolver/Line >= 1 Yr. NR / NR L+557/1/2016 Envision Healthcare Health and allied services, nec 6,300 Term Loan NR / NR NA6/7/2016 CHG Healthcare Services Health and allied services 1,365 Term Loan NR / NR L+375
3/18/2016 HCA Inc General med'l/surgical hospitals 1,500 Term Loan B Ba1 / BBB- L+325
5
(dollars in millions)Announced Enterprise
Date Acquiror Target Value(1)
12/21/16 Brown Brothers Harriman & Co. American Physician Partners $208.412/12/16 Fujian Thailot Investment Co., Ltd. Alliance Healthcare Services, Inc. $710.710/31/16 The BlackStone Group Team Health Holdings, Inc. 6,020.18/20/16 Summit Partners LLP HealthSun Health Plans; Wellmax
Medical Centers; Pasteur Medical1,000.0
8/9/16 EQT Partners AB Press Ganey Holdings, Inc. 2,382.28/1/16 Brown Brothers Harriman & Co. Haven Behavioral Healthcare, Inc.
6/15/16 Envision Healthcare Holdings, Inc. AmSurg Corp. 7,609.55/25/16 Urgent Team Physicians Care, P.C.5/5/16 Hellman & Friedman LLC; Leonard
Green & Partners, LP; GIC Pte.MultiPlan, Inc. 7,500.0
5/5/16 Encompass Home Health Camellia Healthcare5/3/16 Quintiles Transnational Holdings IMS Health Holdings, Inc. 13,170.5
4/28/16 Abbott Laboratories St. Jude Medical Inc. 29,840.83/8/16 Nordic Capital; Novo A/S eResearchTechnology, Inc. 1,800.0
2/29/16 MAXIMUS, Inc. Ascend Management Innovations2/18/16 IBM Watson Health Truven Holding Corp. 3,593.01/11/16 Shire plc Baxalta Incorporated 35,218.9
(1) Data from SEC filings and Capital IQ.
BCA Proprietary
BCA Proprietary
BCA Proprietary
BCA Proprietary
BCA Proprietary
80%
90%
100%
110%
120%
1/1/2016 4/1/2016 7/1/2016 10/1/2016 1/1/2017
NASDAQ S&P 500 S&P Healthcare Index
HC, 339
All Other,
719
IPO, 46
Follow-on, 293
HEALTHCARE INDUSTRY OVERVIEW
FY 2016 HEALTHCARE PUBLIC OFFERINGSLTM HEALTHCARE INDEX VS. S&P & NASDAQ
SELECT 2016 HEALTHCARE M&A TRANSACTIONS For the last twelve months ended December 31, 2016, healthcare stocks’ 2.5%decrease significantly underperformed the NASDAQ’ 9.8% increase and S&P500’s 11.2% increase.
The stock market has recovered from 1Q16 losses that were driven by thesuspension of QE and decreased oil prices, though the announcement of Britain’sdecision to leave the EU caused volatility in the equity markets in June 2016.− Healthcare stocks ended 4.3% lower for 4Q16 primarily due to the post-
election uncertainty surrounding the future of the ACA. The S&P 500 andNASDAQ were up 3.6% and 1.6%, respectively.
339 of the 1,058 announced public offerings in 2016 were healthcare-related,including 46 IPOs and 293 follow-on offerings.− IPOs announced in 2016 included Cotiviti Holdings, Inc., NantHealth, Inc.,
Tactile Systems Technology, Inc. and iRhythm Technologies, Inc.
Large healthcare transactions continued to lead 2016 M&A activity including TheBlackstone Group’s announced acquisition of Team Health Holdings, Inc. for $6.0billion and Envision’s merger with AmSurg Corp. for $7.6 billion.
2016 healthcare M&A activity declined relative to 2015, with 2016 value andvolume lower than levels achieved in 2015.
Source: Capital IQ. Source: Capital IQ.
$ in billions$ Value # Offerings HC # by Offering Type
HC, $24,261
All Other, $171,228 Select Public Offerings ($ in millions)
Offer Date Issuer Industry IPO/Follow-on Trans. Value
11/10/16 K2M Group Holdings, Inc. Healthcare Equipment Follow-on $83
9/23/16 iRhythm Technologies, Inc. Healthcare Equipment IPO 107
9/6/16 Evolent Helath, Inc. Healthcare Technology Follow-on 169
5/6/16 NantHealth, Inc. Healthcare Technology IPO 91
4/29/16 Cotiviti Holdings, Inc. Healthcare Technology IPO 238
1/25/16 Tactile Systems Technology, Inc. Healthcare Equipment IPO 40
1/5/16 Acadia Healthcare Company, Inc. Behavioral Healthcare Follow-on 610
6
159
64
34
12
113
43
34
19
0 20 40 60 80 100 120 140 160 180
$25 - $100
$101 - $250
$251 - $500
$501 - $750
Tran
sact
ion
Volu
me
FY2016 FY2015
QUARTERLY HEALTHCARE M&A ACTIVITY
QUARTERLY MIDDLE MARKET HEALTHCARE M&A – VALUEQUARTERLY MIDDLE MARKET HEALTHCARE M&A – VOLUME
YEAR-OVER-YEAR M&A VOLUME BY TRANSACTION SIZE
Overall, 2016 middle market healthcare M&A volume was lower versus 2015with 209 and 269 transactions, respectively.
