Private Equity Healthcare Acquisitions – March 2024

In light of continued 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 March 2024. We will continue to track acquisitions on a monthly basis.

See February 2024 acquisitions here.

Using a combination of PitchBook and news searches/alerts, PESP identified 50 completed or announced private equity-backed healthcare deals for March 2024, including 11 buyouts, 23 add-on acquisitions, and 16 growth/expansion investments, though some companies may have yet to report major deals in March.

Health IT
RevSpring was sold in a secondary buyout from private equity firm GTCR to Frazier Healthcare Partners. RevSpring is a company that provides billing services for healthcare providers. As of March 2024, the company estimates more than $8 billion in payment volume annually.[1] One source reported that Frazier Healthcare Partners agreed to buy the company from GTCR for $1.3 billion.[2]

Frazier Healthcare Partners has invested in tech-enabled revenue management companies for at least five years. Frazier Healthcare and The Edgewater Funds acquired healthcare revenue cycle management company Elevate Patient Financial Solutions(formerly known as MedData[3]) in 2019.[4] In 2020, Frazier acquired Accuity Delivery Systems, which provides revenue integrity and clinical documentation improvement services for healthcare providers.[5]

Frazier has also raised funds in recent years to invest in healthcare technology. In May 2021, Frazier announced it had raised $1.4 billion for a growth fund which would focus on investments in the sector.[6]

The RevSpring acquisition in March is Frazier’s second revenue cycle management deal this year. In January 2024, its portfolio company ElevatePFS acquired Professional Medical Services, a tech-enabled company focused on collecting medical debts from low-balance accountholders.[7]

Practice management services
WindRose Health Investors bought CardioOne for an undisclosed amount in early March. CardioOne is “a physician enablement company built specifically to serve independent cardiologists.”[8] It provides management services including “comprehensive staff management,” “practice optimization programming,” and a “payer contracting network.”[9]

Private equity firms have increasing interest in cardiology, and dealmaking has accelerated in the sector since 2021.[10] The cardiology 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.[11] The industry is still highly fragmented, which may attract private equity firms using consolidation strategies to generate profits.[12]

CardioOne and other practice management companies claim to offer physician independence as a feature, but studies suggest they may contribute to higher patient costs. A 2022 study on anesthesia services published in the Journal of American Medicine found that physician practice management companies and private equity investment were associated with a dramatic rise in prices.[13]

A recent report in Modern Healthcare discussed private equity’s divisive role among physicians, as doctors are decreasingly part of practices wholly owned by physicians themselves, and instead are increasingly joining health systems, PE-backed management services organizations, and insurers. Critics of the management services model point out concerns about physicians’ ability to maintain clinical independence. One physician told Modern Healthcare, “Not until we got the contract language did we realize that although the PE firm talked about this being a partnership, it would be a takeover. They would have a significant say in the clinical workflow.”[14]

Continued dental growth
Specialized Dental Partners made five acquisitions in March, in Mississippi,[15] Texas, Ohio,[16] Illinois,[17] and Colorado.[18] The company is a dental service organization (DSO) founded in 2018 and was known as US Endo Partners until August 2023.[19] It was established in through the combination of three practices acquired by private equity firm Thurston Group, which sold the company to Quad-C Management in late 2021.[20]

Specialized Dental Partners made more dental care acquisitions in 2023 than any other private equity-owned company, with 31 add-on deals.[21] It currently has more than 200 practices in at least 35 states.[22] According to the company’s website, practices acquired by Specialized Dental Partners keep their own practice name and brand identity after being acquired.[23]

DSOs handle the business side of dental practices, such as administrative, marketing, bookkeeping, and financial services. As of 2021, private equity firms dominated the DSO market; 9 of the top 10 DSOs in the US were owned by private equity firms. Private equity firms owned 27 of the top 30 DSOs, accounting for approximately 84% of practice locations affiliated with the top 30 firms.[24]

Some private equity-owned DSOs have been found to employ profit-driven practices that impacted patient care, and DSOs provide an avenue for private equity firms to skirt around regulations. 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.[25]

See our 2021 report for more information on private equity investments in dental care: “Deceptive Marketing, Medicaid Fraud, and Unnecessary Root Canals on Babies: Private Equity Drills into the Dental Care Industry.”

March 2024 Buyouts

February 2024 Add-on Acquisitions

February 2024 Growth/Expansion Investments

[1] GTCR. “GTCR Announces Sale of RevSpring.” PR Newswire, March 12, 2024. https://www.prnewswire.com/news-releases/gtcr-announces-sale-of-revspring-302086705.html.

[2] Luisa Beltran. “Repay Holdings Looks to Private Equity for a Buyer, While GTCR Is Selling RevSpring” Fortune, March 12, 2024. https://fortune.com/2024/03/12/repay-holdings-gtcr-revspring-payments-sale-private-equity/.

