“The Corner Series” is a multiperspective podcast series by McGuireWoods featuring commentaries from lawyers, bankers and a number of specialists about the developments and issues dominating today’s middle-market private equity. Tune in with McGuireWoods partner, Geoff Cockrell as he and specialists share real-world insight to help enhance your knowledge.
Videos are posted on YouTube and social media channels. Podcasts also are available on Apple and Spotify.
Episode 73: November 19, 2024
At fast-growing Allied Digestive Health, with 194 gastrointestinal (GI) physicians, 75 nurse practitioners and locations throughout New Jersey and New York, COO Sap Sinha is excited about the future. “Private equity in general is looking at GI very specifically, and there are multiple reasons for it,” Sap says in this conversation with McGuireWoods partner and host Geoff Cockrell.
One reason is that colon cancer is the second-largest cause of cancer death in the United States. Sap describes the current landscape, in which Allied focuses on clinical quality and partnerships with large institutions. It also invests in frontier treatments, such as the use of genetic testing to detect colon cancer and weight management tools to control liver disease among obese patients.
Episode 72: November 12, 2024
McGuireWoods partner and host Geoff Cockrell talks to Steve DeLong, founder and co-CEO of Bluetree Dental, about growing a dental service organization (DSO) in a competitive healthcare landscape.
Bluetree, which has expanded to more than 40 offices across six states since its inception in 2012, represents a successful model of combining de novo growth with acquisitions. Steve emphasizes the importance of maintaining a balance between central guidance and local practice autonomy, ensuring that dental professionals retain a degree of control over their operations. Geoff and Steve cover the strategic alignment of interests between a DSO and its dental providers, detailing Bluetree’s approach to equity ownership and partnership models.
Steve also shares insights about Bluetree’s decision to partner with Clairvest Group for a minority private equity investment, highlighting the preference for a cautious, long-term growth strategy over rapid expansion.
Episode 71: October 29, 2024
In this installment of McGuireWoods’ Corner Series podcast, partner and host Geoff Cockrell observes that seller anxiety about the potential for broken deals appears high right now. A surprising number of deals, he says, are less likely to “go out into a wider market process.”
Guest Reed Van Gorden of Deerpath Capital sees the same trend: Mergers and business sales are slow, but he’s waiting to see if two additional interest rate cuts expected this year will set more deals in motion.
Despite this slowing, Van Gorden says companies are performing well and have stabilized since the COVID-19 pandemic. Local businesses that Deerpath focuses on, such as medical offices, are not affected by world events such as supply chain problems or fluctuating oil prices.
Episode 70: October 22, 2024
The U.S. Department of Justice has annunciated several enforcement priorities relevant to the healthcare sector: senior care, opioids, cybersecurity and privacy, and – of particular interest to listeners of “The Corner Series” – private equity investors in the healthcare space.
Michael Podberesky, a former DOJ prosecutor who is now co-chair of McGuireWoods’ False Claims Act Investigations, Litigation and Enforcement team, outlines these priorities in this installment of “The Professor’s Corner,” a special episode of “The Corner Series” in which host Geoff Cockrell invites experienced practitioners to share insight about nuanced topics.
Michael offers an insider’s view of the agency, including how it balances political pressure with its evidentiary burden and how its attorneys triage the large number of complaints they receive. He observes that his former DOJ colleagues typically have one overriding calculus: “Am I dealing with a bad actor?” For the most part, he says, they are fair and reasonable, adding: “That doesn’t mean we’re going to agree, and it doesn’t mean our listeners are going to agree.”
Episode 69: October 1, 2024
The business side of operating an oral and maxillofacial surgery practice can present challenges, such as purchasing the latest equipment, staffing offices and dealing with technology and cybersecurity. That’s where private equity and a group run by doctors can help.
With host Geoff Cockrell, Daniel Hosler, who brings experience in equity, and Dr. David Kostohryz, Jr., an oral surgeon, discuss Allied OMS, an oral and maxillofacial surgery platform they founded that helps with the “business of the business” of oral surgery offices.
Their platform helps offices purchase equipment, hire staff, keep up with rules and regulations, communicate with other doctors who are part of Allied OMS, receive mentoring, and access IT support. The group also helps open satellite offices to expand the services of respected practices.
Episode 68: September 24, 2024
Everyone wants to dip their toe in the medical aesthetics space. And why not? It’s beautiful. But among platforms in this space, such as day spas, it is the pure med spa that has longevity “because it mixes the experiential with the service and the clinical outcomes,” says Nicole Chiaramonte.
In October 2022, Nicole founded Advanced MedAesthetic Partners, which has 62 locations operated by “motivated entrepreneurs” hungry to grow their one or two locations into more. AMP integrates the partners under one umbrella, offering standardized back-office functions with individualized local patient experiences.
With host Geoff Cockrell, Nicole explains AMP’s strategies for expansion and discusses one of the biggest trends in med spa: weight loss drugs. She also shares insights about risks in the industry, including competition, lack of credit, and state legislation. As AMP approaches its two-year mark, she is optimistic about what 2025 will bring.
Episode 67: September 12, 2024
On this cross-over episode of Deal by Deal and The Corner Series, McGuireWoods’ partners Greg Hawver and Geoff Cockrell welcome labor and employment partner Meghaan Madriz to discuss recent headlines regarding the FTC’s proposed ban and the broader legal landscape for non-competes.
Tune in as Meghaan breaks down the evolving enforceability of restrictive covenants, including non-competes tied to employment agreements, sales of businesses, and equity ownership. She also highlights trends in state-specific legislation and shares insights from her experience litigating these issues. The conversation covers how businesses can use alternative tools, such as deferred compensation or retention bonuses, to retain employees amidst increasing scrutiny of non-competes.
Episode 66: September 2, 2024
There are already big players in the pediatric and orthodontic space, so what inspired Ananya Shah and Will MacInnis to launch their own dental service organization? The answer lies in untapped markets and “a ton of opportunity.”
