healthcare industry - scott-macon, ltd. · scott-macon healthcare review november 2019 2 segments...

SCOTT-MACON Healthcare ReviewNovember 2019

A D V I S O R Y S E R V I C E S D E B T/ E Q U I T Y F I N A N C I N G SVA L UAT I O N S E R V I C E SM & A A D V I S O R Y

HEALTHCARE INDUSTRYMonthly Update | November 2019

| | |


2

SEGMENTS AT A GLANCE

◼ Deal activity in the U.S. healthcare market continued to be robust in November 2019 with 87 deals announced, a 4% increase from 2018.

– Through the first 11 months of 2019, deal activity has been 9% higher than the prior year.

◼ Healthcare deal activity is likely to continue to be strong through the remainder of 2019 and into 2020 given high availability of capital, potential for disruption from horizontal industry consolidation, reimbursement pressure and rise of digitization & consumerism.

◼ Potential contributors to an M&A slowdown include the ramp-up of the 2020 U.S. presidential election / other legislative uncertainty, escalation of the U.S. / China trade tension, prolonged inversion of the yield curve and corporate debt loads athistoric levels.

– Despite several headwinds, the non-discretionary nature of healthcare spending should make the sector outperform during a potential economic slowdown.

◼ Please feel free to contact Nate Cortright at [email protected], or schedule a call here, should you wish to discuss how Scott-Macon can assist you in achieving your business objectives.

Nate CortrightManaging DirectorGroup Head, Healthcare

“Consistent with prior months, the number of healthcare deals in November 2019 was robust and we anticipate continued activity for the remainder of 2019 and into 2020. Factors such as non-traditional businesses making forays into healthcare, private equity fundraising reaching all-time highs and inorganic corporate strategic initiatives continue to drive healthcare transactions.”

SEGMENT SNAPSHOT

M&A Stats Nov-19 Trailing 18mo M&A Median Public Comps

$ in millions # Deals TEV TEV / Revenue TEV / EBITDA

Healthcare IT and Tech-enabled Services 16 41.4$ 3.83x 16.6x

Consumer Driven Healthcare 2 43.0 5.17x NA

Faci l i ties Management 3 - NA NA

Workforce Solutions 3 612.0 1.72x 11.5x

Insurance - Commercia l - - 0.37x 10.4x

Insurance - Government 1 - 0.85x 18.8x

Distribution - - NA NA

Labs 2 - NA NA

Services Segment 27 696.4 3.03x 13.9x

Acute 4 - 0.90x 8.5x

Senior Living / Long-term Care 6 2.1 NA NA

Behavioral 5 - NA NA

Home Health 7 - 0.96x 10.2x

Specia l ty 20 49.5 1.17x 7.1x

Providers Segment 42 51.6 1.09x 8.4x

Suppl ies & Distribution 8 20.3 1.55x 11.8x

Durable Medical Equipment - - 0.56x 10.2x

Medical Devices & Products - - 3.62x 16.2x

Specia l ty Devices & Products 10 464.3 4.83x 16.0x

Consumer - - 1.94x 15.2x

Products Segment 18 484.6$ 3.31x 15.2x

Public Comps

TEV / Revenue TEV / EBITDA

3.67x 20.3x

5.98x 19.4x

1.72x 14.8x

1.58x 25.7x

0.82x 12.0x

0.36x 9.9x

0.41x 14.5x

2.18x 11.9x

1.57x 13.8x

1.27x 8.9x

1.85x 16.7x

2.05x 11.3x

2.12x 22.8x

1.60x 10.2x

1.65x 13.0x

0.32x 8.6x

1.82x 25.0x

5.36x 20.6x

6.53x 24.6x

0.67x 10.6x

4.49x 18.3x

mailto:[email protected]

https://ratemycampushouse.com/[email protected]


3Sources

INDUSTRY SPOTLIGHT: LIFE SCIENCES CONSULTING

◼ M&A activity among life sciences consulting companies has been strong in 2019 with 28 deals announced, already surpassing the total for full year 2018

◼ Scott-Macon expects life sciences consulting M&A activity to remain robust for the near- to medium-term

– Favorable market dynamics (e.g., increased outsourcing of non-core operations, evolving regulatory environment, etc.)

– Strategic buyers seeking to augment organic growth

– Cost-savings from gaining scale in a fragmented market

◼ Scott-Macon identified three M&A tail-winds to support our 2020 M&A outlook for the life science consulting market:

12/16/19 Veris tatCata lyst Regulatory

Services

Regulatory s trategy

consulting

11/15/19 IQVIA ValueCentric Data management

11/07/19 Veeva Systems Inc. Phys icians WorldMarketing & data

management

11/08/19WIRB-Copernicus Group

(WCG)Waife & Associates Consulting for R&D

11/01/19 Val idant DataReviveRegulatory s trategy

consulting

10/01/19 Trini ty Partners Bel l Canyon Consulting Data management

10/09/19 NSF International Inc. AmarexRegulatory s trategy

consulting

09/10/19 Sparring Capita l Nalys GroupProject management

services

06/04/19 Cytel Inc. Axio Research Data management

09/03/19Indegene Li fesystems Pvt

Ltd.DT Associates Research

Commercia l i zation & price

consulting

10/30/19 EversanaCornerstone Research

Group

Commercia l i zation & price

consulting


(WCG)PharmaSeek

Consulting & tra ining

solutions

07/01/19Vois in consulting l i fe

sciencesIWA consulting (IWAC)

