Private Equity Health Care Acquisitions – December 2023
January 11, 2024
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 December 2023. We will continue to track acquisitions on a monthly basis.
See November 2023 acquisitions here.
See all our 2022 acquisitions updates here.
Private equity firms completed or announced 4 buyouts, 28 add-on acquisitions, and 17 growth/expansion investments in the healthcare space in December 2023. This was the second slowest month of 2023 for deal activity, with only 51 total deals (September had the fewest deals recorded, at 45). Although deal activity was down overall, certain subsectors were hotter than others.
Medtech companies, including medical device and equipment manufacturers and distributors, saw the highest proportion of deals at nearly 20 percent, or 10 total deals. Outpatient care and biopharma were tied for the second highest proportion, with 9 deals each.
Lifepoint Health enters a new joint venture with Ascension St. Thomas
On December 1, 2023, Lifepoint Health, a hospital chain owned by Apollo Global Management, announced the formation of a joint venture (JV) with Ascension Saint Thomas to jointly own Highpoint Health System, a regional health system in Tennessee that was previously solely under Lifepoint’s ownership.[1] According to PitchBook, this transaction was financed by private equity firms ATP Private Equity Partners, Apollo Global Management and Pantheon International.[2] Under the JV, LifePoint retains majority ownership of the four hospitals and 15 affiliated clinics.[3]
Lifepoint currently owns more than 120 hospitals around the country[4] and employs over 50,000 workers.[5] Under Apollo’s ownership, some Lifepoint hospitals have faced patient quality issues, safety issues, and service and job cuts.[6]
Because Ascension St. Thomas is a nonprofit Catholic provider, the facilities under the new JV must now provide services in line with Catholic directives, which will impact patient access to various forms of reproductive healthcare, including vasectomies.[7]
Lifepoint uses JVs and other forms of partnerships to grow its business.[8] As of December 2023, LifePoint was party to at least 25 JVs covering at least 49 hospitals.[9] Many of Lifepoint’s JVs are with tax-exempt nonprofit health systems. Such arrangements are permitted under tax law, given that certain criteria around management and control are met.[10][11]
In an environment in which typical health system transaction activity has slowed down, hospital joint venture arrangements are on the rise.[12] Lifepoint’s use of JVs as a business strategy may allow it to expand in lower risk ways and afford it more flexibility than if it was acquiring hospitals and systems outright.
Issues such as poor quality of care and understaffing have been reported at private equity-owned healthcare facilities, including Lifepoint’s.[13] There is growing evidence that these types of problems are directly related to private equity cost-cutting strategies and unwieldy debt loads. Most recently, a study published in JAMA demonstrated that private equity acquisition of hospitals was associated with a statistically significant increase in hospital-acquired conditions, such as falls and central-line associated bloodstream infections.[14]
As an increasing number of private equity firms pivot to JVs as a business strategy in the hospital sector,[15] more research is needed to determine how such business arrangements may impact patient care and access to care.
Private equity expands its footprint in pharmaceuticals
The biopharma sector – which encompasses contract research organizations, drug developers, drug brands, and more, had 9 private equity-backed deals in December 2023. These deals included ADQ’s acquisition of a company that will expand its global reach in drug markets, and Avista Capital Partners and Constitution Capital’s acquisition of a woman’s health drug.
