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Private Equity Takes Root What Does It Mean for Optometry?

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Private Equity Takes Root What Does It Mean for Optometry? PRIVATE EQUITY TAKES ROOT WHAT DOES IT MEAN FOR OPTOMETRY? A Special Vision Expo Event September 27, 2018 Vision Expo West | Venetian/Sands Convention Center Las Vegas, Nevada PROGRAM AGENDA TIME TOPIC PRESENTER 7:15 A M Greeting Marge Axelrad & Roger Mummert “Opportunity Brings Us Together” 7:20 Overview Mark Wright, OD, FCOVD “Situation & Opportunity” ROB Professional Editor 7:30 “New Economics of Practice Richard Edlow, OD & New Strategies of Investment” Eyeconomist 7:50 The Decision Tree Michael Kling, OD “Pros & Cons: Acquisition vs. Retention” InVision Optometry 8:10 “Defining the Private Equity Value Statement” Marge Axelrad & Roger Mummert 8:15 Panel Discussion Sue Downes, MyEyeDr./Capital Vision Services “The Value We Present to ODs” Kelly McCrann, EyeCare Partners/FFL Eric Anderson, Acuity Eyecare Group Bob Barton, Total Eyecare Partners 8:50 Q&A Marge Axelrad & Roger Mummert moderators 9:15 Conclusion Copyright © 2018 Jobson Medical Information LLC. The reproduction, distribution and/or display of the material in this presentation without permission is expressly prohibited. For permission, contact Marc Ferrara, CEO, Information Services Division, Jobson Medical Information, [email protected]. 2| PRESENTERS Mark Wright, OD, FCOVD Sue Downes is Professional Editor of Review of Optomet- is CEO of MyEyeDr., a group which has ric Business. Dr. Wright heads the Bennett/ been actively expanding in several major VSP Business Management Program at The markets in the MidAtlanic, Northeast, Ohio State University College of Optometry. Southeast and Midwest for the past several He is Founder and CEO of Optometry- years to include more than 420 offices match.com, which facilitates the transfer of today. MyEyeDr.’s Capital Vision Services optometric practices. He is the founder of a is backed by investment firms Altas Partners 9-OD, four-location practice in central Ohio. and CDPQ. Michael Kling, OD Bob Barton is Founder and CEO of Invision Optometry, is President and CEO of Total Eyecare Part- a five-OD practice in San Diego. He also ners, which launched in 2017 to seek part- is founder of Impact Leadership, which pro- nerships with ODs and to assist in managing vides leadership, culture and business con- medically focused OD practices in the U.S. It sulting for eyecare providers. He frequently is backed by Toronto-based Imperial Capital. speaks at optometric meetings and authors The network currently includes Gaddie Eye articles on optometric practice management. Centers, Shady Grove Eye & Vision Care, Gailmard Eye Centers, Omni Eye Specialists, Bladen Eye Center and several others. Richard Edlow, OD Kelly McCrann is known as The Eyeconomist. He formerly is CEO of EyeCare Partners, whose portfo- chaired the AOA Information & Data Com- lio of approximately 240 offices includes mitee and continues to publish data on the Clarkson Eyecare, Thoma & Sutton, Eye- economics of the eyecare industry. He is a care Centers, Eye Care Associates, Rinkov founding partner in Catonsville Eye Group and and others in the central and Southeast is past president of the Maryland Optometric regions of the U.S. EyeCare Partners is Association. Formerly, he was CEO of Katzen backed by FFL Partners. Eye Group, a 22-doctor co-managed practice acquired by EyeCare Services Partners in 2014. Eric Anderson is CEO of Acuity Eyecare Group, which Roger Mummert includes Crown Vision Centers, Eyetique is Editorial Director of Review of Optometric and International Eyecare Center, and Business, an online forum for optometrists other eyecare organizations. The group to share winning business strategies with has more than 65 locations across six colleagues. In addition, he develops videos, states and recently expanded its senior webinars, podcasts and live events for the management team. Acuity is backed by publication. Mummert has chronicled the Riata Capital. eyecare field for Jobson Optical Group s i n c e 19 8 7. Marge Axelrad is Senior VP/Editorial Director for Vision Monday and its daily online VMAIL. She oversees the VM Global Leadership Summit and other VM Live events. She is a frequent speaker on emerging optical industry, retail and healthcare trends. |3 KEY DYNAMICS OF THE OPTOMETRIC MARKETPLACE Vision Care Revenues: $40.2 Billion GROWING DEMAND FOR EYECARE As the U.S. population grows and ages, the need for Examinations eyecare services grows along with it. Recent Vision $6 Council figures (left) show a roughly $40 billion industry, Rx Surgery $1.9 and there is growth in nearly all areas within it. An optometry practice typically derives 60 percent of Optical Goods revenues from optical sales, and 40 percent from exam (In $ billion) $32.3 fees, according