− 4Q16 volume of 39 deals was 9.3% lower than the 43 deals in 3Q16 and50.6% lower than the 79 deals in 4Q15.
− Total transaction value in 4Q16 totaled $6.4 billion, a 36.6% decrease from3Q16 and a 45.8% decrease from 4Q15.
− A larger number of deals valued between $501 – 750 million allowed YoYM&A value to be comparable in 2016 even though the transaction volumedropped significantly.
Many anticipate that 2017 activity will continue to be lower and contain fewerlarge transactions as sellers’ high valuation expectations keep investors on thesideline.
Source: Capital IQ. Includes all disclosed, closed deals between $25 and $750 million, through December 31, 2016.
$9.2
$6.6
$11.3 $11.8 $12.9
$9.0 $10.1
$6.4
$0
$5
$10
$15
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
2015 2016
Tran
sact
ion
Valu
e ($
in b
illio
ns)
$25 - $100 $101 - $250 $251 - $500 $501 - $750
64
55
71
79 79
4843
39
0
20
40
60
80
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
2015 2016
Tran
sact
ion
Volu
me
$25 - $100 $101 - $250 $251 - $500
7
HEALTHCARE SECTORS COMPARISON
PUBLIC COMPANY ANALYSIS BY SECTOR4Q16 EBITDA MULTIPLES YEAR-OVER-YEAR
LTM EBITDA MULTIPLE COMPARED TO PROJECTED REVENUE GROWTH
BCA tracks publicly-traded companies within certain healthcare IT and servicessectors. The following is a summary of our findings.
Healthcare companies finished the quarter trading at a median of 10.4x LTMadjusted EBITDA.
− This represents a 5.5% decrease from 11.0x in 4Q15.
− The only sectors with an increase in valuation multiples were healthcareIT, home health, hospice, laboratory services and population healthmanagement.
− High healthcare valuation multiples are beginning to compress, thoughmost sectors remain at elevated levels.
Size of bubble indicates aggregate sector enterprise value.
Source: Capital IQ and SEC filings.Source: Capital IQ and SEC filings.
Source: Capital IQ and SEC filings. (1) Data from Capital IQ and SEC filings. Revenue and EBITDA for period ending September 30, 2016 and stock price as of December 31, 2016.
0.0x
2.0x
4.0x
6.0x
8.0x
10.0x
12.0x
14.0x
16.0x
0% 5% 10% 15% 20%
Contract Services
Dialysis
Healthcare IT
Ambulatory Surgical Center
Healthcare Staffing
Hospital Management
Diagnostic Imaging
Laboratory Services
Hospice
Pharmacy Benefit Mgmt.
Home Health
Population Health Mgmt.
Psychiatric & Behavioral Health
Rehabilitation
17.4x
12.6x
7.2x
9.4x10.2x
12.3x 11.7x 12.2x
7.9x
10.4x10.3x
8.5x
12.2x
9.3x
12.8x
11.5x
7.0x
9.2x
12.3x10.9x
12.7x12.4x
7.8x
10.7x
7.7x
9.3x 10.2x8.9x
0.0x
4.0x
8.0x
12.0x
16.0x
20.0x
Q4 2015 Q4 2016
LTM LTM(1)
Price EBITDATrend Revenue EBITDA Revenue EBITDA Revenue EBITDA Margin
Ambulatory Surgical Center 1.9x 12.8x 1.7x 11.2x 25.2% 19.1% 14.9%Contract Services 1.5x 11.5x 1.7x 10.5x 11.7% 7.5% 10.6%Diagnostic Imaging 1.1x 7.0x 1.0x 6.7x 11.2% 9.9% 17.6%Dialysis 1.5x 9.2x 1.4x 8.0x 7.3% 6.3% 16.3%Healthcare IT 3.3x 12.3x 3.0x 11.5x 8.4% 6.0% 20.5%Healthcare Staffing 1.2x 10.9x 1.1x 9.9x 14.2% 23.7% 11.5%Home Health 1.0x 12.7x 0.9x 11.1x 14.2% 7.7% 8.3%Hospice 1.8x 12.4x 1.7x 11.3x 3.1% (0.7%) 14.3%Hospital Management 0.8x 7.8x 0.9x 7.4x 7.9% 3.4% 11.4%Laboratory Services 2.1x 10.7x 2.0x 9.8x 5.8% 2.5% 19.8%Pharmacy Benefit Mgmt. 0.6x 7.7x 0.6x 7.6x 0.5% 1.2% 7.9%Population Health Mgmt. 1.4x 9.3x 1.4x 7.9x 13.6% 11.8% 6.4%Psychiatric / Behavioral Health 1.8x 10.2x 1.7x 8.6x 20.3% (4.4%) 17.9%Rehabilitation 1.4x 8.9x 1.4x 8.4x 2.8% 8.7% 13.5%
