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Zombie Investments: The State of Private Equity in Healthcare

  • Private equity (PE) firms are facing challenges in the healthcare services sector due to a confluence of factors including challenges recruiting and retaining physicians, reimbursement headwinds, accelerating labor costs and restrictive antitrust policies.
  • Over the past decade, institutional capital poured into healthcare services and physician practice management companies.
  • PE-backed physician platforms have found the variability in clinical practices and patient preferences across markets has limited the ability to achieve back-office efficiencies while accelerating labor costs and a challenging reimbursement environment have squeezed margins.
  • Acquisition-driven growth strategies for PPMs have proven very risky, requiring high levels of leverage and added integration.
  • As a result of several high-profile bankruptcies and a growing level of layoffs, clinic closures and service reductions caused by cash-strapped PE platforms, Lawmakers are increasingly wary of PE’s involvement in healthcare with its focus on profit maximization.
  • Finding buyers has become increasingly difficult, leaving PE firms holding onto healthcare assets longer than intended. 
  • Amidst the turmoil, there are opportunities for innovation and collaboration.
  • Opportunities exist within many sectors to “disaggregate” platforms, creating local or regional platforms that can operate more efficiently and responsively.
  • By learning from the mistakes of the past and embracing a more sustainable approach, PE can still play a role in shaping the future of healthcare.
  • PE firms will need to adapt their strategies by focusing on smaller deals, partnerships with payors and existing health systems, and reducing leverage.

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