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0
INDUSTRY UPDATE │ NOVEMBER 2015
www.harriswilliams.com
W
HAT
W
E
’
RE
R
EADING
CONTENTS
PUBLIC MARKETS OVERVIEW
EQUITY MARKETS OVERVIEW
M&A OVERVIEW
DEBT MARKETS OVERVIEW
HEALTHCARE & LIFE SCIENCES
PUBLIC COMPARABLES
M&A TRANSACTIONS
CONTACTS
Turner Bredrup
Managing Director
tbredrup@harriswilliams.com
+1 (804) 915-0110
James Clark
Managing Director
jclark@harriswilliams.com
+1 (804) 915-0119
Cheairs Porter
Managing Director
cporter@harriswilliams.com
+1 (804) 915-0130
Geoff Smith
Managing Director
gsmith@harriswilliams.com
+1 (804) 915-0195
Andy Dixon
Director
adixon@harriswilliams.com
+1 (415) 217-3419
Paul Hepper
Director
phepper@harriswilliams.com
+1 (804) 932-1326
Whit Knier
Director
wknier@harriswilliams.com
+1 (804) 932-1321
Jacques Fu
Vice President
jfu@harriswilliams.com
+1 (804) 915-0185
Andy Hewlett
Vice President
ahewlett@harriswilliams.com
+1 (415) 217-3427
Bill Kayser
Vice President
bkayser@harriswilliams.com
+1 (804) 915-0180
Nick Owens
Vice President
nowens@harriswilliams.com
+1 (804) 887-6027
SPECIALTY PHARMACEUTICALS | PRICE HIKES TURN SPOTLIGHT ON TURING
In September, Martin Shkreli and Turing Pharmaceuticals ignited controversy across
the medical and political communities after obtaining the manufacturing license
for the drug Daraprim and increasing the price $750 per pill. This represents a
more than 5,000% increase, up from $13.50 per pill. The drug is typically used for
treatments of a dangerous parasitic infection. Shortly after the backlash created
from its decision to dramatically increase prices, Turing announced that they had
agreed to lower the price point to one which would still allow the company to
make a small profit – that price is yet to be announced to the market. In the
interim, however, Imprimis Pharmaceuticals announced its customized version of
the drug for just $1 per pill. Imprimis has made available its alternative through a
compounded to order program. Increasing prices for pharmaceuticals will likely
remain a much debated topic after several effective albeit extremely expensive
hepatitis C drugs initially made headlines for their sticker prices. A link to the article
can be found
here
.
ACA | 2016 OPEN ENROLLMENT TRENDS
With 2016 open enrollment in full swing as of November 1
st
, enrollees are logging in
to find noticeable premium increases when buying health coverage on the
exchanges. Federal officials quoted an estimated 7.5% increase on average for
the second-lowest-cost midrange silver plan.
The primary driver for the rate
increases sought by insurance plans and approved by the states were trends in
plans being more costly than expected including many resulting in losses for
carriers. The Obama administration is also predicting overall enrollment levels far
below those previously predicted by government officials.
The most recent
exchange enrollment estimates by the Health and Human Services expect just 10
million Americans by the end of 2016. This figure represents just 50% of the most
recent estimates by congressional budget analysts. Links to the relevant articles
can be found
here
and
here
.
HW&CO. HCLS GROUP INSIGHT
PAGE |
Contract Pharma Manufacturing Home Care, Hospice, and Home InfusionHealthcare Staffing Retail Pharmacy Specialty Pharmacy Specialty Managed Care Physician Practice Management Dental Products
Dialysis Services Specialty Managed Care Medical Devices and Products HW&Co. HCLS Composite Index Clinical Laboratories Behavioral Health / Management Contract Research Organizations Life Sciences Tools Durable Medical Equipment
Medical / Surgical / Dental Supplies & Distribution Specialty Pharmacy Management Long-Term Care Surgicenters / Rehabilitation Information Services S&P 500 Disease Management Emergency Services Assisted Living Acute-Care Hospitals Diagnostic Imaging (60.0%) (50.0%) (40.0%) (30.0%) (20.0%) (10.0%) 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%
Change in Stock Price
3 mos. 12 mos. Revenue EBITDA Revenue EBITDA
Clinical Laboratories 3 $37,130 (7.5%) 14.3% 2.4x 11.7x 2.2x 10.6x
Contract Pharma Manufacturing 2 5,835 (3.8%) 70.0% 3.4x 16.6x 3.2x 13.5x
Contract Research Organizations 9 34,971 (14.4%) 13.1% 2.4x 12.2x 2.3x 11.5x
Disease Management 2 8,374 (5.4%) (4.5%) 2.0x 12.9x 1.9x 12.2x
Emergency Services 1 2,251 4.3% (11.8%) 2.1x 7.9x 2.1x 8.2x
Healthcare Staffing 5 17,670 (2.2%) 40.5% 1.4x 14.6x 1.4x 13.0x
HMO - Medical 10 321,138 (3.8%) 28.9% 0.8x 9.9x 0.8x 9.7x
Information Services 13 42,042 (5.2%) 5.4% 5.1x 20.0x 4.7x 16.9x
Specialty Managed Care 3 8,976 3.4% 20.4% 1.3x 13.9x 7.3x 6.8x
Specialty Pharmacy 1 1,967 (38.4%) 30.1% 0.7x 30.4x 0.7x NM
Retail Pharmacy 3 253,384 (12.3%) 34.5% 0.9x 12.0x 0.9x 11.4x
Specialty Pharmacy Management 2 74,871 (9.9%) 8.8% 0.7x 9.8x 0.7x 9.5x
Dental Products 3 121,522 6.2% 21.5% 3.5x 16.6x 3.5x 15.4x
Durable Medical Equipment 3 11,753 0.5% 10.6% 1.7x 15.1x 1.3x 10.9x
Life Sciences Tools 4 124,198 (6.1%) 12.0% 2.8x 14.2x 3.1x 13.1x
Medical Devices and Products 15 658,711 (4.6%) 15.8% 3.7x 13.7x 3.7x 13.6x
Medical / Surgical / Dental Supplies & Distribution 6 119,647 (3.1%) 9.8% 0.3x 12.4x 0.3x 9.4x
Acute-Care Hospitals 4 103,703 (35.3%) (22.1%) 1.1x 7.7x 1.0x 7.3x
Assisted Living 3 11,811 (28.1%) (19.1%) 2.4x 12.7x 2.1x 11.9x
Diagnostic Imaging 3 9,034 (8.7%) (28.2%) 1.5x 9.3x 1.8x 9.3x
Dialysis Services 2 59,094 3.8% 20.6% 1.9x 10.7x 1.9x 10.4x
Home Care, Hospice, and Home Infusion 6 6,296 3.5% 51.5% 1.4x 13.0x 1.4x 12.3x
Long-Term Care 3 6,379 (16.5%) 7.8% 0.9x 9.0x 0.7x 7.5x
Physician Practice Management 2 9,393 (3.6%) 27.3% 2.8x 14.6x 2.7x 14.4x
Behavioral Health / Management 6 26,648 (12.7%) 14.0% 1.5x 11.2x 1.4x 10.7x
Surgicenters / Rehabilitation 5 17,879 (13.3%) 5.7% 2.0x 12.5x 1.9x 10.4x
Payor, Provider, & Pharmacy Support Services 54 $808,608 (7.3%) 23.2% 1.3x 12.1x 1.3x 11.0x
