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PitchBook Data, Inc. 2024 Nashville Healthcare Sessions Conference Summary

Core Content

The 2024 Nashville Healthcare Sessions Conference, now in its second year, has established itself as a key event for private equity (PE) healthcare professionals. Hosted by the Nashville Health Care Council, the conference attracted over 1,300 registered attendees, with a growing number of invite-only evening events and off-campus meetings, reflecting its rising prominence in the industry.

Key Takeaways

• Market Sentiment: Improved significantly since early 2024, with expectations of acceleration through the first half of 2025.
• Investor Sentiment: Remains negative toward private equity managed care (PEMs) and value-based care (VBC) platforms.
• Regulatory Trends: California's veto of AB 3129 signals a potential slowdown in state-level regulatory efforts against PE in healthcare.
• IPO Considerations: With limited exit options, healthcare PE firms are increasingly considering IPOs, especially in sectors like healthcare IT where public valuations are relatively strong.
• AI in Healthcare: While AI is being integrated into workflows, a true end-to-end AI transformation in healthcare IT is yet to emerge, with expectations for it to first appear in provider workflow or revenue cycle.

Noteworthy Announcements

• Shore Capital Partners closed nearly $2 billion across three funds, including its first Healthcare Advantage Fund.
• Reveeler, a VBC technology company backed by Oak HC/FT, acquired Curation Health.
• Cohere Health partnered with MGC to launch a combined solution with a large regional payer in 2025.
• Maven Clinic raised $125 million in Series F funding led by StepStone Group.
• Thriveworks acquired Synchronous Health, an AI-driven behavioral health platform.
• Longitude Health was formed by major health systems, focusing on AI and VBC capabilities.

Deal Outlook

• The healthcare PE market is rebounding, but with caution.
• Hot Sectors: Revenue cycle (especially specialty), cost containment (especially oncology), remote patient monitoring, payer tech, behavioral health, site management organizations, and medspa.
• Market Challenges: PPMs continue to face skepticism, with limited price discovery and few large sponsor-to-sponsor transactions since 2022.
• Strategic Buyers: Payers and retailers are still active in M&A, though some commentators suggest this is being overstated.
• IPOs: Recent healthcare services IPOs, such as PACS Group and Concentra, have shown positive public comps, encouraging private equity firms to consider IPOs as an exit strategy.

Regulatory Dynamics

• California's AB 3129 Veto: Seen as a sign that state-level regulatory efforts may be cooling.
• Pennsylvania's HB 2344: Revised to a narrower scope, indicating a potential pause in regulatory expansion.
• FTC's Focus: The FTC is focusing on objective reviews of competition dynamics, with no special treatment for PE transactions.
• Industry Response: Encouraged to cooperate with the FTC by providing clear evidence and raising concerns about anticompetitive behavior.

Medicare Advantage and VBC

• MA Challenges: Margin erosion is a major concern due to changes in risk adjustment, star ratings, and RADV audits.
• VBC Evolution: VBC investors are shifting toward commercial pay and specialty models, with limited progress in Medicaid.
• Main Street Health: Expanding into 26 states and diversifying into MSSP and ACO REACH, with new clinical offerings in key rural markets.
• Strategic Buyers: Payers like Optum, Humana, and Elevance Health remain active in M&A, despite the decline in some retail care delivery initiatives.

IPOs and Take-Privates

• Public Market Role: Public markets are playing a larger role in the conference, with more focus on IPOs and take-privates.
• Exit Strategy: Large-cap PE firms are less active in PPMs, prompting a shift toward IPOs.
• Public Comp Set: Healthcare IT public comps have outperformed the S&P 500, with companies like Guardian Pharmacy and Concentra showing strong performance.
• Take-Privates: The take-private of R1 RCM has highlighted the scarcity of high-quality public healthcare IT companies with strong free cash flow.

AI

• Current Status: AI is primarily used as a plug-in tool for workflow improvement rather than a transformative force.
• Future Outlook: A true AI play for end-to-end workflow transformation is expected to emerge in provider workflow or revenue cycle.
• Large Firm Advantage: Large companies are better positioned to leverage AI due to their ability to invest in infrastructure and tooling.
• Oak HC/FT's Focus: The firm is actively seeking an AI play that offers end-to-end transformation, with no such company currently in existence.

Conclusion

The conference reflects a market that is cautiously optimistic, with a shift in focus from PPMs to more promising areas like VBC, AI, and IPOs. Regulatory dynamics are showing signs of easing, while the healthcare PE ecosystem continues to adapt to new challenges and opportunities.