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Healthcare It Sector Review | Q4 2018 Healthcare It Sector Review | Q4 2018

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Healthcare It Sector Review | Q4 2018 Healthcare It Sector Review | Q4 2018 HEALTHCARE IT SECTOR REVIEW | Q4 2018 HEALTHCARE IT SECTOR REVIEW | Q4 2018 HARRIS WILLIAMS (“HW”) AS A FIRM TECHNOLOGY, MEDIA & TELECOM (“TMT”) GROUP • 300+ professionals across eight offices globally • 35+ professionals across Boston, San Francisco, and London • 140+ closed transactions in the last 24 months • 53+ closed transactions since the beginning of 2016 • 21st record year in 2018 • 98% of revenue is from sell-side M&A advisory • Education Technology • Manufacturing Technology • 10 industry groups • Fintech • Membership Management • Healthcare IT • Public Sector Software • 14 $1bn+ enterprise value engagements in the last 18 • Human Capital Management • Supply Chain, Transportation & Logistics months • Internet & Digital Media • Infrastructure and Security Software MARKET COMMENTARY • Healthcare technology assets continue to garner significant interest from both strategic and financial sponsors, as increasing regulatory complexity, ongoing technology adoption by constituents across healthcare, and the pervasive evolution towards value-based care underpin growth opportunities for innovative software tools • Continued investor appetite for specialty and sector-specific EMR and revenue cycle management solutions, as providers demonstrate a clear preference for purpose-built, best-of-breed solutions • Healthcare organizations continue to extend their focus beyond price and quality of care, with an increasing focus on patient and provider engagement and educational tools • Sector innovations continue to target niche operational challenges including patient and staff management and monitoring, and compliance control solutions for vendors and clinicians • Increasingly complex reimbursement arrangements in the face of rising healthcare costs have supported strong payer interest in specialized cost containment and payment integrity solutions KEY CONTACTS Managing Director Managing Director Managing Director Managing Director Managing Director [email protected] [email protected] [email protected] [email protected] [email protected] Office: (617) 654-2102 Office: (617) 654-2112 Office: (617) 654-2117 Office: +44 (0) 20 7518 8901 Office: (415) 217-3411 Director Director K E Y H C I T Managing Director Director [email protected] [email protected] CONTACTS: [email protected] [email protected] Office: (415) 217-3418 Office: 44 (0)20 7518 8909 Office: (617) 654-2117 Office: (617) 654-2122 TECHNOLOGY, MEDIA & TELECOM PAGE | 1 HEALTHCARE IT SECTOR REVIEW | Q4 2018 . Member Onboarding / Portals . Operational Efficiency . Development . Charge Capture & Coding . PHM Informatics . Patient Outreach & Campaigns . Inpatient – Clinical . Trials . Claims Management . Data Aggregation & . Patient Engagement / . Outpatient – Clinical . Commercialization . Adjudication / Appeal / Review Normalization Education . Post-Acute – Clinical . Adherence . Payment Processing . Privacy / Security . Digital Wellness Tools . Regulatory . Patient Collection . Information Sharing / . Benefits & Consumer-Directed . Other RCM Tools Interoperability . Regulatory & Analytics Healthcare Tools . Population Analytics . Information Tools & Online . Care Coordination Media Select Market Participants Select Market Participants Select Market Participants Select Market Participants Select Market Participants RECENT REPRESENTATIVE HW HCIT TRANSACTIONS Provider of Provider of Provider of Provider of Provider of Provider of market access healthcare education and SaaS solutions population incident a wholly-owned affiliate of and formulary credentialing GRC solutions to the health reporting and information to and payer behavioral management risk has been has been has been pharma, has acquired enrollment health industry solutions has invested in management acquired by payers, and solutions acquired by acquired by software has been providers & acquired by Provider of Provider of Provider of Provider of Provider of Provider of athlete training patient cost online nutrition revenue cycle cloud-based, services engagement containment coaching and management vendor- solutions solutions for certifications solutions for agnostic has been has been has been has been has been healthcare has been for wellness physicians population acquired by acquired by acquired by acquired by acquired by payers acquired by professionals offices health and management consumers Undisclosed solutions Strategic Buyer TECHNOLOGY, MEDIA & TELECOM PAGE | 2 HEALTHCARE IT SECTOR REVIEW | Q4 2018 HW’s TMT Group advised MMIT on its acquisition by Welsh, Carson, Anderson & Stowe. RELEVANT HEALTHCARE IT SUB - SECTORS a portfolio company of COMPANY OVERVIEW MMIT is a leading provider of SaaS-based pharmaceutical data and analytics solutions for market access to pharmaceutical manufacturers, payers, and prescribers. Through a comprehensive data set built through years of experience within multiple segments of healthcare, MMIT focuses on providing the industry source of truth for drug policy and restriction information. KEY VALUE DRIVERS has been acquired by . Comprehensive data set built through years of experience across multiple segments of healthcare . Largest database of drug policy and restriction information in the market . Core software backbone that facilitates formulary management, digital distribution, and compliance for payers . Extensive blue-chip client base with over 200 logos, including 80% of the top 50 pharma manufacturers and payers managing over 100 million insured lives . Well-defined growth vectors to accelerate sales of specialty and oncolytic indication data HW DEAL CONTACTS Managing Director Managing Director Director [email protected] [email protected] [email protected] Office: (617) 654-2117 Office: (804) 932-1326 Office: (617) 654-2122 TECHNOLOGY, MEDIA & TELECOM PAGE | 3 HEALTHCARE IT SECTOR REVIEW | Q4 2018 As of December 31, 2018 300% (Median) 225% Enterprise Value / 150% LTM Rev. LTM EBITDA 2019P EBITDA 75% 2.6x 15.8x 12.0x 0% CLINICAL & CLINICAL Dec-13 Dec-14 Dec-15 Dec-16 Dec-17 Dec-18 ADMINISTRATIVE S&P 500 Clinical & Administrative 300% (Median) - 225% Enterprise Value / 150% LTM Rev. LTM EBITDA 2019P EBITDA 75% 5.0x 22.5x 17.4x PAYER 0% FOCUSED Dec-13 Dec-14 Dec-15 Dec-16 Dec-17 Dec-18 S&P 500 Payer-Focused 