Average 1.6x 10.2x 1.5x 9.3x 10.5% 7.3% 13.6%Median 1.5x 10.4x 1.4x 9.2x 9.8% 6.9% 13.9%
Enterprise Value as Multiple of:LTM(1) NTM(1) LTM Growth(1)
8
0.0x
5.0x
10.0x
15.0x
20.0x
25.0x
30.0x
(10.0%) 0.0% 10.0% 20.0% 30.0% 40.0%
EVHC
MD
TMH
AMN
CCRN
ASGN
HCSG
(dollars in millions, except per share data)
Current % of 52 EnterpriseCompany Ticker Price Week High Value Revenue EBITDA Revenue EBITDA
Contract ServicesEnvision Healthcare Holdings, Inc. EVHC $22.49 79.0% $7,357 1.2x 10.7x N/M N/MHealthcare Services Group Inc. HCSG $39.17 92.9% $2,777 1.8x 25.4x 1.7x 19.8xMedNax, Inc. MD $66.66 86.6% $7,923 2.6x 11.4x 2.3x 10.5xTeam Health Holdings, Inc. TMH $36.80 60.9% $5,432 1.2x 11.6x 1.1x 10.3x
Average 1.7x 14.8x 1.7x 13.5xMedian 1.5x 11.5x 1.7x 10.5x
Healthcare StaffingAMN Healthcare Service, Inc. AMN $38.45 85.5% $2,217 1.2x 9.9x 1.1x 9.0xCross Country Healthcare, Inc. CCRN $15.61 96.1% $565 0.7x 13.1x 0.7x 10.5xOn Assignment, Inc. ASGN $44.16 96.4% $2,991 1.2x 10.9x 1.2x 9.9x
Average 1.1x 11.3x 1.0x 9.8xMedian 1.2x 10.9x 1.1x 9.9x
Note 1: Data per SEC fi l ings and Capital IQ.Note 2: Stock price as of 12/31/2016 close and LTM financial results for Q3 2016.Note 3: EVHC / AMSG merger closed 12/2/16.Note 4: TMH take-private transaction by Tennessee Parent, Inc. (The Blackstone Group) announced 10/31/16.
Total Enterprise Value as Multiple of:LTM NTM
CONTRACT SERVICES AND STAFFING SECTOR OVERVIEW
SELECT CONTRACT SERVICES AND STAFFING M&A TRANSACTIONS FOR 2016
VALUATION ANALYSISPUBLIC COMPANY ANALYSIS
CONTRACT SERVICES & STAFFING INDICES STOCK PRICE PERFORMANCE
LTM EBITDA MULTIPLE COMPARED WITH LTM REVENUE GROWTH
60%
70%
80%
90%
100%
110%
120%
12/31/2015 3/31/2016 6/30/2016 9/30/2016 12/31/2016
NASDAQ S&P 500 Contract Services Healthcare Staffing
(dollars in millions)TEV as a Multiple of:
Announced Enterprise LTM(1)
Date Acquiror Target Value(1) Revenue EBITDAContract Services12/21/16 Brown Brothers Harriman & Co. American Physician Partners, LLC N/A N/A N/A12/13/16 Envision Healthcare Corporation Desert Mountain Consultants in
AnesthesiaN/A N/A N/A
12/12/16 Fujian Thaihot Investment Co, Ltd. All iance Healthcare Services, Inc. $710.7 1.4x 6.0x10/20/16 MEDNAX, Inc. CNY Anesthesia Group, P.C. N/A N/A N/A10/11/16 American Physician Partners, LLC DeGarA, PLLC N/A N/A N/A8/18/16 Team Health Holdings, Inc. Anesthesia Associates of Cincinnati Inc. N/A N/A N/A8/8/16 MEDNAX, Inc. Associated Anesthesiologists of Reno N/A N/A N/A
Healthcare Staffing12/1/16 Cross Country Healthcare, Inc. US Resources Healthcare, LLC N/A N/A N/A
10/31/16 The BlackStone Group Team Health Holdings, Inc. 6,020.1 1.4x 15.0x9/15/16 Team Health Holdings, Inc. EmMed, P.C. N/A N/A N/A4/22/16 Schumacher Clinical Partners ECI Healthcare Partners, Inc. 140.0 N/A N/A
(1) Data from SEC fi l ings and Capital IQ.