Regulatory & development

consulting

06/06/19 Genstar Capita l AdvarraDrug & device ethics

reviews

05/21/19 UDG / Ashfield Putnam Associates , Inc.Commercia l i zation

consulting services

05/21/19 Huntsworth Creativ-Ceutica lMarket access & pricing

consulting

05/21/19 Navitas Li fe Sciences KAI Research Regulatory management

04/30/19 Whitsel l Innovations PharmaKey Regulatory consulting

04/24/19 NNIT A/S Hal fmann Goetsch Partner IT compl iance services

04/16/19 PharmaLogics Recrui ting Orbis Cl inica l Staffing & consulting

04/09/19 Covance/LabcorpRegulatory & Cl inica l

Research Insti tuteRegulatory & CRO services

04/01/19 BDO USABioProcess Technology

Consultants

Technica l , regulatory &

s trategic consulting

03/10/19 ProPharma Group Southwood ResearchPre-approval regulatory

science services

03/05/19 Planet Group Praxis Li fe SciencesRegulatory project

management

Date Buyer Target Description

03/05/19 AccentureEnterprise System

Partners Limited

Regulatory & technica l

project management


(WCG)Firs t Cl inica l Research

Consulting & tra ining

solutions

01/28/19 ProPharma Group The Weinberg GroupRegulatory & compl iance

services

01/21/19 21 Invest France ProductLi fe GroupRegulatory affa i rs &

operations consulting

12/20/18 GHO Capita l Partners Val idantTechnica l & regulatory

consulting

11/09/18 JLL Partners & Water Street Cato Research Regulatory & CRO services

09/25/18 Ekium Group Air Consult EngineeringEngineering & GMP

consulting

09/25/18 Precis ion for Medicine Argint International CRO & regulatory services

09/05/18 Trini ty Partners TGaS AdvisorsBenchmarking & advisory

services

08/30/18 ProPharma Group SOLUTIONS in HealthMedica l information

services

08/20/18 Syneos Health KinapseConsulting & outsourcing

services

07/30/18 Premier Research Regulatory Profess ionalsRegulatory & development

consulting

07/16/18 ProPharma Group Xendo HoldingCompl iance & engineering

consulting

07/16/18 ProPharma Group XendoConsultancy & project

management

06/11/18 Covance/Labcorp Sci formix CorporationConsulting services

throughout drug cycle

06/11/18 NES Group Limited RedbockFDA compl iance &

engineering services

06/05/18Bertram Capita l

ManagementRegis trar Corp FDA regis tration services

05/03/18Innomar /

AmerisourceBergenTPIreg

Regulatory & qual i ty

assurance consulting

02/20/18 JLL Partners & Water Street EVERSANAEnd-to-end drug

development consulting

02/09/18 Keystone Capita l Arbour GroupCompl iance technology &

services

02/08/18 TwoLabs Marketing MKO Global PartnersMarket access & pricing

consulting

02/05/18Iperion Li fe Sciences

Group

Reg. Consulting Practice of

Identi ficaRegulatory consulting

01/30/18 Precis ion Xtract Ins ight Strategy AdvisorsCommercia l development

consulting

11/02/17 Navigant Consulting Quorum Consulting GroupCommercia l & market

access consulting

Date Buyer Target Description

NON-TRADITIONAL PLAYERS ENTER

increased interest from non-life sciences centric companies as non-traditional buyers see significant near-term opportunity in the

life sciences consulting market.

SELECT BUYER / TARGET

CRO EXPANDING CAPABILITIES

CROs continue to be acquisitive to expand their service offering and remain competitive in an evolving landscape where lines between CRO, CDMO, CSO and CMO continue to blur.

SELECT BUYER / TARGET

STRONG PRIVATE EQUITY INTEREST

private equity firms have been aggressively pursuing platform investments and add-on acquisitions across the entire life sciences

outsourcing continuum.

SELECT PEG / PLATFORM

RECENT LIFE SCIENCE CONSULTING M&A


4

Note: $ in millions. Information above only represents transactions with partial or full announced deal terms.ND: SM proprietary deal stat has been included in the median.NA: Not available.NM: Not meaningful.

