Healthcare Services
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HEALTHCARE SERVICES Quarterly Update Second Quarter 2021 CONTENTS Key Highlights . 2 Sub-Sector Highlights . 3 Physician Services . 3 Ambulatory Care . 4 Hospitals & Health Systems . 4 Healthcare Technology & Telemedicine Services . 5 Long-Term Care/Senior Living . 6 Diagnostic Services . 7 Healthcare Distribution . 7 Managed Care . 8 Representative Transaction . 9 Notes . 10 RESTRUCTURING • INVESTMENT BANKING • DISTRESSED ASSET SUPPORT SERVICES KEY HIGHLIGHTS HEALTHCARE SERVICES SECOND QUARTER 2021 KEY HIGHLIGHTS Healthcare M&A activity in Q2 2021 continued on its record pace which began in Q1 2021. According to preliminary figures from Irving Levin Associates Inc., healthcare M&A transaction values reached $126.1 billion, a 38% increase from the $91.3 billion in Q1 2021 and almost 10x the transactionH EvalueAHLTEHA inCLAT Q2HRCE A S2020.RERE VSIEC R EVSI C– EFSIR –S FTI RQSUTA QRUTEARR T2E0R2 12021 Transaction activity was robust in all sectors, but was particularly strong in physician services, post-acute KEY KHEIGY HHLIGIGHHLTIGSHTS care and health systems. • Physician Services: With $1.7 billion in transaction value in Q2 2021, a more than 3x increase from the The recovery in equity capital markets, rollout of COVID-19 vaccine programs, supportive central bank previous quarter, the physician practice sector is attracting significantThe recov einvestorry in eq interest,uity capi tapredominantlyl markets, roll o ut of COVID-19 vaccine programs, supportive central bank monmetoanryetaproylicpyolaicnyd arnodbursotbuasctceascscetoss ctaopitcaalpiatvaal ilaavbalielabtoleptroivaptreivaetqeuietyqu(iPtyE)(PinEv)esintoversstaonrsd asnpdecsiaplecial from private equityHEHA EandLATLHT CHcommercialACRAER SEE SREVRIVC IEinsuranceCSE –S –FI FRISRTS TQcompanies UQAURATRETRE R2 0220121 purppousrepoascequaicsiqtuioisnitcioonmcpoamnipeasn(iSePsA(CSsP)AaClsl)paolilnptotiontatorebaoruenbdoiunngdMing&AMm&Aarkmeatriknet20in212.02A1c.coArcdcinogrdtiong to • Ambulatory Care: The post-acuteKEKYE YH sector IHGIHGLHIGL includingIHGTHSTS surgerypre lcenters,ipmreinliamryin hospice,afirgyurfeigsufr rehomeosmfroIrm vhealth,inIgrvLineg vphysicalinLeAvisnsoAc si a s toecsiaItnecs.,Inhce.a, lhthecaaltrhecMare&AMt&raAnstraacntisoancstiotontsalteodta5le9d6 5in96Qi1n Q1 therapy and personal care is growing in the mid-to-high single20212 ,0digit a2 1,7 a%range 1 in7%cr e iandnacsree consolidatingfarsoem f rtohme pthrieo rp atqriuo anar rqt eu ra, rwteitr,h wailtmhoaslmt $o9s0t $b9il0lio bnil liino nto itna lt otrtanl straacntisoanc tvioalnu eva. lue. accelerating rate, driving private equity investment and M&A activity to record levels ● P●hysPichiyasnicSiaenrvSiceersv:icePso:isePdoisfoerdafnoraacntivaect2iv0e2120w2i1thw1i1th0 1M1&0 AMt&raAnstraacntisoancstioinnsQi1n, Qan1,8a3n%8i3n%creinacsreease ThTehererceocvoevreyryinineqeuqiutyitycacpaiptaitlaml marakrektest,sr,orlololluotuot foCfOCVOIVDI-D1-919vavcaccincieneprporgorgarmafrmso,mss,fu rtsophumpepo p ptrohrtireovt eirpv qreciueocanre rtqntreuatrlaarbltaebnraknk mmonoenteatray•ry p Healthoploiclyicyan Systems:adndrorboubsuts tHealthacaccecsess ssystemstotocacpaipta iintla lageneralvaavilaaiblalbe areletot