凯恩兄弟医疗保健公司、马克德莫特院和约 HPE(英) 2024

PitchBook Analyst Note: Cain Brothers Healthcare, McDermott Hospitals, and HPE NYC

Introduction

• Event Overview: Three conferences—Cain Brothers Private Company Healthcare Conference, McDermott Will & Emery’s Hospitals and Health Systems Summit, and HPE NYC—were held in New York on October 16 and 17. The total attendance was approximately 500 for Cain Brothers, 275 for McDermott Hospitals, and 650 for HPE NYC. McDermott also announced a new McDermott Health Week to be held in Nashville, Tennessee, from May 6 to 9, 2025.

Key Takeaways

Physician Practice Management (PPM) Dislocation

• Market Sentiment: The PPM dislocation is significant, leading some to refer to specialty physicians as a "contrarian play." However, this requires valuations to moderate, which is unlikely without sponsors letting go of PPMs at lower Internal Rate of Return (IRR).
• Current Trends: A few A+ PPMs are testing the market, and sponsors are holding onto lower-rated PPMs, focusing on integration and M&A activities.

Add-On Opportunities

• Value Play: The best "value" to be had right now is in add-ons. Valuation expectations for non-back founder-CEOs have moderated, allowing for softer multiples in previously hot sectors like medspas and cardiology.
• HealthTech Integration: There is a true value play in integrating healthtech companies that have run out of VC runway, leveraging scale and operating efficiency to achieve profitability.

Financing Notes

• Loan Spreads: Current leveraged loan spreads are around 525 basis points for the lower middle market and as low as 450 for the upper middle market, down from 625 basis points at the beginning of the year.
• Leverage Structures: HoldCo pay-in-kinds (PIKs) and preferred equity structures are increasingly used to bridge valuation gaps or invigorate stalled processes.
• Partial Exits: Recapitalization is being pursued as an alternative to full sales, with sponsors frequently shopping for looser covenants and liability management transactions (LMTs).

Partnership Opportunities

• Emerging Collaborations: As health systems seek to outsource and attract capital partners, novel collaborations beyond traditional ASC joint ventures are emerging. Areas of focus include specialty/pharmacy, infusion, and clinical trials.

Noteworthy Dialogues and Companies

• High-Risk Care Management: Discussions centered on innovative approaches to high-risk care management.
• AI Implementation: Panelists highlighted the challenges of implementing AI tools, noting that building tools is easy but implementation is difficult.
• Remote Patient Monitoring: Companies like Aetna and Optum discussed advancements in remote patient monitoring.
• Revenue Cycle Management: Innovations in revenue cycle management were highlighted, showcasing the evolving landscape of healthcare IT.

This summary captures the key themes, trends, and insights from the conferences, emphasizing the current market dynamics and opportunities in the healthcare and healthcare IT sectors.