And Then There Were Two...

The Chicago metro area is home to roughly 9.5 million people who deal with their share of weekend warrior pains, weather aches or chronic health issues.  Fortunately, there’s an abundance of physical therapists and clinics to address such health concerns.  Interestingly, three of the country’s largest PT platforms also call Chicago home – Athletico, Accelerated and ATI.  While each platform is well entrenched in the area, they have all successfully expanded their footprint beyond the Windy City.

Recent news comes that Athletico and Accelerated Rehabilitation Centers are combining efforts...  An enhanced service level to patients is expected along with a bump up in status among the industy’s top companies.  The larger organization will be led by Mark Kaufman from the Oak Brook, IL headquarters.  >>Read more

Shore Sits Pretty with Vet Platform

Chicago's Shore Capital recently acquired three Southeast animal hospitals to create the animal hospital platform, Southern Veterinary Partners (SVP).  Jay Price, owner of the merged clinics, will lead the general veterinary services practice as CEO from its Birmingham, AL headquarters.   Shore and Dr. Price look forward to building a "best-in-class regional platform" through partnerships with like minded veterinarians.  >>Read more  Mike Cooper, Shore Capital partner and Southern Veterinary Partners Chairman noted: 

"As part of our sector-focused investment approach, we’ve spent significant time studying the veterinary services industry and we are confident that the sector benefits from a number of attractive industry dynamics and is ripe for continued consolidation.” 

Let's Connect in Colorado...

We're headed to Colorado Springs…    
to exhibit at the American Physical Therapy Association's annual meeting for practice owners - 2014 Private Practice Section (PPS). 

The Conference & Expo (Nov 5-8) will be held at The Broadmoor, an elegant hotel near the southern edge of the Rockies.  Stop by to see us at Booth 706 in the PPS Expo Hall on Nov 6 or 7 (Thurs. / Fri.)!  >>More info

CSM 2015 is coming in February - MT Consulting will be there too!

Winning Year for TEAMHealth

October acquisitions add to a productive year for TEAMHealth, the Knoxville-based provider of outsourced physician staffing solutions for hospitals.  Premier Physician Services, the latest acquisition, adds 700 physicians and advanced practice clinicians to the TEAMHealth roster.  Premier physicians cares for one million Dayton area patients annually by staffing 42 emergency departments, 7 hospital medicine programs, 11 occupational medicine programs and 14 correctional care programs.   >>Read more    
Other 2014 acquisitions include:

TeamHealth Partners	Headquarters	Annual Patient Care
-Salutis Emergency Specialists	Martinsburg, WV	ER – 54,000
-Physician Services of Cleveland	Cleveland, TN	ER – 52,000
-Trident Emergency Physicians	Charleston, SC	ER – 120,000
-Teaneck Emergency Physicians	Teaneck, NJ	ER – 53,000
-Heartland Anesthesia Services	Omaha, NE	Anesth. - 10,000 cases*
-Florida Gulf-to-Bay Anesth.  Associates	Tampa, FL	Anesth. - 160,000 cases*
-Emergency Medicine Specialists	Detroit, MI	ER – 400,000
-Primary Critical Care Medical Grp	Burbank, CA	Hospital – 100,000
-PhysAssist Scribes	Ft. Worth, TX	Scribe svcs - 155 ERs

TEAMHealth's acquisition lineup underscores a recent comment by Jeff Swearingen, Co-founder of Edgemont Capital Partners and company advisor:

“Physician practice consolidation has accelerated in 2014 as the rollout of the Patient Protection and Affordable Care Act drives significant change and increased complexity in healthcare…"  

Consistently, executives of new partner companies recognized TeamHealth's depth of resources and strong infrastructure...and the organization's support in meeting the demands of advanced patient care.

3Q Deals Add Up / DaVita Adds On

Just released…
Axial*'s third quarter, 2014 snapshots of deal activity in key business sectors  (Energy, Manufacturing, Healthcare, Tech). 

Source:  Axial

Third quarter deal flow in Healthcare & Life Sciences reached the highest level this year - an increase of 28% quarter-over-quarter.  Healthcare Services deals topped that of other Healthcare subsegments: Facilities, Equipment, Life Sciences Tools & Services, Supplies.  Industry executive,  Brent Earles, suggested that:  

"Many medical groups, independent practice associations, hospitals, and health systems will merge or be acquired. These transactions will drive systems to gain increased access points, greater critical mass, expanded population health management knowledge, and a stronger presence in geographic areas or regions.”    

*Axial is a largest network for professionals who run, advise & finance private companies. >>Read more

Source:  Axial

In fact…
Today's news from Colorado supports Mr. Earles' premise.  DaVita HealthCare Partners announced its intention to acquire Colorado Springs Health Partners (CSHP).  DaVita is a provider of population health and kidney care services.  The completed acquisition will add another multi-specialty medical group with 100+ physicians at 11 locations to the organization.  The  company already manages medical groups in six other states:  California, Nevada, Florida, Arizona, New Mexico, Pennsylvania.  >>Read more

  

Five Points Moves into Tennessee

Five Points Healthcare, a Fulcrum Equity Partners' portfolio company, added another  company in 2014.  The late August acquisition of Nashville-based Willowbrook Health Systems, a provider of home health and hospice care,  adds seven point of service to the Five Points network.  The Five Points family of companies already includes BestCare Home Care, AAA Home Health and Hospice, Paramount Hospice.  Led by CEO Rob Radics, the Five Points management team is focused on becoming the premier provider of home health and hospice services throughout the southeast.  >>Read more

Tele-health Green-Light

Industry stakeholders are applauding Medicare's step toward expanding tele-health coverage with its proposed update to the Medicare Physician Fee Schedule for 2015.  California politicians have also seen the light…The governor recently signed a bill that purports to make tele-health easier for rural patients to use. 