With host Geoff Cockrell, Ananya and Will outline their journey from running a tech-focused healthcare start-up in Silicon Valley to co-founding Cliff Ridge Specialty Partners about a year ago. They explain what differentiates Cliff Ridge, including their strategy of giving full clinical autonomy to providers, and their operational and technological playbook that makes the lives of the doctors and office managers easier.
Tune in to hear their insights on how they manage labor pressures, the factors that are more important to doctor retention than noncompete agreements, and why their greatest opportunity in the next year may be to acquire more pediatric practices.
Episode 65: August 26, 2024
At six months out, Seva Dental Team – Naimish Patel’s second venture in the dental consolidation arena – is already as successful as his first operation was at three years. What’s driving Seva’s fast-track? “We believe in picking a lane and swimming really fast in it,” explains Naimish, Seva’s chairman and co-founder. “We are exclusively GP-focused, and we’re acquisition-based.”
With host Geoff Cockrell, Naimish breaks down his strategies. A critical one is to acquire practices that doctors plan to transition within 12 to 24 months. Seva then brings in its own doctors “to take over that practice very quickly and, frankly, grow it.”
Episode 64: August 15, 2024
M&A activity in the healthcare space has slowed since 2022, but with stable interest rates and creative deal structuring, activity should increase going forward.
Host Geoff Cockrell is joined by Jamie Heidbreder, managing director in Fifth Third’s Healthcare Investment Banking group, to discuss challenges in healthcare M&A since 2022, the factors leading to an uptick in activity, and how balancing scrapes, income repair, and other factors can lead to more M&A deals.
Tune in to learn how healthcare M&A, especially in middle markets, should be on the rise for the rest of 2024 and into 2025
Episode 63: August 1, 2024
Michael Pennington used his background in middle-market investment banking to establish Platinum Dermatology Partners eight years ago. Now with 400 providers across five states, the physician-owned practice is thriving in a marketplace beset by challenges such as wage inflation and declining reimbursement models.
In this episode of The Corner Series, Michael describes the foundation of success with host Geoff Cockrell. He acknowledges that navigating healthcare markets is more difficult than it was 10 years ago, but he also promotes the unique advantages of the dermatology space. For instance, “I worry about a lot of things at night,” Michael says, “but patient demand is not one of them.”
Episode 62: June 25, 2024
The back office of a medical practice is like the offensive line on a football team: It does the job no one else wants to do.
On this episode of The Corner Series, host Geoff Cockrell is joined by MedHQ president Erik Miller to discuss how outside back-office support for areas such as HR, accounting and credentialing can improve and streamline a medical practice.
Tune in as Erik discusses how smaller practices and full health systems can benefit from outside back-office support, the “frenemy” relationship between ambulatory surgery centers and large health systems, and how artificial intelligence can benefit the medical community.
Episode 61: June 14, 2024
Tax insurance and representation and warranty insurance (RWI) have become common in M&A deals over the past two decades, but their use continues to evolve as transactions become more complex.
In this episode of The Corner Series, Jordan Tamchin of CAC Specialty joins host Geoff Cockrell to discuss tax insurance and RWI in today’s middle market M&A environment. Jordan discusses the most common uses of tax insurance in M&A deals, trends in how claims have been processed and paid, and how these insurance products are evolving to cover more aspects of M&A deals.
Episode 60: May 30, 2024
Private equity investment in the medical environment is nothing new. But what investment considerations and challenges are specific to pediatric practices?
In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell is joined by Tucker Moore and Chris O’Dekirk of Concierge Capital Advisory to discuss trends and issues related to private equity involvement in pediatric practices. Tucker and Chris discuss how the retail-heavy aspects of pediatrics can be attractive to investors, how consolidation can increase the quality of care provided, and how incentive programs may mean pediatric offices have higher revenue.
Episode 59: May 22, 2024
While the dental practice market is one of the most mature healthcare markets, it also is highly fragmented. That fragmentation means opportunities vary at every valuation level.
In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell is joined by Kevin Cumbus, founding partner and president at TUSK Practice Sales. Tune in as Geoff and Kevin delve into the current dental market from an investment and practice sale perspective, including where strategic buyers are focused, where the buyer market opens up, as well as some of the pressures faced by dental practices. They also address the impact of the FTC’s recent non-compete rule on the healthcare market, and tools to maximize equity alignment at every level.
Episode 58: May 15, 2024
Family offices have been growing since the end of the Great Recession. Now, family offices face new challenges such as determining diversification strategy and succession planning.
In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell welcomes guest R. Adam Smith, managing director of Salomon Brothers, who advises many family office clients. Tune in to hear Adam share his thoughts on family offices engaging in direct investing, the need to hire experienced staff and advisors, and how diversification can provide more financial security.
Episode 57: May 8, 2024
Medical technology is evolving every day. What trends are investment banks seeing, and what are some of the capital trends in the medical technology space?
In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell chats with Brian Scullion, senior director, medical technology at William Blair, a boutique multinational investment bank and financial services company, to discuss how investment banks view emerging healthcare technologies. Listen as Brian talks about private equity considerations in the healthcare industry, how AI and other emerging technologies are impacting capital investments in healthcare, and when value-based healthcare might grow in the commercial healthcare arena.
Episode 56: April 30, 2024
From a seller’s perspective, how does a provider group get ready for a sale process?
In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell interviews Marc Anderson, managing partner of The Belay Group, on the nuances of preparing companies, particularly in healthcare services, for a sale process. The discussion highlights the importance of professionalizing back-office operations and financial reporting and the potential pitfalls around ownership structure and economics.
Marc and Geoff also discuss the variables in strategic decisions, such as consolidating smaller entities to gain scale and the role of tax planning. The conversation provides valuable insights, essential for any healthcare provider group considering a sale.