BCA Proprietary DataBCA Proprietary Data
9
HEALTHCARE IT SECTOR OVERVIEW
SELECT HEALTHCARE IT M&A TRANSACTIONS FOR 2016
VALUATION ANALYSISPUBLIC COMPANY ANALYSIS
HEALTHCARE IT INDEX STOCK PRICE PERFORMANCE
LTM EBITDA MULTIPLE COMPARED WITH LTM REVENUE GROWTH
(dollars in millions, except per share data)
Current % of 52 EnterpriseCompany Ticker Price Week High Value Revenue EBITDA Revenue EBITDA
Advisory Board Co. ABCO $33.25 67.6% $1,842 2.3x 10.3x 2.2x 9.2xAllscripts Healthcare Solutions, Inc. MDRX $10.21 67.3% $3,046 1.9x 10.0x 1.8x 9.7xathenahealth, Inc. ATHN $105.17 62.8% $4,352 4.1x 18.9x 3.5x 15.3xBenefitfocus, Inc. BNFT $29.70 66.0% $936 4.2x N/M 3.6x N/MCastlight Health, Inc. CSLT $4.95 90.0% $408 4.4x N/M 3.4x N/MCerner Corporation CERN $47.37 70.2% $16,129 3.5x 10.8x 3.1x 9.5xCotiviti Holdings, Inc. COTV $34.40 94.4% $4,022 6.6x 17.4x 6.1x 16.0xComputer Programs & Systems, Inc. CPSI $23.60 39.9% $471 1.7x 10.2x 1.8x 9.4xEvolent EVH $14.80 63.9% $908 4.3x 23.3x 2.3x 18.7xHealthStream HSTM $25.05 77.6% $702 3.1x 19.3x 2.9x 18.2xHMS Holding Corp. HMSY $18.16 98.2% $1,593 3.2x 13.7x 3.1x 12.6xInovalon Holdings, Inc. INOV $10.30 36.8% $1,091 2.4x 8.9x 2.5x 10.3xMediData Solutions, Inc. MDSO $49.67 81.0% $2,792 6.4x 28.4x 5.3x 22.8xQuality Systems, Inc. QSII $13.15 75.1% $866 1.8x 10.5x 1.7x 9.4x
Average 3.6x 15.1x 3.1x 13.4xMedian 3.3x 12.3x 3.0x 11.5x
Note 1: Data per SEC fi l ings and Capital IQ.
Note 2: Stock price as of 12/31/2016 close and LTM financial results for Q3 2016.Note 3: MDRX, CPSI and HSTM adjusted for NetSmart, Healthland and Healthline Systems acquisitions, respectively.
Total Enterprise Value as Multiple of:LTM NTM
70%
80%
90%
100%
110%
120%
12/31/2015 3/31/2016 6/30/2016 9/30/2016 12/31/2016
NASDAQ S&P 500 Healthcare IT
0.0x
5.0x
10.0x
15.0x
20.0x
25.0x
30.0x
35.0x
(10.0%) (5.0%) 0.0% 5.0% 10.0% 15.0% 20.0% 25.0%
ABCO
ATHN
CERN
MDRX
COTV
CPSI
HSTM
MDSO
QSII
HMSY
INOV
(dollars in millions)TEV as a Multiple of:
Announced Enterprise LTM(1)
Date Acquiror Target Value(1) Revenue EBITDA
11/25/16 CC Capital Management, LLC Constellation Healthcare Technologies $273.0 2.7x 7.7x10/4/16 Wolters Kluwer Health, Inc. Emmi Solutions, LLC 170.0 N/A N/A9/12/16 Atos SE Anthelio Healthcare Solutions Inc. 275.0 1.4x N/A8/9/16 EQT Partners AB Press Ganey Holdings, Inc. 2,382.2 6.9x 22.7x
7/13/16 Evolent Health, Inc. Valence Health, Inc. 247.3 N/A N/A7/13/16 Thoma Bravo, LLC Imprivata, Inc. 496.9 3.8x N/A5/3/16 Quintiles Transnational Holdings IMS Health Holdings, Inc. 13,170.5 4.3x 17.7x
4/25/16 Veritas Capital Verisk Health; MediConnect Global 820.0 N/A N/A3/23/16 GI Partners, LLC Netsmart Technologies Inc. 950.0 N/A N/A3/8/16 Nordic Capital; Novo A/S eResearchTechnology, Inc. 1,800.0 6.0x N/A
2/22/16 Resmed Corp. Brightree LLC 800.0 7.1x 18.9x2/18/16 IBM Watson Health Truven Holding Corp. 3,593.0 5.9x 35.0x
(1) Data from SEC fi l ings and Capital IQ.