SERVICES

Announced Enterprise Enterprise Value /

Date Target Buyer Value Revenue EBITDA

11/05/2019 Soliant Health, Inc. Olympus Partners 612.0$ 1.78x 11.3x

10/01/2019 M Booth Health M Booth & Associates, Inc. 45.0 2.59x NA

09/30/2019 ECG Management Consultants, Inc. Siemens Medical Solutions USA, Inc. 300.1 3.00x NA

09/11/2019 PharmAgra Labs, Inc. Ruibo Pharmaceutical 16.0 2.22x NA

08/07/2019 Cambrex Corporation Permira Advisers Ltd. 2,545.2 4.43x 17.4x

08/02/2019 Navigant Consulting, Inc. Guidehouse LLP 1,143.4 1.57x 16.2x

07/16/2019 OmniComm Systems, Inc. Anju Software, Inc. 76.4 3.03x NM

06/12/2019 Medidata Solutions, Inc. Dassault Systemes Americas Corp. 5,822.3 8.82x NM

05/21/2019 Putnam Associates, Inc. Ashfield Healthcare Communications Ltd 60.0 NA 11.1x

05/21/2019 Kyne Communications Huntsworth plc 20.5 2.01x NA

05/17/2019 InstaMed Communications, LLC JPMorgan Chase & Co. 500.0 8.00x NA

04/30/2019 Advanced Medical Personnel Services, Inc. AMN Healthcare, Inc. 220.0 1.67x 11.6x

03/27/2019 WellCare Health Plans, Inc. Centene Corporation 17,300.0 0.85x 18.8x

03/14/2019 DCP Holding Company DentaQuest, LLC 41.5 0.37x 10.4x

03/11/2019 Voalte, Inc. Hill-Rom, Inc. 195.0 4.88x NA

03/05/2019 Prescribe Wellness, LLC Tabula Rasa HealthCare, Inc. 150.0 5.17x NM

12/19/2018 Technology Business of MModal IP, LLC 3M Company 1,000.0 5.00x 10.0x

11/12/2018 athenahealth, Inc. Veritas Capital Fund Management, LLC 5,638.5 4.30x 21.3x

11/05/2018 MatrixCare, Inc. ResMed Operations, Inc. 750.0 6.15x 25.0x

08/16/2018 NuGEN Technologies, Inc. Tecan Group, Ltd. 54.5 3.78x NA

08/15/2018 GreatCall, Inc. Best Buy Co., Inc. 800.0 2.67x NA

08/13/2018 UHS Holdco, Inc. Thomas H. Lee Partners, L.P. 1,440.0 2.67x 9.9x

06/19/2018 Cotiviti Holdings, Inc. Verscend Technologies, Inc. 4,929.3 6.68x 17.1x

06/12/2018 Health Prime International, LLC GPB Capital Holdings, LLC 60.0 3.87x NA

Median 400.1$ 3.03x 13.9x

RECENT M&A TRANSACTIONS


5


PROVIDERS



10/01/2019 Eleven Clinic Physical Therapy Practice U.S. Physical Therapy, Inc. 18.4$ 2.78x NA

08/26/2019 Hospice Partners of America, LLC Addus HealthCare Inc. 130.0 2.62x NA

08/19/2019 One Operating Franchise, Located in Chula Vista, California The Joint Corp. 0.3 0.60x NA

08/05/2019 Alliance Home Health Care Addus HomeCare Corporation 24.0 0.96x NA

05/20/2019 Cancer Treatment Services International, Inc. Varian Medical Systems, Inc. 279.3 6.42x NA

05/16/2019 AccentCare, Inc. Advent International Corporation 909.0 1.12x NA

04/15/2019 Advanced Diagnostics Group Akumin Inc. 214.0 NA 7.1x

04/11/2019 BTE Technologies, Inc. U.S. Physical Therapy, Inc. 23.6 1.82x NA

04/02/2019 ISDI Holdings, Inc. IMAC Management of Il l inois, LLC. 5.3 1.06x NA

04/01/2019 Alacare Home Health & Hospice Encompass Health Corporation 217.5 1.86x NA

02/01/2019 Concord Imaging Touchstone Imaging ND ND ND

01/22/2019 Hughes Center for Functional Medicine, P.A. HLYK Florida, LLC 2.0 0.66x 5.4x

12/18/2018 Civitas Solutions, Inc. Centerbridge Partners, L.P. 1,372.7 0.86x 8.4x

12/10/2018 BrightSpring Health Services PharMerica Corporation 1,320.0 0.66x NA

11/12/2018 Four Imaging Centers from Diagnostic Professionals Akumin Inc. 12.1 0.63x NA

10/10/2018 Compassionate Care Hospice Group, Inc. Amedisys Hospice, LLC 324.5 1.57x 12.0x

10/05/2018 Medical Arts Radiology RadNet, Inc. 61.6 1.54x NA

10/03/2018 Birner Dental Management Services, Inc. Mid-Atlantic Dental Service Holdings, LLC 38.5 0.63x NM

09/11/2018 Valley Healthcare Group, LLC/Northwest Medical, Inc. Great Elm Capital Group, Inc. 66.0 1.40x NA

08/20/2018 Business Assets of Comprehensive Home Care, Inc. Nova Leap Health Corp. 1.6 0.50x NA

08/15/2018 11 Imaging Centers from Rose Radiology Centers Akumin Inc. 25.0 0.91x 5.2x