Episode 55: April 23, 2024
Dermatology and aesthetics practices took off after the Great Recession, thrived during Covid, and show no signs of slowing down. What makes dermatology and aesthetics such desirable investments?
In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell chats with Clint Bundy and Stewart Carlin, managing directors of the Bundy Group, a boutique investment bank specializing in the healthcare industry. They discuss considerations for investing in dermatology and aesthetics practices.
Listen as Clint and Stewart explain why those practices are high-value investment targets, including the increasing influence of healthcare technology, the difference between being an investment cornerstone versus an add-on acquisition, and how aggressive investors will keep the market for dermatology and aesthetics providers robust.
Episode 54: April 10, 2024
One common myth about leadership is the idea of the “born leader,” whereby certain individuals are born with inherent leadership traits. However, leadership is not exclusively determined by genetics or innate abilities. Rather, leadership traits can be learned.
In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell welcomes guest Leon Brujis, an experienced investor who serves as partner and head of the East Coast division of 65 Equity Partners, a global investment firm.
Tune in to hear Leon share his thoughts on the necessary components of leadership in a private equity-backed platform, including the significance of the CEO and the characteristics and traits that make a good CEO. Leon also discusses tools such as psychometric evaluations, that can be useful in making assessments.
Episode 53: April 3, 2024
PPM deals are one of the hottest trends in the transaction environment with healthcare professionals.
On this episode of The Corner Series, McGuireWoods’ Geoff Cockrell is joined by fellow partner and chair of the firm’s Healthcare Department, Holly Buckley, along with Justin Chamblee, president of the Coker Group, a healthcare consulting firm that advises leading healthcare organizations on financial, transactional and operational solutions.
Tune in to hear Geoff, Holly and Justin discuss physician compensation in the PPM context, including provider compensation in structuring PPM transactions, provider compensation models, regulatory constraints, such as the Stark Law and the Anti-Kickback Statute, and retention and recruitment in the market.
Episode 52: March 27, 2024
Historically, private equity and venture capital have not been great at marketing, due to the conservative and highly regulated nature of the industry. However, “really good marketing shortens the first-point-of-contact-to-close-of-business, whether that’s on the funding or founder side,” says Laurel Mintz.
On this episode of The Corner Series, McGuireWoods’ Geoff Cockrell welcomes guest Laurel Mintz, CEO of Elevate My Brand, a digital and experiential marketing agency, and general partner at Fabric VC, a venture capital and private equity firm.
Tune in to hear Geoff and Laurel discuss the importance of branding and marketing in the world of private equity and venture capital, including how to target the right audience, the need for consistent communication and messaging, and finding the right mix of omnichannel platforms.
Episode 51: March 11, 2024
Unemployment trends have significant ramifications for labor market dynamics and the macroeconomy. Understanding the implications of the macroeconomy helps business leaders make more informed investment decisions.
In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell welcomes guests Tim Fry, a healthcare partner at McGuirewoods, and Alex Chausovsky, director of analytics and consulting at Bundy Group, a boutique industry-focused investment bank.
Tune in to hear Geoff, Tim and Alex cover the macroeconomic aspects impacting private equity investing in healthcare. Their discussion touches on unemployment trends, including the low unemployment rate in healthcare; inflation and interest rates affecting borrowing costs and investment decisions; and labor market dynamics.
Episode 50: March 4, 2024
“We believe in partnering with people that have that passion, that really want to put the business and the patient over themselves. That’s really the secret sauce of microcap investing.” – Gordon Maner
On this episode of The Corner Series, McGuireWoods’ Geoff Cockrell welcomes healthcare investor Gordon Maner. Gordon is the CEO of AMB Wealth, a financial services firm that specializes in asset management and healthcare investment banking. He also is the founding partner of Frontline Healthcare Partners, a private investment firm focused exclusively on investing in lower middle market, distributed healthcare businesses.
Tune in to hear Geoff and Gordon’s discussion about investing in healthcare, including the microcap side of healthcare; growing areas, such as behavioral health; overlooked sectors that provide good investment opportunities; and creating a world-class board
Episode 49: February 26, 2024
As the market recovers, multiple trends are taking shape in the healthcare provider services industry that will affect investors in 2024.
On this episode of The Corner Series, McGuireWoods’ Geoff Cockrell welcomes Bart Walker and Matt Searles. Bart is a fellow McGuireWoods partner and co-chair of the Healthcare & Life Sciences Industry Team. Matt is the managing partner at Merritt Healthcare Advisors, a healthcare services-focused investment bank.
Tune in to hear Bart and Matt share their perspectives on private equity investing in the healthcare services space and their forecast for 2024. They also discuss impediments to closing and active areas in healthcare investing.
Episode 48: February 5, 2024
People have invested a lot in dermatology, dental and other areas and are now looking for the next sector. In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell is joined by Mitch Stern, managing director and head of healthcare at Dresner Partners, to discuss plastic surgery and medical spa investing.
The discussion delves into the growing private equity interest in these sectors and compares various operating models. Stern addresses considerations for potential sellers in plastic surgery, emphasizing the need to avoid key man risk and highlighting the attractiveness of practices that have boosted the percentage of their business from med spa. The conversation covers both the opportunities and risks inherent in these sectors, with Stern expressing optimism for the market in 2024.
Episode 47: January 22, 2024
The physician practice management (PPM) arena is a mixture of tailwinds, including the ability to expand ancillary services, and headwinds, including more expensive labor costs and antitrust pressures.
On this episode of The Corner Series, McGuireWoods’ Geoff Cockrell speaks with Andrew Colbert, senior managing director at Ziegler, a privately held investment bank, capital markets and proprietary investments firm. Andy joined Ziegler in 2006 as a founding member of its healthcare investment banking practice. He advises healthcare services and healthcare information technology companies on a spectrum of strategic and financing alternatives.
