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The Healthcare Investor

Insights on Issues & Trends that Impact Investments in Healthcare & Life Science Businesses

A View From the Top: Steven Windwer of Bay State Physical Therapy

Posted in Healthcare Services Investing

Please see below for the latest installment of our interview series, A View From the Top. This series features interviews with C-suite leadership of private equity-backed portfolio companies. This installment features Steven Windwer, president and CEO of Bay State Physical Therapy. To recommend a leader for a future interview, email Holly Buckley at hbuckley@mcguirewoods.com.

As a reminder, our 17th annual Healthcare and Life Sciences Private Equity and Finance Conference is February 19 and 20 in Chicago. The save the date is available here. Please contact us for more information or to indicate an interest in participating on a panel.

Q: Your organization recently transitioned to working with a private equity firm. How was your business evolving leading up to this partnership?

Dr. Steven Windwer: We were growing at a very fast pace. Over the past several years, we made a concerted effort to grow the people and infrastructure of the business to the point where we felt it was a platform business.

In our space, we are one of the larger privately owned practices in the country. Since the tailwinds for physical therapy are so strong, there is a lot of activity in the space. We have received calls and emails from folks interested in our business for the past four or five years.

Q: What led you to decide to make the transition?

SW: The decision essentially came from the marketplace telling us we should think about pursuing a partner. We were large, had market share and market dominance, had a proven track record and had built a platform business. As a result, we believed we should think about pursuing a transaction, either with a larger, established and more national physical therapy business or become that platform ourselves.

There was some internal transition in the business, and I was also thinking about my age and how to have a succession plan for myself. In addition, there was consideration of what was happening in the marketplace in general. This included the thought that the money markets wouldn’t remain as strong, meaning the stock markets might eventually crash and valuations could become depressed. I felt an internal tension telling me the timing felt right. My concern was that while we could continue to grow, during that period, the entire marketplace could shift dramatically.

It seemed all of these factors happening simultaneously made it a good time to think about and move ahead with a transaction.

Q: How did you identify the firm you wanted to partner with?

SW: Having so much inbound activity over a number of years gave me an opportunity to get a flavor for the potential prospects in the marketplace.

Ultimately, what I learned during the preceding two to three years is that who the partner is must be the most important consideration. Finding someone who would be a great partner became the top priority on my list. After meeting with many prospective partners, I came to understand what I didn’t want and ultimately set out to find what I did want. This was someone who would be a trusted, thoughtful partner and one that would have tremendous integrity. That turned out to be Calera Capital.

Q: What advice would you give to a founder CEO when evaluating potential partners?

SW: Get to know all of your potential partners so you can decide what’s most important to you. Value and money are certainly important, but you need to think about what life is going to be like after the deal is completed.

Choose your partners wisely. Selecting a partner is a gigantic decision, so ensure you understand before going into it what you are getting into and all the likely ramifications.

Q: What other lessons did you learn while going through the evaluation process?

SW: During the process, you speak with a number of people essentially at the same time. I was blown away by our first conversation with the folks at Calera. They came off as being very impressive and really aligning well with us. With that said, I expected to eventually be disappointed in some aspect of the firm, as this had been our experience with other firms. But that experience never occurred with Calera. They were thoughtful and full of integrity throughout the process, which was long and difficult. Now, many months post-deal, they’re still great. I learned that behavior doesn’t lie. If you follow the behavior during the courting process and diligence process, you really get to know folks.

As a founder and practitioner who does not live in the financial/business world, I’ve found it’s eye-opening what’s out there. There are all types of people and firms. It’s important to stick to your values and attract the type of partner that really fits who you are, and not just chase the dollar.

ABOUT STEVEN WINDWER

Steven Windwer, DC, PT, is president and CEO of Bay State Physical Therapy, based in Randolph, Mass. After graduating from Boston University with his degree in physical therapy, Dr. Windwer elected to go back to New York Chiropractic College. Holding dual degrees in physical therapy and chiropractic, he opened his first office in Quincy, Mass., in 1990. Firmly believing in the manager/partner model, Dr. Windwer has been able to establish more than 60 physical therapy offices and 13 chiropractic offices across Massachusetts, New Hampshire and Rhode Island.

To contact Dr. Steven Windwer, email swindwer@baystatept.com.

 

Healthcare & Life Sciences Private Equity Deal Tracker: Primus Invests in Trilliant Health

Posted in Healthcare Services Investing

Trilliant Health has announced it received a “major growth investment” by Primus Capital.

Trilliant, based in Brentwood, Tenn., is a healthcare analytics and data science company focused on patient acquisition.