to Jobson Optical Research. Source: Vision Council, 2017 Growth in Eyecare Services HIGHER GROWTH IN MEDICAL EYECARE The need for medical eyecare services is growing at a pace nearly three times that of refractive services, Comprehensive +1% Eye Exams according to The Future of Optometry, a report developed by Review of Optometric Business and Medical Eyecare sponsored by Essilor. Factors in this trend include +2.8% Services population aging and increased dry eye and eye strain due to environmental factors and growing reliance on digital devices. Source: The Future of Eyecare, 2017 ODs Growing Faster than MDs OPTOMETRY WORKFORCE GROWING The number of fulltime-equivalent optometrists will grow from roughly 40,000 at present to 46,000 by 2025, a Optometrists 40,000 46,000 15-percent increase. Over this same period, the number of fulltime ophthalmologists is expected to grow only 4 percent, from 16,000 to 16,700, according to The Ophthalmologists 16,000 16,700 Future of Optometry. Accordingly, optometrists are well positioned to meet escalating needs for medical eyecare services. At the same time, independent optometrists 2017 2025 are challenged to upgrade their practice management systems and billing and coding procedures to ensure Source: The Future of Eyecare, 2017 compliance and maintain maximum revenue flow. New practice models and technology advances are emerging to meet these challenges. 4| KEY DYNAMICS OF THE PRIVATE EQUITY MARKETPLACE Private Equity: Vast Resources at Work AVAILABLE CAPITAL IN SEARCH OF OPPORTUNITY The size of private equity resources, while difficult to Estimated private $4-6 trillion equity resources pinpoint, clearly is staggering: $4-6 trillion by various estimates. Private equity firms have $1 trillion available to Funds available invest, according to Fortune. In addition, $561 billion was $1 trillion for investment raised in 2017 by private equity funds that average $1.3 billion in assets, according to Forbes. Further, sovereign Private equity $561 billion wealth funds are coming into play: Norway wants to funds raised in 2017 invest $1 trillion in private equity, Bloomberg reported in January, 2018. With volatility in an overheated stock Sovereign wealth $1 trillion fund available for market, analysts say, private equity acquisitions are investment especially attractive to investors looking to maximize returns. Source: Forbes, Fortune, Bloomberg, 2017, 2018 Consolidation Acquisition Strategies ABILITY TO ACQUIRE QUICKLY, CAPTURE EFFICIENCIES • Acquire quickly. Private equity firms have ready cash that can provide a competitive advantage. Private equity firms have available cash to purchase practices, in contrast to OD-to-OD transitions that may • Present value proposition. Relieve OD-owner of require time to assemble financing. Notably, consulting management burdens and allow them to be the doctor services that match OD-owners with OD-buyers and that they were meant to be. facilitate financing are emerging and showing potential • Create incentives. Tie full OD-owner compensation to to level this playing field. Following an acquisition, sustained performance goals, leveraging their brand though, private equity owners can rapidly apply ready equity in community and promoting continuity. resources to achieve synergies in centralized billing and • Develop networks. Target practices located in growth procurement that can reduce operating expenses. In markets and with geographic proximity that can be addition, some consolidation “feeder models” link MD centrally managed. and OD practices, with the goal of driving (high-fee) surgical procedures to MD practices while directing (low-fee/high-volume) co-management services to OD practices. Consolidation Growth Strategies VARIED STRATEGIES: DEVELOPMENT, RETENTION OR RESALE • Create growth platform. Acquire eyecare practices to create a platform for future expansion as a network. Private equity firms generally apply a strategy to acquire practices that can be consolidated into a network with • Increase value. Manage practices to increase value common efficiencies. Consolidators then seek to rapidly through efficiencies, synergies and volume. optimize practice performance before transferring • Retain and grow. Create a regional or national chain; ownership within three-to-five years for several multiples retain and grow it. of their initial investment. Some models have longer • Grow and divest. Apply a growth strategy designed to development times, and still other models seek to retain maximize the value of practices, as measured by EBITDA. and grow a network of practices. Such consolidation Resell leaner, more profitable practices for multiples of models also are being applied to dentistry, audiology acquisition price. and to general medical practices. |5 Private Equity Takes Root in Optical New Investments Fuel Growth for U.S.
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