Tune in to hear Geoff and Andy talk about the PPM environment and areas of opportunity, including the future of value-based contracting, the impact of a rising senior population, avoiding patient-acquisition expenses, potential around women’s healthcare, and what 2024 will bring to the PPM space.
Episode 46: January 18, 2024
Government investigations by the Department of Justice, Federal Trade Commission and others into private equity funds — both in the civil and the criminal space — are a recent trend that shows no signs of slowing.
On this episode of The Corner Series, McGuireWoods’ Geoff Cockrell speaks with fellow McGuireWoods partners Jason Cowley and Ben O’Neil, both of whom are former federal prosecutors and current members of the firm’s government investigations and white collar litigation practice.
Jason and Ben discuss the government’s attempts to reach beyond the portfolio company to get at the investor and the private equity company itself, as well as factors the government will consider when deciding whether to extend liability up the chain. They also address changes private equity funds should make, if any, in how they manage their investments.
Episode 45: January 15, 2024
The consolidation wave of private equity-backed platforms has moved through different sectors at different times. One of the most recent sectors to see increased interest from private equity is cardiology.
This episode of The Corner Series introduces the “Executive Corner,” where McGuireWoods’ Geoff Cockrell is joined by Tim Attebery, CEO of Cardiovascular Associates of America. Tune in to hear Geoff and Tim explore the drivers of private equity interest in cardiology, antitrust scrutiny of private equity-backed provider services platforms, the opportunities present in value-based contracting in cardiology, and what’s likely to transform the sector.
Episode 44: January 8, 2024
The healthcare sector is witnessing a trend toward consolidation, but it’s not just big hospital mergers making headlines. Private equity is playing a pivotal role in driving smaller consolidations within healthcare provider services.
In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell talks to McGuireWoods antitrust partner Holden Brooks about the role of private equity in the evolving landscape of antitrust enforcement. They cover antitrust regulators’ intensifying scrutiny of PE-backed healthcare transactions, challenges for investors in this changing landscape, and anticipated developments in antitrust enforcement in 2024, including new regulations and guidelines.
Episode 43: December 18, 2023
All sectors of the healthcare market are experiencing investments and growth. Dental and specialty dental practices are part of this growing trend.
In this episode of The Corner Series, McGuireWoods partner Geoff Cockrell speaks with Karan Garg, a partner and head of healthcare services at Solomon Partners, a leading financial advisory firm and one of the oldest independent investment banks. Geoff and Karan discuss the provider services industry, with a specific focus on the dental market and related specialty niches.
Tune in to hear Karan share his experience and insights in the dental arena, including growth strategies, risks and headwinds for dental platforms, market trends, and his 2024 prognosis for provider services and dental services in particular.
Episode 42: December 11, 2023
Although investment in the orthopedic sector is not new, private equity investment interest in this specialty area continues to grow. In fact, orthopedics has become one of the leading sectors for private equity investing, just behind cardiology.
In this episode of The Corner Series, McGuireWoods partner Geoff Cockrell speaks with Scott Davis, managing director at Provident Healthcare Partners, one of the leading investment banks providing M&A advisory services, strategic planning and capital formation to owners and operators of healthcare services businesses. Geoff and Scott focus their discussion on the highly active and evolving orthopedics sector.
Tune in to hear Scott share his insights into the state of the orthopedic industry and the leading drivers that make it so appealing to investors.
Episode 41: November 28, 2023
Some private equity groups buy assets just to pull them apart and sell them in pieces, but that is the exception, not the norm. In fact, private equity has done a lot to build and improve businesses, especially small and medium-sized ones.
In this episode of The Corner Series, McGuireWoods partner Geoff Cockrell speaks with Edward Crawford, co-founder and co-CEO of Coltala, a Dallas-Fort Worth-based venture capital and private equity firm that employs a “mission” investment style. Geoff and Edward discuss Coltala’s unique investment style, the ethos that drives the firm’s investment strategy and the misconception about private equity.
Tune in to learn more about Coltala’s partnership culture, the mission and margin investment strategy that serves as a filter to screen out certain companies, the test used to evaluate potential deals, and why Edward has walked away from opportunities that otherwise looked great financially.
Episode 40: November 20, 2023
As the fee-for-service model in U.S. healthcare grows increasingly unpopular, shifting to a value-based care paradigm can move the healthcare system toward better outcomes, lower costs, better patient access and experiences — and greater investment opportunities.
In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell is joined by Andrew Clark, managing partner at Leavitt Equity Partners, to discuss investment opportunities in value-based care. Tune in to hear Geoff and Andrew explore the evolution of value-based care and how it will continue to shape the healthcare industry. They discuss the different sectors that lend themselves to value-based care investment, including primary care, chronic care, episodic care and women’s care.
They also address the disruptive potential of non-healthcare participants, payer and provider convergence, and the role of artificial intelligence in driving efficiency and improving patient care.
Episode 39: November 13, 2023
After an active 2022, this year has seen a shift in the professional practice model space, with new challenges around the cost of capital, pricing and labor. Some who raised a lot of capital in 2022 will still be looking for deals, while others will focus on valuation and financial performance.
On this episode of The Corner Series, McGuireWoods’ Geoff Cockrell sits down with Robert Aprill, managing director at Physician Growth Partners, to discuss how the market might evolve in 2023 and beyond.
The aftermath of COVID-19 led many business owners to reevaluate the importance of size and scale in their operations, leaving them more open to partnering with larger entities. In private equity, an adviser’s role is to educate clients about compensation and alignment options when considering partnerships with healthcare platforms. The focus is on ensuring that physicians are partners and are compensated based on performance, promoting alignment through incentives rather than punitive measures like production thresholds.
“We spend a lot of time with our clients. I think oftentimes with us, we’re presenting something versus having buyers present something to us,” explains Robert.
The episode also covers areas of consolidation, interest in niche specialties, and aligning equity with compensation.
