In light of the growing investor interest in healthcare and the risks associated with private equity ownership of healthcare companies, the Private Equity Stakeholder Project is tracking private equity-backed healthcare acquisitions. Below is a list of private equity healthcare buyouts, growth investments, and add-on acquisitions completed or announced during April 2023. We will continue to track acquisitions on a monthly basis.
We tracked 34 add-on acquisitions, 4 buyouts, and 11 growth/expansion investments in April, for a total of 49 private equity deals.
Continued expansion in dental care
The dental care sector saw 5 add-on deals in April between three platform companies. Private equity firms operate through dental services organizations (DSOs), which provide non-clinical business services to dental practices (such as billing and marketing). In July 2021, PESP reported how, “Both the DSO and physician practice management industries appear to have been created, largely by private equity firms, to avoid regulation that prohibits investor ownership of clinical practices.”
Critics have also claimed that private equity’s expansion into the dental care sector exacerbates pressure on doctors to increase profits and increased the uncertainty of diminished the doctor/patient relationships for the benefit of private equity investors and their interests.
Smile Doctors made three acquisitions in April, continuing several months of activity by the company. Through mid-April, Smile Doctors had already acquired 21 clinics in 2023. The company operates more than 390 locations in 28 states. Smile Doctors has been private equity-owned since December 2021, when private equity firms Thomas H. Lee Partners and Linden Capital Partners became equal investors in the chain at a $2.4 billion valuation.
Dental add-ons also included Dental Care Alliance’s acquisition of Austell Dental Associates. Dental Care Alliance is owned by Mubadala Investment Company and Harvest Capital Partners. In May 2022, Harvest sold a 50% stake in the company to Abu Dhabi’s Mubadala at a valuation close to $2 billion. In August 2022, Dental Care Alliance paid $3 million to settle a class action lawsuit filed in response to a data breach affecting more than 1.7 million Dental Care Alliance patients.
Private equity-owned Image Specialty Partners bought Castilla Orthodontics in April. Castilla was established in Salem, Oregon, in 2013. Image Specialty Partners is a dental service organization with approximately 30 locations in the western U.S. Private equity firm ONCAP acquired a majority interest in the company in June 2022.
PE continues its incursion into cardiovascular care
Private equity platform companies acquired at least three cardiology companies in April. In February 2023, MedPage Today described private equity’s “new love for cardiology.” The sector is attractive for its size: Heart disease is the leading cause of death in the U.S. and costs more than $200 billion per year in healthcare and lost productivity.
Cardiovascular Associates of America acquired add-on companies Novocardia and the Cardiac and Vascular Institute in April. Cardiovascular Associates is owned by two private equity firms: MedEquity Capital and Webster Equity Partners. Webster established the company as an acquisition platform in December 2021.
Cardiovascular Logistics is another private equity-established cardiology platform. Lee Equity Partners established the company in February 2023. In April, Cardiovascular Logistics acquired First Coast Cardiovascular Institute, a 38-practice provider operating in Florida and Georgia since 2002.
During one session at the 2022 American Medical Association Annual Meeting, an AMA member described private equity’s ownership of physician practices as doing “quite the opposite” what’s desirable: That is, private equity does not encourage building long-term relationships and investments to improve medical practices.
PE buys a correctional healthcare company
One of the few April buyouts was private equity firm Full Guard Capital’s acquisition of Comprehensive Correctional Care. The company provides healthcare services for county correctional facilities in Kentucky. Full Guard Capital also owns IMS Correctional Healthcare, which provides services in North Carolina.
In November 2022, PESP published a report identifying concerns over private equity ownership of correctional healthcare providers, focusing in particular on H.I.G. Capital-owned company Wellpath. The report identified concerns at Wellpath including inadequate access to care, poor intake and screening, and understaffing.