[3] Frazier Healthcare Partners. “Elevate Patient Financial Solutions.” Accessed April 17, 2024. https://www.frazierhealthcare.com/portfolio/Elevate%20Patient%20Financial%20Solutions.

[4] S&P Global Ratings. “FH MD Parent Inc. (d/b/a MedData) Assigned ‘B-’ R,” July 17, 2021. https://disclosure.spglobal.com/ratings/en/regulatory/article/-/view/type/HTML/id/2668927.

[5] Business Wire. “Frazier Healthcare Partners Announces Acquisition of Accuity Delivery Systems,” October 29, 2020. https://www.businesswire.com/news/home/20201029005369/en/Frazier-Healthcare-Partners-Announces-Acquisition-of-Accuity-Delivery-Systems.

[6] Heather Landi. “Frazier Healthcare Partners Brings in $1.4B to Invest in Healthcare IT, Data Analytics” Fierce Healthcare, May 28, 2021. https://www.fiercehealthcare.com/tech/frazier-healthcare-partners-brings-1-4b-to-invest-healthcare-it-data-analytics.

[7] Business Wire. “Elevate Patient Financial Solutions Acquires Professional Medical Services to Expand RCM Offering,” January 9, 2024. https://www.businesswire.com/news/home/20240109655102/en/Elevate-Patient-Financial-Solutions-Acquires-Professional-Medical-Services-to-Expand-RCM-Offering.

[8] WindRose Health Investors. “WindRose Health Investors Acquires CardioOne.” PR Newswire, March 4, 2024. https://www.prnewswire.com/news-releases/windrose-health-investors-acquires-cardioone-302077930.html.

[9] CardioOne. “Homepage.” Accessed April 16, 2024. https://www.cardioone.com/.

[10] Lou, Nichole. “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; Springer, Rebecca. “PE Finds a New Healthcare Play in Cardiology | PitchBook.” News & Analysis, May 13, 2023. https://pitchbook.com/newsletter/pe-finds-a-new-healthcare-play-in-cardiology-Ftr.

[11] Centers for Disease Control and Prevention. “Heart Disease Facts | Cdc.Gov,” October 14, 2022. https://www.cdc.gov/heartdisease/facts.htm.

[12] Strode, Roger. “Cardiology: The New Darling of Private Equity Investment | Foley & Lardner LLP.” Healthcare Law Today, February 6, 2023. https://www.foley.com/en/insights/publications/2023/02/cardiology-new-darling-private-equity-investment.

[13] 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.

[14] Alex Kacik. “Private Equity-Backed Consolidation Divides Physicians.” Modern Healthcare, March 13, 2024. https://www.modernhealthcare.com/mergers-acquisitions/private-equity-physicians-lobbying.

[15] Ariana Portalatin. “Specialized Dental Partners Adds Mississippi Practice | Dental News.” Becker’s Dental + DSO Review, March 7, 2024. https://www.beckersdental.com/dso-dpms/43153-specialized-dental-partners-adds-mississippi-practice.html.

[16] Cameron Cortigiano. “Specialized Dental Partners Adds Practices in Ohio, Texas | Dental News.” Becker’s Dental + DSO Review, March 12, 2024. https://www.beckersdental.com/dso-dpms/43187-specialized-dental-partners-adds-practices-in-ohio-texas.html.

[17] Ariana Portalatin. “Specialized Dental Partners Adds Chicago Practice | Dental News.” Becker’s Dental + DSO Review, March 28, 2024. https://www.beckersdental.com/dso-dpms/43316-specialized-dental-partners-adds-chicago-practice.html.

[18] LinkedIn post from Specialized Dental Partners. Accessed April 19, 2024. https://www.linkedin.com/posts/specializeddentalpartners_newpartners-apexendodontics-coloradoendodontics-activity-7173664219572240384-jr7L/?utm_source=share&utm_medium=member_desktop.

[19] Specialized Dental Partners. “US Endo Partners Changes Name to Specialized Dental Partners.” PR Newswire, August 31, 2023. https://www.prnewswire.com/news-releases/us-endo-partners-changes-name-to-specialized-dental-partners-301915352.html.

[20] Thurston Group. “Thurston Group Exits U.S. Endodontics Partners.” PR Newswire, November 16, 2021. https://www.prnewswire.com/news-releases/thurston-group-exits-us-endodontics-partners-301425434.html.

[21] Private Equity Stakeholder Project. “Private Equity in U.S. Healthcare: Trends in 2023 Deal Activity,” March 6, 2024. https://pestakeholder.org/private-equity-healthcare-2023-trends/.

[22] Specialized Dental Partners. “Become a Partner With the Nation’s Top Speciality DSO.” Accessed April 16, 2024. https://specializeddental.com/partnership/.

[23] Specialized Dental Partners. “Endodontics DSO FAQs.” Accessed April 16, 2024. https://specializeddental.com/faq/.

[24] O’Grady, Eileen. “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.

[25] Id.