08/13/2018 Living at Home SeniorCare, LLC AME, LLC 0.4 0.46x NA

07/23/2018 LifePoint Health, Inc. RCCH HealthCare Partners 5,598.1 0.90x 8.5x

07/17/2018 Giant Creative/Strategy, LLC Huntsworth, PLC 80.0 2.50x 11.4x

07/10/2018 Creative Connections, Inc. Civitas Solutions, Inc. 2.9 0.50x NA

06/11/2018 Envision Healthcare Corporation KKR & Co. L.P. 10,418.6 1.30x 9.7x

06/04/2018 Integrated Medical Delivery, LLC N. Harris Computer Corporation 6.1 1.22x NA

Median 38.5$ 1.09x 8.4x



6




11/22/2019 McKesson Patient Care Solutions, Inc. AdaptHealth, LLC 15.5$ 0.12x NA

10/01/2019 Winpak Control Group Inc. Winpak Ltd. 42.2 1.69x NA

08/28/2019 Computer Task Group, Incorporated Assurance Global Services, LLC 114.3 0.30x 12.8x

08/19/2019 Gould's Discount Medical, Inc. AdaptHealth, LLC 24.3 0.74x NA

08/06/2019 NeoMed, Inc. Avanos Medical, Inc. 35.0 0.97x NA

07/30/2019 Hu-Friedy Mfg. Co., LLC Cantel Medical Corp. 775.0 3.62x 16.2x

07/11/2019 BioTek Instruments, Inc. Agilent Technologies, Inc. 1,165.0 7.19x NA

06/25/2019 Canfield Medical Supply, Inc. WesBev, LLC 0.5 0.39x 7.6x

06/14/2019 Respiratory Assets of Midwest Respiratory Care, Inc. Focus Respiratory, Inc. 6.3 1.79x NA

06/10/2019 Endocare Varian Medical Systems, Inc. 185.0 6.17x NA

06/05/2019 Vilex in Tennessee OrthoPediatrics Corp. 59.8 5.07x NA

05/02/2019 Acelity, Inc. 3M Company 6,725.0 4.48x 15.2x

02/12/2019 CAS Medical Systems, Inc. Edwards Lifesciences Corporation 104.9 4.79x NM

01/28/2019 Anatomical Pathology Business of Thermo Fisher Scientific, Inc. PHC Holdings Corporation 1,140.0 3.31x NA

01/16/2019 Fuse Medical, Inc. Generex Biotechnology Corporation 34.0 1.29x NM

01/11/2019 Vista Research Group, LLC Cantel Medical Corporation 10.5 5.25x NA

12/10/2018 Nutrisystem, Inc. Tivity Health, Inc. 1,340.7 1.94x 15.2x

11/19/2018 DJO Global, Inc. Colfax Corporation 3,150.0 2.66x 16.8x

11/01/2018 Paradigm Spine, LLC RTI Surgical, Inc. 299.1 7.48x NA

09/26/2018Vascular Clot Management Business of Applied Medical Resources

CorporationLeMaitre Vascular, Inc. 14.2 4.18x NA

09/26/2018 Focal Therapeutics, Inc. Hologic, Inc. 117.9 7.37x NA

09/20/2018 AquaGuard Business of Cenorin, LLC Covalon Technologies, Ltd. 12.5 1.45x NA

09/11/2018 Invuity, Inc. Stryker Corporation 200.3 4.91x NM

08/30/2018 K2M Group Holdings, Inc. Stryker Corporation 1,340.0 4.93x NM

08/06/2018 Bemis Company, Inc. Amcor Limited (nka:Amcor plc) 6,777.9 1.65x 11.8x

07/31/2018 Faxitron Bioptics, LLC Hologic, Inc. 85.0 3.15x NA

06/06/2018 Advanced Steril ization Products Services, Inc. Fortive Corporation 2,700.0 3.48x NA

06/05/2018 CoolSystems, Inc. Halyard Health, Inc. (nka:Avanos Medical, Inc.) 65.0 1.86x NA

06/04/2018 elliquence, LLC Shanghai Xianfeng Investment Management Co., Ltd 77.2 4.83x NA

Median 104.9$ 3.31x 15.2x


PRODUCTS


7

NM: Not meaningful.(1) Represents company that has announced potential acquisition that is subject to shareholder approval, regulatory approval and/or other customary

closing conditions.

