scott-macon healthcare may 2019 update...scott-macon healthcare review august 2019 2 segments at a...

SCOTT-MACON Healthcare ReviewAugust 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 | August 2019

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SEGMENTS AT A GLANCE

◼ U.S. healthcare M&A activity in August 2019 continues to show signs of strength with 93 deals announced, a 7% increase from the prior year.

◼ Healthcare deal activity is likely to continue to be strong through the remainder of 2019 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.

◼ Private equity interest continues to be high with no slow down in sight as financial buyers look to put their $1+ trillion capital of dry powder to work.

◼ 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 August 2019 was robust and we anticipate continued activity for the remainder of 2019. 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 across all subsectors.”

SEGMENT SNAPSHOT

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

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

Healthcare IT and Tech-enabled Services 22 1,144.9$ 3.87x 16.4x

Consumer Driven Healthcare - - 5.17x NA

Faci l i ties Management 1 - NA NA

Workforce Solutions 1 - 1.64x 11.6x

Insurance - Commercia l 2 - 0.30x 10.4x

Insurance - Government - - 0.85x 18.8x

Distribution 2 0.5 0.69x 9.6x

Labs - - 2.80x NA

Services Segment 28 1,145.4 2.80x 13.9x

Acute 5 30.8 0.90x 8.5x

Senior Living / Long-term Care 10 51.6 1.64x 16.8x

Behaviora l 1 - NA NA

Home Health 9 154.0 0.96x 6.1x

Specia l ty 22 4.6 1.30x 9.7x

Providers Segment 47 241.0 1.12x 8.4x

Suppl ies & Dis tribution - - 1.45x 13.1x

Durable Medica l Equipment 5 286.6 0.56x 10.2x

Medica l Devices & Products - - 3.68x 15.9x

Specia l ty Devices & Products 13 2,075.0 4.79x 16.0x

Consumer - - 1.94x 15.2x

Products Segment 18 2,361.6$ 3.31x 15.2x

Public Comps

TEV / Revenue TEV / EBITDA

4.06x 20.7x

5.41x 21.0x

1.51x 13.9x

1.64x 23.4x

0.89x 11.5x

0.38x 9.4x

0.39x 11.8x

2.24x 12.3x

1.55x 13.8x

1.30x 9.0x

1.99x 17.6x

1.85x 10.9x

2.25x 25.2x

1.44x 9.8x

1.69x 12.4x

0.31x 8.4x

1.76x 16.1x

5.43x 22.3x

6.67x 24.1x

0.64x 10.2x

4.60x 18.2x

mailto:[email protected]

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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

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

05/28/2018 Counsyl, Inc. Myriad Genetics, Inc. 375.0 2.80x NA

04/09/2018 Phill ips, DiPisa & Associates Inc. and Leaders For Today, LLC AMN Healthcare Services, Inc. 37.0 1.61x NA

04/06/2018 MedFORCE Technologies, Inc. Ideagen, PLC 8.7 1.85x NA

03/28/2018 CMH Services Subsidiary, LLC HGS Population Health, LLC 14.0 0.23x NA

03/27/2018 Accelovance, Inc. Linical USA, Inc. 32.9 1.23x NA

03/08/2018 Express Scripts Holding Company Cigna Corporation 68,671.4 0.69x 9.6x

03/07/2018 ABILITY Network, Inc. Inovalon Holdings, Inc. 1,200.0 8.57x 16.6x

Median 297.5$ 2.80x 13.9x

RECENT M&A TRANSACTIONS


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PROVIDERSAnnounced Enterprise Enterprise Value /


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

08/05/2019Alliance Home Health Care, LLC/House Calls of New Mexico, LLC /The

Operating Assets of ForemostAddus HomeCare Corporation 24.0 0.96x NA

06/24/2019 Home Care Business in South Central U.S. Nova Leap Health Corp. 0.7 0.46x 3.8x

05/20/2019 Cancer Treatment Services International, Inc. Varian Medical Systems, Inc. 283.0 6.51x 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