Episode 38: November 7, 2023
On this episode of The Corner Series, McGuireWoods’ Geoff Cockrell invites Alessio Baraldi, managing director at Albaron Partners, to discuss value creation in healthcare provider services. Alessio provides insight into the equity structures that work best for his portfolios and how he approaches compensation to keep everyone aligned.
“In an environment where there is quite a bit of wage inflation, having a unified system where the management team is able to manage expenses at the center level without relying on the doctors making those calls, has been quite helpful,” Alessio says.
Value creation from a growth strategy can be quite effective, and firms use various approaches such as de novo or acquisitions. Alessio and Albaron Partners prefer a mixture of both to add the most value to their partners. Integrations and centralization also provide value to a portfolio company. Being well-integrated and centralizing support functions like billing and call centers can help a company adapt to wage inflation while increasing operational efficiency.
Episode 37: November 1, 2023
The difficulties faced by healthcare provider consolidations could be temporary or they could indicate a long-term decline in the attractiveness of consolidation. Some challenges, like high debt and labor market imbalances, are temporary and don’t reflect the fundamental quality of the businesses involved.
On this episode of The Corner Series, McGuireWoods’ Geoff Cockrell is joined by Mark Francis, managing director and global head of healthcare investment banking at Houlihan Lokey. The two discuss the future of healthcare provider consolidations through the lens of those working in the industry right now.
Mark and Geoff talk about the future of healthcare provider consolidations through the lens of those working in the industry. Over the past six to eight months, some larger platforms that were acquiring smaller companies paused their acquisition activities due to a disconnect between seller expectations and current valuations. They also were waiting for more favorable credit conditions and pricing adjustments. Now, these platforms are beginning to look to the market again to see what is available.
Mark and Geoff also discuss the healthcare sector’s resilience during economic slowdowns. Healthcare often is less volatile than other sectors, making it an attractive option for investors looking to allocate funds during economic uncertainties. Healthcare is a mature market, but new interest in private equity has led to a reshuffling of focus within sectors. Some sectors such as healthcare technology, veterinary care and behavioral health remain highly attractive despite varying trends in their valuations.
In addition, Mark and Geoff address valuations and the importance of running and operating integrated businesses. “Great companies get great valuations, and we can debate what great is, but if people don’t feel good about the valuations, largely they’re not trading,” Mark says.
Episode 36: The Professor’s Corner, October 23, 2023
On this episode of The Professor’s Corner, Diwakar Sinha of Polaris Healthcare Partners joins McGuireWoods’ Geoff Cockrell to discuss how practices can prepare to sell, what specialties are most attractive and how the search for investors varies from practice to practice.
According to Diwakar, the same volume of deals is occurring, but the number of A-grade deals may be fewer. Currently, most A-grade deals exist in certain specialties. Diwakar also predicts that the cost of capital will come down mid-2024, which is a good reason to start planning from the sell-side now.
Episode 35: The Banker’s Corner, October 16, 2023
On this episode of The Banker’s Corner, McGuireWoods’ Geoff Cockrell talks to Craig Sager, director at Provident Healthcare Partners, about investing in primary care.
Craig, who leads the company’s sell-side M&A in primary care and behavioral health, shares his insights on investors working with fee-for-service healthcare groups. Some investors may find it too risky and prefer to wait for the transition to value-based care before investing, he notes. Others see an opportunity to enter at a lower price and facilitate the conversion to value-based care.
For the remainder of 2023 and into 2024, investors can be confident that there will always be interest in this sector and capital is available to be deployed.
Episode 34: The Capital Corner, October 5, 2023
On this episode of The Capital Corner, McGuireWoods’ Geoff Cockrell sits down with Hector Torres and Rich Blann, managing directors on DC Advisory‘s global healthcare team. They discuss market trends and current areas of interest from both investors’ and sellers’ perspectives.
Hector and Rich share the challenges they’ve seen in the market this year, as well as where they see the upward trends heading. From the bid-ask spread to physician practice consolidations, they offer plenty of advice and hope for the remainder of the year.
Episode 33: The Banker’s Corner, August 7, 2023
The healthcare system is one of the most fragmented industries in the United States. As strategic players begin consolidating through mergers and acquisitions, however, private equity investors are seeing growth opportunities in the sector.
On this episode of The Banker’s Corner, McGuireWoods’ Geoff Cockrell invites Rex Burgdorfer, partner at Juniper Advisory, to discuss M&A trends, consolidation and activity in the healthcare sector.
Geoff and Rex also discuss trends for private equity and health systems, regulatory scrutiny in this area, creative competitors, and the impact a looming recession could have on the industry.
Episode 32: The Capital Corner, July 26, 2023
Closing a deal requires give and take, and in times of uncertainty, the right sponsors will have your back.
On this episode of The Capital Corner, Andy Silverman, managing director at Parkway Capital, joins McGuireWoods’ Geoff Cockrell to discuss the trends, deal structures and challenges an SBIC may see in the market now.
Andy and Geoff explore topics related to investment and underwriting, including the significance of independent sponsors in Parkway Capital’s deal flow. Andy notes that being a long-tenured capital partner of independent sponsors allows his firm to make informed decisions on which deals to pursue, with eight of its nine portfolio company deals led by independent sponsors.
Episode 31: The Banker’s Corner, July 19, 2023
The healthcare sector attracts interest from the investment community because it’s seen as more resilient than other parts of the economy. But how does the medspa sector compare? During the pandemic, cosmetic procedures actually rebounded faster than the medical dermatology side.
On this episode of The Banker’s Corner, McGuireWoods’ Geoff Cockrell discusses all things medspa with Mike Pisani, managing director and co-head of healthcare services at Houlihan Lokey. They cover trends, growth opportunities and challenges for today’s medspas and how they affect investors’ view of the space.
Episode 30: The Banker’s Corner, July 7, 2023
Proceed with caution — and a little creativity.
That’s the tipoff for 2023. In this episode, host Geoff Cockrell sits down with Bob Bartell, managing director and president of Kroll Corporate Finance and CEO of Kroll Securities LLC.