SERVICES Stock Price as 52-Week Market Enterprise LTM EBITDA EV/LTM

$ in millions, except per share data of 10/31/19 % Change Cap Value (EV) Revenue Margins Revenue EBITDA

Healthcare IT and Tech-enabled Services

Allscripts Healthcare Solutions, Inc. $ 10.94 (8.1%) $ 1,823 $ 2,732 $ 1,763 7.4% 1.55x 21.1x

Cerner Corporation 67.12 17.2% 21,082 21,758 5,616 19.8% 3.87x 19.6x

Computer Programs and Systems, Inc. 23.07 (7.7%) 319 444 276 12.7% 1.61x 12.7x

Evolent Health, Inc. 7.62 (65.7%) 639 846 803 (6.4%) 1.05x NM

HMS Holdings Corp. 32.69 13.4% 2,856 2,839 619 23.3% 4.59x 19.7x

Inovalon Holdings, Inc. 15.63 66.1% 2,422 3,350 605 27.2% 5.54x 20.3x

Model N, Inc. 29.79 93.9% 974 958 141 (5.8%) 6.78x NM

NextGen Healthcare, Inc. 16.91 14.5% 1,106 1,115 532 7.4% 2.10x 28.3x

National Research Corporation 57.43 50.9% 1,424 1,453 126 36.7% 11.54x 31.4x

Omnicell, Inc. 70.39 (0.4%) 2,932 2,935 860 13.5% 3.41x 25.3x

R1 RCM Inc. 10.63 25.5% 1,192 1,599 1,135 10.8% 1.41x 13.0x

Tabula Rasa HealthCare, Inc. 50.94 (31.1%) 1,052 1,253 269 4.0% 4.66x NM

Vocera Communications, Inc. 19.92 (42.6%) 627 659 180 (2.9%) 3.67x NM

Mean 9.7% 2,958$ 3,226$ 994$ 11.3% 3.98x 21.3x

Median 13.4% 1,192$ 1,453$ 605$ 10.8% 3.67x 20.3x

Consumer Driven Healthcare

Castlight Health, Inc. $ 1.51 (38.9%) $ 221 $ 205 $ 149 (20.1%) 1.38x NM

HealthEquity, Inc. 56.79 (38.1%) 4,011 5,147 407 32.7% 12.66x 38.7x

Teladoc Health, Inc. 76.60 10.5% 5,544 5,534 520 (6.0%) 10.65x NM

Tivity Health, Inc. 16.21 (52.9%) 775 1,872 1,011 19.7% 1.85x 9.4x

Mean (29.9%) 2,638$ 3,190$ 522$ 6.6% 6.63x 24.0x

Median (38.5%) 2,393$ 3,510$ 463$ 6.9% 6.25x 24.0x

Facilities Management

Healthcare Services Group, Inc. $ 24.36 (40.0%) $ 1,806 $ 1,794 $ 1,895 5.5% 0.95x 17.2x

Stericycle, Inc. 57.60 15.3% 5,249 8,360 3,362 19.9% 2.49x 12.5x

Mean (12.4%) 3,527$ 5,077$ 2,628$ 12.7% 1.72x 14.8x

Median (12.4%) 3,527$ 5,077$ 2,628$ 12.7% 1.72x 14.8x

Workforce Solutions

AMN Healthcare Services, Inc. $ 58.76 16.1% $ 2,742 $ 3,424 $ 2,164 10.8% 1.58x 14.6x

Cross Country Healthcare, Inc. 10.81 22.4% 399 485 808 2.2% 0.60x 27.9x

HealthStream, Inc. 28.06 6.7% 909 808 251 12.5% 3.22x 25.7x

Mean 15.1% 1,350$ 1,573$ 1,074$ 8.5% 1.80x 22.7x

Median 16.1% 909$ 808$ 808$ 10.8% 1.58x 25.7x

Insurance - Commercial

Anthem, Inc. $ 269.08 (2.4%) $ 68,229 $ 85,374 $ 100,165 6.7% 0.85x 12.7x

Cigna Corporation 178.46 (16.5%) 66,641 101,474 129,660 8.1% 0.78x 9.7x

Humana Inc. 294.20 (8.2%) 39,743 40,997 62,761 5.8% 0.65x 11.3x

UnitedHealth Group Incorporated 252.70 (3.3%) 239,479 272,010 239,671 8.8% 1.13x 12.9x

Mean (7.6%) 103,523$ 124,964$ 133,064$ 7.4% 0.86x 11.6x

Median (5.7%) 67,435$ 93,424$ 114,913$ 7.4% 0.82x 12.0x

Insurance - Government

Centene Corporation $ 53.08 (18.5%) $ 21,964 $ 23,578 $ 68,369 4.7% 0.34x 7.3x

Molina Healthcare, Inc. 117.64 (7.2%) 7,376 6,269 16,674 7.0% 0.38x 5.4x

WellCare Health Plans, Inc. 296.60 7.5% 14,927 14,658 26,983 4.3% 0.54x 12.5x

Magellan Health, Inc. 64.90 (0.2%) 1,584 2,137 7,201 1.7% 0.30x 17.2x

Mean (4.6%) 11,463$ 11,660$ 29,807$ 4.4% 0.39x 10.6x

Median (3.7%) 11,152$ 10,463$ 21,829$ 4.5% 0.36x 9.9x

Distribution

CVS Health Corporation $ 66.39 (8.3%) $ 86,340 $ 170,825 $ 243,331 6.5% 0.70x 10.8x