04/02/2019 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

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

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

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

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

05/30/2018 Ernest Health, Inc. OEP Capital Advisors, L.P. 175.0 2.48x NA

04/21/2018 Sound Inpatient Physicians, Inc. Summit Partners, LLP 2,150.0 1.40x 21.2x

04/03/2018Aging Well Adult Day Health Center And Living Well Adult Day Health

CenterCivitas Solutions, Inc. 13.2 1.64x NA

03/19/2018 Business Assets of Home Health Solutions, Inc. Nova Leap Health Corp. 1.2 0.63x 3.8x

03/15/2018 Camellia Healthcare Encompass Health Corporation 135.0 1.73x NA

03/02/2018 HCR ManorCare, Inc. ProMedica Health System, Inc. 6,142.2 1.64x 16.8x

Median 73.0$ 1.12x 8.4x



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Announced Enterprise Enterprise Value /


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

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

08/06/2019 NeoMed, Inc. Avanos Medical, Inc. 35.0 0.97x 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 Solsys Medical, LLC Misonix, Inc. 116.7 6.83x 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

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

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

05/16/2018 Abaxis, Inc. Zoetis, Inc. 1,827.8 7.47x NM

05/03/2018 CID Resources, Inc. Superior Group of Companies, Inc. 88.2 1.35x 13.1x

05/03/2018 Advanced Surgical and Orthopedic product l ines from Accellent, LLC Viant 600.0 1.50x NA

04/10/2018 Analogic Corporation Altaris Capital Partners, LLC 920.9 1.96x 20.4x

04/05/2018 General Surgery Product Assets of LeMaitre Vascular, Inc. Symmetry Surgical, Inc. 7.4 2.24x NA

04/03/2018 Paragon Medical, Inc. Precision Engineered Products, LLC 375.0 2.66x 15.6x

04/03/2018 Assets of LifeGlobal Group, LLC CooperSurgical, Inc. 125.0 5.21x NA

03/26/2018 BioMed Laboratories, LLC Scapa Group, PLC 32.0 3.14x 22.9x

03/26/2018 OraMetrix, Inc. DENTSPLY SIRONA, Inc. 150.0 7.50x NA

03/16/2018 LifeScan, Inc. Platinum Equity, LLC 2,100.0 1.40x 4.0x

03/12/2018 Cogentix Medical, Inc. LM US Parent, Inc. 210.9 3.75x NM

03/12/2018 Sarnova, Inc. Patricia Industries 903.0 1.63x NA

03/09/2018 Integrated DNA Technologies, Inc. Danaher Corporation 2,000.0 7.69x NA

03/05/2018 ABACA, Ambary, Tarmac Manufacturing and Tower Management CGX Life Sciences, Inc. 21.3 1.42x 6.1x

Median 125.0$ 3.31x 15.2x


PRODUCTS


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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 8/31/19 % Change Cap Value (EV) Revenue Margins Revenue EBITDA

Healthcare IT and Tech-enabled Services

Allscripts Healthcare Solutions, Inc. $ 9.08 (37.9%) $ 1,513 $ 2,337 $ 1,751 6.6% 1.33x 20.1x