oshiftingprpivraivtaet etheireqeuqiut yfocusity(P(EP) Efrom)inivnevs eacquisitionstostrosrsanadndspse pofceiac small,lial independent ● A●mbAumlabtourlayt Coaryre C:aMre&:AM a&cAti vaitcyti vinit Qy 1in e Qxp1e erxiepnecreiedn scevde sreavl ehriaghl h pigrohf pilero tfrialen straacntisoancstions puprupropsoesea c a qhospitalscuqiusiitsiiotinonc toocmo regionalmpapnaineises( Spartnerships,(PSAPCAsC)sa)llalpl opion anditnto tfor-profitoa arerbeobuonud nichainsdnigngMM& areA&A mfocusingmarakrekteitn onin20 2building2012.1.AcAcc ostrongcrodridnigng tregionaloto markets o KoKR KbKuRy sb Aubyso dAeb oHdeea lHthecaaltrhecare prperleimliminian r ay r andyfigfuig divestingruersesfrofrmom hospitalsIrvIrinvigngLeLve outsideinvinAsAssosc otheiriactiaetse coresInIcn.,c .regionalh, ehaeltahltchac rscopeaereMM&A&Atratrnasnascatciotinosnstottoatlealded595696ininQ1Q1 o HoCAH bCuAy sb Buryoso Bkrdoaolekd Haolem Heo Hmeea lHthe a< Hh o&s pHicoespice 2022012,1 a, 1a 71%7 %in icnrceraesaes efr ofrmom th teh ep rpioriro qr uqauratertre, rw, iwthithalmalmosot s$t 9$09 0b iblliollino nin i nto ttoatl atlr atrnasnascaAtcTiotIino Pnvha vyluaslieuc.ael. Therapy, operator of 900 clinics in 25 states merges with SPAC for $2.5B • Digital Health: Investment in digital health has shown no signs ofo slowing,o ATI evenPhys iasca ltheTh globalerapy, pandemicoperator of 900 clinics in 25 states merges with SPAC for $2.5B transaction ●● PhPyh s y i cs beginsiiacinanSeSr etovricv subside.eicse:s:PoPios eiSectorsdedfofroar investmentnanacatcivteive2022 0recently121wiwthith11 1topped010MM&A& $14.7Atratrnasna sbillioncatciotinosn isatni nQthe1Qt,1r enda,nasn8a of3c8%t3 iQ2o%innic n2021,rceraesaes eexceeding last ● Long Term Care: Continues to struggle to recover from sharp occupancy declines from pandemic frofrmo m t year’sh teh ep rpio rtotaliro qr uqa uinrate rjusttrer the first half of 2021 ● Long Term Care: Continues to struggle to recover from sharp occupancy declines from pandemic (occupancy below 80% in many SNFs and ALs) ●● AmAmbublualtaotroyr Cy aCraer:eM: M&A& Aac atcivtitvyit iyn i nQ 1Q 1ex epxepreierinecnecde dse sveevrearlahlihghig hp rporfoilfeil etr atrnasna(socatccicotuinopsnasncy below 80% in many SNFs and ALs) ● Hospitals and Health Systems: Continue to try to rebound from suspended elective procedures, ooOneKKKR Kof Rb uthebyusy Asbiggest bAobdoed eH trendseHaeltahltchac rinaer Q2e 2021 was the growing consolidat●ion Hacrossospita marketsls and H eina lhealthcare.th Systems :HumanaContinu e to try to rebound from suspended elective procedures, plummeting ED visits, temporary closures of physician practices and home health visit cancellations ooInc.HCH (NYSE:AC Ab ubyusy BsHUM) rBorookodk aacquireddleal eH oHmome eHthe eHae lremainingtahlt h& &H oHsopsi pc60%eice of Kindred at Home itp didlum notme towning E forD v i$5.7sits, tbillion,empor aar yclearclos ures of physician practices and home health visit cancellations fromfr2o0m202.02E0v.enEvweinthweicthoneocmonyormeoypreenoipnegnwinigthwviathccvinaeccrionlel-oroultl-,oAuHtA, ApHreAdpicrtesdhicotsphitoaslpsictaoluslcdoluolsdelose ooexampleATAITIPhPy hofsyics theaiclalT verticalhTehrearpayp, yintegration,opoepreartaotroro thatfof909 0is00 continuingclicnlincsicsinin2 with525stas managedttaetsesmmeregre gcareseswiw companies.thithSPSAPCACfofr oLifePointr$2$.25.B5B Health, one of betwbeeetwn e$e5n3 $b5il3lio bnil laionnd a$n1d2 2$ 1b2il2lio bnil ldioune dtou eth teo ltihnege lirninggereinffgecetfsf eocft Cs ovf iCdo-1v9id.