Products & Devices 31 $1,035,832 (2.4%) 4.0% 3.4x 13.6x 3.3x 12.6x
Provider-Based Services 34 $250,236 (11.4%) 9.8% 1.9x 10.6x 1.8x 10.1x
HW&Co. HCLS Composite Index 119 $2,094,676 (8.2%) 14.5% 2.5x 12.8x 2.4x 11.9x
S&P 500 (1.4%) 4.2% Pr od uct s & D ev ices Pr ov id er -B a sed S er vi ces Median TEV/ Forward Mulitples Sector CompaniesNumber of
Aggregate Enterprise Value ($ mm) Median TEV/ LTM Multiples Pa yor , P rov id er , & P ha rm a cy S up p or t Ser vi ces
P
UBLIC
M
ARKETS
O
VERVIEW
2
Key Trading Statistics
(detail begins on page 6)
Public Company Sector Performance
40%
60%
80%
100%
120%
140%
160%
180%
200%
220%
Oct-12
Jan-13
Apr-13
Jul-13
Oct-13
Jan-14
Apr-14
Jul-14
Oct-14
Jan-15
Apr-15
Jul-15
Oct-15
S&P 500
Dow Jones U.S. Health Care Index
HW&Co. HCLS Index
E
QUITY
M
ARKETS
O
VERVIEW
Healthcare & Life Sciences Industry Stock Performance
Top Equity Offerings
(by proceeds)
179.9%
147.2%
159.9%
Closing Date
Issuer
Ticker
Transaction Type
Gross Proceeds ($ mm)
10/06/15
Sarepta Therapeutics Inc
SRPT
Follow-On
$126.8
10/07/15
CytomX Therapeutics Inc
CTMX
IPO
92.0
10/21/15
Dimension Therapeutics Inc
DMTX
IPO
71.5
10/06/15
Aclaris Therapeutics Inc
ACRS
IPO
63.3
10/28/15
MyoKardia Inc
MYOK
IPO
54.4
10/01/15
Civitas Solutions Inc
CIVI
Follow-On
49.5
10/01/15
Medgenics Inc
MDGN
Follow-On
46.0
10/22/15
Vital Therapies Inc
VTL
Follow-On
34.5
10/15/15
Cerecor Inc
CERC
IPO
26.0
10/16/15
Strongbridge Biopharma plc
SBBP
Follow-On
25.0
10/05/15
Mirna Therapeutics Inc
MIRN
Follow-On
16.8
10/07/15
ContraVir Pharmaceuticals Inc
CTRV
Follow-On
15.0
PAGE |
221 291 200 209 304 248 304 290 279 292 303 312 369 12 22 16 12 18 15 22 14 11 15 11 13 14 0 50 100 150 200 250 300 350 400 3Q12 4Q12 1Q13 2Q13 3Q13 4Q13 1Q14 2Q14 3Q14 4Q14 1Q15 2Q15 3Q15 Nu m ber of Tran sact ion sPEG Acquirer Series1
Aggregate Number Median Transaction Multiples Value ($bn) of Deals TEV/Rev TEV/EBITDA
$479.9 1,315 2.07x 14.0x
HC&LS Industry
Number of
Segment
Companies
Healthcare Facilities
41
Healthcare Serv ices
46
Healthcare Equipment
21
Pharmaceuticals
18
Healthcare Technology
16
Life Sciences Tools & Serv ices
15
Healthcare Supplies
11
Healthcare Distributors
5
Biotechnology
1
Managed Healthcare
3
$110.6 $141.4 $101.6 $108.2 $236.6 $369.6 0 200 400 600 800 1,000 1,200 1,400 $0 $50 $100 $150 $200 $250 $300 $350 $400 $450 $500 2010 2011 2012 2013 2014 2015YTD Nu m b er of Tr a ns a ct ions Agg reg a te Tr a ns a ct ion V a lu e ($ in b illi ons )Aggregate Deal Value Number of Transactions
12.8x 11.1x 10.9x 10.0x 13.6x 14.2x 0.0x 0.5x 1.0x 1.5x 2.0x 2.5x 3.0x 3.5x 4.0x 0.0x 3.0x 6.0x 9.0x 12.0x 15.0x 18.0x 21.0x 2010 2011 2012 2013 2014 2015YTD EV / LTM Sa les Mult iple EV / LTM EBIT D A Mult iple
TEV / LTM EBITDA TEV / LTM Sales
69 94 113 79 42 71 65 65 61 62 40 60 62 95 49 50 80 120 139 144 143 95 0 20 40 60 80 100 120 140 160 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015YTD Nu m b er of T ra ns a ct ions
Number of Investments Number of Exits
Announced Target Buyer
10/23/2015 Animal Trustees of Austin, Inc. Emancipet, Inc. 10/19/2015 Doctors Allergy Formula, LLC Bausch & Lomb Incorporated 10/15/2015 Northstar Psychological Serv ices, Inc. South Bay Mental Health Center, Inc. 10/15/2015 MedMark Serv ices, Inc. Addiction Research and Treatment, Inc. 10/13/2015 Project Rendezv ous Holding Corporation Digirad Corporation (NasdaqGM:DRAD) 10/12/2015 Team Health Holdings, Inc. (NYSE:TMH) AmSurg Corp. (NasdaqGS:AMSG)
10/9/2015 BluePearl Veterinary Partners LLC Mars Petcare US, Inc. 10/8/2015 Lone Star Dermatology Dermatology Associates of Central Texas 10/7/2015 Hospice Adv antage, Inc. Hospice Compassus, Inc. 10/5/2015 PharMEDium Healthcare Holdings, Inc. AmerisourceBergen Drug Corporation 10/4/2015 nContact, Inc. AtriCure, Inc. (NasdaqGM:ATRC) 10/1/2015 Global Medical Imaging, LLC Jordan Industries International, LLC
M&A O
VERVIEW
4
Announced Healthcare & Life Sciences M&A
Healthcare & Life Sciences M&A Trends
Announced Private Equity M&A Activity
QUARTERLY
M&A ACTIVITY
HEALTHCARE TRANSACTION
HIGHLIGHTS
ANNOUNCED HEALTHCARE &
LIFE SCIENCES TRANSACTIONS
MEDIAN HEALTHCARE &
LIFE SCIENCES TRANSACTION MULTIPLES
PEG INVESTMENTS BY SEGMENT (LAST 3 YEARS)
PEG INVESTMENTS AND EXITS
Note: Transactions based on publicly available information
LTM DEAL STATISTICS
$0 $3 $6 $9 $12 $15 $18 $21 $24 3Q10 1Q11 3Q11 1Q12 3Q12 1Q13 3Q13 1Q14 3Q14 1Q15 3Q15 Lo an V o lum e by Quar te r ( $ in bil lio ns )
Pro Rata Institutional
L + 0 L + 100 L + 200 L + 300 L + 400 L + 500 2010 2011 2012 2013 2014 2015 YTD A ver a g e Spr ead O ver L IBOR
Revolving Credit / Term Loan A Weighted-Average Institutional
L + 0 L + 200 L + 400 L + 600 L + 800 3Q10 1Q11 3Q11 1Q12 3Q12 1Q13 3Q13 1Q14 3Q14 1Q15 3Q15 A ver a g e Spr ead O ver L IBOR 0.0x 2.0x 4.0x 6.0x
Debt/EBITDA Senior Debt/EBITDA EBITDA/Cash
Interest Capex/CashEBITDA -Interest EB ITDA Mu lti p le 2010 2011 2012 2013 2014 2015 YTD
Date Effective
Borrower Name
Description
Amount ($ mm)
Tranche
Rating
Spread
09/28/15
Schumacher Group
Health and allied services, nec
$610.0
Term Loan B
B1 / B
L+ 400
09/28/15
Schumacher Group
Health and allied services, nec
610.0
Term Loan
Caa1 / CCC+
L+ 850
09/18/15
First Choice ER LLC
Health and allied services, nec
175.0
Revolver/Line >= 1 Yr.
NR / NR
L+ 375
09/18/15
First Choice ER LLC
Health and allied services, nec
175.0
Term Loan A
NR / NR
L+ 375
09/03/15
AccentCare Inc
Home health care services
170.0
Term Loan B
NR / NR
L+ 575
09/03/15
AccentCare Inc
Home health care services
170.0
Term Loan
NR / NR
L+ 950
09/01/15
Emerus Holdings Inc
General med'l/surgical hospitals
140.0
Revolver/Line >= 1 Yr.
NR / NR
L+ 450
09/01/15
Emerus Holdings Inc
General med'l/surgical hospitals
140.0
Term Loan
NR / NR
L+ 450
09/30/15
Northwestern Memorial Hospital
General med'l/surgical hospitals
80.0
Revolver/Line >= 1 Yr.