Cerner Corporation 68.91 5.8% 21,941 22,418 5,527 21.8% 4.06x 18.6x

Computer Programs and Systems, Inc. 21.15 (22.5%) 292 422 277 12.1% 1.53x 12.6x

Evolent Health, Inc. 6.87 (73.1%) 576 784 733 (6.5%) 1.07x NM

HMS Holdings Corp. 36.53 14.0% 3,191 3,187 626 24.6% 5.09x 20.7x

Inovalon Holdings, Inc. 16.92 53.8% 2,609 3,533 585 27.5% 6.04x 22.0x

Model N, Inc. 28.63 68.4% 937 927 141 (4.4%) 6.56x NM

NextGen Healthcare, Inc. 14.21 (37.9%) 929 960 528 7.2% 1.82x 25.1x

National Research Corporation 64.03 63.6% 1,588 1,624 124 36.6% 13.14x 35.9x

Omnicell, Inc. 71.80 4.4% 2,991 3,045 836 12.9% 3.64x 28.2x

R1 RCM Inc. 11.66 17.0% 1,308 1,708 1,084 8.7% 1.58x 18.1x

Tabula Rasa HealthCare, Inc. 56.80 (35.2%) 1,172 1,367 249 5.6% 5.49x NM

Vocera Communications, Inc. 22.95 (30.8%) 722 798 177 (3.2%) 4.52x NM

Mean (0.8%) 3,059$ 3,316$ 972$ 11.5% 4.30x 22.4x

Median 4.4% 1,308$ 1,624$ 585$ 8.7% 4.06x 20.7x

Consumer Driven Healthcare

Castlight Health, Inc. $ 1.41 (53.0%) $ 205 $ 177 $ 154 (17.3%) 1.15x NM

HealthEquity, Inc. 59.36 (37.0%) 4,184 3,409 320 34.3% 10.65x 31.0x

Teladoc Health, Inc. 57.88 (25.4%) 4,170 4,188 493 (6.2%) 8.50x NM

Tivity Health, Inc. 18.26 (46.9%) 873 1,987 859 21.0% 2.31x 11.0x

Mean (40.6%) 2,358$ 2,440$ 456$ 8.0% 5.66x 21.0x

Median (42.0%) 2,522$ 2,698$ 406$ 7.4% 5.41x 21.0x

Facilities Management

Healthcare Services Group, Inc. $ 22.55 (45.3%) $ 1,671 $ 1,705 $ 1,945 5.7% 0.88x 15.3x

Stericycle, Inc. 44.89 (27.2%) 4,090 7,279 3,384 17.4% 2.15x 12.4x

Mean (36.3%) 2,881$ 4,492$ 2,664$ 11.5% 1.51x 13.9x

Median (36.3%) 2,881$ 4,492$ 2,664$ 11.5% 1.51x 13.9x

Workforce Solutions

AMN Healthcare Services, Inc. $ 58.40 0.2% $ 2,725 $ 3,481 $ 2,123 11.2% 1.64x 14.6x

Cross Country Healthcare, Inc. 10.25 2.4% 378 450 800 2.3% 0.56x 24.5x

HealthStream, Inc. 25.27 (20.4%) 818 731 249 12.6% 2.94x 23.4x

Mean (5.9%) 1,307$ 1,554$ 1,057$ 8.7% 1.71x 20.9x

Median 0.2% 818$ 731$ 800$ 11.2% 1.64x 23.4x

Insurance - Commercial

Anthem, Inc. $ 261.52 (1.2%) $ 66,901 $ 83,382 $ 96,742 6.7% 0.86x 12.9x

Cigna Corporation 153.97 (18.2%) 58,140 94,400 102,510 8.7% 0.92x 10.6x

Humana Inc. 283.21 (15.0%) 38,259 39,856 60,726 6.1% 0.66x 10.8x

UnitedHealth Group Incorporated 234.00 (12.8%) 221,757 250,285 235,876 8.7% 1.06x 12.2x

Mean (11.8%) 96,264$ 116,981$ 123,964$ 7.5% 0.88x 11.6x

Median (13.9%) 62,521$ 88,891$ 99,626$ 7.7% 0.89x 11.5x

Insurance - Government

Centene Corporation $ 46.62 (36.3%) $ 19,282 $ 20,309 $ 65,491 4.8% 0.31x 6.5x

Molina Healthcare, Inc. 130.28 (5.6%) 8,170 7,547 17,054 6.9% 0.44x 6.4x

WellCare Health Plans, Inc. 270.74 (10.5%) 13,621 12,974 24,901 4.2% 0.52x 12.3x

Magellan Health, Inc. 63.01 (14.3%) 1,537 2,177 7,226 1.9% 0.30x 16.1x

Mean (16.7%) 10,653$ 10,752$ 28,668$ 4.5% 0.39x 10.3x

Median (12.4%) 10,896$ 10,260$ 20,978$ 4.5% 0.38x 9.4x

Distribution

CVS Health Corporation $ 60.92 (19.0%) $ 79,226 $ 165,086 $ 226,053 6.6% 0.73x 11.1x