Acino, a Swiss pharmaceutical company owned by private equity firm ADQ, completed an add-on acquisition of M8 Pharmaceuticals on December 4.[16] M8 works with pharmaceutical companies to commercialize drugs in Mexico and Brazil.[17] Acino’s press release claims that “this acquisition provides Acino with access to the two largest pharmaceutical markets in Latin America, significantly expanding its geographic footprint and strengthening its position in the region.”[18]
In another pharmaceuticals-related deal, Cosette Pharmaceuticals, owned by Avista Capital Partners and Constitution Capital Partners,[19] acquired Vyleesi, a drug that treats hypoactive sexual desire in women, from Paladin Technologies.[20] Avista and Constitution Capital were co-investors in Acino[21] before its sale to ADQ.[22]
According to Bain, deals in the biopharma category accounted for 48 percent of the total global value of healthcare deals in 2023. In North America, this category accounted for 25 percent of deal activity and 54 percent of deal value.[23]
December 2023 Buyouts
| Companies | Company type | Secondary type | PE Firm(s) |
| ZimVie (Spine Business) | Medtech | dental and spine implants developer/manufacturer | H.I.G. Capital |
| Doctors of Internal Medicine | Outpatient care | primary care | Greyrock Capital Group, Tygon Peak Capital |
| Carisk Partners | Managed care/Occupational health | risk transfer services | Elements Health Investors, Lee Equity Partners |
| Alpha Source Group | Medtech | manufacturer of medical devices and imaging equipment | Avista Capital Partners, Probo Medical |
| Lone Peak Dental Group | Outpatient care | dental care | BlackRock |
December 2023 Add-on acquisitions
| Companies | Company type | Secondary type | PE Firm(s) | Add-on Platform |
| Cameron Care | Behavioral health | residential treatment | Zamwell Capital | Jackson House |
| Advanced Psychiatric Group | Behavioral health | Five Points Capital, Thurston Group | ARC Psychiatry | |
| Exult Healthcare | Behavioral health | Five Points Capital, Thurston Group | ARC Psychiatry | |
| Lucas Research | Clinical research organization | endocrine diseases research | Trinity Hunt Partners | Centricity Research |
| Suncoast Clinical Research | Contract research organization | clinical research services | BPOC, PNC Erieview Capital | Atlas Clinical Research |
| EcoBrite Linen | Contract services | laundry services for long-term and acute-care facilities | Tuckahoe Holdings | NOVO Health Services |
| ClorDiSys | Decontamination and sterilization services | Aterian Investment Partners | Allentown | |
| Advent Health Partners | Health IT | data management software provider | Lone View Capital | Trend Health Partners |
| Decision Point (US) | Health IT | platform serving health plans | PSG | mPulse Mobile |
| MyACTome | Health IT | smartphone-based fall risk and frailty assessment platform | Audax Private Debt, Linden Capital Partners | HOPCo |
| T3 Labs | Healthcare education and training | medical device training services | Accelmed, Lauxera Capital Partners, Summit Partners | Veranex |
| Affinity Health | Healthcare services/Pharmaceuticals | facilitates access to/enrollment in clinical trials | CFT Capital Partners, Curewell Capital | Alliance for Multispecialty Research |
| Binx (At-home Consumer Testing Business) | Home health testing | McNair Interests, Plug and Play Tech Center, Undeterred Capital | imaware | |
| Highpoint Health Systems | Hospital services | Apollo Global Management, Ascension Saint Thomas, ATP Private Equity Partners, Pantheon International | LifePoint Health | |
| aycan Medical Systems | Medical imaging | Greenpeak Partners | PARATUS Holding | |
| Southtowns Radiology | Medical imaging | Sunny River Management | Rezolut | |
| Seisa Medical | Medtech | contract manufacturing | Genstar Capital | Tekni-Plex |
| Salvin Dental Specialties | Medtech | designer and manufacturer of products used in oral surgery/dentistry | The Jordan Company | Young Innovations |
| Tomtec | Medtech | manufacturer of laboratory instruments | Argosy Healthcare Partners | Hudson Robotics |
| Radiation Protection Services | Medtech | radiation physics consulting services | LNC Partners | West Physics |
| Hospice Source | Medtech/Hospice | medical equipment and respiratory therapy distributor for hospice care providers | New Mountain Capital | National HME |