NR / NR
L+ 55
09/18/15
Circleville Health Partners LLC
Skilled nursing care facilities
12.2
Other Loan
NR / NR
L+ 375
D
EBT
M
ARKETS
O
VERVIEW
Key Credit Statistics
QUARTERLY HEALTHCARE LOAN VOLUME
AVERAGE SPREAD ON HEALTHCARE LOANS
Select Healthcare & Life Sciences Debt Offerings
(by deal amount)
PAGE |
Stock Price
% Change 52 Week
10/30/2015 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Clinical Laboratories
Laboratory Corp. of America Holdings $122.74 (2.3%) 14.3% $131.19 $98.54 $12,421 $6,681 $713 $18,405 $7,774 $1,567 $1,198 Sep-15 Dec-14 $8,488 $1,734 $1,215 2.4x 11.7x 2.2x 10.6x
Quest Diagnostics Inc. 67.95 (7.5%) 7.0% 89.00 59.25 9,741 3,731 123 13,450 7,527 1,489 1,180 Sep-15 Dec-14 7,495 1,510 1,209 1.8x 9.0x 1.8x 8.9x
VCA Inc. 54.77 (10.6%) 21.1% 62.45 45.10 4,445 881 75 5,275 2,080 391 310 Sep-15 Dec-14 2,133 402 328 2.5x 13.5x 2.5x 13.1x
Number of Companies 3 Median: (7.5%) 14.3% Total $26,607 $37,130 $17,380 $18,116 2.4x 11.7x 2.2x 10.6x
Market Cap. Weighted Average: (5.6%) 12.8% 2.2x 11.0x 2.1x 10.4x
Contract Pharma Manufacturing
Cambrex Corporation. $45.97 (7.9%) 120.4% $54.60 $20.96 $1,442 $30 $60 $1,440 $406 $111 $89 Sep-15 Dec-14 $430 $122 $99 3.5x 13.0x 3.4x 11.8x
West Pharmaceutical Services, Inc. 60.01 0.4% 19.6% 61.73 48.66 4,321 303 257 4,396 1,390 217 128 Sep-15 Dec-14 1,407 289 191 3.2x 20.3x 3.1x 15.2x
Number of Companies 2 Median: (3.8%) 70.0% Total $5,763 $5,835 $1,796 $1,836 3.4x 16.6x 3.2x 13.5x
Market Cap. Weighted Average: (1.7%) 44.8% 3.3x 18.5x 3.2x 14.3x
Contract Research Organizations
Albany Molecular Research Inc. $18.04 (14.4%) (20.6%) $23.95 $13.73 $640 $360 $79 $800 $363 $44 $20 Sep-15 Dec-14 $408 $73 $50 2.2x 18.1x 2.0x 10.9x
Catalent, Inc. 26.58 (20.1%) 3.7% 34.42 22.85 3,310 1,884 151 5,052 1,836 416 274 Sep-15 Jun-15 1,855 442 304 2.8x 12.2x 2.7x 11.4x
Charles River Laboratories International, Inc. 65.24 (12.4%) 3.9% 84.69 59.99 3,052 852 74 3,690 1,339 306 215 Sep-15 Dec-14 1,346 322 244 2.8x 12.1x 2.7x 11.5x
ICON Public Limited Company 63.87 (21.0%) 21.2% 84.14 49.75 3,824 350 235 3,692 1,562 323 267 Sep-15 Dec-14 1,580 336 280 2.4x 11.4x 2.3x 11.0x
INC Research Holdings, Inc. 41.71 (12.4%) NM 51.69 19.61 2,356 475 136 2,695 887 198 142 Sep-15 Dec-14 913 218 198 3.0x 13.6x 3.0x 12.4x
PAREXEL International Corporation 63.12 (8.1%) 18.8% 76.17 52.19 3,374 483 158 3,521 2,036 301 213 Sep-15 Jun-15 2,146 348 257 1.7x 11.7x 1.6x 10.1x
PRA Health Sciences, Inc. 35.04 (16.8%) NM 46.35 18.47 2,108 930 48 2,991 1,337 215 133 Sep-15 Dec-14 1,367 239 216 2.2x 13.9x 2.2x 12.5x
Quintiles Transnational Holdings Inc. 63.65 (19.2%) 13.1% 80.45 54.77 7,835 2,488 1,082 9,467 4,262 781 656 Sep-15 Dec-14 4,332 799 671 2.2x 12.1x 2.2x 11.8x
WuXi PharmaTech (Cayman) Inc. 44.70 7.7% 18.4% 46.14 32.50 3,171 190 155 3,062 778 132 84 Sep-15 Dec-14 798 176 117 3.9x 23.2x 3.8x 17.4x
Number of Companies 9 Median: (14.4%) 13.1% Total $29,670 $34,971 $14,400 $14,746 2.4x 12.2x 2.3x 11.5x
Market Cap. Weighted Average: (13.9%) 10.6% 2.5x 13.5x 2.5x 12.1x
Disease Management
Alere Inc. $46.12 (5.1%) 15.2% $55.99 $35.81 $3,954 $3,602 $479 $7,699 $2,496 $601 $282 Sep-15 Dec-14 $2,569 $581 $496 3.1x 12.8x 3.0x 13.3x
Healthways Inc. 11.77 (5.7%) (24.2%) 23.30 9.93 424 252 2 675 783 52 31 Sep-15 Dec-14 775 61 13 0.9x 13.0x 0.9x 11.1x
Number of Companies 2 Median: (5.4%) (4.5%) Total $4,378 $8,374 $3,280 $3,343 2.0x 12.9x 1.9x 12.2x
Market Cap. Weighted Average: (5.1%) 11.4% 2.9x 12.8x 2.8x 13.0x
Emergency Services
Air Methods Corp. $40.93 4.3% (11.8%) $54.98 $32.81 $1,608 $681 $15 $2,251 $1,062 $284 $202 Sep-15 Dec-14 $1,056 $274 $190 2.1x 7.9x 2.1x 8.2x
Number of Companies 1 Median: 4.3% (11.8%) Total $1,608 $2,251 $1,062 $1,056 2.1x 7.9x 2.1x 8.2x
Market Cap. Weighted Average: 4.3% (11.8%) 2.1x 7.9x 2.1x 8.2x
Healthcare Staffing
AMN Healthcare Services Inc. $28.37 (2.2%) 65.2% $37.47 $15.62 $1,352 $217 $14 $1,564 $1,340 $135 $115 Sep-15 Dec-14 $1,401 $145 $113 1.2x 11.6x 1.1x 10.8x
Envision Healthcare Holdings, Inc. 28.20 (30.6%) (18.6%) 45.95 20.33 5,238 2,239 130 7,334 5,124 578 403 Sep-15 Dec-14 5,365 599 394 1.4x 12.7x 1.4x 12.2x
Cross Country Healthcare, Inc. 13.50 11.4% 40.5% 16.72 9.25 435 72 25 499 762 31 23 Sep-15 Dec-14 764 31 22 0.7x 16.3x 0.7x 16.1x
On Assignment Inc. 45.11 16.4% 60.7% 51.00 28.36 2,375 785 29 3,130 2,064 215 169 Sep-15 Dec-14 2,053 241 158 1.5x 14.6x 1.5x 13.0x
Team Health Holdings, Inc. 59.67 (8.2%) (3.7%) 70.21 45.45 4,323 755 18 5,143 3,408 338 232 Sep-15 Dec-14 3,529 381 241 1.5x 15.2x 1.5x 13.5x
Number of Companies 5 Median: (2.2%) 40.5% Total $13,722 $17,670 $12,698 $13,112 1.4x 14.6x 1.4x 13.0x
Market Cap. Weighted Average: (11.3%) 10.0% 1.5x 15.2x 1.5x 13.5x
TEV/ Fwd Multiples Forward Twelve Month
Estimate
Company Name Equity Mkt. PeriodLTM FYE DateLatest TEV/ LTM Multiples
Value
Total Debt Cash and Equiv. Total Ent. Value (TEV)
Latest Twelve Months (LTM)
P
UBLIC
C
OMPARABLES
6
Payor, Provider, & Pharmacy Support Services
As of October 30, 2015.
PAGE |
Stock Price
% Change 52 Week
10/30/2015 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
HMO - Medical Commercial:
Aetna Inc. $114.78 0.6% 42.4% $134.40 $81.01 $40,024 $7,838 $1,797 $46,129 $59,950 $5,222 $4,561 Sep-15 Dec-14 $60,311 $5,630 $4,844 0.8x 8.8x 0.8x 8.2x
Anthem, Inc. 139.15 (10.2%) 12.9% 173.59 121.22 36,328 17,778 1,548 52,558 77,953 6,325 5,769 Sep-15 Dec-14 78,221 5,219 4,861 0.7x 8.3x 0.7x 10.1x
Cigna Corp(1) 134.04 (6.9%) 38.0% 170.68 97.58 34,532 5,205 2,381 37,848 37,276 3,991 3,659 Sep-15 Dec-14 38,091 4,139 3,580 1.0x 9.5x 1.0x 9.1x
Health Net, Inc.(2) 64.26 (3.3%) 35.3% 76.67 44.66 4,967 610 973 4,819 15,966 427 408 Sep-15 Dec-14 16,727 589 571 0.3x 11.3x 0.3x 8.2x
Humana Inc.(3) 178.63 (2.8%) 30.2% 219.79 129.31 26,477 4,129 1,597 28,659 53,256 2,697 2,429 Sep-15 Dec-14 54,954 2,917 2,560 0.5x 10.6x 0.5x 9.8x
UnitedHealth Group Incorporated 117.78 (2.3%) 25.5% 126.21 93.01 112,311 31,783 7,983 137,681 146,941 12,486 11,318 Sep-15 Dec-14 156,235 12,939 11,332 0.9x 11.0x 0.9x 10.6x