Diplomat Pharmacy, Inc. 5.81 (71.9%) 439 1,041 5,278 1.6% 0.20x 12.5x

Rite Aid Corporation 6.46 (76.4%) 347 7,015 21,624 2.2% 0.32x 14.7x

Walgreens Boots Alliance, Inc. 51.19 (25.3%) 46,232 63,003 136,354 5.3% 0.46x 8.7x

Mean (48.2%) 31,561$ 59,036$ 97,327$ 3.9% 0.43x 11.8x

Median (48.6%) 23,336$ 35,009$ 78,989$ 3.8% 0.39x 11.8x

Labs

Laboratory Corporation of America Holdings $ 167.56 (3.1%) $ 16,371 $ 23,612 $ 11,292 16.8% 2.09x 12.5x

Quest Diagnostics Incorporated 102.37 (6.9%) 13,786 18,085 7,572 19.6% 2.39x 12.2x

Mean (5.0%) 15,078$ 20,849$ 9,432$ 18.2% 2.24x 12.3x

Median (5.0%) 15,078$ 20,849$ 9,432$ 18.2% 2.24x 12.3x

Median (18.6%) 2,667$ 3,298$ 1,848$ 6.8% 1.55x 13.8x

(1)

PUBLIC COMPANY PERFORMANCE


7

NM: Not meaningful.

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


Acute

Community Health Systems, Inc. $ 2.49 (35.8%) $ 284 $ 14,291 $ 13,583 9.8% 1.05x 10.7x

HCA Healthcare, Inc. 120.20 (10.4%) 40,986 76,548 48,844 19.3% 1.57x 8.1x

Tenet Healthcare Corporation 21.65 (35.8%) 2,240 17,935 18,213 15.1% 0.98x 6.5x

Universal Health Services, Inc. 144.58 11.1% 12,791 17,211 11,063 15.6% 1.56x 10.0x

Mean (17.7%) 14,075$ 31,496$ 22,926$ 14.9% 1.29x 8.8x

Median (23.1%) 7,515$ 17,573$ 15,898$ 15.3% 1.30x 9.0x

Senior Living / Long-term Care

Brookdale Senior Living Inc. $ 8.18 (17.5%) $ 1,517 $ 7,224 $ 3,326 13.7% 2.17x 15.8x

Capital Senior Living Corporation 4.61 (48.0%) 140 1,371 455 12.3% 3.01x 24.4x

Ensign Group, Inc. 49.90 27.7% 2,658 3,945 2,177 9.3% 1.81x 19.5x

National HealthCare Corporation 80.80 4.8% 1,238 1,498 989 10.0% 1.52x 15.2x

Mean (8.3%) 1,388$ 3,510$ 1,737$ 11.3% 2.13x 18.7x

Median (6.4%) 1,378$ 2,722$ 1,583$ 11.1% 1.99x 17.6x

Behavioral

AAC Holdings, Inc. $ 0.60 (93.2%) $ 15 $ 413 $ 245 (17.4%) 1.69x NM

Acadia Healthcare Company, Inc. 26.46 (36.3%) 2,342 6,114 3,054 18.3% 2.00x 10.9x

Mean (64.8%) 1,179$ 3,264$ 1,650$ 0.5% 1.85x 10.9x

Median (64.8%) 1,179$ 3,264$ 1,650$ 0.5% 1.85x 10.9x

Home Health

Addus HomeCare Corporation $ 87.98 35.6% $ 1,149 $ 1,151 $ 566 7.3% 2.03x 27.7x

Amedisys, Inc. 128.71 3.0% 4,141 4,485 1,812 9.9% 2.48x 24.9x

Chemed Corporation 429.43 32.7% 6,837 7,021 1,837 15.0% 3.82x 25.4x

LHC Group, Inc. 118.50 19.8% 3,734 4,023 2,037 10.0% 1.97x 19.8x

Mean 22.8% 3,965$ 4,170$ 1,563$ 10.6% 2.58x 24.5x

Median 26.3% 3,937$ 4,254$ 1,825$ 10.0% 2.25x 25.2x

Specialty

American Renal Associates Holdings, Inc. $ 6.20 (71.8%) $ 202 $ 894 $ 819 15.1% 1.09x 7.2x

