Barclays: healthcare fairness opinions
18 opinions in healthcare transactions, 2011-2024 — 11 to the target board, 6 to the acquirer, 1 to a special committee. Each links to the filing and the full summary of analyses.
Deals
| Announced | Target | Acquirer | Segment | EV | EV/EBITDA | EV/Rev | DCF rate |
|---|---|---|---|---|---|---|---|
| 2024-08-01 | R1 RCM | TowerBrook and CD&R | Outsourced Services | $8.9B | 13.6x | 3.34x | 9.5%–11.0% |
| 2022-11-01 | Benefitfocus | Voya Financial | Digital / HealthTech | $570M | 11.6x | 2.25x | 11.0%–13.0% |
| 2020-12-21 | HMS | Gainwell Technologies | Digital / HealthTech | $3.4B | 18.4x | 5.01x | 9.0%–10.0% |
| 2019-03-27 | WellCare Health Plans | Centene | Managed Care | $17B | 14.5x | 0.62x | 7.0%–8.3% |
| 2018-12-18 | Civitas Solutions | Centerbridge Partners | Behavioral Health | $1.4B | 8.1x | 0.87x | 9.0%–9.5% |
| 2017-12-19 | Kindred Healthcare | Humana/TPG/WCAS | Hospitals | $4.1B | 8.0x | 0.68x | 8.5%–9.5% |
| 2017-12-03 | Aetna | CVS Health | Managed Care | $71B | 12.1x | 1.18x | 7.0%–8.5% |
| 2017-12-03 | CVS Health | Aetna | Pharmacy / Infusion | $90B | 7.2x | 0.49x | 7.0%–8.5% |
| 2017-04-03 | Syneron Medical / Candela | Apax Partners | Medical Devices and Supplies | $340M | 16.8x | 1.14x | 15.5%–17.5% |
| 2016-08-09 | Press Ganey Holdings | EQT | Digital / HealthTech | $2.4B | 16.1x | 6.28x | 8.0%–10.0% |
| 2016-07-13 | Imprivata | Thoma Bravo | Digital / HealthTech | $544M | — | 3.78x | 11.0%–15.0% |
| 2016-05-03 | Quintiles | IMS Health | Pharmaceutical Services | $10B | 10.8x | 2.18x | 7.8%–8.3% |
| 2016-05-03 | IMS Health | Quintiles | Pharmaceutical Services | $13B | 13.5x | 4.09x | 7.8%–8.3% |
| 2014-10-09 | Gentiva Health Services | Kindred Healthcare Services | Home-Based Services | $1.8B | 9.7x | 0.92x | 9.5%–11.5% |
| 2012-11-05 | Metropolitan Health Networks | Humana | Physician Groups | $851M | 8.2x | 1.09x | 10.5%–12.0% |
| 2012-07-09 | AMERIGROUP | Wellpoint Healthcare Networks | Managed Care | $4.8B | 12.3x | 0.53x | 9.5%–11.5% |
| 2012-04-18 | Catalyst Health Solutions | SXC Health Solutions | Managed Care | $4.7B | 19.1x | 0.72x | 8.0%–9.5% |
| 2011-01-24 | Genoptix | Novartis AG | Diagnostics / Life Sciences | $470M | 11.0x | 2.38x | 10.0%–13.0% |
Segments: Digital / HealthTech (4) · Managed Care (4) · Pharmaceutical Services (2) · Outsourced Services (1) · Behavioral Health (1) · Hospitals (1) · Pharmacy / Infusion (1) · Medical Devices and Supplies (1) · Home-Based Services (1) · Physician Groups (1) · Diagnostics / Life Sciences (1)
Discount rates Barclays has used
| Deal | Discount rate | Terminal | Growth / exit | Implied per share |
|---|---|---|---|---|
| R1 RCM 2024 | 9.5%–11.0% | perpetuity growth | 3.5%–4.5% | $9.93–$16.24 |