Together, Bob and Geoff delve into a topic overshadowing private equity for the past few months: tightening credit. Given his position at Kroll and experience in a broad array of corporate finance advisory engagements, Bob provides an apt commentary on the current climate, including the impact on healthcare business.
Tune in to hear about the outlook for the rest of 2023 and the creative ways professionals are managing workarounds and earnouts in this strange market climate.
Episode 29: The Professors’ Corner, June 27, 2023
In most professions, pay-for-performance is the norm. A certain level of performance is expected for an individual to get paid. So why has the fee-for-service model in healthcare persisted for so long? And what’s causing the shift toward value-based care?
On this episode of The Professor’s Corner, Larry Elisco, partner at Wipfli LLP, discusses trends in value-based medicine with McGuireWoods’ Geoff Cockrell. The two acknowledge that the compensation structure has had a slow start despite its promising future.
“My view is that value-based care changes the landscape. It’s pay-for-performance. It creates risk at the provider level, where providers are in fact either going to be paid for performing well or not being paid if they don’t perform well. And that’s really what I see as a mega trend,” says Larry.
Episode 28: The Capital Corner, June 8, 2023
Did you know that pharma services is one of the most active areas of healthcare investing? On this episode of The Capital Corner, McGuireWoods’ Geoff Cockrell sits down with Daniel Brinkenhoff, managing director at Centre Partners, to discuss the segmenting of the pharma services sector and some of the headwinds and tailwinds investors are seeing.
Episode 27: The Capital Corner, May 23, 2023
On this episode of The Capital Corner, McGuireWoods’ Geoff Cockrell sits down with Dan Hosler, managing partner and founder of DuneGlass Capital, to discuss trends for healthcare services companies interested in using the private equity playbook to surcharge their growth.
Episode 26: The Banker’s Corner, May 3, 2023
On this episode of The Banker’s Corner, Provident Healthcare Partners Senior Managing Director Rebecca Leiba and Managing Director Eric Major sit down with McGuireWoods’ Geoff Cockrell to discuss investing in cardiology, a sector that has seen a sizable uptick in activity over the past two years.
Episode 25: The Professor’s Corner, April 17, 2023
Compliance in Healthcare Is King — Even for Investors
In this era of private equity involvement with healthcare, companies and individuals can no longer avoid liability by claiming they are just investors in a business. Investors’ liability is now in the spotlight. Professionals in the industry predict that the government will increase the frequency of commercial audits and audits by the Centers for Medicare & Medicaid Services.
On this episode of The Professor’s Corner, host Geoff Cockrell is joined by Wiks Moffat for a discussion of the importance of compliance programs. Bringing over 25 years of professional experience to this discussion, Wiks is a co-founder and principal at HealthCare Compliance Network, where he assesses, builds, implements and maintains compliance programs.
Episode 24: The Banker’s Corner, April 6, 2023
Healthcare Provider Services: Trends and Opportunities in 2023
On this episode of The Banker’s Corner, Kyle Brown, managing director at Brown Gibbons Lang & Company, joins McGuireWoods’ Geoff Cockrell to discuss the latest developments in healthcare private equity investing. With the current deal market offering lower valuations, companies are looking at internal improvements, such as operations and platform infrastructure, as well as mergers and organic growth strategies.
Kyle discusses how diversification, platform infrastructure and a true dual-pronged growth strategy are key drivers of value regardless of the subsector. “Sure, buy and build all day. You have that integration strategy in spades, great,” Kyle says. “But I’ve seen — and not because of the debt financing markets, but really since COVID — folks are putting a premium on de novo growth strategies.”
Kyle and Geoff also discuss two subsectors they predict will experience increased investor activity in 2023: orthopedics and pain management. Both sectors have unique traits that add value to investors and make them ideal for investment activity.
Episode 23: The Banker’s Corner, March 30, 2023
What to Expect in Healthcare Investing in 2023
On this episode of The Banker’s Corner, McGuireWoods’ Geoff Cockrell invites Raj Kothari, managing director at Cascade Partners, to discuss the current challenges of the healthcare investing market.
An uncertain market and disagreements on valuations have created an interesting start to 2023, which saw a decrease in transactions in the first quarter. For those looking to make larger healthcare sales, the general consensus seems to be to wait until Q2 or Q3 and see if market conditions improve. Raj recognizes that buyers are being more thoughtful and cautious when considering a deal. However, the lower and middle market valuations are holding up.
Episode 22: The Banker’s Corner, March 20, 2023
What to Expect from the Healthcare Deal Market in 2023 with David Baker
With higher interest rates causing anxiety throughout much of the first quarter of 2023, McGuireWoods’ Geoff Cockrell invites David Baker, managing director at FTI Consulting Group, to share his view of the market and how it is impacting sellers in the M&A space.
Healthcare as an industry is more resilient in a down economy, David explains, as demand is less likely to be impacted by economic factors. This resilience attracts investors looking to avoid the challenges present in other sectors. “I think what attracts a lot of investors to the segment is how steady it is,” says David. “Healthcare hasn’t had the highs and lows that many other sectors have gotten over the years.”
Episode 21: The Banker’s Corner, March 14, 2023
Opportunities in MedTech for 2023
On this episode of The Banker’s Corner, McGuireWoods’ Geoff Cockrell chats with Larry Barr, partner at Middle Branch Partners, about the buy side of private equity transactions, particularly in the healthcare industry. Larry also shares his take on some of the drivers bringing private equity investment into the medtech space.
Despite uncertain waters due to macroeconomic dynamics and uncertainty around credit availability, Larry remains bullish on medtech. “I’m one of those that’s a perennial bull,” Larry explains. “As I like to say, I couldn’t do what I do for a living if I wasn’t an optimist.” He cites a recent medtech deal, coming in at just under $200 million, as proof that there are good transactions in the market and people are going to find a way to close them.