10
HOME HEALTH AND HOSPICE SECTOR OVERVIEW
SELECT HOME HEALTH AND HOSPICE M&A TRANSACTIONS FOR 2016
VALUATION ANALYSISPUBLIC COMPANY ANALYSIS
HOME HEALTH AND HOSPICE INDEX STOCK PRICE PERFORMANCE
LTM EBITDA MULTIPLE COMPARED WITH LTM REVENUE GROWTH
(dollars in millions, except per share data)
Current % of 52 EnterpriseCompany Ticker Price Week High Value Revenue EBITDA Revenue EBITDA
Home HealthAddus HomeCare Corporation ADUS $35.05 96.6% $399 1.0x 14.3x 0.9x 11.8xAlmost Family Inc. AFAM $44.10 97.0% $605 1.0x 11.5x 0.8x 9.0xAmedisys, Inc. AMED $42.63 77.3% $1,527 1.1x 13.6x 1.0x 12.0xLHC Group, Inc. LHCG $45.70 97.8% $915 1.0x 11.8x 0.9x 10.3x
Average 1.0x 12.8x 0.9x 10.8xMedian 1.0x 12.7x 0.9x 11.1x
HospiceChemed Corporation CHE $160.41 97.8% $2,786 1.8x 12.4x 1.7x 11.3x
Note 1: Data per SEC fi l ings and Capital IQ.Note 2: Stock price as of 12/31/2016 close and LTM financial results for Q3 2016.
Total Enterprise Value as Multiple of:LTM NTM
70%
80%
90%
100%
110%
120%
12/31/2015 3/31/2016 6/30/2016 9/30/2016 12/31/2016
NASDAQ S&P 500 Home Health Hospice
0.0x
5.0x
10.0x
15.0x
20.0x
0.0% 5.0% 10.0% 15.0% 20.0% 25.0%
AFAM
AMED
ADUS
LHCG
CHE
(dollars in millions)TEV as a Multiple of:
Announced Enterprise LTM(1)
Date Acquiror Target Value(1) Revenue EBITDA
12/19/16 Bain Capital Private Equity, LP Epic Health Services, Inc. N/A N/A N/A12/19/16 Associated Home Care Inc. Home Staff, LLC N/A N/A N/A11/29/16 Blue Wolf Capital Partners LLC Great Lakes Home Health Services, Inc. N/A N/A N/A10/13/16 Altaris Capital Partners, LLC SH Franchising, LLC N/A N/A N/A7/12/16 Geneva Glen Capital, LLC Southeastern Home Health Services of PA N/A N/A N/A6/20/16 Kindred Healthcare Inc. Arkansas Department of Health & Human
Services, In-Home Health Care $39.0 N/A N/A
5/5/16 Encompass Home Health Camellia Healthcare3/9/16 Hospice Compassus, Inc. Genesis Healthcare, Inc.; Majority of Home
Health and Hospice Operations84.0 1.2x 9.3x
3/2/16 LHC Group, Inc. Heartlite Hospice, Inc. N/A N/A N/A2/11/16 Amedisys Inc. Associated Home Care Inc. 38.1 1.0x N/A2/10/16 One Equity Partners LLC All Metro Aids Inc. N/A N/A N/A1/28/16 Blue Wolf Capital Partners LLC National Home Health Care Corp. 103.0 N/A N/A1/27/16 Curo Health Services, LLC New Century Hospice, Inc.
(1) Data from SEC fi l ings and Capital IQ.
BCA Proprietary Data
BCA Proprietary Data
11
HEALTHCARE FACILITIES SECTOR OVERVIEW
SELECT HEALTHCARE FACILITIES M&A TRANSACTIONS FOR 2016
VALUATION ANALYSISPUBLIC COMPANY ANALYSIS
HEALTHCARE FACILITIES INDEX STOCK PRICE PERFORMANCE
LTM EBITDA MULTIPLE COMPARED WITH LTM REVENUE GROWTH
(dollars in millions, except per share data)
Current % of 52 EnterpriseCompany Ticker Price Week High Value Revenue EBITDA Revenue EBITDA
Hospital ManagementCommunity Health Systems, Inc. CYH $5.59 20.5% $15,918 0.8x 7.9x 0.9x 8.3xHCA Holdings, Inc. HCA $74.02 88.4% $59,095 1.4x 7.6x 1.4x 7.2xLifepoint Hospitals, Inc. LPNT $56.80 75.0% $4,989 0.8x 7.1x 0.8x 6.6xTenet Healthcare Corp. THC $14.84 43.5% $15,338 0.8x 7.8x 0.8x 7.4xUniversal Health Services, Inc. UHS $106.38 76.1% $14,143 1.5x 8.4x 1.4x 7.8x
Average 1.1x 7.8x 1.0x 7.5xMedian 0.8x 7.8x 0.9x 7.4x
Psychiatric / Behavioral HealthAAC Holdings, Inc. AAC $7.24 29.7% $348 1.4x 9.6x 1.2x 6.9xAcadia Healthcare Company, Inc. ACHC $33.10 50.2% $6,530 2.3x 10.7x 2.3x 10.3x
Average 1.8x 10.2x 1.7x 8.6xMedian 1.8x 10.2x 1.7x 8.6x
RehabilitationHealthSouth Corporation HLS $41.24 95.1% $6,678 1.9x 8.6x 1.7x 8.2xKindred Healthcare, Inc. KND $7.85 50.1% $3,776 0.5x 7.3x 0.5x 7.5xSelect Medical Holdings Corporation SEM $13.25 92.7% $4,363 1.0x 9.2x 1.0x 8.5xUS Physical Therapy, Inc. USPH $70.20 96.6% $906 2.7x 16.5x 2.4x 14.4x
Average 1.5x 10.4x 1.4x 9.7xMedian 1.4x 8.9x 1.4x 8.4x
Note 1: Data per SEC fi l ings and Capital IQ.Note 2: Stock price as of 12/31/2016 close and LTM financial results for Q3 2016.Note 3: KND and SEM adjusted for Gentiva and Concentra acquisitions, respectively.