DaVita Inc. 56.37 (18.6%) 7,805 16,260 11,253 18.7% 1.44x 7.7x

MEDNAX, Inc. 21.08 (55.5%) 1,748 3,898 3,649 14.4% 1.07x 7.4x

Providence Service Corporation 56.21 (16.3%) 729 721 1,436 3.6% 0.50x 13.8x

RadNet, Inc. 13.91 0.4% 697 1,858 1,060 12.0% 1.75x 14.6x

Select Medical Holdings Corporation 16.22 (18.1%) 2,200 6,478 5,218 12.2% 1.24x 10.2x

Surgery Partners, Inc. 6.44 (62.9%) 319 2,946 1,786 19.1% 1.65x 8.7x

U.S. Physical Therapy, Inc. 133.52 6.6% 1,706 1,817 468 16.1% 3.88x 24.1x

Mean (29.1%) 2,378$ 4,855$ 3,346$ 14.6% 1.63x 11.5x

Median (18.6%) 1,706$ 2,946$ 1,786$ 15.1% 1.44x 9.8x

Median (17.5%) 1,748$ 4,023$ 2,037$ 13.7% 1.69x 12.4x



8

NM: Not meaningful.

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


Supplies & Distribution

AmerisourceBergen Corporation $ 82.27 (8.6%) $ 17,139 $ 18,645 $ 177,248 1.3% 0.11x 8.2x

Cardinal Health, Inc. 43.13 (17.4%) 12,859 18,365 145,534 1.9% 0.13x 6.5x

Henry Schein, Inc. 61.62 (20.7%) 9,136 10,522 13,421 8.5% 0.78x 9.2x

McKesson Corporation 138.27 7.4% 25,567 33,559 217,440 1.9% 0.15x 7.9x

Owens & Minor, Inc. 5.08 (70.1%) 320 2,137 9,953 2.1% 0.21x 10.3x

Patterson Companies, Inc. 16.72 (25.9%) 1,578 2,306 5,567 4.8% 0.41x 8.6x

Premier, Inc. 35.26 (20.3%) 2,231 2,124 1,218 42.9% 1.74x 4.1x

West Pharmaceutical Services, Inc. 145.46 24.3% 10,727 10,673 1,767 21.4% 6.04x 28.2x

Mean (16.4%) 9,945$ 12,291$ 71,519$ 10.6% 1.20x 10.4x

Median (18.8%) 9,932$ 10,598$ 11,687$ 3.5% 0.31x 8.4x

Durable Medical Equipment

Hill-Rom Holdings, Inc. $ 107.68 10.7% $ 7,195 $ 9,066 $ 2,884 19.5% 3.14x 16.1x

Invacare Corporation 4.84 (68.2%) 163 358 948 0.6% 0.38x NM

Mean (28.7%) 3,679$ 4,712$ 1,916$ 10.1% 1.76x 16.1x

Median (28.7%) 3,679$ 4,712$ 1,916$ 10.1% 1.76x 16.1x

Medical Devices & Products

Abbott Laboratories $ 85.32 27.6% $ 150,794 $ 167,724 $ 30,935 24.3% 5.42x 22.3x

Baxter International Inc. 87.95 18.3% 44,903 47,764 11,080 23.6% 4.31x 18.2x

Boston Scientific Corporation 42.73 20.2% 59,522 69,200 10,077 26.7% 6.87x 25.7x

Cantel Medical Corp. 91.93 (5.2%) 3,837 4,019 908 17.4% 4.43x 25.4x

Hologic, Inc. 49.37 24.2% 13,197 15,844 3,315 31.0% 4.78x 15.4x

Johnson & Johnson 128.36 (4.7%) 338,763 354,817 81,325 34.4% 4.36x 12.7x

Medtronic plc 107.89 11.9% 144,695 166,855 30,666 30.8% 5.44x 17.7x

Mettler-Toledo International Inc. 656.79 12.4% 16,163 17,269 2,964 25.5% 5.83x 22.8x