Diplomat Pharmacy, Inc. 5.44 (72.6%) 411 990 5,206 1.0% 0.19x 18.2x

Rite Aid Corporation 9.20 (61.7%) 495 7,469 21,569 2.2% 0.35x 15.5x

Walgreens Boots All iance, Inc. 54.78 (31.3%) 48,893 65,799 136,866 4.8% 0.48x 10.0x

Mean (43.5%) 34,035$ 61,271$ 101,743$ 3.6% 0.43x 13.7x

Median (46.5%) 24,694$ 36,634$ 79,217$ 3.5% 0.41x 13.2x

Labs

Laboratory Corporation of America Holdings $ 164.77 2.6% $ 16,049 $ 23,125 $ 11,389 16.7% 2.03x 12.2x

Quest Diagnostics Incorporated 101.25 7.6% 13,638 17,766 7,639 20.0% 2.33x 11.6x

Mean 5.1% 14,843$ 20,446$ 9,514$ 18.3% 2.18x 11.9x

Median 5.1% 14,843$ 20,446$ 9,514$ 18.3% 2.18x 11.9x

Median (2.8%) 2,582$ 3,143$ 1,829$ 7.2% 1.57x 13.8x

(1)

PUBLIC COMPANY PERFORMANCE


8

NM: Not meaningful.

PROVIDERS

Stock Price as 52-Week Market Enterprise LTM EBITDA EV/LTM


Acute

Community Health Systems, Inc. $ 3.54 12.0% $ 403 $ 14,487 $ 13,378 10.1% 1.08x 10.8x

HCA Healthcare, Inc. 133.54 0.0% 45,535 81,016 50,087 19.2% 1.62x 8.4x

Tenet Healthcare Corporation 25.34 (1.5%) 2,621 18,344 18,292 15.5% 1.00x 6.5x

Universal Health Services, Inc. 137.46 13.1% 12,163 16,382 11,237 15.7% 1.46x 9.3x

Mean 5.9% 15,181$ 32,557$ 23,248$ 15.1% 1.29x 8.7x

Median 6.0% 7,392$ 17,363$ 15,835$ 15.6% 1.27x 8.9x

Senior Living / Long-term Care

Brookdale Senior Living Inc. $ 7.35 (17.7%) $ 1,363 $ 7,061 $ 3,282 12.5% 2.15x 17.2x

Capital Senior Living Corporation 4.11 (54.3%) 125 1,353 451 10.6% 3.00x 28.3x

Ensign Group, Inc. 42.25 14.1% 2,254 3,521 2,263 9.6% 1.56x 16.1x

National HealthCare Corporation 82.18 3.3% 1,259 1,459 990 9.5% 1.47x 15.5x

Mean (13.7%) 1,250$ 3,348$ 1,746$ 10.6% 2.05x 19.3x

Median (7.2%) 1,311$ 2,490$ 1,626$ 10.1% 1.85x 16.7x

Behavioral

Acadia Healthcare Company, Inc. 29.99 (27.7%) 2,655 6,294 3,071 18.2% 2.05x 11.3x

Mean (27.7%) 2,655$ 6,294$ 3,071$ 18.2% 2.05x 11.3x

Median (27.7%) 2,655$ 6,294$ 3,071$ 18.2% 2.05x 11.3x

Home Health

Addus HomeCare Corporation $ 84.21 28.6% $ 1,285 $ 1,124 $ 598 7.0% 1.88x 26.7x

Amedisys, Inc. 128.52 16.8% 4,145 4,449 1,889 10.0% 2.35x 23.6x

Chemed Corporation 393.91 29.4% 6,272 6,508 1,874 15.8% 3.47x 21.9x

LHC Group, Inc. 110.97 21.4% 3,496 3,799 2,059 10.4% 1.85x 17.7x

Mean 24.1% 3,800$ 3,970$ 1,605$ 10.8% 2.39x 22.5x

Median 25.0% 3,821$ 4,124$ 1,882$ 10.2% 2.12x 22.8x

Specialty

American Renal Associates Holdings, Inc. $ 8.32 (56.9%) $ 271 $ 957 $ 824 15.4% 1.16x 7.6x

DaVita Inc. 58.60 (13.0%) 8,114 18,053 11,311 20.1% 1.60x 7.9x

MEDNAX, Inc. 21.96 (46.8%) 1,821 3,820 3,689 14.3% 1.04x 7.2x

Providence Service Corporation 63.87 (3.4%) 824 806 1,486 3.5% 0.54x 15.7x

RadNet, Inc. 15.62 5.5% 783 1,936 1,111 11.9% 1.74x 14.7x

Select Medical Holdings Corporation 18.22 9.9% 2,471 6,728 5,344 12.4% 1.26x 10.2x

Surgery Partners, Inc. 7.95 (41.5%) 393 3,054 1,805 18.8% 1.69x 9.0x

U.S. Physical Therapy, Inc. 141.47 31.6% 1,807 1,920 472 16.2% 4.06x 25.0x

Mean (13.3%) 2,533$ 5,209$ 3,395$ 14.7% 1.69x 12.0x

Median (4.9%) 1,807$ 3,054$ 1,805$ 15.4% 1.60x 10.2x

Median 1.7% 2,037$ 4,134$ 2,161$ 13.4% 1.65x 13.0x



9

NM: Not meaningful.