-19. thetrat country’srnasnascatciotinon largest health systems, acquired Kindred Healthcare, creating a dominant player in the acute LoLnogngTeTremrmCaCraer:e:CoCnotnintiuneusetsotostrsutrgugglegletotorerceocvoevrefrrofrmomshsahraprpococcucpuapnacnycydedcelicnliensefsrofrmompapnadnedmemicic ●● and post-acute healthcare market, and HCA Healthcare, theT hlargeste TMh&e AM publicly-tradedr&eAcorveecroyvtehrayttbh ehospitalagtabneginant hproviderien stheceosned cinoh ntheadlf ho aflf20o2f020is2l0ikieslylikteolyactcoealecrcaetleriante20in212.0W21it.hWloitwh lcoowstcoofst of (o(coccucpuapnacnyc by ebleolwo w8 08%0 %in i nm manayn SyN SFNsF asn adn dA LAsL)s) country, closed its transaction to acquire an 80% interest inc Brookdaleapitcaalpaitnadl a aHealthncdceascscibe Carelsesidbele bServices,tdmebatrkmeat sexpandingr,kelatrsg,elabrgaela itsbnac elasnhceesthse, eavtsa,ilaavbaiilliatybiolifty$2o.f5$t2ri.l5liotrnilloiofnproivfaptreiveaqteuietyqudirtyy dry ●● HoHsopsiptaitlaslsanadndHeHaelathlthSySsytsetmems:s:CoCnotnintiuneuetototrytrytotorerbeobuonudndfrofrmopmosuwssudpseprn,ednaedndeddealerlcetcivtoeirvdepr$po8rco1ecdebudilruleiorsen,s,raised by SPACs in 2020 that must be invested in the next two years, reach of post-acute care services across the continuum of care.powder, and a record $81 billion raised by SPACs in 2020 that must be invested in the next two years, plpulmummeteintignEgDEDvisviitssit,st,etmempoproarrayrcyloclsousruerseosfopfhpyhsyicsiiacnianprparcatcicteicseasnacdonrdhpochomoorramepteohrehaaentletadhltaphvnridsivviitaspitctreaicvnaincntevecleelasilntlaovioterinssostnhosarsvehavceceascscteosscatopitcaalpaitnadl aanrde abreleatboleputorspuuersdueealdsetaolsbutoildbusciladlescaanled and frofrmoWem202 welcome2002.0.EvEevne nyourwiwthit hecommentsceocnoonmomy yre androepoep nhopeeinigngw youiwthith vfindavcacci ncieourneroSOLIConnect rlol-lol-uotu, teA,xHApAHaenApx reportdrppeasrdneciodcpticse tcinformative.h.soohpAsoesp.siCptAOaitlsVsaCIlcsDOoc-uV1ol9IudDlcd-lo1lsn9oetscineounetisntuoesimtopaimctpoaucrt foaumriflaiemsialineds afrniednfdriseanrdosuanrdouthnedwthoerlwd,oorludr, tohuorutghhotusghts bebtewteweene n$ 5$35 3b iblliollino nan adn d$ 1$2122 2b iblliollino nd udeu eto t oth teh elin lignegreinrignegfefeffcetcst os fao Cnf odCvaoipndvrid-ad1y-9p1e.r9as.yearse athreatthyaotu yaonud aynoduryofaumr iflaymairlye ahreealhtheya,ltshayf,e,saafned, amndakminagktinhge tbheestboefstaorfealirteyatlihtyatthat continues to change. We welcome your comments and hope you find our SOLIConnect report ThTeheMM&A&Arerceocvoevreyrythtahtabtebgeagnanininthtehesesceocnodndhahlfaloffo2f0220020isilsikleikleyltyotoacacceclelrceaortaneteiiniun2e02s2012t.o1W. Wcithhiathlnoglwoew.cocWsotesotfowfelcome your comments and hope you find our SOLIConnect report informative. cacpaiptaitlaalnadndacaccecsessibsilbelededbetbmt marakrektest,sla, rlagregebablanlacneceshseheetest,sa,vaavilaaiblaiblitilyitoyfo$f2$.25in.5tfroitrlrlmiollainotinovfeop.frpivraivtaeteqeuqiutyitdyrdyry