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The Healthcare Investor

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

Leading Private Equity Investors in Healthcare Website Features 150-Plus Firms

Posted in Healthcare Services Investing

With deal flow picking up as the country reopens, we wanted to remind you about the Leading Private Equity Investors in Healthcare website.

Launched in fall 2019 by the McGuireWoods Healthcare Private Equity Team, the website initially featured more than 125 firms. That figure has since surpassed 150. The team had previously published a multi-part series highlighting some of the more active PE investors in the healthcare space. Following that original publication, we witnessed many more PE investors turning toward healthcare investments, forming new healthcare-focused funds, and continuing healthcare PE deal activity at a staggering pace. This prompted the development of the Leading Private Equity Investors in Healthcare resource, which allows us to organize these firms in a more accessible format.

Existing profiled investors are invited to send us updates to their descriptions, and we welcome suggestions for investors to add to the list. Please submit information using the “Update My Information” and “Submit New Recommendation” buttons below the introductory text on the website.

We hope you find this website to be a valuable tool. It is just one of the many ways our team supports the healthcare PE community. If you would like to learn more about how McGuireWoods can help you ensure business continuity, please contact me at awalsh@mcguirewoods.com.

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Healthcare & Life Sciences Private Equity Deal Tracker: TA Associates and Francisco Partners Invest in Edifecs

Posted in Healthcare Services Investing

TA Associates and Francisco Partners have signed a definitive agreement to make a significant growth investment in Edifecs, according to a news release.

Edifecs, based in Bellevue, Wash., is a healthcare technology company with solutions focused on interoperability, workflows, value-based care payments and analytics.

TA Associates, which is based in Boston, considers a range of investment types, from minority to majority investments. Founded in 1968, the firm invests in healthcare and several other sectors.

Francisco Partners, with its U.S. headquarters in San Francisco, is a private equity firm that specializes in investments in technology and technology-enabled businesses.

Terms of the transaction, which is expected to close in the third quarter of 2020, were not disclosed. PEHub reported that the deal is worth more than $1.4 billion and will result in the two private equity firms jointly owning a majority of the company.

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Up-and-Coming Women in PE to Know: Katie-Rose Higgins

Posted in Healthcare Services Investing

McGuireWoods is continuing its effort to profile up-and-coming women leaders in private equity. For this profile, we are pleased to feature Katie-Rose Higgins of Falfurrias Capital. Access her profile.

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

Healthcare & Life Sciences Private Equity Deal Tracker: WindRose Acquires Stake in Caregiver From DWHP and Council Capital

Posted in Healthcare Services Investing

WindRose Health Investors has announced it has completed the recapitalization of Caregiver.

Caregiver, based in Fort Worth, Texas, is provider of intermediate, home and residential care to individuals with intellectual or developmental disabilities.

WindRose acquired its stake in Caregiver from DW Healthcare Partners (DWHP) and Council Capital. Both companies are retaining an ownership stake in the business going forward.

WindRose, which is based in New York, pursues control equity investments in healthcare companies. Founded in 2000, the firm invests in a broad range of industry segments, including outsourced services to payors and health systems, technology-enabled services, healthcare providers and value-added distribution.

DWHP, which has its U.S. office in Park City, Utah, prefers to make shareholder liquidity, management buyout and growth capital investments in mid-to-late-stage companies. Founded in 2002, the firm is focused exclusively on the healthcare industry.

Council Capital, which is based in Nashville, Tenn., focuses exclusively on healthcare services and healthcare technology. Founded in 2000, the firm targets growth and early-growth stage companies with revenues generally between $5 million and $50 million.

Terms of the transaction were not disclosed.

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A View From the Top: Joshua Gwinn of Hero Practice Services

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 Joshua Gwinn of Hero Practice Services. To recommend a leader for a future interview, email Holly Buckley at hbuckley@mcguirewoods.com.

Q: What do you think makes Hero Practice Services unique?

Joshua Gwinn: Hero is set up as a mostly pediatric-focused practice primarily serving Medicaid beneficiaries. We deliver dental, vision and orthodontic services all under one roof. What makes us unique is that tripartite structure.

In addition, we say we “build palaces to children” in very tough neighborhoods. Many of the children we serve are on Medicaid or some form of financial assistance. We are devoted to providing our patients a healthcare home they can count on — where they never feel underserved or undeserved. We say that all of our children are our “little bosses.” You will hear this throughout Hero. We have about 1,100 teammates, and they constantly talk about taking care of their little bosses, whether they work in direct patient care or not.

At Hero, we started with culture first. Our success leading up to COVID-19, and throughout this crisis, has been about having a strong culture that is driven by supporting our teammates’ desire to be connected to something greater than themselves: doing the right thing for children in underserved communities. By supporting that and living in a culture where any teammate can raise a hand to offer a better idea or way of doing things, and the best idea wins, we have an engaged and invested team.

We boil what we do down to what we call our “virtuous cycle,” so every teammate can see specifically how they enable us to care for more children. From marketing and our call center to our care teams, revenue cycle team and beyond, we have created a common language about how Hero works and why every person has a deep impact on our ability to deliver care and grow as a company.