April 2023 Buyouts
|Companies||Company Type||Type 2||PE Firms|
|Comprehensive Correctional Care||Correctional healthcare||Full Guard Capital|
|Cordant Health Solutions||Laboratory services||CVF Capital Partners, DCA Partners|
|Fastest Labs||Laboratory services||Genesis Park, LP First Capital|
|OneOncology||Outpatient care||Oncology||TPG AmerisourceBergen|
April 2023 Add-on Acquisitions
|Companies||Company Type||Type 2||PE Firms/Lenders||Add-on Platform|
|Accelemed Research Institute||Clinical research||Centre Partners||The IMA Group|
|Austell Dental Associates||Outpatient care||dental care||Mubadala Investment Company, Harvest Capital Partners||Dental Care Alliance|
|Capstone Medical||Medtech||medical equipment||Seven Hills Capital||Reliable Medical Supply|
|Castilla Orthodontics||Outpatient care||dental care||ONCAP||Image Specialty Partners|
|Comprehensive A/R Solutions||Health IT||revenue cycle management||HealthEdge Investment Partners||The Corridor Group|
|Crestline Advisors||Healthcare administration||consulting||BPOC||Health Management Associates|
|Devlin Consulting||Health IT||BPEA EQT||Sagility|
|First Coast Cardiovascular Institute||Outpatient care||cardiovascular care||Lee Equity Partners||Cardiovascular Logistics|
|Fitzgerald Industries International||Biotechnology||BroadOak Capital Partners, KKR||Biosynth|
|Greenwood Products||Medtech||laboratory equipment||StoneCalibre||Calibre Scientific|
|Grinz Orthodontics||Outpatient care||dental care||Thomas H. Lee Partners, Linden Capital Partners||Smile Doctors|
|Henneberry Orthodontics||Outpatient care||dental care||Thomas H. Lee Partners, Linden Capital Partners||Smile Doctors|
|Johnson Family Orthodontics||Outpatient care||dental care||Thomas H. Lee Partners, Linden Capital Partners, AlpInvest Partners||Smile Doctors|
|Kidzcare Pediatrics||Outpatient care||pediatrics||Webster Equity Partners||MyTown Health Partners|
|MedStream Anesthesia||Anesthesiology||Archimedes Health Investors, Assured Investment Management||National Partners in Healthcare|
|Novocardia||Outpatient care||cardiovascular care||MedEquity Capital, Webster Equity Partners||Cardiovascular Associates of America|
|Nura Pain Clinics||Outpatient care||pain management||Iron Path Capital||Capitol Pain Institute|
|Otolaryngology Consultants||Outpatient care||ear, nose, and throat||Audax Group||Elevate ENT Partners|
|Ovation Fertility||Outpatient care||fertility treatment||Privately Held (backing)||US Fertility|
|Plaza Medical Centers||Outpatient care||elder care||BPOC, Revelstoke Capital Partners||Claremedica Health Partners|
|Premier ER & Urgent Care||Urgent care||Kingfish Group, Altamont Capital Partners||Intuitive Health|
|Prodigo Solutions||Health IT||Acquired/Merged (Operating Subsidiary)||Global Healthcare Exchange|
|ReachBio Research Labs||Biotechnology||Ares Capital Corporation BDC, Water Street Healthcare Partners||Discovery Life Sciences|
|Rochester Clinical Research||Clinical research||PNC Erieview Capital, BPOC||Atlas Clinical Research|
|Shapiro Aesthetic Plastic Surgery||Cosmetic surgery||Hidden Harbor Capital Partners||Inspire Aesthetics|
|Six Physical Therapy Clinics in the Southeastern U.S.||Outpatient care||physical therapy||Acquired/Merged||APT Healthcare|
|Taos Urgent Care||Urgent care||Enhanced Healthcare Partners||NextCare|
|The Cardiac and Vascular Institute||Outpatient care||cardiovascular care||MedEquity Capital, Webster Equity Partners||Cardiovascular Associates of America|
|The MYND Group||Healthcare marketing||pharmaceutical strategic marketing||Knox Lane||Fingerpaint|
|Ultra Select Medical||Medtech||medical imaging||Avista Capital Partners||Probo Medical|
|Valley Medical Centers||Outpatient care||primary care||MBF Healthcare Partners||Palm Medical Centers|
|Virginia Fertility & IVF||Outpatient care||fertility treatment||InTandem Capital Partners||Ivy Fertility|
|Windsor Dermatology||Outpatient care||dermatology||LLR Partners, SV Health Investors, LNK Partners||Schweiger Dermatology Group|
|Workwell Medical Group||Outpatient care||occupational health||Acquired/Merged (Operating Subsidiary)||Agile Occupational Medicine|
April 2023 Growth/Expansion Investments
|Companies||Company Type||Type 2||PE Firms|
|AllyAlign Health||Managed care||Lorient Capital Management|
|American Vascular Associates||Outpatient care||vascular care||Canopy Capital Partners, Petra Capital Partners|
|Baseline A.I||Behavioral health||HEALTHEON Asia|
|BTST Services||Behavioral health||Webster Equity Partners|
|Heartland Dental Care||Outpatient care||dental care||Align Technology, Kohlberg Kravis Roberts, Ontario Teachers’ Pension Plan|
|Medshift||Medtech||Turning Rock Partners, Micota Capital, OY6 Capital|
|Midwest Express Clinic||Outpatient care||Lorient Capital Management|
|PYRAMID Laboratories||Contract development and manufacturing organization||Drug development||Audax Group|
|Rhapsody (Boston)||Health IT||Undisclosed|
|Stretch Zone||Wellness||Princeton Equity Group|
 Eileen O’Grady. “Deceptive Marketing, Medicaid Fraud, and Unnecessary Root Canals on Babies: Private Equity Drills into the Dental Care Industry.” Private Equity Stakeholder Project, July 2021. https://pestakeholder.org/wp-content/uploads/2021/08/PESP_DSO_July2021.pdf.