Stryker Corporation 220.66 30.2% 82,329 89,445 14,204 28.2% 6.30x 22.3x

Teleflex Incorporated 363.92 47.1% 16,825 18,775 2,517 27.1% 7.46x 27.6x

Mean 18.2% 87,103$ 95,171$ 18,799$ 26.9% 5.52x 21.0x

Median 19.2% 52,213$ 58,482$ 10,579$ 26.9% 5.43x 22.3x

Specialty Devices & Products

Abiomed, Inc. $ 193.07 (52.5%) $ 8,761 $ 8,673 $ 797 31.9% 10.88x 34.2x

AngioDynamics, Inc. 18.37 (18.1%) 685 589 271 9.2% 2.18x 23.7x

AtriCure, Inc. 27.39 (20.7%) 1,082 1,110 216 (8.2%) 5.15x NM

BioTelemetry, Inc. 39.65 (35.8%) 1,344 1,511 398 27.9% 3.79x 13.6x

Cardiovascular Systems, Inc. 48.43 25.7% 1,708 1,655 248 1.1% 6.67x NM

CONMED Corporation 100.77 25.3% 2,851 3,655 901 16.8% 4.05x 24.1x

DexCom, Inc. 171.61 18.9% 15,648 16,040 1,222 (9.9%) 13.13x NM

Edwards Lifesciences Corporation 221.84 53.8% 46,136 46,077 3,964 30.7% 11.62x 37.8x

Glaukos Corporation 64.31 (5.9%) 2,369 2,409 211 (3.0%) 11.44x NM

Globus Medical, Inc. 51.07 (4.1%) 5,061 4,945 743 29.1% 6.66x 22.9x

Inogen, Inc. 46.37 (82.5%) 1,017 810 373 11.7% 2.17x 18.6x

Intuitive Surgical, Inc. 511.34 (8.7%) 58,934 58,218 4,040 34.8% 14.41x 41.4x

LeMaitre Vascular, Inc. 31.66 (15.6%) 628 622 111 23.0% 5.63x 24.5x

Masimo Corporation 153.25 30.0% 8,172 7,784 895 25.8% 8.70x 33.7x

Utah Medical Products, Inc. 98.32 8.2% 366 333 43 51.3% 7.80x 15.2x

Mean (5.5%) 10,317$ 10,296$ 962$ 18.1% 7.62x 26.3x

Median (5.9%) 2,369$ 2,409$ 398$ 23.0% 6.67x 24.1x

Consumer

GNC Holdings, Inc. $ 1.96 (36.8%) $ 166 $ 1,420 $ 2,227 9.1% 0.64x 7.0x

Prestige Consumer Healthcare Inc. 31.88 (17.2%) 1,602 3,370 954 34.6% 3.53x 10.2x

Vitamin Shoppe, Inc. 6.45 (49.6%) 157 680 1,079 5.8% 0.63x 10.9x

Mean (34.5%) 641$ 1,823$ 1,420$ 16.5% 1.60x 9.4x

Median (36.8%) 166$ 1,420$ 1,079$ 9.1% 0.64x 10.2x

Median (5.0%) 7,683$ 8,229$ 1,997$ 22.2% 4.60x 18.2x


SCOTT-MACON Healthcare ReviewAugust 2019VENTURE INVESTMENT TRENDS

9Note: Funding represents capital raised over the last twelve months for deals where the identified VC firm participated.