Number of Companies 6 Median: (3.0%) 32.7% Total $254,638 $307,695 $391,341 $404,540 0.7x 10.1x 0.7x 9.5x
Market Cap. Weighted Average: (3.7%) 28.7% 0.8x 10.0x 0.8x 9.8x
Government:
Centene Corp. $59.48 (14.9%) 32.2% $83.00 $45.40 $7,090 $1,281 $1,665 $6,864 $19,854 $853 $747 Sep-15 Dec-14 $22,528 $815 $706 0.3x 8.0x 0.3x 8.4x
Molina Healthcare, Inc. 62.00 (8.8%) 33.3% 82.37 43.83 3,477 927 2,164 2,240 12,728 490 407 Sep-15 Dec-14 14,160 513 408 0.2x 4.6x 0.2x 4.4x
Universal American Corp 7.46 (18.5%) (19.5%) 11.16 6.56 602 85 216 560 1,936 18 8 Sep-15 Dec-14 1,671 37 36 0.3x 30.8x 0.3x 15.1x
WellCare Health Plans, Inc. 88.60 12.0% 37.5% 98.79 65.12 3,905 1,213 1,423 3,779 13,808 448 409 Sep-15 Dec-14 13,931 557 477 0.3x 8.4x 0.3x 6.8x
Number of Companies 4 Median: (11.9%) 32.7% Total $15,075 $13,443 $48,326 $52,290 0.3x 8.2x 0.3x 7.6x
Market Cap. Weighted Average: (6.7%) 31.8% 0.3x 8.3x 0.3x 7.3x
Information Services Data/Analytics:
Castlight Health, Inc. $5.06 (30.9%) (61.1%) $13.44 $3.94 $477 $0 $26 $313 $68 ($79) ($81) Sep-15 Dec-14 $76 ($64) ($66) 4.6x NM 4.1x NM
Inovalon Holdings, Inc. 23.05 (6.8%) NM 33.75 17.78 3,411 285 167 2,904 407 137 117 Sep-15 Dec-14 437 159 133 7.1x 21.2x 6.6x 18.2x
National Research Corp. 31.99 (6.5%) (6.4%) 39.30 27.54 434 6 38 400 101 29 25 Sep-15 Dec-14 103 31 27 4.0x 13.6x 3.9x 13.1x
Number of Companies 3 Median: (6.8%) (33.7%) Total $4,321 $400 $576 $616 4.6x 17.4x 4.1x 15.6x
Market Cap. Weighted Average: (9.5%) (7.4%) 6.5x 20.4x 6.1x 17.6x
eHealth:
WebMD Health Corp. $40.66 (6.3%) (2.3%) $48.91 $35.64 $1,500 $803 $612 $1,695 $607 $129 $111 Sep-15 Dec-14 $630 $188 $123 2.8x 13.2x 2.7x 9.0x
Number of Companies 1 Median: (6.3%) (2.3%) Total $1,500 $1,695 $607 $630 2.8x 13.2x 2.7x 9.0x
Market Cap. Weighted Average: (6.3%) (2.3%) 2.8x 13.2x 2.7x 9.0x
Hospital/Physician:
Allscripts Healthcare Solutions, Inc. $14.06 (2.4%) 1.7% $15.41 $11.00 $2,656 $655 $91 $3,251 $1,382 $98 $15 Sep-15 Dec-14 $1,404 $243 $149 2.4x 33.1x 2.3x 13.4x
Athenahealth, Inc. 152.45 9.6% 26.7% 163.79 110.68 5,920 300 117 6,102 880 68 4 Sep-15 Dec-14 925 181 88 6.9x NM 6.6x 33.7x
Cerner Corporation 66.29 (7.9%) 5.8% 75.72 57.42 22,875 631 262 22,940 4,103 1,133 835 Oct-15 Jan-15 4,532 1,467 1,091 5.6x 20.2x 5.1x 15.6x
Computer Programs & Systems Inc. 38.01 (29.9%) (41.3%) 63.60 36.04 430 0 28 391 184 35 32 Sep-15 Dec-14 184 33 29 2.1x 11.1x 2.1x 11.7x
HMS Holdings Corp. 10.53 (9.3%) (53.0%) 23.69 8.11 932 198 145 980 458 85 33 Sep-15 Dec-14 466 112 49 2.1x 11.5x 2.1x 8.7x
MedAssets, Inc. 23.68 0.4% 8.4% 24.00 17.00 1,421 798 0 2,251 764 218 100 Sep-15 Dec-14 763 237 78 2.9x 10.3x 3.0x 9.5x
Premier, Inc. 33.81 (4.0%) 2.2% 39.81 30.05 1,277 168 110 1,335 1,049 340 279 Sep-15 Jun-15 1,161 440 340 1.3x 3.9x 1.1x 3.0x
Quality Systems Inc. 14.05 8.5% (6.0%) 18.75 12.00 855 0 99 744 499 57 44 Sep-15 Mar-15 501 81 42 1.5x 13.0x 1.5x 9.1x
The Advisory Board Company 43.83 (26.3%) (17.2%) 60.38 37.47 1,865 560 56 2,380 722 76 35 Sep-15 Dec-14 773 171 43 3.3x 31.2x 3.1x 13.9x
Number of Companies 9 Median: (4.0%) 1.7% Total $38,231 $40,374 $10,042 $10,709 2.4x 12.3x 2.3x 11.7x
Market Cap. Weighted Average: (5.2%) 5.4% 5.0x 20.3x 4.6x 17.2x
Total Ent. Value (TEV)
Latest Twelve Months (LTM) LTM Period Latest FYE Date Company Name Equity Mkt.
Value Total Debt Cash and Equiv.
Forward Twelve Month
Estimate TEV/ LTM Multiples TEV/ Fwd Multiples
P
UBLIC
C
OMPARABLES
7
Payor, Provider, & Pharmacy Support Services
As of October 30, 2015.
(1) To be acquired by Anthem (NYSE:ANTM) in a $54.2 billion transaction announced July 24, 2015. (2) To be acquired by Centene (NYSE:CNC) in a $6.3 billion transaction announced July 2, 2015.
PAGE |
P
UBLIC
C
OMPARABLES
8
Payor, Provider, & Pharmacy Support Services
As of October 30, 2015.
Stock Price
% Change 52 Week
10/30/2015 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Specialty Managed Care
Assurant Inc. $81.53 8.5% 20.4% $82.58 $59.73 $5,448 $1,222 $1,544 $6,619 $10,400 $374 $236 Sep-15 Dec-14 $8,362 $980 $795 0.6x 17.7x 0.8x 6.8x
CorVel Corporation 33.20 3.4% (3.3%) 39.29 29.27 662 0 25 635 496 63 44 Sep-15 Mar-15 NA NA NA 1.3x 10.0x NA NA
HealthEquity, Inc. 32.71 (2.9%) 61.7% 34.56 16.11 1,872 0 109 1,723 107 29 22 Jul-15 Jan-15 125 38 24 16.1x NM 13.8x NM
Number of Companies 3 Median: 3.4% 20.4% Total $7,981 $8,976 $11,003 $8,487 1.3x 13.9x 7.3x 6.8x
Market Cap. Weighted Average: 5.4% 28.1% 4.3x 16.9x 4.1x 6.8x
Retail Pharmacy
CVS Health Corporation $98.78 (12.5%) 15.5% $113.65 $81.37 $109,646 $27,222 $2,890 $133,863 $149,199 $11,186 $9,187 Sep-15 Dec-14 $152,886 $980 NA 0.9x 12.0x 0.9x NM
Walgreens Boots Alliance, Inc. 84.68 (12.3%) 34.5% 97.30 63.47 92,199 14,383 3,000 103,985 103,444 6,872 5,308 Aug-15 Aug-15 120,150 8,870 7,312 1.0x 15.1x 0.9x 11.7x
Rite Aid Corporation 7.88 (12.1%) 52.1% 9.47 5.17 8,244 7,444 153 15,536 27,853 1,301 852 Aug-15 Feb-15 30,932 1,408 847 0.6x 11.9x 0.5x 11.0x
Number of Companies 3 Median: (12.3%) 34.5% Total $210,089 $253,384 $280,496 $303,967 0.9x 12.0x 0.9x 11.4x
Market Cap. Weighted Average: (12.4%) 25.6% 1.1x 13.5x 1.0x 11.4x
Specialty Pharmacy
Diplomat Pharmacy, Inc. $28.11 (38.4%) 30.1% $52.33 $15.45 $1,789 $140 $16 $1,967 $2,992 $65 $44 Sep-15 Dec-14 $2,796 $46 $71 0.7x 30.4x 0.7x NM
Number of Companies 1 Median: (38.4%) 30.1% Total $1,789 $1,967 $2,992 $2,796 0.7x 30.4x 0.7x NM
Market Cap. Weighted Average: (38.4%) NM 0.7x 30.4x 0.7x NM
Specialty Pharmacy Management
Express Scripts Holding Company $86.38 (4.3%) 14.4% $94.61 $68.06 $58,417 $15,687 $438 $73,673 $101,889 $6,928 $4,849 Sep-15 Dec-14 $102,123 $7,078 $6,636 0.7x 10.6x 0.7x 10.4x
PharMerica Corporation 28.57 (15.5%) 3.3% 36.96 19.42 869 337 40 1,198 2,031 134 83 Sep-15 Dec-14 2,000 139 89 0.6x 9.0x 0.6x 8.6x
Number of Companies 2 Median: (9.9%) 8.8% Total $59,286 $74,871 $103,920 $104,123 0.7x 9.8x 0.7x 9.5x
Market Cap. Weighted Average: (4.5%) 14.2% 0.7x 10.6x 0.7x 10.4x
Total Ent. Value (TEV)
Latest Twelve Months (LTM) LTM
Period Latest FYE Date
Forward Twelve Month Estimate Company Name
Equity Mkt.
Value Total Debt Cash and Equiv.