 Ariana Portalatin. “Is Private Equity Hurting or Benefiting Dentistry? 10 Dentists Weigh In.” Becker’s Dental + DSO Review, September 9, 2022. https://www.beckersdental.com/dentists/39305-is-private-equity-hurting-or-benefiting-dentistry-10-dentists-weigh-in.html.
 Smile Doctors. “Smile Doctors Marks Q1 2023 with Double-Digit Clinic Growth and Entry into Arizona.” Cision PR Newswire, April 18, 2023. https://www.prnewswire.com/news-releases/smile-doctors-marks-q1-2023-with-double-digit-clinic-growth-and-entry-into-arizona-301799703.html.
 Sarah Pringle. “Scoop: THL Buys into Smile Doctors at $2.4 Billion Valuation.” Axios, December 23, 2021. https://www.axios.com/2021/12/23/thl-investment-kicks-off-smile-doctors-deal.
 Sarah Pringle. “Mubadala Buys Stake in Harvest’s DCA.” Axios, May 12, 2022. https://www.axios.com/pro/health-tech-deals/2022/05/12/harvest-dental-care-alliance-mubadala-dca-continuation-fund.
 HIPAA Journal. “Dental Care Alliance Settles Class Action Data Breach Lawsuit for $3 Million,” August 4, 2022. https://www.hipaajournal.com/dental-care-alliance-settles-class-action-data-breach-lawsuit-for-3-million/.
 ONCAP. “Image Specialty Partners.” Accessed May 12, 2023. https://www.oncap.com/operating-companies/operating-companies/ideal-dental.html.
 Nicole Lou. “Private Equity Has New Love for Cardiology. Should Doctors Take the Deal?” MedPage Today, February 16, 2023. https://www.medpagetoday.com/special-reports/exclusives/103144.
 EIN Presswire. “Cardiovascular Associates of America Expands Reach in Florida with Acquisition of The Cardiac and Vascular Institute.” WHO13 Des Moines, April 27, 2023. https://who13.com/business/press-releases/ein-presswire/630422104/cardiovascular-associates-of-america-expands-reach-in-florida-with-acquisition-of-the-cardiac-and-vascular-institute/.
 MedEquity Capital. “Cardiovascular Associates of America.” Accessed May 12, 2023. https://medequity.com/portfolio/cardiovascular-associates-of-america/.
 Riz Hatton. “6 Cardiovascular Platforms’ Private Equity Partners.” Becker’s ASC Review, April 24, 2023. https://www.beckersasc.com/cardiology/6-cardiovascular-platforms-private-equity-partners.html.
 Healthcare Dive. “Cardiovascular Associates of America Launches with Leading Partner Cardiovascular Medicine of Quad Cities,” December 14, 2021. https://www.healthcaredive.com/press-release/20211213-cardiovascular-associates-of-america-launches-with-leading-partner-cardiov/.
 Iris Dorbian. “Lee Equity Partners and CIS Form New Platform Cardiovascular Logistics.” Content. PE Hub, February 1, 2023. https://www.pehub.com/lee-equity-partners-and-cis-form-new-platform-cardiovascular-logistics/.
 Business Wire. “First Coast Cardiovascular Institute Announces Partnership With Cardiovascular Logistics,” April 24, 2023. https://www.businesswire.com/news/home/20230420005997/en/First-Coast-Cardiovascular-Institute-Announces-Partnership-With-Cardiovascular-Logistics.
 Andis Robeznieks. “Physicians Warned of the Pitfalls behind Private Equity Promises.” American Medical Association, August 1, 2022. https://www.ama-assn.org/practice-management/private-practices/physicians-warned-pitfalls-behind-private-equity-promises.
 Full Guard Capital. “Full Guard Capital Partners with Comprehensive Correctional Care – Full Guard Capital,” April 21, 2023. https://fullguardcapital.com/full-guard-capital-partners-with-comprehensive-correctional-care/, https://fullguardcapital.com/full-guard-capital-partners-with-comprehensive-correctional-care/.
 Full Guard Capital. “Full Guard Capital Partners With IMS Correctional Healthcare,” July 31, 2020. https://fullguardcapital.com/lancer-capital-partners-with-ims-correctional-healthcare/.
 Michael Fenne. “Private Equity Firms Rebrand Prison Healthcare Companies, But Care Issues Continue.” Private Equity Stakeholder Project, November 15, 2022. https://pestakeholder.org/reports/private-equity-firms-rebrand-prison-healthcare-companies-but-care-issues-continue/.