Primus, with offices in Cleveland and Atlanta, is a growth-oriented private equity firm focused on investing in healthcare, software and technology-enabled services companies. The firm targets companies with enterprise values of up to $250 million and typically invests between $15 million and $70 million.

Trilliant stated that the investment by Primus will be used to “… continue building its data science and technology teams to enhance the capabilities of its analytics platform.”

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Up-and-Coming Women in PE to Know: Kim Hruby

Posted in Healthcare Services Investing

McGuireWoods is undertaking a yearlong effort to profile up-and-coming women leaders in private equity. This profile series complements our existing Women Leaders in Private Equity profile series, which will continue throughout 2019. For this profile, we are pleased to feature Kim Hruby of Council Capital. Access her profile.

To recommend a rising star for a future interview, email Amber Walsh at awalsh@mcguirewoods.com.

A View From the Top: Greg Bellomy of CareATC

Posted in Healthcare Services Investing

Please see below for the latest installment of our interview series, A View From the Top. This series features interviews with C-suite leadership of private equity-backed portfolio companies. This installment features Greg Bellomy, president and CEO of CareATC. To recommend a leader for a future interview, email Holly Buckley at hbuckley@mcguirewoods.com.

As a reminder, our 17th annual Healthcare and Life Sciences Private Equity and Finance Conference is February 19 and 20 in Chicago. The save the date is available here. Please contact us for more information or to indicate an interest in participating on a panel.

Q: What do you believe is the most significant current challenge to growing your business and what will be necessary to overcome it?

Greg Bellomy: Education of employers and their advisers (i.e., brokers and consultants) will be our biggest challenge. Healthcare has largely been built around an economic model that has driven behavior of providers and insurers.

The notion was that people would access what they need in a rational manner, and so long as providers were compensated in a manner reflective of their skills and regional market conditions, it would be a fair and balanced model for care. This notion also contemplated that carriers would be satisfied with covering their costs and enjoying a reasonable profit margin.

As payers attempted to control costs, providers began looking for ways to capture additional revenues and margins by controlling downstream revenue sources, such as surgery centers, dialysis clinics, radiology and the like. This created an incentive for increased utilization of services that, although state of the art, might not be appropriately utilized. Since carriers were compensated on a percentage of costs/fees paid, there was little incentive for them to fundamentally change how care was delivered. In fact, they are now trying to control more of the spend and participate in margins across the continuum.

In short, no one was really working for the employers and their covered employees. The model we follow at CareATC is simple and very different. We are paid to provide the appropriate care in the appropriate setting; to do no more and no less than what is clinically appropriate. We measure our success based on our ability to drive down total cost of care and improve the health and wellbeing of those we serve.

As simple as that concept appears, implementing it is not as easy as it sounds. It requires collaboration and cooperation with the employer around a number of elements. Plan design, employee education, risk stratification, engagement strategies and plan administration all have to be looked at differently. It’s not enough to build a clinic and make it available. You need to modify and reward the right behavior to see meaningful results. This takes effort and a commitment to change. The reward for doing so is a true reduction in healthcare spend and ultimately a happier and healthier workforce. Most employers have no idea that these solutions are available to them; thus, our challenge.

Q: What do you believe is the most important personality trait in a leader?

GB: I’m a fan of Peter Lencioni. In his book The Ideal Team Player, he describes the desired attributes as being hungry, humble and smart. Intuitively, I sought these characteristics with my leadership team, but didn’t have a framework for how to think about them. Looking back at the teams that were most effective and sustainable, I saw they had leaders that put the wellbeing of the organization and their teams ahead of personal interests. There were those who could drive better financial or key performance indicator results, but they usually achieved it through brute force versus leadership. Invariably, things would break down over time. Pairing these attributes with a clear vision for success and being able to make it relatable to a meaningful mission makes for an effective and dynamic leader.

Q: You have worked at a high level in various healthcare sectors. How do you quickly learn the most important things about an industry?

GB: For every healthcare organization, there are four stakeholders who must be served:

  • Patient
  • Payer
  • Provider
  • Bank

For the patient, we must understand the individual’s need and how to best meet it in a manner that delivers a positive experience. For the payer, we must demonstrate that we are exercising fiscal responsibility with the available resources that are afforded to meet the need. Providers want to make a difference, feel valued for their skills and not be commoditized. Finally, whoever is providing the financial resources to meet the needs has to believe the capital is being put to good use with a reasonable return on investment.

Understanding the industry dynamics relative to these stakeholders’ needs and wants helps you understand where to focus your energies. In doing so, you have to look at the trends within your sector and how they correlate to broader healthcare trends. Everything in healthcare goes through cycles. Knowing where the particular sector is in the cycle and how it correlates to the broader trends helps you understand where future opportunity may exist.