Stock Price
% Change 52 Week
10/30/2015 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Dental Products
3M Company $157.21 3.7% 3.4% $170.50 $134.00 $96,796 $11,253 $2,983 $106,329 $30,695 $8,496 $7,108 Sep-15 Dec-14 $30,378 $8,405 $7,034 3.5x 12.5x 3.5x 12.7x
DENTSPLY International Inc. 60.85 8.5% 21.5% 61.87 49.42 8,511 1,157 96 9,432 2,722 567 443 Sep-15 Dec-14 2,695 614 522 3.5x 16.6x 3.5x 15.4x
Sirona Dental Systems Inc.(1) 109.13 6.2% 38.9% 111.24 77.46 6,100 80 423 5,760 1,146 307 244 Jun-15 Sep-14 1,150 340 293 5.0x 18.8x 5.0x 16.9x
Number of Companies 3 Median: 6.2% 21.5% Total $111,407 $121,522 $34,564 $34,224 3.5x 16.6x 3.5x 15.4x
Market Cap. Weighted Average: 4.2% 6.7% 3.5x 13.2x 3.6x 13.1x
Durable Medical Equipment
Hill-Rom Holdings, Inc. $52.69 (4.8%) 19.2% $58.73 $42.54 $2,989 $2,233 $123 $3,453 $1,988 $243 $124 Sep-15 Sep-15 $2,670 $489 $376 1.7x 14.2x 1.3x 7.1x
Invacare Corporation 17.28 0.5% 10.1% 23.59 14.00 562 48 23 576 1,177 11 (10) Sep-15 Dec-14 1,146 15 (11) 0.5x NM 0.5x NM
ResMed Inc. 57.61 2.7% 10.6% 75.33 48.99 8,045 501 717 7,724 1,710 485 413 Sep-15 Jun-15 1,781 521 449 4.5x 15.9x 4.3x 14.8x
Number of Companies 3 Median: 0.5% 10.6% Total $11,596 $11,753 $4,876 $5,596 1.7x 15.1x 1.3x 10.9x
Market Cap. Weighted Average: 0.6% 12.8% 3.6x 15.5x 3.4x 12.7x
Life Sciences Tools
Agilent Technologies Inc. $37.76 (7.8%) (30.5%) $55.41 $33.12 $12,514 $1,655 $2,075 $12,097 $6,979 $1,198 $912 Jul-15 Oct-14 $4,040 $844 $753 1.7x 10.1x 3.0x 14.3x
Becton, Dickinson and Company 142.52 (6.2%) 11.8% 154.98 125.35 29,965 13,171 1,559 41,539 10,282 2,268 1,500 Sep-15 Sep-15 12,741 3,558 2,822 4.0x 18.3x 3.3x 11.7x
Thermo Fisher Scientific, Inc. 130.78 (6.0%) 12.2% 141.25 14.00 52,194 13,321 768 65,012 16,806 4,061 2,384 Sep-15 Dec-14 16,870 4,179 3,814 3.9x 16.0x 3.9x 15.6x
VWR Corporation 27.51 3.3% 24.1% 28.83 20.60 3,614 2,053 130 5,550 4,308 448 324 Sep-15 Dec-14 4,293 464 374 1.3x 12.4x 1.3x 12.0x
Number of Companies 4 Median: (6.1%) 12.0% Total $98,287 $124,198 $38,375 $37,944 2.8x 14.2x 3.1x 13.1x
Market Cap. Weighted Average: (6.0%) 7.1% 3.6x 15.8x 3.5x 14.1x
Medical Devices and Products
Abbott Laboratories $44.80 (11.8%) 3.0% $51.74 $39.00 $66,772 $8,355 $4,048 $64,491 $20,573 $4,716 $3,288 Sep-15 Dec-14 $20,563 $4,910 $4,038 3.1x 13.7x 3.1x 13.1x
Baxter International Inc. 37.39 (6.5%) (46.6%) 75.29 32.18 20,398 6,729 6,680 27,981 16,106 4,144 3,138 Sep-15 Dec-14 9,904 1,526 865 1.7x 6.8x 2.8x 18.3x
Boston Scientific Corporation 18.28 6.0% 38.7% 18.62 12.56 24,568 5,859 903 30,077 7,314 1,799 1,047 Sep-15 Dec-14 7,496 2,021 1,235 4.1x 16.7x 4.0x 14.9x
ConforMIS, Inc. 19.57 (12.3%) NM 26.93 13.33 796 1 14 792 61 (51) (53) Sep-15 Dec-14 65 (52) (55) 13.0x NM 12.2x NM
CR Bard Inc. 186.35 (3.5%) 15.8% 202.47 161.79 13,769 1,410 1,098 14,175 3,412 1,038 857 Sep-15 Dec-14 3,416 1,026 863 4.2x 13.7x 4.2x 13.8x
Danaher Corp. 93.31 1.6% 17.1% 94.61 79.65 63,944 15,012 3,342 77,194 20,662 4,665 3,655 Oct-15 Dec-14 20,826 4,708 3,651 3.7x 16.5x 3.7x 16.4x
Hanger, Inc. 14.42 (32.0%) (38.7%) 26.79 13.27 495 540 5 1,030 1,061 159 119 Jun-14 Dec-13 1,072 163 116 1.0x 6.5x 1.0x 6.3x
Hologic Inc. 38.86 (4.6%) 49.9% 43.00 25.26 10,951 3,640 885 14,007 2,705 976 484 Sep-15 Sep-15 2,843 1,083 970 5.2x 14.4x 4.9x 12.9x
Johnson & Johnson 101.03 1.2% (5.6%) 109.49 81.79 279,544 19,935 0 262,173 70,517 22,554 18,850 Sep-15 Dec-14 70,199 23,058 19,575 3.7x 11.6x 3.7x 11.4x
K2M Group Holdings, Inc. 18.25 (18.7%) 16.9% 26.29 15.21 754 0 29 726 209 (13) (37) Sep-15 Dec-14 216 0 (33) 3.5x NM 3.4x NM
Medtronic plc 73.92 (5.6%) 9.6% 79.50 55.54 104,494 35,600 2,979 122,107 23,127 7,024 5,232 Jul-15 Apr-15 28,939 10,019 8,351 5.3x 17.4x 4.2x 12.2x
Penumbra, Inc. 37.03 0.0% NM 43.06 38.59 1,112 0 37 1,187 167 4 3 Sep-15 Dec-14 168 (6) (9) 7.1x NM 7.1x NM
Stryker Corporation 95.62 (6.1%) 9.9% 105.34 86.74 35,953 3,490 3,626 36,069 9,849 2,644 2,259 Sep-15 Dec-14 9,944 2,645 2,480 3.7x 13.6x 3.6x 13.6x
Teleflex Incorporated 133.00 (0.3%) 17.8% 140.50 107.45 5,533 1,063 325 6,321 1,788 404 305 Sep-15 Dec-14 1,806 463 392 3.5x 15.7x 3.5x 13.7x
Zemach Hammerman Ltd. 2.56 (0.8%) 16.4% 10.44 8.20 181 293 29 381 190 3 1 Jun-15 Dec-14 NA NA NA 2.0x NM NA NA
Number of Companies 15 Median: (4.6%) 15.8% Total $629,265 $658,711 $177,741 $177,456 3.7x 13.7x 3.7x 13.6x
Market Cap. Weighted Average: (2.0%) 3.1% 3.9x 13.6x 3.8x 12.8x
Medical / Surgical / Dental Supplies & Distribution
AmerisourceBergen Corporation $96.51 (7.6%) 13.8% $120.68 $84.77 $20,866 $3,493 $2,555 $22,191 $135,962 $1,611 $1,368 Sep-15 Sep-15 $148,010 $2,414 $2,216 0.2x 13.8x 0.1x 9.2x
Cardinal Health, Inc. 82.20 (1.4%) 5.1% 91.91 74.76 27,031 5,550 4,616 27,908 106,516 2,842 2,362 Sep-15 Jun-15 115,249 3,174 2,871 0.3x 9.8x 0.2x 8.8x
Henry Schein, Inc. 151.71 3.4% 26.2% 152.54 119.37 12,652 798 47 13,911 10,481 917 759 Sep-15 Dec-14 10,625 925 767 1.3x 15.2x 1.3x 15.0x
McKesson Corporation 178.80 (17.7%) (12.1%) 243.61 160.10 41,144 9,388 5,635 46,668 187,716 4,213 3,323 Sep-15 Mar-15 192,333 5,249 4,715 0.2x 11.1x 0.2x 8.9x
Owens & Minor Inc. 35.85 2.3% 8.5% 36.44 31.89 2,254 574 201 2,703 9,777 270 223 Sep-15 Dec-14 9,806 280 217 0.3x 10.0x 0.3x 9.6x
Patterson Companies, Inc. 47.40 (4.8%) 11.2% 53.07 42.62 4,776 1,726 186 6,266 4,579 440 384 Aug-15 Apr-15 5,434 470 414 1.4x 14.2x 1.2x 13.3x
Number of Companies 6 Median: (3.1%) 9.8% Total $108,723 $119,647 $455,030 $481,457 0.3x 12.4x 0.3x 9.4x
Market Cap. Weighted Average: (8.3%) 3.0% 0.4x 11.9x 0.4x 9.9x
TEV/ LTM Multiples TEV/ Fwd Multiples Cash and Equiv. Company Name Equity Mkt. Value Total Debt Total Ent. Value (TEV)
Latest Twelve Months (LTM) LTM
Period Latest FYE Date
Forward Twelve Month Estimate
P
UBLIC
C
OMPARABLES
Products & Devices
As of October 30, 2015.
