As Predicted, Gastroenterology Acquisition Activity Surges to New High in Q1 2021 – Major Opportunity for Selling Physicians
The first quarter of 2021 delivered nineteen gastroenterology practice acquisitions, marking an enormous surge of M&A activity within the specialty. To put that into context, the past three months had more acquisitions than the entire year of 2020. We expect that higher level of activity to continue as GI moves through the expansion lifecycle stage.
Transaction Volume Continues to Increase Across Home Health & Hospice. Heaviest Activity in the West and Southwest.
The first quarter of 2021 delivered 35 reported home health and hospice transactions. We expect some of this activity reflects deals that were delayed due to COVID-19, however the pandemic generally increased attention on the sector. We expect high deal flow throughout 2021, supported by strong private equity interest, a favorable government, and a seller pool that is ready to transact. Transactions in the West and Southwest dominated the landscape.
After a Strong First Quarter, 2021 Is Now Looking Like a True Window of Opportunity for Ophthalmology Deals
The first quarter of 2021 delivered fifteen reported ophthalmology practice acquisitions, continuing the surge of M&A activity within the specialty. Notably, EyeCare Partners, now owned by Partners Group, acquired Blue Sky Vision from Sterling Partners, marking a recapitalization of the Michigan-based platform. Acquisitions were spread across ten different buyers highlighting the competitive landscape and various choices practices have for potential partners.
Seventeen PE Firms are now Investing in Orthopedic Practice Acquisitions, Signaling a Probable Surge in 2021 Deal Activity
The first quarter of 2021 delivered four reported orthopedic practice acquisitions continuing a steady pace of transactions in the specialty. Notably, we saw the formation of two new platforms. Trivest partners acquired Bluegrass Orthopedics to form a platform of the same name, and Kohlberg & Company acquired Orthopedic Associates of Manhasset and formed Spire Orthopedic Partners. Seventeen PE firms now have orthopedic platform investments. We believe activity will continue to build throughout the year.
Private Equity Deals for Urology Practices Surges to All-time Record in the First Quarter of 2021. More Expansion Coming?
In our Q4-20 report we noted an increasing interest in urology and posed the question, “Is Urology the Next Darling of Private Equity?” That looks more likely now as the first quarter of 2021 delivered more urology practice acquisitions than any full year since 2017. With six firms now actively seeking to grow their urology platform presence, we believe this specialty may just be entering the Geographic Expansion stage.
Q1 Women’s Health Deals with Private Equity Remain Steady. Investor Activity Indicators Suggest Growth Through 2021.
The first quarter of 2021 delivered three reported Women's Health practice acquisitions. Notably, Shore Capital Partners announced the formation of Together Women's Health, a leading network of integrated women’s healthcare providers with founding practices in greater Detroit.
In the short 10 months since ServiceNow announced the expansion of its partner program and industry-aligned solutions in May 2020, Partners have benefited from rapid growth in the ServiceNow category. Furthermore, as most IT projects move to a virtual environment in the post-COVID-19 era, ServiceNow has emerged as the preferred IT service management (ITSM) platform for enterprise IT departments.
The FOCUS Carrier-Focused Telecom Technology Index (CFTTI) was in the black for the second straight reporting period with a three-month gain of 5.7%. While this gain beat the 5.2% increase in the S&P 500 over the corresponding time period, it also fell short of the 8.2% gain in the NASDAQ. The sector also looks strong for the full year period with a gain of 17.8%. However, despite the robust increase, the CFTTI still lagged far behind both the 29.0% gain in the S&P 500 and the 54.0% gain in the NASDAQ. Sector multiples closed out the period at 2.3x revenue and 11.2x EBITDA. Both of these are higher than year-ago multiples of 2.1x revenue and 10.4x EBITDA.
The FOCUS Enterprise-Focused Telecom Technology Index (EFTTI) turned in a very strong overall performance this period with a three-month gain of 18.2%.This handily out- performed the 13.6% gain in the S&P 500 but fell slightly short of the 19.8% gain in the NASDAQ over the same time frame. The story is similar for the full year period with a 41.5% gain in the EFTTI comparing favorably to the 15.2% gain in the S&P 500 but trailing the 42.8% gain in the NASDAQ. Sector multiples are up sharply compared to this same time last year. The sector revenue multiple jumped from 4.3x a year ago to 6.3x currently, while the sector EBITDA multiple expanded from 16.8x to 24.7x.
The FOCUS Communications Service Provider Index (CSPI) managed to pull off a hat trick by posting its third straight reporting period with a strong gain. The sector was up 7.8% over the past three months. While a very good performance, it still managed to lag the 11.7% gain in the S&P 500 and the 15.4% gain in the NASDAQ over the corresponding time frame. This period’s gain was enough to bring the CSPI into the black for the full year period with a gain of 4.9%. Once again, this underperformed both the S&P 500 (up 16.3%) and the NASDAQ (up 43.6%). Sector multiples are slightly higher than at this same time last year. The sector revenue multiple closed out the period at 3.1x (up from 3.0x a year ago) and the sector EBITDA multiple ended at 8.7x (up from 8.4x a year ago).