Total Enterprise Value as Multiple of:LTM NTM
50%
60%
70%
80%
90%
100%
110%
120%
12/31/2015 3/31/2016 6/30/2016 9/30/2016 12/31/2016
NASDAQ S&P 500Hospital Management Psychiatric / Behavioral HealthRehabilitation
0.0x
5.0x
10.0x
15.0x
20.0x
(10.0%) (5.0%) 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0%
CYH
HCA
LPNT
THC
UHS
ACHC
HLS
KND
SEM
USPH
AAC
(dollars in millions)TEV as a Multiple of:
Announced Enterprise LTMDate Acquiror Target Value(1) Revenue EBITDA
Hospital Management10/26/16
SSM Health Care Of Oklahoma, Inc.; University Hospitals Authority and Trust OU Medical Center $750.0 N/A N/A
8/20/16 Summit Partners LLP HealthSun Health Plans; Wellmax Medical Centers; Pasteur Medical
1,000.0 N/A N/A
5/2/16 Universal Health Services Inc. Valley Health System LLC 1,618.2 N/A N/ABehavioral Facil ities
12/19/16 The Riverside Company Lakeview Health Systems, LLC N/A N/A N/A8/10/16 Linden LLC Pinnacle Treatment Centers, Inc. N/A N/A N/A4/18/16 Alita Care, LLC The Meadows of Wickenburg, Inc. 180.0 N/A N/A
Rehabilitation1/25/16 Select Medical Corporation Physiotherapy Associates Holdings 414.8 N/A N/A
(1) Data from SEC fi l ings and Capital IQ.
12
LABORATORY SERVICES SECTOR OVERVIEW
SELECT LABORATORY SERVICES M&A TRANSACTIONS FOR 2016
VALUATION ANALYSISPUBLIC COMPANY ANALYSIS
LABORATORY SERVICES INDEX STOCK PRICE PERFORMANCE
LTM EBITDA MULTIPLE COMPARED WITH LTM REVENUE GROWTH
(dollars in millions, except per share data)
Current % of 52 EnterpriseCompany Ticker Price Week High Value Revenue EBITDA Revenue EBITDA
Laboratory Corp. of America Holdings LH $128.38 90.8% $18,936 2.0x 10.2x 1.9x 8.9xQuest Diagnostics Incorporated DGX $91.90 98.2% $16,410 2.2x 11.2x 2.2x 10.7x
Average 2.1x 10.7x 2.0x 9.8xMedian 2.1x 10.7x 2.0x 9.8x
Note 1: Data per SEC fi l ings and Capital IQ.Note 2: Stock price as of 12/31/2016 close and LTM financial results for Q3 2016.
Total Enterprise Value as Multiple of:LTM NTM
80%
90%
100%
110%
120%
12/31/2015 3/31/2016 6/30/2016 9/30/2016 12/31/2016
NASDAQ S&P 500 Laboratory Services
0.0x
5.0x
10.0x
15.0x
(5.0%) 0.0% 5.0% 10.0% 15.0%
LH
DGX
(dollars in millions)TEV as a Multiple of:
Announced Enterprise LTM(1)
Date Acquiror Target Value(1) Revenue EBITDA
10/12/16 Precipio Diagnostics, LLC Transgenomic, Inc. N/A N/A N/A10/3/16 Laboratory Corp. of America Holdings ClearPath Diagnostics N/A N/A N/A8/1/16 Pritzker Group Private Capital; Vesey
Street Capital Partners, LLCPathGroup, Inc. N/A N/A N/A
7/29/16 West Pacific Medical Laboratory Internist Laboratory, Inc. N/A N/A N/A7/27/16 Laboratory Corp. of America Holdings Sequenom Inc. $352.7 3.1x N/A6/14/16 mTuitive, Inc. AccuCore Group LLC N/A N/A N/A4/29/16 Advanced Derm & Cosmetic Surgery Skin Pathology Associates, Inc. N/A N/A N/A4/1/16 Aurora Diagnostics, LLC Pacific Pathology Associates, Inc. N/A N/A N/A
(1) Data from SEC fi l ings and Capital IQ.