Episode 20: The Professor’s Corner, March 1, 2023
The Broad Impact of The FTC Noncompete Proposed Rule
In January 2023, the Federal Trade Commission released a proposed rule that is making waves in the business and legal communities. The proposed rule would make it illegal for employers to enter into noncompete agreements with workers in most circumstances and would require employers to rescind existing noncompete provisions.
McGuireWoods antitrust partner Holden Brooks sits down with Geoff Cockrell to explore the potential ramifications of a noncompete ban, potential legal challenges to the rule and the scope of the FTC’s rulemaking authority, what to watch in the ongoing debate surrounding the scope of the rule, and what alternatives to consider to protect your business interests if the rule goes into effect.
Episode 19: The Capital Corner, January 26, 2023
Terry Wang on the Demand Driving Growth in Behavioral Health
Only 20% to 25% of patients who need behavioral health support actually receive care. That means the behavioral health sector offers opportunity and high return on investment for investors focused on delivering better outcomes at lower costs.
Terry Wang, partner at Regal Healthcare Capital Partners, joins host Geoff Cockrell on this episode of The Capital Corner for a discussion of opportunities in the behavioral health sector, growth strategies and what 2023 may look like.
Episode 18: The Banker’s Corner, December 12, 2022
PPM Investing with Geoff Smith and Charles Busch of Harris Williams
The physician practice management (PPM) and the consumer healthcare sector are often referred to interchangeably, but they have very different needs and concerns on the market. In consumer healthcare, patients have a lot of discretion in their choice of physician. PPM, by contrast, is more referral-driven. But these distinctions are softening.
On this episode of The Banker’s Corner, host Geoff Cockrell welcomes Geoff Smith, managing director and co-head Harris Williams’ Healthcare & Life Sciences Group and Charles Busch, vice president of the company’s Healthcare & Life Sciences Group. Together, they discuss the appeal of PPM to investors, reimbursement stability and trends they expect to see in the future
Episode 17: The Professor’s Corner, November 21, 2022
How Sponsors Can Avoid Liability with Mark Freedlander
In this second episode of a two-part series, McGuireWoods partner Mark Freedlander returns to discuss the ways a sponsor company can find itself liable if its portfolio companies enter financial distress.
Join Mark and host Geoff Cockrell for insight on different situations a sponsor may encounter, the protection available to a sponsor who recognizes problems early and the benefits of taking a cautious approach.
Episode 16: The Professor’s Corner, October 28, 2022
The Liability Implications of Financial Challenges in Portfolio Companies with Mark Freedlander
Many investors take on an operating thesis that, by law, the obligations of investment companies are not the obligations of the investor. They apply this whether their fund has invested in the securities of a limited partnership, a limited liability company or a corporation.
In the first of two episodes, McGuireWoods partner Mark Freedlander joins host Geoff Cockrell to explore the limits of this idea. Tune in as they discuss preference statutes, fraudulent conveyance and patterns that emerge in troubled portfolio companies.
Episode 15: The Professor’s Corner, August 25, 2022
When Claims Arise: Tackling the Internal and External Elements with Tony Tatum
It’s nine to 12 — maybe even 18 — months after the deal closed. There’s an R&W policy in place, and the purchase agreement covers an array of representations and warranties. But you become aware of something that might be a breach.
In this episode of The Professor’s Corner, McGuireWoods partner and insurance recovery practice leader Tony Tatum joins host Geoff Cockrell to walk listeners through the process of filing a claim, citing the issues that might arise and errors to look out for at the onset. He also discusses the importance of gathering evidence, being thorough, advocating for your company and mitigating losses.
Episode 14: The Capital Corner, August 10, 2022
OB-GYN and Fertility Care Investing with Jason Porter of Baird
OB-GYNs and fertility providers present a range of opportunities for investors. Many patients see them more frequently than they do general healthcare providers, and advancing research and technology in the space continues to generate successful outcomes.
Tune in to host Geoff Cockrell and Baird managing director of healthcare investment banking Jason Porter as they discuss where the OB-GYN and fertility sectors differ, where opportunities in the sector are growing, and what providers and groups can do to be more successful as they shift to value-based care.
Episode 13: The Professor’s Corner, July 21, 2022
How Increased Demand Is Driving Interest in Women’s Health Investing
The women’s health sector is a diverse subset of businesses covering multiple specialties, including fertility and ancillary services. On this episode of The Professor’s Corner, McGuireWoods lawyer Kayla McCann Marty joins partner and host Geoff Cockrell to discuss women’s health investing — from models like de novo growth and acquisitions to regulatory compliance issues and future trends in this active sector of the market.
Episode 12: The Banker’s Corner, July 7, 2022
Trending Valuations in Healthcare IT With Mikel Parker of AMB
On this episode of The Banker’s Corner, McGuireWoods’ Geoff Cockrell invites Mikel Parker, a head of investment banking and managing director at AMB, to discuss current valuation trends in healthcare IT and other subsectors.
During their discussion, Mikel pinpoints four main sectors within the concentrated field and the two types of buyers he comes across in his work. Tune in to learn why healthcare IT continues to prove profitable and why companies are shifting from transaction-based models to recurring-based models.
Episode 11: The Capital Corner, June 14, 2022
Strong Margins and Recession Resistant: The Allure of Pharma Services
The pharmaceutical services industry has piqued the interest of private equity investors over the last five to 10 years as more drugs move into development and high-quality science continues to grow.
On this episode of The Capital Corner, McGuireWoods’ Geoff Cockrell sits down with Dr. Bijan Salehizadeh, managing director at NaviMed Capital, to discuss the latest developments in the pharma services space within healthcare private equity.
Episode 10: The Capital Corner, June 1, 2022
Thesis-Driven Investing With Pete Tedesco of Health Enterprise Partners
In this episode of The Capital Corner, Pete Tedesco of Health Enterprise Partners joins host Geoff Cockrell to discuss post-pandemic demands within the healthcare industry and the growing interest in investment of niche healthcare sectors. Pete explains that it’s all about understanding the current industry climate — and it’s important to stay ahead of the curve.
