In light of the growing investor interest in health care and the risks associated with private equity ownership of health care companies, the Private Equity Stakeholder Project will be tracking private equity-backed health care acquisitions. Below is a list of private equity health care buyouts and add-on acquisitions completed during November 2020. We will continue to track acquisitions on a monthly basis.
Aspen Dental Management (Ares Management, Leonard Green & Partners) Acquires ClearChoice Management Services (Sun Capital Partners)
Aspen Dental Management, which is owned by Ares Management, Leonard Green & Partners, and American Securities, announced that it will acquire ClearChoice Management Services, which is owned by Sun Capital Partners.
Aspen Dental is a large dental support organization (DSO) with more than 850 offices in 42 states. ClearChoice provides non-clinical support services to dental implant centers at 60 locations across the U.S.[i]
Aspen is funding the acquisition of ClearChoice almost entirely with debt; the $1.135 billion purchase price will be funded with a $1.2 billion first lien senior secured term loan, and rollover management equity. The acquisition will bring Aspen Dental’s leverage to 6.7x.[ii]
Ares first invested in Aspen Dental in 2006 and Leonard Green invested in 2010.[iii]
Since the private equity owners took control of Aspen Dental, the company has faced substantial scrutiny for engaging in business practices harmful to patients. Complaints against Aspen Dental range from poor quality of care, billing practices, misleading advertising, upselling of medical services and products the consumers felt were unnecessary, and unclear or incomplete terms for the financing of dental care.[iv]
Over the last decade, Aspen Dental has paid at least $1.7 million in settlements with state attorneys general in Pennsylvania, Massachusetts, New York, and Indiana. Meanwhile, Aspen Dental has paid over $212 million in debt-funded dividends to its ownership group since 2012.[v]
Despite being the second largest dental services company in the U.S., Aspen Dental received millions of dollars in Paycheck Protection Program (PPP) loans meant to support small businesses during the COVID-19 pandemic.[vi] According to data released by the Small Business Administration, Aspen Dental applied for and received between $8.85 million and $21.35 million in PPP loans.[vii]
This the second major private equity dental services acquisition in recent weeks; New Mountain Capital acquired Benevis, a pediatric dental support services company, out of bankruptcy in October.
|Accuity Delivery Systems||Frazier Healthcare Partners||Revenue cycle management|
|Best Value Healthcare||Arsenal Capital Partners||Health centers|
|HST Pathways||Bain Capital, Nexxus Holdings||Health tech|
|Miami Beach Medical Group||Sun Capital Partners||Geriatric medical group|
|National Dentex||Cerberus Capital Management||Medical devices & supplies|
|nThrive (software business)||Clearlake Capital||Revenue cycle management|
|PCI Pharma Services||Kohlberg & Company, Mubadala Development Company||Pharmaceuticals|
|Syneo (Florida)||Arcline Investment Management||Medical devices & supplies|
|Synergy IOM||Monument MicroCap Partners||Neurodiagnostics|
|Zeus Health||KKR||Medical devices & supplies|
|Unified Women’s Healthcare||Ares Private Equity Group, Altas Partners||Medical group|
|Wytech||Vance Street Capital||Medical devices & supplies|
|Company||Acquiring Company||PE Firm||Type|
|Alternative Medical Enterprises||Verano Holdings||Sol Global investments, Serruya Private Equity||Medical cannabis|
|ClearChoice||Aspen Dental Management||Ares Private Equity Group, American Securities, and Leonard Green & Partners||Dental services|
|Limestone Health||BayMark Health Services||Webster Capital Management||Addiction treatment|
|Thermacare||Bridges Consumer Healthcare||Charlesbank Capital Partners||Medical devices & supplies|
|Two Labs||Envision Pharma||GHO Capital||Pharmaceuticals|
|UPMC pharmacy services (Chartwell)||CarepathRx||Nautic Partners, Alpinvest||Pharmacy and home infusion services|
[iii] Pitchbook, accessed November 30, 2020.
[v]https://www.moodys.com/research/Moodys-rates-Aspen-Dentals-amended-credit-facility-B2-CFR-affirmed%E2%80%93PR_237938; https://www.moodys.com/research/Moodys-affirms-ADMIs-B2-CFR-assigns-B2-to-the-proposed%E2%80%93PR_381690; Pitchbook.
[vii] Data reported by the Small Business Administration and compiled by Good Jobs First- COVID-19 Stimulus Watch. See our earlier report: https://pestakeholder.org/huge-private-equity-owned-aspen-dental-secured-millions-in-ppp-loans-meant-for-small-businesses/