PRODUCTSStock Price as 52-Week Market Enterprise LTM EBITDA EV/LTM


Supplies & Distribution

AmerisourceBergen Corporation $ 85.38 (3.0%) $ 17,787 $ 18,906 $ 179,589 1.3% 0.11x 8.0x

Cardinal Health, Inc. 49.45 (2.3%) 14,459 21,653 147,662 1.9% 0.15x 7.6x

Henry Schein, Inc. 62.59 (24.6%) 9,279 10,543 13,574 8.6% 0.78x 9.0x

McKesson Corporation 133.00 6.6% 23,965 32,944 221,981 1.8% 0.15x 8.5x

Owens & Minor, Inc. 6.73 (14.8%) 424 2,195 9,888 1.8% 0.22x 12.1x

Patterson Companies, Inc. 17.13 (24.1%) 1,617 2,244 5,581 3.7% 0.40x 10.7x

Premier, Inc. 32.58 (27.6%) 2,250 2,199 1,227 42.4% 1.79x 4.2x

West Pharmaceutical Services, Inc. 143.84 35.8% 10,643 10,515 1,792 21.6% 5.87x 27.2x

Mean (6.7%) 10,053$ 12,650$ 72,662$ 10.4% 1.18x 10.9x

Median (8.9%) 9,961$ 10,529$ 11,731$ 2.8% 0.31x 8.7x

Durable Medical Equipment

Hill-Rom Holdings, Inc. $ 104.69 24.5% $ 6,995 $ 9,232 $ 2,907 19.2% 3.18x 16.6x

Invacare Corporation 7.72 (40.2%) 260 447 940 1.4% 0.48x 33.0x

Mean (7.9%) 3,627$ 4,839$ 1,923$ 10.3% 1.83x 24.8x

Median (7.9%) 3,627$ 4,839$ 1,923$ 10.3% 1.83x 24.8x

Medical Devices & Products

Abbott Laboratories $ 83.61 21.3% $ 147,861 $ 163,771 $ 31,355 24.7% 5.22x 21.1x

Baxter International Inc. 76.70 22.7% 39,160 42,021 11,080 23.6% 3.79x 16.1x

Boston Scientific Corporation 41.70 15.4% 58,087 69,010 10,392 26.4% 6.64x 25.1x

Cantel Medical Corp. 72.89 (7.9%) 3,082 3,986 950 17.9% 4.20x 23.4x

Hologic, Inc. 48.31 23.9% 12,914 15,421 3,367 31.0% 4.58x 14.8x

Johnson & Johnson 132.04 (5.7%) 347,512 361,473 81,706 34.6% 4.42x 12.8x

Medtronic plc 108.90 21.2% 146,108 168,783 30,891 30.6% 5.46x 17.8x

Mettler-Toledo International Inc. 704.94 28.9% 17,348 18,492 2,983 25.9% 6.20x 24.0x

Stryker Corporation 216.27 33.3% 80,971 87,803 14,549 28.5% 6.04x 21.2x

Teleflex Incorporated 347.41 44.3% 16,084 17,950 2,556 27.5% 7.02x 25.5x

Mean 19.7% 86,913$ 94,871$ 18,983$ 27.1% 5.36x 20.2x

Median 22.0% 48,623$ 55,515$ 10,736$ 27.0% 5.34x 21.1x

Specialty Devices & Products

Abiomed, Inc. $ 207.58 (39.2%) $ 9,373 $ 9,236 $ 820 32.3% 11.26x 34.8x

AngioDynamics, Inc. 15.30 (25.1%) 576 497 273 9.7% 1.82x 18.9x

AtriCure, Inc. 26.59 (16.4%) 1,052 1,095 222 (8.4%) 4.92x NM

BioTelemetry, Inc. 39.36 (32.3%) 1,334 1,489 409 27.0% 3.64x 13.5x

Cardiovascular Systems, Inc. 44.52 58.7% 1,567 1,530 256 (0.1%) 5.97x NM

CONMED Corporation 110.02 63.2% 3,122 3,906 933 17.4% 4.19x 24.0x

DexCom, Inc. 154.24 16.2% 14,065 14,780 1,351 (5.4%) 10.94x NM

Edwards Lifesciences Corporation 238.38 61.5% 49,719 49,203 4,152 30.6% 11.85x 38.7x