13
(dollars in millions, except per share data)
Current % of 52 EnterpriseCompany Ticker Price Week High Value Revenue EBITDA Revenue EBITDA
Ambulatory Surgical CenterAmSurg Corp. AMSG $67.75 80.0% $6,388 1.9x 11.9x 1.1x 11.2xSurgical Care Affi l iates, Inc. SCAI $46.27 87.6% $2,870 2.4x 26.1x 2.0x 13.4xSurgery Partners, Inc. SGRY $15.85 71.0% $2,100 1.9x 12.8x 1.7x 10.1x
Average 2.0x 16.9x 1.6x 11.6xMedian 1.9x 12.8x 1.7x 11.2x
Diagnostic ImagingAlliance Healthcare Services, Inc. AIQ $9.60 97.5% $617 1.2x 5.3x N/A N/ARadNet, Inc. RDNT $6.45 80.8% $948 1.0x 8.6x 1.0x 6.7x
Average 1.1x 7.0x 1.0x 6.7xMedian 1.1x 7.0x 1.0x 6.7x
DialysisDaVita, Inc. DVA $64.20 81.5% $20,293 1.4x 8.5x 1.3x 8.0xFresenius Medical Care AG & Co. KGAA FME $84.74 94.4% $34,430 1.9x 11.7x 1.8x 9.6xAmerican Renal Holdings ARA $29.65 100.0% $1,120 1.5x 9.2x 1.4x 5.9x
Average 1.6x 9.8x 1.5x 7.8xMedian 1.5x 9.2x 1.4x 8.0x
Note 1: Data per SEC fi l ings and Capital IQ.Note 2: Stock price as of 12/31/2016 close and LTM financial results for Q3 2016.Note 3: AMSG acquired by EVHC and delisted; stock price as of last day of trading on 12/1/16.
Total Enterprise Value as Multiple of:LTM NTM
OUTPATIENT FACILITIES SECTOR OVERVIEW
SELECT OUTPATIENT FACILITIES M&A TRANSACTIONS FOR 2016
VALUATION ANALYSISPUBLIC COMPANY ANALYSIS
OUTPATIENT FACILITIES INDEX STOCK PRICE PERFORMANCE
LTM EBITDA MULTIPLE COMPARED WITH LTM REVENUE GROWTH
70%
80%
90%
100%
110%
120%
12/31/2015 3/31/2016 6/30/2016 9/30/2016 12/31/2016
NASDAQ S&P 500 Ambulatory Surgical Center Diagnostic Imaging Dialysis
0.0x
5.0x
10.0x
15.0x
20.0x
25.0x
30.0x
0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0%
AMSG
SCAI
AIQ
RDNT
DVA
FME
ARA
SGRY
(dollars in millions)TEV as a Multiple of:
Announced Enterprise LTM(1)
Date Acquiror Target Value(1) Revenue EBITDA
Ambulatory Surgical Centers and Other Outpatient Facil ities12/16/16 Surgical Care Affi l iates, Inc. Midwest Surgical Management Group N/A N/A N/A8/22/16 Kelso & Company; Guidon Partners Physicians Endoscopy LLC N/A N/A N/A6/15/16 Envision Healthcare Holdings, Inc. AmSurg Corp. $7,609.5 2.8x 10.5x
Diagnostic Imaging9/19/16 Pharos Capital Group, LLC TECHLAB, Inc. N/A N/A N/A7/5/16 Sheridan Healthcare, Inc. AllegiantMD, Inc. N/A N/A N/A
Other10/14/16 GTCR, LLC Riverchase Dermatology & Cosmetic
SurgeryN/A N/A N/A
8/23/16 Revelstoke Capital Partners LLC Fast Pace Urgent Care N/A N/A N/A6/20/16 CI Capital Partners LLC Epiphany Dermatology PA N/A N/A N/A5/23/16 Urgent Team Holdings, Inc. Physicians Care, Inc.5/18/16 Harvest Partners, LP Advanced Derm & Cosmetic Surgery N/A N/A N/A3/9/16 Envision Healthcare Holdings, Inc. Emergency Physicians Medical Group 120.0 N/A N/A
(1) Data from SEC fi l ings and Capital IQ.