| Lifecycle Biotechnologies | Pharmaceuticals/Biotech | manufacturer of life science products | PNC Riverarch Capital | TCP Analytical Holdings |
| Internal Medicine Associates of Plano | Outpatient care | primary care | Greyrock Capital Group, Tygon Peak Capital | Doctors of Internal Medicine |
| Urologic Consultants | Outpatient care | urology | Lee Equity Partners | Solaris Health |
| Millburn Laser Center | Outpatient care/Medical aesthetics | dermatology | LLR Partners, LNK Partners, RVM Enterprises Investment Group, SV Health Investors, Zenyth Partners | Schweiger Dermatology Group |
| Scherl Dermatology | Outpatient care/Medical aesthetics | dermatology | LLR Partners, LNK Partners, RVM Enterprises Investment Group, Zenyth Partners | Schweiger Dermatology Group |
| Skin and Cancer Associates | Outpatient care/Medical aesthetics | dermatology | Sterling Partners | Platinum Dermatology Partners |
| M8 Pharmaceuticals | Pharmaceuticals | contract organization to help commercialize pharmaceutical products in Latin America | ADQ | Acino |
| Palatin Technologies (Vyleesi) | Pharmaceuticals | drug brands that treat hypoactive sexual desire | Avista Capital Partners, Constitution Capital Partners | Cosette Pharmaceuticals |
December 2023 Growth/Expansion Investments
| Companies | Company type | Secondary type | PE Firm(s) |
| CHE Behavioral Health Services | Behavioral health | psychological services for nursing and rehabilitation facilities | Cane Investment Partners |
| Worldwide Clinical Trials | Contract research organization | NB Capital Solutions | |
| Abound Health | Disability services | I/DD support services | M2O |
| Ludi | Health IT | financial management system | Great Point Partners |
| ABI Health | Health IT | InvAscent | |
| Ntracts | Health IT | Accel-KKR | |
| UnityAI | Health IT | Whistler Capital Partners | |
| Virtual OfficeWare | Health IT | M2O | |
| Alcanza Clinical Research | Healthcare services/Pharmaceuticals/Contract research organization | facilitates access to/enrollment in clinical trials | Alpha Leonis Partners |
| Agile Infusion Services | Infusion services | Walnut Court Capital | |
| Cortex | Medtech | AFib ablation tech company | AI Life Sciences Investments, Cordis, Kohlberg Kravis Roberts |
| CME (United States) | Medtech | medical equipment distributor | SNH Capital Partners |
| Neurolens | Medtech | vision measurement device system | Trinity Capital |
| Gastroenterology Associates | Outpatient care | gastroenterology | PE Healthcare Associates |
| American Pain Consortium | Outpatient care | pain management | Undisclosed |
| Wonderbelly | Pharmaceuticals | antacid drug developer | Loft Growth Partners, Silas Capital |
| Equiscript | Pharmacy services | Undisclosed |
[1] Lifepoint Health. “Lifepoint Health and Ascension Saint Thomas Partner to Advance Healthcare for Middle Tennesseans,” December 1, 2023. https://lifepointhealth.net/news/lifepoint-health-and-ascension-saint-thomas-partner-to-advance-healthcare-for-middle-tennesseans.
[2] PitchBook. “PitchBook Profile – Highpoint Health Systems.” Accessed January 3, 2024. https://my.pitchbook.com/profile/541385-20/company/profile#general-info.
[3] Lifepoint Health. “Lifepoint Health and Ascension Saint Thomas Partner to Advance Healthcare for Middle Tennesseans,” December 1, 2023. https://lifepointhealth.net/news/lifepoint-health-and-ascension-saint-thomas-partner-to-advance-healthcare-for-middle-tennesseans.
[4] Lifepoint Health. “Locations.” Accessed January 3, 2024. https://lifepointhealth.net/locations.
[5] Kacik, Alex. “Lifepoint Health and Kindred Healthcare Close Deal, Form New Company.” Modern Healthcare, December 22, 2021, sec. Mergers & Acquisitions. https://www.modernhealthcare.com/mergers-acquisitions/Lifepoint-health-and-kindred-healthcare-close-deal-form-new-company.
[6] Pgs. 11-14; O’Grady, Eileen, Mary Bugbee, and Michael Fenne. “Private Equity Descends on Rural Healthcare.” Private Equity Stakeholder Project, January 2023. https://pestakeholder.org/wp-content/uploads/2023/02/PE_Rural_Health_Jan2023-compressed.pdf.
[7] Vogel, Susanna. “Lifepoint Health and Ascension Saint Thomas Announce Joint Venture.” Healthcare Dive, December 4, 2023. https://www.healthcaredive.com/news/lifepoint-health-ascension-saint-thomas-joint-venture/701422/.