PAGE |
Stock Price
% Change 52 Week
10/30/2015 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Acute-Care Hospitals
Community Health Systems, Inc. $28.04 (52.8%) (47.2%) $65.00 $25.36 $3,313 $16,989 $365 $20,492 $19,557 $2,806 $1,668 Sep-15 Dec-14 $19,629 $2,959 $1,746 1.0x 7.3x 1.0x 6.9x
HCA Holdings, Inc. 68.79 (26.0%) (0.9%) 95.49 43.91 28,043 29,905 673 58,791 39,065 7,691 5,808 Sep-15 Dec-14 39,559 7,770 5,822 1.5x 7.6x 1.5x 7.6x
LifePoint Health, Inc. 68.88 (19.9%) (0.1%) 88.18 58.61 2,998 2,206 423 5,035 5,107 650 372 Sep-15 Dec-14 5,212 708 417 1.0x 7.7x 1.0x 7.1x
Tenet Healthcare Corp. 31.37 (44.6%) (43.4%) 60.93 26.62 3,123 14,754 299 19,384 18,085 2,270 1,441 Sep-15 Dec-14 19,639 2,287 1,402 1.1x 8.5x 1.0x 8.5x
Number of Companies 4 Median: (35.3%) (22.1%) Total $37,478 $103,703 $81,814 $84,040 1.1x 7.7x 1.0x 7.3x
Market Cap. Weighted Average: (29.4%) (8.5%) 1.4x 7.7x 1.4x 7.5x
Assisted Living
Brookdale Senior Living Inc. $20.91 (36.1%) (36.8%) $39.89 $20.27 $3,858 $6,485 $78 $10,256 $4,240 $809 ($7) Sep-15 Dec-14 $4,996 $863 $78 2.4x 12.7x 2.1x 11.9x
Capital Senior Living Corp. 22.62 2.7% 2.8% 27.75 19.20 667 752 39 1,352 404 71 19 Sep-15 Dec-14 410 82 18 3.3x 18.9x 3.3x 16.5x
Five Star Quality Care Inc. 3.27 (28.1%) (19.1%) 5.07 2.74 160 79 22 203 1,118 20 (15) Sep-15 Dec-14 1,369 34 2 0.2x 10.4x 0.1x 6.0x
Number of Companies 3 Median: (28.1%) (19.1%) Total $4,686 $11,811 $5,762 $6,775 2.4x 12.7x 2.1x 11.9x
Market Cap. Weighted Average: (30.3%) (30.5%) 2.5x 13.5x 2.2x 12.3x
Long-Term Care
Kindred Healthcare Inc. $13.40 (34.0%) (36.9%) $24.66 $12.18 $1,124 $3,165 $120 $4,353 $6,539 $508 $353 Sep-15 Dec-14 $7,197 $625 $471 0.7x 8.6x 0.6x 7.0x
National Healthcare Corp. 65.28 4.6% 7.8% 66.50 58.57 930 44 72 956 899 106 69 Sep-15 Dec-14 NA NA NA 1.1x 9.0x NA NA
The Ensign Group, Inc. 42.16 (16.5%) 11.3% 54.08 37.67 1,078 70 51 1,071 1,246 105 80 Sep-15 Dec-14 1,294 134 108 0.9x 10.2x 0.8x 8.0x
Number of Companies 3 Median: (16.5%) 7.8% Total $3,132 $6,379 $8,683 $8,491 0.9x 9.0x 0.7x 7.5x
Market Cap. Weighted Average: (16.5%) (7.0%) 0.9x 9.3x 0.7x 7.5x
Diagnostic Imaging
Alliance Healthcare Services, Inc. $8.46 (38.6%) (66.3%) $25.83 $7.58 $90 $552 $43 $669 $458 $116 $59 Sep-15 Dec-14 NA NA NA 1.5x 5.8x NA NA
RadNet, Inc. 6.61 0.8% (28.2%) 10.35 5.19 304 646 5 947 779 102 44 Sep-15 Dec-14 774 126 49 1.2x 9.3x 1.2x 7.5x
Varian Medical Systems, Inc. 78.53 (8.7%) (6.5%) 96.67 71.07 7,752 496 951 7,417 3,099 616 549 Oct-15 Oct-15 3,219 668 584 2.4x 12.0x 2.3x 11.1x
Number of Companies 3 Median: (8.7%) (28.2%) Total $8,146 $9,034 $4,337 $3,992 1.5x 9.3x 1.8x 9.3x
Market Cap. Weighted Average: (8.7%) (8.0%) 2.3x 11.9x 2.3x 11.0x
Dialysis Services
DaVita HealthCare Partners Inc. $77.51 (1.4%) (0.1%) $85.17 $70.12 $16,703 $9,198 $934 $25,102 $13,565 $2,486 $1,858 Sep-15 Dec-14 $13,701 $2,518 $1,936 1.9x 10.1x 1.8x 10.0x
Fresenius Medical Care AG & Co. KGAA 81.97 9.0% 41.4% 82.38 56.48 24,988 9,097 582 33,992 17,125 3,025 2,303 Sep-15 Dec-14 16,875 3,129 2,393 2.0x 11.2x 2.0x 10.9x
Number of Companies 2 Median: 3.8% 20.6% Total $41,691 $59,094 $30,690 $30,575 1.9x 10.7x 1.9x 10.4x
Market Cap. Weighted Average: 4.8% 24.7% 1.9x 10.8x 1.9x 10.5x
Home Care, Hospice, and Home Infusion Home Care / Hospice:
Addus HomeCare Corporation $24.98 (5.5%) 29.4% $38.08 $19.51 $276 $3 $42 $237 $335 $24 $19 Sep-15 Dec-14 $338 $26 $21 0.7x 9.9x 0.7x 9.0x
Almost Family Inc. 41.38 3.5% 43.9% 50.48 26.25 406 92 6 450 512 37 34 Oct-15 Dec-14 535 40 35 0.9x 12.0x 0.8x 11.1x
Amedisys Inc. 39.58 (7.4%) 56.6% 48.34 24.62 1,332 100 33 1,396 1,230 89 67 Sep-15 Dec-14 1,241 110 82 1.1x 15.7x 1.1x 12.6x
Chemed Corp. 157.29 7.1% 48.3% 158.48 100.49 2,655 138 33 2,755 1,524 218 190 Sep-15 Dec-14 1,537 230 189 1.8x 12.7x 1.8x 12.0x
LHC Group, Inc. 45.07 16.8% 85.3% 51.83 22.37 809 93 18 847 772 78 66 Sep-15 Dec-14 792 72 63 1.1x 10.9x 1.1x 11.8x
Number of Companies 5 Median: 3.5% 48.3% Total $5,479 $5,685 $4,373 $4,443 1.1x 12.0x 1.1x 11.8x
Market Cap. Weighted Average: 4.1% 54.5% 1.4x 12.9x 1.4x 11.9x
Home Infusion:
BioScrip, Inc. $1.97 (18.9%) (68.4%) $7.01 $1.30 $135 $449 $1 $611 $1,040 ($30) ($50) Sep-15 Dec-14 $983 $20 ($265) 0.6x NM 0.6x 29.8x
Number of Companies 1 Median: (18.9%) (68.4%) Total $135 $611 $1,040 $983 0.6x NM 0.6x 29.8x
Market Cap. Weighted Average: (18.9%) (68.4%) 0.6x NM 0.6x 29.8x
TEV/ Fwd Multiples TEV/ LTM Multiples
Company Name
Equity Mkt.
Value Total Debt Cash and
Equiv. Total Ent.
Value (TEV)
Latest Twelve Months
(LTM) PeriodLTM FYE DateLatest
Forward Twelve Month Estimate
P
UBLIC
C
OMPARABLES
10
Provider-Based Services
P
UBLIC
C
OMPARABLES
Provider-Based Services
As of October 30, 2015.
(1)
To be acquired by TeamHealth (NYSE:TMH) in a $1.6 billion transaction announced August 4, 2015.
