Several significant acquisitions and important trends have marked the first quarters of 2014, paving the way for an impressive year in the healthcare investment sector. Single-payer systems, Medicare, the uninsured, and cost control measures hinted at downside trends, balanced by stronger positive trends pointing to growth in populations living longer with disease, those afflicted with obesity and/or diabetes, new technologies, or the global spread of disease. Personalized medicine may also hold promising returns.
J&J, Carlyle Group: deals in the billions dollars…
Seasoned investors know that as the healthcare landscape changes, outlooks can shift. It is important to consider investment strategies from an individualized perspective, remembering that one man’s down market is another man’s golden opportunity. As big data and technology become more essential tools for healthcare professionals, strong growth is forecast in that arena. Similarly, as the aging population born in the United States during the Baby Boomer era requires more care in assisted living facilities, growth for those investments appears strong. As America works through The Affordable Care Act, there are some uncertainties that will need a bit of time to sort out, but for those that are vigilant, there will be pockets of opportunity filled with solid returns.
Shortages of government funding in specific healthcare sectors, especially nursing homes and ER units, is driving a turn toward private care facilities. Proving attractive to investors, money moves toward those vehicles are showing aggressive gains. Formation Capital, Safanad, Northstar Realty, and a few other groups with similar foresight are leading the way.
The Carlyle Group completed the acquisition of Johnson & Johnson’s Ortho Clinical Diagnostics operation headquartered in Raritan, N.J. for approximately $4 billion. The global alternative asset manager Carlyle Group boasts $199 billion in assets, spread across 120 funds and 133 additional funding vehicles. Ortho delivers early screening, diagnosis, monitoring, and confirmation of disease for hospitals, laboratories, blood centers, and health care facilities around the world.
Data analytics, pharmacy software: niche markets on the uptick
In other transactions, Roper Industries acquired Managed Care Associates for $1 billion, completing an attractive investment deal in the pharmacy software and data analytics niche of healthcare.
Thoma Bravo, LLC, a private equity investment firm, acquired supply chain provider Global Healthcare Exchange in a first quarter exchange. Thoma Bravo is the holder of $4 billion worth of equity commitment. ThomaBravo also recently acquired Sparta Systems in a deal expected to close in the third quarter this year. Sparta provides enterprise quality management solutions for the top 30 pharmaceutical corporations and a dozen of the top 15 medical device manufacturers, in addition to other industries.
One of 2013’s transactions, however, continues to stand as a landmark in the industry. In October of 2013, Tenet Healthcare’s acquisition of Vanguard Health Systems was completed for a price of $4.3 billion, tugging along with it $2.5 billion worth of debt from Vanguard. Tenet subsidiaries operates 77 acute care hospitals and 173 outpatient centers.Tenet also controls Conifer Health Solutions, a business process solutions group that works with 15 centers in 43 states, serving more than 600 hospitals.
But so far, none of the transactions have eclipsed the merger between Community Health Systems and Health Management Associates, Inc, initiated in July of 2013. Community acquired HMA for $7.6 billion. Completion of the agreement on January 27, 2014, found the FTC granting clearance for Community to take the reins, with final approval granted February 7, 2014.
2014-2015 investment trends…
As 2014 moves into the third quarter, additional niches are showing promise as places to invest for positive returns. News and numbers indicate the following:
- The anesthesia market has shown some positive signsof growth and investment opportunities with significant investments in 2013.
- The ambulatory surgery center sector does face some challenges, but interest remains strong with investment in existing centers outpacing startups. United Surgical Partners International, headquartered in Addison, TX, is one of the largest groups with the most centers, went public in 2001, but returned to the private sector in 2007, continuing to show growth and interest.
- Urgent care clinics indicate up to 20 percent growth with many groups planning for expansion. Interest is ticking upward but with fragmented growth, so acquisitions may improve their overall performance.
- Health information technology is exploding with new ways to measure and analyse data from devices used across healthcare systems.
- Electronic health records systems are expected to continue to rise significantly, as hospitals and healthcare centers increasingly rely on electronic media to record patient history and information.
- Health data mining and analytics is promising as a way of improving healthcare marketing as well as performance and delivery.
As we look toward the closing quarter of 2014 and ahead to 2015, trends embracing health care IT and data management, streamlined testing and diagnosis for routine health issues, and development of advances in preventive prescription drugs hold promise. Continued value in assisted health care facilities for an aging population, along with improved prescription drugs for diabetes, cancer, and symptoms of aging are expected to stand well through the coming year.