BCA Proprietary DataBCA Proprietary DataBCA Proprietary DataBCA Proprietary DataBCA Proprietary DataBCA Proprietary Data
14
(dollars in millions)TEV as a Multiple of:
Announced Enterprise LTM(1)
Date Acquiror Target Value(1) Revenue EBITDA
12/23/16 Gauge Capital, LLC Miami Beach Medical Group LLC N/A N/A N/A8/1/16 Telligen, Inc. Total Well Being, LLC N/A N/A N/A
7/27/16 Sharecare, Inc. Healthways SC, LLC $30.0 N/A N/A7/20/16 Koninklijke Philips N.V. Wellcentive, Inc. N/A N/A N/A7/11/16 Healthcare Services & Solutions, LLC The Staywell Company, LLC N/A N/A N/A6/30/16 Teladoc, Inc. Healthiest You Corporation 155.8 15.6x N/A6/30/16 HealthRight, LLC HealthNEXT, LLC N/A N/A N/A4/28/16 GE Healthcare Limited Caradigm USA LLC N/A N/A N/A3/24/16 Invo HealthCare Associates, Inc. Progressus Therapy, LLC N/A N/A N/A2/24/16 Virgin Pulse, Inc. Shape Up, Inc. N/A N/A N/A1/19/16 ExamWorks, Inc. Advanced Medical Reviews, Inc. 39.8 N/A N/A1/5/16 National Health Industries, Inc. Long Term Solutions, Inc. 36.7 2.3x N/A1/5/16 Healthcare Interactive, Inc. PopSpring Wellness, LLC N/A N/A N/A
(1) Data from SEC filings and Capital IQ.
0.0x
5.0x
10.0x
15.0x
20.0x
25.0x
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%
HWAY
MGLN
WBMD
(dollars in millions, except per share data)
Current % of 52 EnterpriseCompany Ticker Price Week High Value Revenue EBITDA Revenue EBITDA
Healthways Inc. HWAY $22.75 83.3% $1,141 1.4x 22.0x 1.4x 10.1xMagellan Health Services Inc. MGLN $75.25 97.3% $2,114 0.4x 7.5x 0.4x 6.3xWebMD WBMD $49.57 73.4% $1,924 2.8x 9.3x 2.6x 7.9x
Average 1.5x 13.0x 1.5x 8.1xMedian 1.4x 9.3x 1.4x 7.9x
Note 1: Data per SEC fi l ings and Capital IQ.Note 2: Stock price as of 12/31/2016 close and LTM financial results for Q3 2016.
Total Enterprise Value as Multiple of:LTM NTM
POPULATION HEALTH MANAGEMENT SECTOR OVERVIEW
SELECT POPULATION HEALTH M&A TRANSACTIONS FOR 2016
VALUATION ANALYSISPUBLIC COMPANY ANALYSIS
POPULATION HEALTH INDEX STOCK PRICE PERFORMANCE
LTM EBITDA MULTIPLE COMPARED WITH LTM REVENUE GROWTH
80%
90%
100%
110%
120%
130%
12/31/2015 3/31/2016 6/30/2016 9/30/2016 12/31/2016
NASDAQ S&P 500 Population Health Mgmt.
15
BRENTWOOD CAPITAL ADVISORS HEALTHCARE OVERVIEW
THE BEST DEAL. DONE. REPRESENTATIVE HEALTHCARE TRANSACTIONS
Recapitalization
Senior Debt PlacementLed by
$14,000,000
Debt RaiseGrowth Equity
Equity Investment Led by
$13,300,000
&
Sell-Side
Sell-Side Advisory to
RecapitalizationLed by
Recapitalization
Recapitalization
Sell-Side AdvisoryLed by
Sell-Side
Sell-Side AdvisoryLed by
Sell-Side
Equity Investment Led by
Growth Equity
RecapitalizationLed By
Recapitalization
Debt-Private placementLed by
Unitranche Debt
RecapitalizationLed By
Recapitalization
Sell-Side Advisory to
Sell-Side
RecapitalizationLed by
Recapitalization
RecapitalizationLed By
Recapitalization
Equity Investment Led By
Growth Equity
RecapitalizationLed By
Recapitalization
Sell-Side Advisory to
Sell-Side
RecapitalizationLed By
Recapitalization
Sell-Side Advisory to
Sell-Side
Senior Debt Placement Led by
Debt Raise
$15,000,000
Sell-Side Advisory to
Sell-Side
Sell-Side Advisory to
Sell-Side
Sell-Side Advisory to
Sell-Side
RecapitalizationLed by
Recapitalization
81 transactions with aggregate value of approximately $5.0 billion, since 2002.
63 M&A and equity raising assignments with aggregate volume of $4.3 billion,since 2002.
18 debt raises representing approximately $700 million in capital, since 2002.
Average enterprise value per healthcare M&A transaction of approximately$100 million, since 2002.
TRANSACTION ACTIVITY
TRANSACTION EXPERTISE INDUSTRY FOCUS
Sell-Side M&A Advisory
Buy-Side M&A Advisory
Recapitalizations
Fairness Opinions
Growth Equity
Senior Debt
Subordinated Debt
PE-SponsoredTransactions
Healthcare
Information Technology
Business Services
Technology-enabled and Outsourced Services
Financial Technology & Services
Application Software
Medical Devices, Specialty Pharma & Contract Research Organizations
Recapitalization
Sell-Side Advisoryto
Sell-Side
RecapitalizationLed By
Recapitalization
RecapitalizationLed by
Recapitalization