Stock Price
% Change 52 Week
10/30/2015 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Physician Practice Management Multispecialty / Primary Care:
IPC Healthcare, Inc.(1) $78.50 46.6% 88.5% $80.23 $37.68 $1,370 $130 $12 $1,498 $729 $67 $61 Sep-15 Dec-14 $746 $66 $57 2.1x 22.5x 2.0x 22.9x
Number of Companies 1 Median: 46.6% 88.5% Total $1,370 $1,498 $729 $746 2.1x 22.5x 2.0x 22.9x
Market Cap. Weighted Average: 46.6% 88.5% 2.1x 22.5x 2.0x 22.9x
Specialty:
MEDNAX, Inc. $70.47 (14.1%) 14.6% $86.09 $61.66 $6,601 $1,362 $65 $7,895 $2,689 $608 $548 Sep-15 Dec-14 $2,787 $624 $561 2.9x 13.0x 2.8x 12.6x
Number of Companies 1 Median: (14.1%) 14.6% Total $6,601 $7,895 $2,689 $2,787 2.9x 13.0x 2.8x 12.6x
Market Cap. Weighted Average: (14.1%) 14.6% 2.9x 13.0x 2.8x 12.6x
Behavioral Health / Management
AAC Holdings, Inc. $23.20 (38.1%) 9.4% $46.60 $15.09 $520 $122 $45 $631 $175 $32 $26 Sep-15 Dec-14 $211 $43 $24 3.6x 19.5x 3.0x 14.7x
Acadia Healthcare Company, Inc. 61.41 (22.3%) 3.9% 85.62 54.41 4,399 2,134 35 6,318 1,594 342 286 Sep-15 Dec-14 1,771 399 319 4.0x 18.5x 3.6x 15.8x
Civitas Solutions, Inc. 25.73 15.4% 62.2% 27.85 14.08 954 652 17 1,587 1,343 143 72 Jun-15 Sep-14 1,364 152 65 1.2x 11.1x 1.2x 10.4x
Magellan Health, Inc. 53.40 (11.8%) (11.1%) 73.00 45.40 1,333 262 168 1,406 4,311 208 149 Sep-15 Dec-14 4,545 196 70 0.3x 6.8x 0.3x 7.2x
Providence Service Corp. 51.65 13.3% 18.6% 55.99 34.03 829 482 145 1,250 1,984 112 56 Sep-15 Dec-14 2,010 113 56 0.6x 11.2x 0.6x 11.1x
Universal Health Services Inc. 122.09 (13.7%) 18.9% 148.57 95.63 12,090 3,098 42 15,456 8,765 1,654 1,260 Sep-15 Dec-14 9,656 1,655 1,288 1.8x 9.3x 1.6x 9.3x
Number of Companies 6 Median: (12.7%) 14.0% Total $20,125 $26,648 $18,172 $19,557 1.5x 11.2x 1.4x 10.7x
Market Cap. Weighted Average: (13.6%) 15.5% 2.1x 11.6x 1.9x 10.9x
Surgicenters / Rehabilitation Surgery Centers(2):
AmSurg Corp. $70.09 1.2% 32.1% $87.42 $48.49 $3,395 $2,250 $126 $5,701 $2,444 $340 $294 Sep-15 Dec-14 $2,530 $483 NA 2.3x 16.8x 2.3x 11.8x
Surgical Care Affiliates, Inc. 29.61 (21.0%) (2.8%) 40.99 27.88 1,169 809 78 1,880 976 146 96 Sep-15 Dec-14 1,016 173 NA 1.9x 12.9x 1.9x 10.9x
Number of Companies 2 Median: (9.9%) 14.7% Total $4,564 $7,581 $3,420 $3,547 2.1x 14.8x 2.1x 11.3x
Market Cap. Weighted Average: (4.5%) 23.2% 2.2x 15.8x 2.1x 11.6x
Rehabilitation:
HEALTHSOUTH Corp. $34.83 (22.8%) (12.1%) $48.37 $33.00 $3,185 $2,824 $46 $5,481 $2,857 $653 $527 Sep-15 Dec-14 $3,117 $682 $549 1.9x 8.4x 1.8x 8.0x
Select Medical Holdings Corporation 11.30 (22.9%) (13.7%) 17.20 10.07 1,482 2,375 25 4,140 3,420 363 275 Sep-15 Dec-14 3,711 400 298 1.2x 11.4x 1.1x 10.4x
US Physical Therapy Inc. 49.06 (6.0%) 14.2% 56.37 37.44 609 49 13 677 320 54 46 Sep-15 Dec-14 329 49 48 2.1x 12.6x 2.1x 13.7x
Number of Companies 3 Median: (22.8%) (12.1%) Total $5,277 $10,298 $6,597 $7,157 1.9x 11.4x 1.8x 10.4x
Market Cap. Weighted Average: (20.9%) (9.5%) 1.7x 9.7x 1.6x 9.3x
Company Name
Equity Mkt.
Value Total Debt Cash and Equiv. Total Ent.
Value (TEV)
Latest Twelve Months (LTM) LTM
Period Latest FYE Date
Forward Twelve Month
PAGE |
M&A T
RANSACTIONS
12
Announced U.S. Healthcare & Life Sciences M&A
Enterprise Enterprise Value / LTM Private Equity
Announced Target Seller Buyer Value ($mm) Sales EBITDA EBIT Involvement
hoh18.7510/30/2015 A Senior Living Community in Virginia - Capital Senior Living Corp. (NYSE:CSU) $38.0 - - - No 10/30/2015 PDI, Inc., Commercial Services Business PDI, Inc. (NasdaqGM:PDII) Publicis Touchpoint Solutions, Inc. $32.6 271.4x - 105.1x No
10/30/2015 HealthFusion, Inc. BNY Mellon-Alcentra Mezzanine
Partners
Quality Systems Inc. (NasdaqGS:QSII) $190.0 - - - Yes
10/29/2015 Blue Belt Technologies, Inc. - Smith & Nephew plc (LSE:SN.) $275.0 - - - No
10/29/2015 Wheaton Franciscan Services, Inc., Southeast Wisconsin operations and related Corporate Services
Wheaton Franciscan Services, Inc. Ascension - - - - No
10/29/2015 Consultants in Laboratory Medicine of Greater Toledo, Inc.
- Aurora Diagnostics Holdings, LLC - - - - No
10/29/2015 Aesynt Incorporated Francisco Partners Management LLC Omnicell, Inc. (NasdaqGS:OMCL) $275.0 1.5x 13.8x - No
10/28/2015 CKS Productions, Inc. - Kinnser Software, Inc. - - - - No
10/28/2015 Embassy Dental Professionals, P.C. - Marquee Dental Partners, LLC - - - - No
10/28/2015 Pacific Cancer Institute - Alliance Oncology, LLC - - - - No
10/28/2015 Peace Inc. - Grace Harbor Group - - - - Yes
10/28/2015 Abbeville County Memorial Center, Home Medical Equipment Business
Abbeville Area Medical Center Aeroflow Inc. - - - - No
10/27/2015 Nipro Diagnostics, Inc. Nipro Corporation (TSE:8086) Sinocare Inc. (SZSE:300298) $272.5 - - - No
10/27/2015 Neurowave Monitoring, Inc. - BNN Holdings Corp. - - - - No
10/26/2015 CAS Medical Systems, 740 SELECT Product Line CAS Medical Systems Inc. (NasdaqCM:CASM)
Zoe Medical, Incorporated $0.9 - - - No
10/26/2015 Perseon Corporation (NasdaqCM:PRSN) Heights Capital Management, Inc.; Empery Asset Management, LP; Sabby Management, LLC
Galil Medical Inc. $6.8 3.1x - - Yes
10/26/2015 Intersection Medical, Inc., Key Assets and Intellectual Property
Intersection Medical, Inc. ImpediMed Limited (ASX:IPD) - - - - No
10/26/2015 Mach7 Technologies, Inc. - 3D Medical Limited (ASX:3DM) $26.0 - - - No
10/26/2015 VBI Vaccines Inc (NasdaqCM:VBIV) Arch Venture Partners, L.P.; Perceptive Advisors LLC; 5AM Venture Management LLC; Sandor Advisors, LLC; Clarus Ventures, LLC; RTW Investments, LLC; The Del Mar Consulting Group, Inc. Retirement Plan Trust
SciVac Therapeutics Inc. (TSX:VAC) $83.0 - - - No
10/26/2015 Atlas Medical Software Atlas Development Corporation Roper Technologies, Inc. (NYSE:ROP) $48.0 - - - No
10/26/2015 TriVascular Technologies, Inc. (NasdaqGS:TRIV) Delphi Ventures; MPM Capital; New Enterprise Associates; Permal Group LLC; Kaiser Permanente Ventures; Greenspring Associates, Inc.; Deerfield Management Company, L.P.; Pinnacle Ventures, L.L.C; Kearny Venture Partners; Redmile Group, LLC; FMR Co., Inc.; Epidarex Capital; Rock Springs Capital
Endologix Inc. (NasdaqGS:ELGX) - - - - Yes
10/26/2015 Fremont Emergency Services and Advanced Care Emergency Services and Advanced Care Emergency
- Team Health Holdings, Inc. (NYSE:TMH) - - - - No
10/23/2015 Animal Trustees of Austin, Inc. - Emancipet, Inc. - - - - No
10/23/2015 Advanced Foot Care Centers, LLP - Extremity Healthcare, Inc. - - - - No
10/22/2015 Hospital Medicine Consultants, LLC - IPC Healthcare, Inc. (NasdaqGS:IPCM) - - - - No
10/22/2015 Radiology Associates, Inc. - Rhode Island Medical Imaging, Inc. - - - - No
10/22/2015 NextGen Healthcare Information Systems, Hospital Solutions Division
NextGen Healthcare Information Systems, LLC
QuadraMed Affinity Corporation - - - - No
10/22/2015 Orthopaedicare Ventures, LLC - The Rothman Institute - - - - No
10/22/2015 NovaRx Corporation - Viropro Inc. (OTCPK:VPRO) - - - - No
10/21/2015 Vree Health, LLC Merck Sharp & Dohme Corp. PatientSafe Solutions, Inc. - - - - No
10/21/2015 Eating Recovery Center, The Carolinas - Eating Recovery Center LLC - - - - No
10/20/2015 Talyst Systems, LLC Talyst, Inc. Columbia Pacific Advisors, LLC - - - - No
10/20/2015 McGuire Group Pharmacy, Inc. - PharMerica Corporation (NYSE:PMC) - - - - No
10/20/2015 Xtend Healthcare LLC WestView Capital Partners;
Brentwood Capital Advisors LLC, Investment Arm
Navient Corporation (NasdaqGS:NAVI) - - - - Yes
10/20/2015 River Valley Health Partners - Prime Healthcare Services, Inc. - - - - No
10/20/2015 Cervel Neurotech, Inc., Multi-Coil Transcranial Magnetic Stimulation Technology And Related Patents
Cervel Neurotech, Inc. Rio Grande Neurosciences Inc. - - - - No
10/19/2015 MP Biomedicals, LLC - Valiant Co., Ltd. (SZSE:002643) $142.5 0.4x - 2.9x No
10/19/2015 Mediscan, LLC. And Mediscan Diagnostic Services, LLC And Mediscan Nursing Staffing, LLC
- Cross Country Healthcare, Inc.
