Private Equity and Healthcare: Leadership, Economics, and Trends for the Future
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Authored by expert Max Reiboldt, CPA, and a distinguished group of contributing authors, this comprehensive guide explores every facet of private equity (PE) within the healthcare industry. From understanding the fundamental structure to mastering strategic and tactical considerations, this book provides a clear, unbiased, and fact-based examination of this complex field. Max Reiboldt is joined by Coker contributors, John Reiboldt, Mark Reiboldt, Ryan Grey, Andy Sobczyk, and Taylor Cowart. Chad Eckhardt, an attorney at Frost Brown Todd, rounds out the contributing author team.
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Private equity is now an integral part of the healthcare landscape, making it essential to understand its impact. This book doesn't promise one-size-fits-all solutions but equips you with the knowledge to tackle PE challenges head-on. Through keen analysis and practical problem-solving, it fosters informed decision-making and strategic thinking.
Who Should Read This Book?Whether you're a physician, health system leader, PE sponsor, payer, or any participant in the healthcare industry, this book is tailored to help you grasp the nuances of PE deals in healthcare.
Addressing Critical Industry Challenges:Navigate the completion of PE deals
Understand the economics of PE transactions
Ensure the long-term viability of PE relationships
Reader Benefits:Master complex industry dynamics: Gain confidence in handling the intricacies of PE in healthcare.
Enhance your understanding: Achieve self-satisfaction from a deeper comprehension of the subject.
Empower your decision-making: Feel empowered to address PE challenges with informed choices.
Access unbiased insights: Benefit from fact-based information with no hidden agendas.
Learn from real-world examples: Rich with case studies and practical examples.
Cost-effective knowledge: More affordable and comprehensive than hiring a consultant.
Empower Yourself with the Ultimate ResourceEquip yourself with the definitive guide to PE and healthcare to navigate this intricate landscape with confidence. Make informed decisions and master the complex world of private equity in healthcare.
About the author
Max Reiboldt, CPA, is the chief executive officer of Coker. He has dedicated his career to understanding and solving the complexities faced by healthcare providers, health systems, and private equity investors. His hands-on approach and open communication style have made him a trusted advisor and consultant nationwide.
Contents
- Acknowledgments
- Introduction to Private Equity and Healthcare
- Chapter 1: An Overview of Private Equity and Healthcare
- Defining Private Equity
- History of Private Equity in the Healthcare Industry
- Evolution of the System
- Private Equity Successes and Failures
- Private Equity and Ancillary Services
- Financial Ramifications of Private Equity Transactions in Healthcare
- Private Equity and Investment Return
- Summary
- Chapter 2: Typical Private Equity Healthcare Structures
- Inherent Features of PE and Healthcare Transactions
- Features of Typical PE Healthcare Transactions — Purchaser
- PE Operational Entity/Management Organization
- Purchaser Characteristics
- Features of Typical PE Healthcare Transactions — Seller
- Seller Considerations — Exit Windows
- Healthcare Regulatory Considerations
- Overall Goals and Objectives
- Summary
- Chapter 3: Healthcare Laws Impacting Private Equity Transactions
- Corporate Practice of Medicine
- Antitrust Considerations
- The Anti-Kickback Statute
- The Physician Self-Referral Law (Stark Law)
- The False Claims Act
- Loper Bright Enterprises v. Raimondo
- Summary
- Chapter 4: Valuation and Quality of Earnings in Private Equity Transactions
- Enterprise Value
- Valuation Processes
- Overview of QofE
- Key Benefits
- QofE Report Example
- Key Steps
- Summary
- Chapter 5: Physician Dynamics in Private Equity Transactions
- Physician Options Relative to Practice Structure
- Physicians and Private Equity Opportunities
- Relevant Matters for Physicians
- Summary
- Chapter 6: Economic Pros and Cons in Private Equity Transactions
- Economic Components
- Upfront Funds
- PE Model Valuation
- Practice Agreements Regarding Valuation and Upfront Dollars
- Rollover Equity Considerations
- Multiples of Earnings
- Post-Transaction Economics
- Summary
- Chapter 7: Non-Economic Pros and Cons of Private Equity
- Economic vs. Non-Economic Considerations
- Non-Economic Factors
- Summary
- Chapter 8: Ancillaries and Private Equity Transactions
- Structural Examples
- Ancillary Values
- Non-Clinical Ancillaries
- Legal and Regulatory Issues
- Specific Ancillary Services
- Ambulatory Surgery Centers
- Cardiology
- Orthopedics
- Other Specialties
- Summary
- Chapter 9: The Role of MSOs and BSOs in Private Equity Deals
- PE Deal Structure and MSOs or BSOs
- MSO and BSO Structures and Strategies
- Exit Scenarios
- Summary
- Chapter 10: Affiliate Contrasts
- PE vs. Platform
- Other Possible Affiliates
- Summary
- Chapter 11: Specialty Nuances
- The Consolidation Curve
- Hospital- and Contract-Based Specialties
- Anesthesiology
- Radiology
- Emergency Medicine
- Non-Hospital-Affiliated Specialties
- Dermatology
- Ophthalmology
- Dental
- Other Specialty Practices
- Gastroenterology
- Urology
- Women’s Health
- Orthopedics
- Oncology
- Cardiology
- Future Specialties
- Summary
- Chapter 12: Conclusions Regarding Private Equity Deals
- Critical Characteristics of PE-Backed Firms and Healthcare Entity Affiliation
- Key Similarities
- Key Differences
- Economics
- Structure
- Governance
- Recommended Attitude Toward PE — Practice or Healthcare Provider
- Perspectives
- Challenges Involving Hospitals
- Challenges Regarding Group Mergers and PE Deals
- Summary
- Chapter 13: The Future of Private Equity in Healthcare
- Trends and Considerations
- Summary
- Appendix A: Examples of Private Equity Firms and Associated Specialties
- Appendix B: Case Studies
- Case Study One: Preparing to Consider Private Equity Affiliation
- Case Study Two: Sell-Side Representation Processes
- Summary
- Case Study Three: Sell-Side Negotiations
- Case Study Four: Sell-Side Transaction Finalization
- Appendix C: Statutory Resources
- Corporate Practice of Medicine
- Antitrust
- Pre-merger Notification Program
- Private Equity
- No Surprises Act
- Anti-Kickback
- Appendix D: Glossary of Terms in PE Transactions
- Appendix E: General Formatting for the QofE Report