Seed Early Stage Later Stage

TOP INVESTORS (TTM)

TOP DEALS (AUG-19)

TOP INVESTORS (TTM)

TOP DEALS (AUG-19)

TOP INVESTORS (TTM)

TOP DEALS (AUG-19)

Keiretsu Forumwww.keiretsuforum.com

14 $30M 2000HC DEALS FUNDING FOUNDED

66137-14 57367-72 62043-67Attune Medical ZSX Medical OtoNexus Medical Technologies

SV Health Investorswww.svhealthinvestors.com


12867-58 52879-33 51522-49AcuFocus Endotronix CSA Medical

Optum Ventureswww.optumventures.com


150131-26 59233-42 114295-69Buoy Health IDx Diameter Health

F-Prime Capital Partnerswww.fprimecapital.com


136458-82 56235-97 57385-54Good Methods GlobalUS HealthVest Amphora Medical

40380-31

11288-17

222605-20

124929-64

1

2

3

4

Keiretsu Forumwww.keiretsuforum.com


167818-78 155733-40 264632-14PainQx Stream Dx Trauma Ready

Sand Hill Angelswww.sandhillangels.com


124141-42 122056-21 181114-30Kenzen Innovein Roman Health

Plug and Play Tech Centerwww.plugandplaytechcenter.com


169047-19 223820-65 102274-93Limbix Health Sotera Medical MedPilot

Keiretsu Capitalwww.keiretsucapital.com


167818-78 155733-40 126082-18PainQx Stream Dx Novuson Surgical

40380-31

51662-62

54172-81

98634-70

1

2

3

4

Jumpstart Foundry www.jsf.co


97781-50 169669-90 267588-10TheraB Medical Kegelbell Vision Care Connect

Joyance Partnerswww.joyancepartners.com


178703-56 230714-65 229948-03WeRecover Epicore BiosystemsProbius

Plug and Play Tech Centerwww.plugandplaytechcenter.com


171881-83 234199-99 264312-28Basepaws Visionairy HealthGali Health

Alumni Ventures Groupwww.avgfunds.com


128094-58 266513-77 229812-76Mahmee E25Bio MDMetrix

54677-62

224091-55

54172-81

60082-66

1

2

3

4

$52M $287M 2015RAISED VALUATION FOUNDED

Nurx Nurx nurx.com


Sight Sciences sightsciences.com

$30M N/A 2003RAISED VALUATION FOUNDED

EBR Systems ebrsystemsinc.com


emulatebio.comEmulate

65411-20

Platform emulates the complexit ies of human biology to

enable insights into human biology and health

120154-96

Offers delivery of birth control, STI tests & related products

for women enabled by telehealth for prescribing

95135-05

Non-invasive medical devices designed for treatment of eye

disease (e.g., glaucoma)

42163-30

Wireless cardiac pacing system designed to treat

heart failures

1

2

3

4


Exo Imaging exo-imaging.com


SkinCure Oncologyskincureoncology.com


ChromaCode chromacode.com


twochairs.com Two Chairs

170758-27

M ental health therapy platform intended to o ffer in-

person psychotherapy at clinics

164065-96

M edical technology intended to revo lutionize the

field o f medical imaging

166927-60

Skin cancer treatment technology designed to treat the ever-

increasing incidence of skin cancer

148844-98

M olecular diagnostics algorithms and models

designed to perform assays at lower costs

1

2

3

4


Figur8 figur8tech.com


MedAnswers medanswers.com


nOCD treatmyocd.com


zerofasting.com Zero (Application Software)

Health and wellness application intended to help

people with fasting

185798-71

184287-16

143347-96

230417-38

Wearable sensor platform designed to digitize 3D

body movement

Healthcare app that connects infertility patients with

experts for on-demand Q&A

M obile applicat ion designed for the self-treatment and

monitoring of OCD symptoms

1

2

3

4

SCOTT-MACON Healthcare ReviewAugust 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

Joshua H. KeattsVice [email protected](646) 572-2440

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

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

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 been recapitalized by

has acquired

National Capital Health

has been acquired by


Affiliated

Healthcare


Kimberly

Quality Care

has acquired

S.J. Tutag

has entered into a debt facility with


has sold its securement division to

has acquired

Cobe Laboratories


has acquired

Friendly Hills Health System

has been acquired by has been acquired by




a portfolio company of



®

Advanced Technologies Group, Inc.

has been acquired by has acquired


has sold its laboratory services business to


has acquired


CareScount®


Grant

Hospital

has sold its patient monitoring division to

has received an equity investment from

has acquired

Longview Associates

scott-macon healthcare may 2019 update...scott-macon healthcare review august 2019 2 segments at a...

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