(NasdaqGS:CCRN)
$40.3 1.3x - - No
M&A T
RANSACTIONS
Announced U.S. Healthcare & Life Sciences M&A cont.
Enterprise Enterprise Value / LTM Private Equity
Announced Target Seller Buyer Value ($mm) Sales EBITDA EBIT Involvement
10/16/2015 Admune Therapeutics LLC - Novartis International AG $140.0 - - - No
10/16/2015 Bartow HMA, LLC Health Management Associates Inc. BayCare Health System, Inc. - - - - No
10/16/2015 Reconceived, LLC - Vivere Health, LLC - - - - No
10/16/2015 Dirigo Pines Retirement Community, LLC Affiliated Healthcare Systems, Inc.; Rosscare, Inc.
CPF Senior Living Acquisitions LLC - - - - No
10/15/2015 Diagnostic Imaging Group, LLC New Primecare Llc; Mid Flushing Medical Arts Building, Inc.
Mid Rockland Imaging Partners, Inc. $65.4 - - - No
10/15/2015 Shippert Enterprises, Ltd. - SCP Medical Products, LLC - - - - No
10/15/2015 Northstar Psychological Services, Inc. - South Bay Mental Health Center, Inc. - - - - No
10/15/2015 MedMark Services, Inc. - Addiction Research and Treatment, Inc. - - - - No
10/14/2015 B&H Consulting Services, Inc. - Voisin Consulting SARL - - - - No
10/14/2015 Medicom Technologies, Inc. - Concert Care Healthcare Solutions - - - - No
10/13/2015 Thermomedics, Inc. Sanomedics, Inc. (OTCPK:SIMH.D) PositiveID Corporation (OTCPK:PSID) - - - - No
10/13/2015 Project Rendezvous Holding Corporation Platinum Equity, LLC Digirad Corporation (NasdaqGM:DRAD) $36.0 - - - Yes
10/13/2015 DNA Diagnostics Center, Inc. MTS Health Investors, LLC GHO Capital Partners LLP $118.4 - - - Yes
10/13/2015 Global Laser Vision San Diego Lasik Center - Vision Group Holdings, LLC - - - - No
10/12/2015 Team Health Holdings, Inc. (NYSE:TMH) The Blackstone Group, Private Equity Group; Pennant Capital Management, LLC; Maverick Capital, Ltd.
AmSurg Corp. (NasdaqGS:AMSG) $5,917.5 1.7x 17.5x 25.5x Yes
10/12/2015 Crozer-Keystone Health System Inc. - Prospect Medical Holdings, Inc. - - - - No
10/9/2015 Adheron Therapeutics, Inc. HealthCare Ventures LLC; SR One; MedImmune Ventures, Inc.; Amgen Ventures
Roche Holding AG (SWX:ROG) $580.0 - - - No
10/9/2015 Optics Plus, Inc. - HOYA Vision Care, North America, Inc. - - - - No
10/9/2015 BluePearl Veterinary Partners LLC - Mars Petcare US, Inc. - - - - No
10/8/2015 Immunomic Therapeutics, Inc., Worldwide License to LAMP-vax Products
Immunomic Therapeutics, Inc. Astellas Pharma, Inc. (TSE:4503) $300.0 - - - No
10/8/2015 Lone Star Dermatology - Dermatology Associates of Central
Texas
- - - - No
10/8/2015 Start Fresh Private Management, Inc. - MyLife Recovery Centers, Inc. - - - - No
10/8/2015 Rocky Mountain Artificial Limb and Brace, Inc. - BCP Group - - - - No
10/7/2015 Healthcare Revenue Strategies, LLC - RevSpring, Inc. - - - - No
10/7/2015 Bradley & Monson Physical Therapy, LLP - MOTION PT Holdings, Inc. - - - - No
10/7/2015 South Kingston Internal Medicine - Swedish Health Services, Inc. - - - - No
10/7/2015 Hospice Advantage, Inc. Sentinel Capital Partners, L.L.C.; Norwest Mezzanine Partners
Hospice Compassus, Inc. - - - - Yes
10/6/2015 Lancaster Regional Hospital, L.P. R&K Healthcare Real Estate, L.L.C. Global Medical REIT, Inc. $20.5 - - - No
10/6/2015 The Hammonds Centre, LLC - Physiotherapy Corporation - - - - No
10/6/2015 Blue Jay Consulting, LLC - Koninklijke Philips N.V (ENXTAM:PHIA) - - - - No
10/6/2015 Benchmark Systems, Inc. - Antworks $5.0 - - - No
10/6/2015 Tech Pharmacy Services, Inc. DFW Capital Partners; Galen Partners Partners Pharmacy, L.L.C. - - - - Yes
10/6/2015 Aria Health System - Jefferson Health System, Inc. - - - - No
10/5/2015 PharMEDium Healthcare Holdings, Inc. Clayton, Dubilier & Rice, Inc. AmerisourceBergen Drug Corporation $3,060.8 7.5x NM 58.1x Yes
10/5/2015 FSC Laboratories, Inc., Primsol Business FSC Laboratories, Inc. Aytu BioScience, Inc. (OTCPK:AYTU) $1.8 - - - No
10/5/2015 For Eyes Optical Company, Inc. - Grandvision B.V. (ENXTAM:GVNV) - - - - No
10/5/2015 Concordia Pharmaceuticals Inc., Three Commercialized Injectable Products
Concordia Pharmaceuticals Inc. Teligent, Inc. (NasdaqGS:TLGT) $11.0 - - - No
10/5/2015 Excelsior Medical Corporation PNC Erieview Capital; RoundTable Healthcare Management, LLC
ICU Medical, Inc. (NasdaqGS:ICUI) $59.5 - - - Yes
10/5/2015 ASAP Urgent Care, Medical Facility in Hamden ASAP Urgent Care, LLC PhysicianOne Urgent Care - - - - No
10/5/2015 Insero Health, Inc. Florida Institute for the
Commercialization of Public Research
Biscayne Pharmaceuticals, Inc. - - - - No
10/5/2015 Nightingale Informatix Corporation, Practice Management Business
Nightingale Informatix Corporation (TSXV:NGH)
Pulse Systems, Inc. $12.8 3.5x - - No
10/5/2015 Lifestages Centers for Women - Premier Health Specialists, Inc. - - - - No
10/5/2015 St. Luke's Cornwall Hospital - Montefiore Health System, Inc. - - - - No
PAGE |
M&A T
RANSACTIONS
14
Announced U.S. Healthcare & Life Sciences M&A cont.
Enterprise Enterprise Value / LTM Private Equity
Announced Target Seller Buyer Value ($mm) Sales EBITDA EBIT Involvement
10/4/2015 nContact, Inc. Hercules Technology Growth Capital,
Inc. (NYSE:HTGC); Harbert Venture Partners, LLC
AtriCure, Inc. (NasdaqGM:ATRC) $132.2 - - - No
10/2/2015 Spectra Healthcare Management, Inc., Revenue Cycle Management Business
Spectra Healthcare Management, Inc.
Doctors Administrative Solutions, LLC - - - - No
10/2/2015 Hospital Resources Management LLC - HNI Healthcare - - - - No
10/2/2015 HealthPlus of Michigan, Inc. - Health Alliance Plan of Michigan, Inc. - - - - No
10/1/2015 Global Medical Imaging, LLC WJ Partners, LLC Jordan Industries International, LLC - - - - Yes
10/1/2015 Ocala Hospital Group, PA and Hospitalists of Ocala, LLC and Ocala Geriatric Services
- IPC Healthcare, Inc. (NasdaqGS:IPCM) - - - - No
10/1/2015 Sikka Software Corporation Sierra Ventures; OrbiMed Advisors, L.L.C.; ATA Venture Management, LLC
RingCentral, Inc. (NYSE:RNG) - - - - No
10/1/2015 20/20 Healthcare LLC Prudent Management; 20/20
HealthCare Partners LLC
Konica Minolta Medical Imaging U.S.A., Inc.
- - - - Yes
10/1/2015 Cardea Associates, Inc. - Cardiac Insight, Inc. - - - - No
10/1/2015 Star Ophthalmic Instruments, Inc. - Enhanced Medical Services, LLC - - - - No