Glaukos Corporation 63.83 10.2% 2,353 2,396 225 (4.9%) 10.64x NM

Globus Medical, Inc. 52.37 (0.9%) 5,190 5,026 770 29.2% 6.53x 22.3x

Inogen, Inc. 54.44 (71.3%) 1,194 1,045 370 11.5% 2.83x 24.6x

Intuitive Surgical, Inc. 552.95 6.1% 63,906 63,014 4,247 34.9% 14.84x 42.5x

LeMaitre Vascular, Inc. 34.60 29.6% 687 681 115 23.4% 5.90x 25.2x

Masimo Corporation 145.79 26.1% 7,774 7,282 913 25.7% 7.97x 31.0x

Utah Medical Products, Inc. 102.47 17.5% 381 344 45 51.2% 7.68x 15.0x

Mean 6.9% 10,820$ 10,768$ 1,007$ 18.3% 7.40x 26.4x

Median 10.2% 2,353$ 2,396$ 409$ 23.4% 6.53x 24.6x

Consumer

GNC Holdings, Inc. $ 2.64 (28.3%) $ 223 $ 1,432 $ 2,146 9.0% 0.67x 7.4x

Prestige Consumer Healthcare Inc. 35.46 (1.9%) 1,781 3,542 953 34.5% 3.72x 10.8x

(Invalid Identifier) (Invalid

Identifier) N/A

(Invalid

Identifier) n/a

(Invalid

Identifier) n/a NA NA

Mean (15.1%) 1,002$ 2,487$ 1,549$ 21.7% 2.19x 9.1x

Median (15.1%) 1,002$ 2,487$ 1,549$ 21.7% 2.19x 9.1x

Median 6.6% 7,774$ 9,232$ 2,146$ 23.4% 4.58x 18.9x


SCOTT-MACON Healthcare ReviewNovember 2019ABOUT SCOTT-MACON

10

Disclaimer:In the preparation of the information contained in this document, Scott-Macon, Ltd. has endeavored to present information that is as accurate and current as possible from sources believed to be reliable. However, inadvertent errors can occur. Therefore, the information is provided “as is”, without any representation or warranty of any kind, expressed or implied. Any reproduction, retransmission, republication, or other use of all or part of this document is expressly prohibited, unless written permission has been granted by Scott-Macon, Ltd. All other rights are reserved.

Copyright 2019 © Scott-Macon, Ltd., all rights reserved.

Scott-Macon is one of the oldest independent investment banks in the United States focused exclusivelyon middle-market transactions. Founded in 1973 by Alfred L. Scott, the firm’s senior professionals haveextensive experience in mergers and acquisitions advisory, debt and equity financing, corporatevaluations, fairness opinions and general corporate financial consulting.

In business for over 40 years, Scott-Macon has been retained to undertake a diverse range of domesticand international corporate finance engagements for both public and privately-held corporations. Thefirm’s professionals have significant operating and advisory experience across key industry sectors.

HEALTHCARE INDUSTRY EXPERIENCE

1. Pitchbook

2. S&P CapitalIQ

3. Scott-Macon proprietary transaction information

INDUSTRY GROUPS

Healthcare Financial Institutions

Consumer ProductsIndustrial & Automotive

Media / InformationChemicals

Transportation / LogisticsAerospace / Defense

Services Segment

Revenue Cycle Management

Facility Management

Tech-enabled

Data Analytics

Insurance

Medical Review

Consulting

Regulatory Compliance

Providers Segment

Non-acute Care

Home Health & Hospice

Laboratories

Acute Care

Long-Term Care

Behavioral Health

Specialty Care

Alternative / Integrative Health

Products Segment

Disposables

Commercial

Consumer

Clinical Devices

Distribution

Non-Clinical Devices

Diagnostic

Durable Medical Equipment

Nathan D. CortrightManaging DirectorGroup Head, [email protected](203) 246-6527

Alfred L. ScottPresident & [email protected](212) 755-8200

Robert B. DimmittSenior Managing [email protected](212) 755-8200

Alex L. ScottManaging [email protected](212) 755-8200

Jeffrey M. TepperManaging Director [email protected](212) 755-8200

Spencer R. BergVice [email protected](646) 572-2420

George B. JamesAssistant Vice [email protected](646) 572-2461

Elliot B. [email protected](646) 572-2431

CONTACTS

Sources










11Note: These include companies where Principals of Scott-Macon were active advisors while employed at Scott-Macon and previous firms.All logos listed above are registered trademarks of the respective companies.

SELECT HEALTHCARE TRANSACTIONS

has sold its patient monitoring division to

has been acquired by

®

Advanced Technologies Group, Inc.has been acquired by

a portfolio company of


a portfolio company of

a division of Compass Group

has been acquired byhas sold its laboratory

services business tohas acquired

has been acquired byhas received an equity

investment fromhas acquiredhas acquired

has been acquired byhas been acquired by a joint

venture betweenhas been acquired by has been acquired byhas been acquired by

has entered into a debt facility with

has been acquired by has acquired has acquired has been acquired byhas been acquired by

has acquiredhas sold its securement

division tohas acquired has been acquired by has acquired

has sold its managed care business to

has been recapitalized by


Blue Cross Blue Shield of Missouri

Friendly Hills Health System

Pioneer HealthCare

S.J. Tutag

National Capital Health

The Keystone Peer Review

OrganizationCobe Laboratories

healthcare industry - scott-macon, ltd. · scott-macon healthcare review november 2019 2 segments...

Documents