300% (Median) 225% Enterprise Value / 150% LTM Rev. LTM EBITDA 2019P EBITDA 75% 6.7x 46.1x 26.9x PHARMA 0% Dec-13 Dec-14 Dec-15 Dec-16 Dec-17 Dec-18 S&P 500 Pharma 300% (Median) 225% Enterprise Value / 150% LTM Rev. LTM EBITDA 2019P EBITDA 75% 6.2x 26.4x 21.7x 0% CONSUMER Dec-13 Dec-14 Dec-15 Dec-16 Dec-17 Dec-18 HEALTHCARE S&P 500 Consumer Healthcare 300% (Median) 225% HCIT Enterprise Value / - 150% LTM Rev. LTM EBITDA 2019P EBITDA 75% 3.3x 14.1x 12.6x 0% EURO Dec-13 Dec-14 Dec-15 Dec-16 Dec-17 Dec-18 S&P 500 Euro HCIT TECHNOLOGY, MEDIA & TELECOM PAGE | 4 HEALTHCARE IT SECTOR REVIEW | Q4 2018 VALUATION AND OPERATING METRICS1 As of December 31, 2018 ($ in millions) Stock Performance Current % of LTM TEV / EBITDA Mkt Cap TEV Price LTM High Revenue % Growth EBITDA Margin LTM 2019E CLINICAL / ADMINISTRATIVE EMR Cerner Corporation $17,891 $17,519 $54.30 73.9% $5,314 4.5% $1,459 27.5% 12.0x 11.1x Allscripts Healthcare Solutions, Inc. 1,794 4,000 10.27 63.7% 2,079 21.3% 218 10.5% 18.4x 9.5x NextGen Healthcare, Inc. 1,025 1,027 15.85 66.8% 531 1.4% 70 13.1% 14.7x 12.9x Computer Programs and Systems, Inc. 344 477 24.44 70.5% 286 8.6% 38 13.1% 12.7x 10.6x Median $1,410 $2,514 68.7% $1,305 6.6% $144 13.1% 13.7x 10.8x RCM / Performance Premier Inc. $4,948 $4,913 $37.11 78.6% $1,672 2.6% $518 31.0% 9.5x 8.9x Nuance Communications, Inc. 4,095 5,829 14.24 75.9% 2,052 4.3% 374 18.2% 15.6x 9.6x Evolent Health Inc 1,441 1,309 18.39 63.3% 548 16.9% 49 8.9% 26.9x NM R1 RCM Inc 918 1,242 8.33 75.7% 746 46.2% 37 5.0% 33.1x 22.7x Median $2,768 $3,111 75.8% $1,209 10.6% $211 13.6% 21.2x 9.6x Other Administrative Omnicell, Inc. $2,521 $2,662 $63.63 80.1% $774 3.4% $83 10.7% 32.1x 21.2x Vocera Communications, Inc. 1,198 1,093 39.22 92.5% 176 5.9% 3 1.7% NM 51.1x HealthStream, Inc. 793 618 24.52 77.0% 235 (3.3%) 39 16.5% 16.0x 15.4x Median $1,198 $1,093 80.1% $235 3.4% $39 10.7% 24.1x 21.2x Clinical / Administrative Median $1,441 $1,309 75.7% $746 4.5% $70 13.1% 15.8x 12.0x PAYER - FOCUSED Inovalon Holdings $2,012 $2,864 $13.20 84.9% $506 16.6% $106 20.9% 27.1x 17.9x HMS Holdings 2,476 2,592 29.51 77.4% 591 7.7% 145 24.5% 17.9x 16.9x Payer-Focused Median $2,244 $2,728 81.1% $548 12.1% $125 22.7% 22.5x 17.4x PHARMA IQVIA Holdings Inc $22,906 $32,891 $115.66 85.4% $10,298 3.2% $1,950 18.9% 16.9x 14.8x Veeva Systems Inc 12,726 11,674 86.02 78.9% 815 18.9% 209 25.6% 55.9x 38.5x Medidata Solutions, Inc. 4,215 4,111 68.89 77.5% 610 7.4% 89 14.6% 46.1x 26.9x Pharma Median $12,726 $11,674 78.9% $815 7.4% $209 18.9% 46.1x 26.9x CONSUMER HEALTHCARE WEX Inc. $6,109 $7,943 $141.74 69.7% $1,440 9.6% $561 39.0% 14.1x 12.8x HealthEquity Inc 3,720 3,390 59.63 58.7% 272 18.5% 88 32.3% 38.6x 30.7x Benefitfocus, Inc. 1,657 1,736 51.86 93.5% 251 (1.7%) (18) NM NM NM Castlight Health, Inc. 298 235 2.13 35.8% 151 8.0% (40) NM NM NM Consumer Healthcare Median $2,689 $2,563 64.2% $261 8.8% $35 35.6% 26.4x 21.7x EURO - HCIT CompuGroup Medical SE $2,322 $2,663 $43.62 58.4% $816 14.9% $187 23.0% 14.2x 13.0x EMIS Group plc 730 730 11.53 81.6% 223 NA 52 23.1% 14.1x 11.4x NEXUS AG 414 386 26.30 71.9% 153 7.2% 32 20.6% 12.2x 12.6x Euro Median $730 $730 71.9% $223 11.0% $52 23.0% 14.1x 12.6x Consolidated Median
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