So, what has made Hero unique is how we are positioned with the dental, vision and orthodontic services, and then, culturally, with how we have built our entire flow around taking care of those bosses.

Q: You have been in the dental sector much of your career. What do you find compelling about the industry?

JG: What I find most compelling about the dental industry is that we know the mouth and oral health is the gateway to the entire body and our physical health. The science is really catching up with us on this. The oral-systemic link has been the subject of numerous papers and significant research over the past few decades. A lot of that research is finally coming out and helping people understand that heart disease, strokes and many other ailments are more preventable than we may have thought, just by improving our oral health.

What has been really compelling to me is being on the front end of this education and helping people understand that to have great overall health, you need to start with your dental health.

Q: What have you learned about leadership throughout the challenges of the pandemic?

JG: I have learned that you can never communicate enough. Leadership is what is needed to pump fear out of the room — or Zoom — during a crisis, and communication is the tool at our disposal to accomplish this objective.

Throughout the pandemic, our leadership team has been incredible. One of the things we did at Hero is write an all-teammate email every workday since the pandemic started. On March 17, we furloughed almost 900 teammates. That day, I wrote my first all-teammate update. I have written one every workday since. We have added video town halls, where we have up to 800 teammates on at a time, and surveyed our teammates regularly to understand their perspectives and concerns — and then addressed those concerns through our “you spoke, we listened” campaign. Also central to our communication is that we have been transparent about our priorities: keeping our teams and little bosses safe and ensuring Hero is here for the long term. I have also recorded video book clubs, so we have been able to accomplish some leadership growth and development throughout this time.

Through this unwavering focus on communication, we have pumped a lot of the fear out of the practice. Direct patient care requires close proximity to our patients. Hiding from that would not serve Hero, our teammates or our patients. We directly address concerns with clear answers. Sometimes that answer is, “We don’t know.” This has continued to earn our teammates’ trust and engaged them. Communication and transparency have allowed us to come back to work stronger.

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

JG: The ones I see on the horizon that I think will push things forward the most are artificial intelligence (AI) and big data. The ability to leverage AI and big data to streamline revenue cycle collections as well as treatment planning will produce a massive change in the way we see, prescribe and access healthcare.

For Hero specifically, we have already seen treatment plan reviews performed by AI. The machine has learned how to read dental X-rays and can tell us where cavities may exist.

What I see happening is that such a tool can be used as a training and “clinical double-check” resource to help ensure our providers are consistently treatment planning. Building more consistency into the treatment is especially valuable with pediatrics. In pediatrics, you provide limited dental services, such as fillings, crowns and extractions. You are not doing the expanded treatments you might provide to adults. A double-check clinical tool would also be fantastic for training new dentists fresh out of school.

On the back end of the revenue cycle, we see AI helping streamline claims processing and reducing days sales outstanding. This will allow us to turn revenue around faster so the time from billing to receiving payment on those collections decreases dramatically. In addition, we could reduce the number of human hands and touches involved as the claim goes through the system.

Finally, we expect AI to continue to help with real estate development and location planning. As we receive more statistical population analyses, we will be able to identify where our patients reside with even more accuracy, which will provide us with better structure when we are building out de novo practices.

Q: What was the most significant business challenge you have faced?

JG: It is absolutely COVID-19. Going back to what I said earlier, the most significant challenge associated with it was the fear, uncertainty and deluge of constantly changing guidance coming our way.

For Hero specifically, we are located in seven states and about 50 separate counties. We were tracking state-level, county-level and board guidance, as well as recommendations from the American Dental Association, American Optometric Association, American Association of Orthodontia, Centers for Disease Control and Prevention and the rest of the alphabet soup. All that guidance, coupled with rumor and fear amplified on social media and traditional media, created the biggest challenge we have faced as an organization.

For any leader, uncertainty and not knowing the answers your team needs can be difficult. Leaders who struggle with uncertainty and presenting transparency and calm struggle more during a moment like this. What we did in those moments was act with transparency; seek answers; look around corners to see what is to come; develop plans and pivot rapidly when things inevitably changed; and communicate, communicate, communicate. We set up an email inbox that any teammate could reach that went directly to our leadership team. Questions were answered within 24 hours — often significantly faster. We received thousands of emails in the early days of this crisis and throughout our reopening. We have an entirely new vernacular that drives our company today — things like assuming positive intent, speaking up and giving grace, practicing agility and being a team together and a team apart. Today, every leader at Hero understands the meaning of, “In times like this, leaders lead.”

Also, making it through this time required us to express the genuine care we had for our teammates; to be motivated to do more for them through this time and to build their trust in our intentions. These things only worked because we did genuinely empathize with our teammates’ concerns and struggles.