Armed with this information, you can typically ascribe an equation or formula that speaks to the motives of each stakeholder and postulate a thesis that describes what the ideal state looks like for all concerned. Then you must test the thesis and see if your assumptions are correct. Then you need to determine what the gaps are in the model you have today versus your thesis and define a plan to get there. Unless you have substantial buy-in with the core stakeholders, your probability of success is low.

Q: What is your best tip for recruiting talent?

GB: My field of vision for hiring talent is focused on the need three to five years from now, not today. My guidance to my teams is to hire two levels up from what they need today. If the person they hire is only competent to perform the task needed today, they are setting themselves up for a problem in the future. Hiring talent that understands the goals of the organization and is motivated to grow with the organization is a much smarter way to go.

Q: What healthcare trend will cause the most change in the next 10 years?

GB: Technology and disintermediation of the traditional healthcare service delivery chain or continuum of care is going to yield amazing results qualitatively and financially. The technology you wear on your wrist knows more about your health and wellbeing than what your doctor could possibly tell you in a typical patient encounter. Little things like sleep patterns and gait patterns, not to mention heart rate and other biometric data, can accurately predict the probability of an adverse event when normalized against a peer group and your historical data. Unlocking the data and using artificial intelligence tools to alert patients and providers will unquestionably lead to better outcomes and lower costs.

Similarly, creating engagement strategies with patients around how to manage their health and wellbeing in a non-fee-for-service environment, where there is total transparency around costs and outcomes, will change purchasing and utilization patterns. It is conceivable, and it is already happening, that employers will create a “virtual health plan” and eliminate carriers and plan administrators from the service equation as they add more cost than value for the relative spend. Employers now want to understand the financial incentives of the various stakeholders embedded within their plan design and will begin taking control over provider network contracting and purchasing of routine items, such as medications. This will create a more competitive and higher-quality product in the future as their claims administration cost for providers will be substantially less. In addition, the employers can steer utilization that allows for economy of scale for the providers, leading to the market becoming more efficient and effective.

About Greg Bellomy

Greg Bellomy has 20-plus years’ experience as president and CEO of some of the most influential healthcare service companies in the country. Most recently, he joined CareATC as president and CEO in the spring of 2019.

Being on the spear tip of healthcare innovation is his passion and what drew him to CareATC. Innovation and leading transformational change in how care is delivered is the common thread in his experience. CareATC is uniquely positioned to fundamentally change how healthcare is delivered for millions of insured but underserved people secondary to the dysfunctional economics of main street healthcare.

Bellomy has enjoyed tremendous success as a division president of a company that was ranked No. 2 on the Inc. 100 Fastest-Growing Companies and division president of three publicly traded companies on the NYSE and NASDAQ. He has led two private equity/venture capital-backed companies as president and CEO. Bellomy has also served as a senior operating adviser for LLR Partners.

To contact Greg Bellomy, email gregbellomy@careatc.com.

NovaQuest Closes New PE Fund With $275 Million

Posted in Healthcare Services Investing

NovaQuest Private Equity has reached its hard cap of $275 million in capital commitments for a new private equity (PE) fund, according to a news release.

NovaQuest Private Equity Fund I targets tech-enabled healthcare solutions and pharmaceutical services investments.

NovaQuest Private Equity is the PE group of NovaQuest Capital Management. Based in Raleigh, N.C., and formed in 2000, NovaQuest Capital Management provides strategic capital to life science and healthcare companies.

The firm stated it has already completed three platform investments and two add-on acquisitions out of its new PE fund, including investments in Azurity Pharmaceuticals, Clinical Ink and Catalyst Clinical Research.

Women in PE to Know: Cindy Babitt and Beth Haas

Posted in Healthcare Services Investing

McGuireWoods has long been an avid supporter of the advancement of professional women. As part of our initiative seeking to expand the leadership of women in private equity, we are continuing our series of profiling women leaders in private equity. We are hopeful that this series will serve to inspire other women to pursue their careers in private equity in a way that best challenges and motivates them, which these impressive women have all done. We are pleased to feature Cindy Babitt and Beth Haas of Cyprium Partners. Access their profiles by clicking here.

To recommend a woman for a future interview, email Amber Walsh at awalsh@mcguirewoods.com.

Vivo Capital Closes Ninth Fund With $1.43 Billion

Posted in Healthcare Services Investing

Vivo Capital has announced the closing of its ninth fund with $1.43 billion in committed capital.

The firm indicated it plans to use these funds to invest in and build healthcare and life science companies.

Founded in 1996 and based in Palo Alto, Calif., Vivo is a healthcare-focused investment firm. It has raised more than $4 billion in capital and backed more than 200 private and public portfolio companies since its inception.