Episode 9: The Professor’s Corner, May 16, 2022
Indemnity or Self-Disclosure? Here Are The Best Ways to Deal With Policy Compliance Issues
In the healthcare industry, some significant compliance issues and violations can go unnoticed or implemented unintentionally. When addressing common healthcare mistakes like Stark Law violations or billing and coding issues, should one fix on a go-forward basis, address through indemnification in the deal context, or self-disclose to the government? The answer isn’t as simple as you might think.
McGuireWoods partner Timothy Fry joins host Geoff Cockrell to discuss the most common mistakes he sees in healthcare policy compliance, the potential consequences and the smartest solutions.
Episode 8: The Professor’s Corner, May 2, 2022
Understanding Antitrust Law in the Healthcare Space
In healthcare transactions, people often think antitrust issues are a big corporation’s problem, but smaller companies may be at risk, too — and not just for civil liability. The past couple of years have brought multiple criminal cases against individual healthcare providers and corporate entities alike.
In this episode of The Professor’s Corner, host Geoff Cockrell interviews Holden Brooks, a partner in McGuireWoods’ Antitrust, Trade, and Commercial Litigation Department, to discuss best practices for managing antitrust risk in the healthcare space. Holden details new developments and regulations to help you prepare for deals and avoid antitrust risk — no matter the size of your business.
Episode 7: The Professor’s Corner, April 20, 2022
Mitigating Risk With Healthcare Investing
Record-setting deal activity toward the end of 2021 strained the representation and warranties insurance (RWI) markets, directly impacting certain sectors including healthcare. This led to RWI policies with significantly higher rates and limited appetite for healthcare transactions. However, as we work through the second quarter of 2022, RWI prospects for healthcare transactions are looking brighter, with carrier appetite returning and rates settling.
In this episode of The Professor’s Corner, host Geoff Cockrell is joined by Sumit Agarwal, a senior vice president in Marsh’s Transactional Risk Group, and Sam Bell, a senior client executive and vice president at Marsh, who discuss how the RWI market reacted to the 2021 deal flow, the current state of the RWI market and returning carrier appetite for healthcare transactions.
Episode 6: The Professor’s Corner, March 24, 2022
Representation and Warranty Policies for Private Equity-Backed Healthcare Deals
When preparing a private equity-backed healthcare investment, a reps and warranty insurer can request two types of exclusions: general exclusions and specific exclusions. The end of 2021 showed a significant increase in general exclusions, which left companies exposed to risk under the False Claims Act. Though the trend started shifting in early 2022, general exclusions are still something counsel should examine.
In this episode of The Professor’s Corner, host Geoff Cockrell invites colleague and McGuireWoods partner Trey Andrews to discuss how to navigate general and specific exclusions when purchasing a reps and warranty policy.
Episode 5: The Banker’s Corner, March 4, 2022
Investor Interest: What’s Happening in Home Healthcare?
On this episode of The Banker’s Corner, McGuireWoods’ Geoff Cockrell invites Barry Freeman, managing director of Lincoln International’s U.S. healthcare industry team, to discuss trends and investing opportunities in home health, hospice and palliative care. Barry shares his in-depth knowledge of the home healthcare space, including key takeaways from the recent Home Care 100 industry event. Barry also walks listeners through changes in the industry, where he believes the sector is headed and the advances being made to help manage risk.
Episode 4: The Capital Corner, February 28, 2022
Investing Beyond Capital – Finding the Right Partnership Fit
On episode one of The Capital Corner, McGuireWoods partner Geoff Cockrell talks to Seven Hills Capital founding partner Matt Pettit about investing in the small to mid-sized healthcare market. As a former CEO of a dermatology practice management company who now leads a firm focused on first-round institutional capital investment, Matt speaks from experience on both sides of the healthcare services table.
Matt discusses why investing in small to medium-sized companies requires a much different approach than strategies larger-scale equity firms employ. He also explains why healthcare businesses need more than just capital and examines the importance of investors knowing their limits.
Episode 3: The Banker’s Corner, January 28, 2022
The Prognosis for Healthcare M&A Heading Into 2022
In episode one of The Banker’s Corner, McGuireWoods host Geoff Cockrell and WestCove Partners managing director Justin Hand discuss why investors have a responsibility to drive disruptive evolution in the healthcare business and how the competitive landscape impacts small and less-capitalized practices. Learn what’s driving healthcare exits and why there is more to partnerships for physicians beyond the cash considerations at the close.
Episode 2: The Professor’s Corner, December 28, 2021
The Legal Implications of Board-Driven Decision Making (Pt. 2)
In the premiere episode of The Professor’s Corner, McGuireWoods partner David Pivnick shared best board practices to mitigate risk when making challenging decisions. In this follow-up episode, David joins host Geoff Cockrell to expand on a larger trend in healthcare litigation: Private equity funds are finding themselves legally responsible for the activity of the companies in their portfolio.
Hear how qui tam rules increase the risk of qui tam plaintiffs naming PE funds and why investors have a responsibility to ensure proper conduct. Learn why, the darker the gray area of misconduct, the greater the risk is for everyone involved.
Episode 1: The Professor’s Corner, December 2, 2021
The Legal Implications of Board-Driven Decision Making
In the premier episode of The Professor’s Corner, McGuireWoods partner and host Geoff Cockrell is joined by McGuireWoods partner and complex corporate healthcare litigator David Pivnick. They discuss a recent whistleblower case in Massachusetts that challenged the widely accepted notion that private equity investors are insulated from risk beyond the scope of their financial investment.
Learn about the ruling’s implications for private equity funds and the gray areas of board-driven decision making. Find out about the “one purpose” rule and what Dave deems the red flag of document deliberation.
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