Fortunately, I have a team of leaders behind me who just settled in when the pandemic hit and went to work on how to overcome the challenges we faced, including how much communication to get out and how to effectively shift and sift through the guidance. With 1,100 teammates, 900 of whom we furloughed in less than 48 hours, it was imperative that we made sure they had everything needed to fill out their unemployment claims and work through all of the disparate programs that came down. Where other groups may not have gathered and maintained that information, we felt we owed it to our teams to help them navigate the systems. In addition, we needed to work through all of the guidance on the three stimulus packages to determine what would be the best for our teammates and most effective for our company as well as preparing for reopening.

We wrote well over 40 new policies and procedures for the organization and implemented a three-phase reopening approach. Our leadership team came together and started to pump out that communication to rebuild the company for the “new world.”

COVID-19 was definitely the biggest challenge I have faced, but it seems like we are going to come out of it with flying colors.

About Joshua Gwinn

Joshua Gwinn brings extensive operational experience in dental, orthodontic and vision care to his role as Hero Practice Services chief executive officer. He is keenly focused on patient needs and driving a culture that always puts patients above all else. After starting his career as an operations specialist in the U.S. Navy, Gwinn spent several years with National Vision-affiliated brands building his skills in all aspects of the optical field, including optical dispensing, lab operations, field training, leadership and de novo operations. He then shifted focus to the dental field, becoming the regional director for Great Expressions Dental Centers throughout Michigan and Ohio. Most recently, Gwinn led operations as well as training and education for a large fleet of Gentle Dental practices in the Pacific Northwest and California.

To contact Joshua Gwinn, email joshua.gwinn@herodvo.com.

Healthcare & Life Sciences Private Equity Deal Tracker: EW Healthcare Partners Leads Investment in Cardiva Medical

Posted in Healthcare Services Investing

EW Healthcare Partners has led a $45 million equity financing round into Cardiva Medical, according to a news release.

EW Healthcare Partners, a new investor, joined Cardiva’s existing major investors, including affiliates of Luther King Capital Management, PTV Healthcare Capital, and Evidity Health Capital, in the round.

Cardiva, based in Santa Clara, Calif., is a medical device company focused on vascular closure.

EW Healthcare Partners, with U.S. offices in Houston, New York, and Palo Alto, Calif., is a private healthcare investment firms that seeks to make growth equity investments in commercial-stage companies. Founded in 1985, the firm targets investments in the pharmaceutical, medical device, diagnostics, and technology-enabled services sectors in the United States and Europe.

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Healthcare & Life Sciences Private Equity Deal Tracker: Accel-KKR Invests in Forcura

Posted in Healthcare Services Investing

Accel-KKR has made a “significant” growth investment in healthcare technology company Forcura, according to a news release.

Forcura, based in Jacksonville, Fla., is a developer of document management and communication solutions for home health and hospice organizations.

Accel-KKR, based in Menlo Park, Calif., is a technology-focused investment firm. The firm pursues middle-market companies and provides a broad range of capital solutions, including buyout capital, minority-growth investments and credit alternatives.

The news release indicated that the investment would go toward accelerating innovation, growth and expansion of the Forcura software platform.

Terms of the transaction were disclosed.

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Blackstone Closes Life Sciences Fund With $4.6 Billion

Posted in Life Sciences Investing

Blackstone has announced the closing of its inaugural life sciences fund with $4.6 billion of total capital commitments.

The company stated that the fund, Blackstone Life Sciences V, is the largest life sciences private fund raised to date.

Blackstone Life Sciences has three main investment strategies: collaborations with established companies, late-stage product financings, and growth investments in emerging companies.

Blackstone Life Sciences has already committed nearly $1 billion from this fund to investments in Alnylam, a biotechnology company; Reata Pharmaceuticals, which is developing a medicine for a kidney disease affecting children; and Medtronic, in support of the company’s diabetes management products.

Healthcare & Life Sciences Private Equity Deal Tracker: Abry Partners Acquires HealthEZ

Posted in Healthcare Services Investing

Abry Partners has acquired HealthEZ, according to a news release.

HealthEZ, founded in 1982 and based in Minneapolis, is an independent, third-party administrator of employer-sponsored, self-funded medical plans.

Founded in 1989, Abry focuses on lower middle market companies in healthcare and other industries. Based in Boston, the firm pursues a wide range of investments in companies with revenue between $10 million and $50 million and prefers to make more substantial investments from a dollars perspective.

The announcement states that Abry’s investment is intended to help HealthEZ provide more and enhanced services to clients and pursue strategic acquisitions.

Terms of the acquisition were not disclosed.

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Healthcare & Life Sciences Private Equity Deal Tracker: GTCR Partnership Acquires Citra Health

Posted in Healthcare Services Investing

GTCR has announced its Cedar Gate Technologies management partnership with CEO David Snow has acquired Citra Health Solutions.

Citra Health, based in Morrisville, N.C., is a provider of capitation management software solutions.

GTCR, based in Chicago, pursues a wide range of investments in several industries, including healthcare. Founded in 1980, the firm prefers to make more substantial investments from a dollars perspective.

Cedar Gate Technologies, based in Greenwich, Conn., is a value-based care performance management company founded in 2014.

Terms of the acquisition were not disclosed.

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