[8] Lifepoint Health. “Types of Partnerships | Partnering with Lifepoint.” Accessed September 8, 2023. https://lifepointhealth.net/types-of-partnerships.
[9] LifePoint does not list its JVs online. These numbers were derived from a combination of press releases from LifePoint and its partners, as well as from news articles.
[10] Woods, LaVerne, and Thomas C. Schroeder. “Joint Ventures Between Tax-Exempt Health Care Organizations and For-Profit Parties: Avoiding Federal Tax Law Traps.” willamette.com, Spring 20210. https://willamette.com/insights_journal/10/spring_2010_5.pdf.
[11] Sanders, Michael I. “Health Care Joint Ventures between Tax-Exempt Organizations and for-Profit Entities.” Health Matrix (Cleveland, Ohio: 1991) 15, no. 1 (2005): 83–123.
[12] McGuireWoods. “Five Things to Know: Hospital Joint Venture Arrangements in Today’s Landscape,” September 6, 2023. https://www.mcguirewoods.com/client-resources/alerts/2023/9/five-things-to-know-hospital-joint-venture-arrangements/.
[13] Pgs. 11-14; O’Grady, Eileen, Mary Bugbee, and Michael Fenne. “Private Equity Descends on Rural Healthcare.” Private Equity Stakeholder Project, January 2023. https://pestakeholder.org/wp-content/uploads/2023/02/PE_Rural_Health_Jan2023-compressed.pdf.
[14] Kannan, Sneha, Joseph Dov Bruch, and Zirui Song. “Changes in Hospital Adverse Events and Patient Outcomes Associated With Private Equity Acquisition.” JAMA 330, no. 24 (December 26, 2023): 2365–75. https://doi.org/10.1001/jama.2023.23147.
[15] Linch, Rachel. “The Rise of Hospital and Health System JVs with Private Equity.” VMG Health (blog), October 19, 2023. https://vmghealth.com/thought-leadership/blog/the-rise-of-hospital-and-health-system-jvs-with-private-equity/.
[16] Acino. “Acino Completes Acquisition of M8 Pharmaceuticals Significantly Expanding Presence and Capabilities in Latin America,” December 4, 2023. http://acino.swiss/news/acquisition-of-m8-pharmaceuticals.
[17] m8pharmaceuticals.com. “Purpose-Built to Provide Access to Proven and Innovative Medicines | M8 Pharmaceuticals.” Accessed January 3, 2024. https://www.m8pharmaceuticals.com/company.
[18] Acino. “Acino Completes Acquisition of M8 Pharmaceuticals Significantly Expanding Presence and Capabilities in Latin America,” December 4, 2023. http://acino.swiss/news/acquisition-of-m8-pharmaceuticals.
[19] Constitution Capital Partners. “Co-Investments.” Accessed January 3, 2024. https://www.concp.com/investment-strategies/private-equity/direct-equity/.
[20] Palatin Technologies, Inc. “Palatin Completes Sale of Vyleesi® to Cosette Pharmaceuticals for up to $171 Million.” Accessed January 3, 2024. https://www.prnewswire.com/news-releases/palatin-completes-sale-of-vyleesi-to-cosette-pharmaceuticals-for-up-to-171-million-302020026.html.
[21] “Constitution Capital Partners Completes Co-Investment with Avista Capital Partners in Acino Holding AG,” Deember 2013. https://www.concp.com/wp-content/uploads/2019/06/2013-12-6-Acino.pdf.
[22] “Avista Capital Partners and Nordic Capital to Sell Acino, a Leader in Advanced Drug Delivery Technologies, to ADQ | Avista Capital Partners,” September 16, 2021. https://www.avistacap.com/news_item/avista-capital-partners-and-nordic-capital-to-sell-acino-a-leader-in-advanced-drug-delivery-technologies-to-adq/.
[23] Jain, Nirad, Kara Murphy, Dmitry Podpolny, Franz-Robert Klingan, Vikram Kapur, and Alex Boulton. “Healthcare Private Equity Market 2023: Year in Review and Outlook.” Bain & Company, January 3, 2024, sec. Report. https://www.bain.com/insights/year-in-review-global-healthcare-private-equity-report-2024/.