A View From the Top: Andy Blankemeyer of Beacon Orthopaedics & Sports Medicine

Posted in Healthcare Services Investing

Please see below for the third installment of our interview series, A View From the Top. This series features interviews with C-suite leadership of private equity-backed portfolio companies. This installment features Andy Blankemeyer, CEO of Beacon Orthopaedics and Sports Medicine. The previous installment, featuring Scotte Hudsmith of Smile Doctors, is available here. To recommend a leader for a future interview, email Holly Buckley at hbuckley@mcguirewoods.com.

As a reminder, our 17th annual Healthcare and Life Sciences Private Equity and Finance Conference is February 19 and 20 in Chicago. The save the date is available here. Please contact us for more information or to indicate an interest in participating on a panel.

Q: What do you believe is the most significant current challenge to growing your business and what will be necessary to overcome it?

Andy Blankemeyer: The orthopedics space backed by private equity is in its infancy. We were one of the first major orthopedic platforms in partnership with Revelstoke Capital Partners.

I think the biggest challenge to growing our business is education, more specifically, education for the physicians and administrative leadership of potential partner orthopedic groups, regionally and nationally, to better understand the model we’re developing and how it differs from previous consolidation efforts back in the 1990s.

Q: What plans do you have to further grow your business and what will be necessary to achieve this growth?

AB: We want to become a regional and potentially national orthopedic management services organization. We want to take our skill sets and knowledge, as well as the skill sets and knowledge of other partner groups that we consolidate with, to help drive our three key differentiators: quality, access and value. We want to provide high-quality orthopedic care that is readily available to any patient, such as by offering extended and weekend hours, for a cost-effective rate.

That’s our ultimate goal. We believe there are a lot of other independent and current hospital-employed doctors in our region and around the country who are looking for the administrative support necessary to maintain their independence and clinical autonomy.

Q: What is your best tip for recruiting physician talent?

AB: It’s all about putting the physician in the driver’s seat. We need to have a physician-led and -driven consolidation effort to make this work. We must allow physicians to run their clinical practices the way they have run them for years, without the interference of overreaching administration like myself. They need to be motivated, engaged and incentivized to run an efficient and busy practice.

Our recruitment strategy is to give physicians the platform required to do just that and have all the back-office, administrative and contracting work done for them. This will allow these physicians to focus on the patient and run the effective clinical practice they want rather than being told what to do by either a hospital partner or market forces that are out of their control.

Q: What characteristics do you look for in administrative leaders within your organization?

AB: Orthopedics is a very fast-paced environment. It’s constantly changing. When we’re looking at administrative leaders, we are looking for people who understand that what they are doing today might not be what they are doing tomorrow. They need that flexible and driven mindset that allows them to pick up new initiatives and push them toward implementation. We need leaders who are able to act quickly and enact positive change for the organization.

Q: What do you think is the key to retaining your talent?

AB: It’s all about empowerment — empowering them to lead the organization to the best of their ability following a well-communicated, companywide strategic roadmap.

About Andy Blankemeyer

Andy Blankemeyer is the chief executive officer of Beacon Orthopaedics and Sports Medicine. Prior to becoming CEO in 2016, he served in multiple roles for the organization, including chief operating officer for seven years. In 2019, Blankemeyer became the CEO of a new orthopedic management services organization, formed by Beacon and Revelstoke Capital Partners.

Blankemeyer is a graduate of the Xavier University, having earned a master’s degree in healthcare administration. He serves on the executive board for the Andy and JJ Dalton Foundation, the data governance committee at the Health Collaborative and the payer contracting and financial operations committee for TriHealth’s PHO. He is also a member of the Xavier HSA advisory board.

To contact Andy Blankemeyer, email ablankemeyer@beaconortho.com.

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Women in PE to Know: Caroline Young

Posted in Healthcare Services Investing

McGuireWoods has long been an avid supporter of the advancement of professional women. As part of our initiative seeking to expand the leadership of women in private equity, we are continuing our series of profiling women leaders in private equity. We are hopeful that this series will serve to inspire other women to pursue their careers in private equity in a way that best challenges and motivates them, which these impressive women have all done. We are pleased to feature Caroline Young of Hammond, Kennedy, Whitney & Company. Access her profile by clicking here.

To recommend a woman for a future interview, email Amber Walsh at awalsh@mcguirewoods.com.

Private Equity in Healthcare – An Updated Review of Selected Niche Investment Areas

Posted in Healthcare Services Investing

Private equity investment in healthcare has continued to evolve since McGuireWoods examined various niche investment areas last year. Overall, valuations remain high, consolidation continues and the investment community is eyeing up larger buyers.

Please download this new McGuireWoods white paper for analysis of the current market and updated observations and insights on 19 key investment niches.

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