| Benefitfocus 2022 | 11.0%–13.0% | exit multiple | 9.5x–11.5x | $7.63–$11.09 |
| HMS 2020 | 9.0%–10.0% | perpetuity growth | 4.0%–4.5% | $23.80–$31.79 |
| WellCare Health Plans 2019 | 8.0%–9.0% | perpetuity growth | 2.5%–3.0% | $259.75–$345.00 |
| Civitas Solutions 2018 | 9.0%–9.5% | perpetuity growth | 2.0%–2.5% | $15.05–$20.24 |
| Kindred Healthcare 2017 | 8.5%–9.5% | perpetuity growth | 1.8%–2.3% | $0.31–$7.02 |
| Aetna 2017 | 6.5%–7.5% | perpetuity growth | 2.0%–3.0% | $170.50–$263.00 |
| CVS Health 2017 | 6.5%–7.5% | perpetuity growth | 2.0%–3.0% | $170.50–$263.00 |
| Press Ganey Holdings 2016 | 8.0%–10.0% | exit multiple | 12.0x–16.0x | $34.25–$49.00 |
| Imprivata 2016 | 11.0%–15.0% | exit multiple | 9.5x–13.5x | $17.86–$26.14 |
| Quintiles 2016 | 7.8%–8.3% | exit multiple | 10.0x–12.0x | — |
| IMS Health 2016 | 7.8%–8.3% | exit multiple | 10.0x–15.0x | — |
| Gentiva Health Services 2014 | 9.5%–11.5% | exit multiple | 8.0x–9.0x | $16.14–$23.80 |
| Metropolitan Health Networks 2012 | 10.5%–12.0% | exit multiple | 5.5x–6.5x | $10.79–$13.78 |
| AMERIGROUP 2012 | 9.0%–11.0% | exit multiple | 5.5x–7.5x | $75.05–$108.11 |
| Catalyst Health Solutions 2012 | 7.5%–8.5% | exit multiple | 11.0x–13.0x | $71.00–$87.00 |
| Genoptix 2011 | 10.0%–13.0% | perpetuity growth | 2.5%–3.5% | $23.61–$32.67 |
Peer companies Barclays selects most often
UnitedHealth Group Incorporated (5) · Inovalon Holdings, Inc. (4) · Cigna Corporation (4) · Humana Inc. (4) · HealthStream, Inc. (3) · Anthem, Inc. (3) · The Advisory Board Company (3) · Nielsen Holdings plc (3) · Verisk Analytics, Inc. (3) · Gartner, Inc. (3) · FactSet Research Systems Inc. (3) · Premier, Inc. (2) · Cerner Corporation (2) · Allscripts Healthcare Solutions, Inc. (2) · Molina Healthcare, Inc. (2) · LHC Group, Inc. (2) · The Ensign Group, Inc. (2) · INC Research Holdings, Inc. (2) · PRA Health Sciences, Inc. (2) · IMS Health (2)
Precedent transactions Barclays cites most often
WellChoice, Inc. / WellPoint, Inc. (4) · Coventry Health Care, Inc. / Aetna Inc. (3) · First Health Group Corp. / Coventry Health Care, Inc. (3) · Trigon Healthcare, Inc. / Anthem, Inc. (3) · HealthSpring, Inc. / Cigna Corporation (3) · Sierra Health Services, Inc. / UnitedHealth Group Incorporated (3) · Oxford Health Plans, Inc. / UnitedHealth Group Incorporated (3) · Cotiviti Holdings, Inc. / Verscend Technologies, Inc. (2) · Regency Hospital Company, L.L.C. / Select Medical Holdings Corporation (2) · Cigna Corporation / Anthem, Inc. (2) · Humana Inc. / Aetna Inc. (2) · Health Net, Inc. / Centene Corporation (2) · Amil Participações S.A. / UnitedHealth Group Incorporated (2) · AMERIGROUP Corporation / WellPoint, Inc. (2) · PacifiCare Health Systems, Inc. / UnitedHealth Group Incorporated (2)