The fact that there is greater acceptance of the technology and approach is not lost among early stage investors…Teladoc, a provider of 24/7 tele-health consultations, is the beneficiary of $50M more in new venture capital funding.

For more information: 
Telemedicine Interest Surges 
Rx for the Future?

ADCS Adds Offices Out West

The team at ADCS continues its push into western states with the latest acquisition in northern Colorado (Ft. Collins).  Florida-based Advanced Dermatology and Cosmetic Surgery boasts over 100 clinics, primarily in the southeast.  With the Fort Collins Skin Clinic acquisition, the nationwide derm platform adds 11 more Colorado locations to its office list. >>Read more

Related:
Derm Platform Continues Buying Spree

Nationwide Derm Practice Adds Midwest Clinic

Calling Dr. Walmart…

The world's largest retailer wants to be your doctor too.

Walmart is stepping up its healthcare game with a leap into primary care.  This is a bold move following limited success with its retail health clinics (opened 260; closed 166*).  CVS and until last year, Walgreens, have been careful not to overstep into primary care - thus, minimizing the ire of local doctors.  Contrary to that, Walmart's intention is for new clinics in South Carolina and Texas to act as a primary care provider.  Given Walmart's geo footprint, their primary care concept may play out well as rural areas are traditionally underserved by primary care providers.

Expansion will continue by Walmart, as well as CVS and Walgreens.  At stake, a greater slice of the Obamacare pie…or, is it goodwill they're after?  >>Read more

Weigh in…would you call on Dr. Walmart?  

*Merchant Medicine

Partners Acquire Skilled Nursing Portfolio

Two investment firms with a strategic partnership enhanced their skilled nursing facility portfolio with the acquisition of 14 Mid-Atlantic facilities.  The newly acquired facilities, operated by Consulate Health Care, are located in Virginia, Maryland, Pennsylvania.

The partners…Formation Capital and Safanad have done this before... to the tune of over $1B invested in the sector.  Other recent acquisitions include:
2013… 36-property senior housing portfolio across 13 states
2012… 68-property portfolio on the East Coast
2011… 36 senior care facilities across 3 deals

>>Read more

Urgent Care Still on Fire

In a recent article, the NY Times restated a fact that we've know for awhile.  The urgent care healthcare segment continues to be Hot.  As noted by the author, Julie Creswell, "The business model is simple:  Treat many patients as quickly as possible."  From this simple approach, the industry has grown to an estimated $14.5 billion business and garnered the attention of commercial insurance companies, regional health systems, local hospitals.  And now..private equity firms.  In fact, PE investors are driving the growth these days.  Of course, expensive ER visits, limited office hours, the more insureds/less doctors conundrum may have contributed to the UC interest and clinic increase.  (~9000 US clinics)

Certainly, well-run platforms are appealing - wonder how many will evolve into a McDonald's type brand?  What do you think?

>>More food for thought:  Race Is On to Profit From Rise of Urgent Care

USAP Extends Houston Coverage

US Anesthesia Partners (USAP), an anesthesia-focused physician services organization, added another group of Houston providers to its physician services organization through a recent partnership.  

The new group of anesthesiologists / anesthetists will become the Northeast Houston Division of Greater Houston Anesthesiology - one of USAP's founding practices.This partnership extends USAP's coverage of the high growth Houston market.  New division providers will enjoy the benefits of USAP's resources as practices nationwide recognize the need to invest in IT and address other key care initiatives.  Read more

Related Articles: 
More Fish in the Net…
New Partner for Anesthesia Specialty

American CareSource Scores Again…

2014 FIFA World Cup Brazil
June 12 - July 13, 2014

Not long after entering the "Urgent Care Game" with its acquisition of CorrectMed of Atlanta, American CareSource is making a pass at another clinic.  They're on the move with an agreement to purchase Bay Walk-in Clinic assets on Florida's panhandle.  Bay Walk-in Clinic is well-established in the Panama City area.  
In reference to the agreement, the American CareSource CEO said that this planned acquisition "...builds momentum for its move into the vibrant Urgent Care industry...”  A move...Dr. Richard W. Turner expects will be a WINNING one!   Read more

One More in NC for U.S. HealthWorks

U.S. HealthWorks strengthens its strong urgent care network and North Carolina presence with the acquisition of IndustriCare.  Dr. Fabienne Ransom currently directs the operation of the Charlotte occupational medical center which was established over 17 years ago.  >>Read more

The U.S. HealthWorks activity continues the 2014 interest in urgent care.  Consider last month's acquisition of two Georgia clinics by American Caresource.  The clinic's previous owner, CorrectMed, LLC, now operates as a subsidiary.   In April, Rite Aid acquired Houston-based RediClinic, a retail clinic operator.  Rite Aid's support will accelerate RediClinic's expansion plans.

See Related Articles on U.S. HealthWorks

Athletico Partners with Harvest

For their next phase of growth, Athletico can rely on Harvest Partners.  The private equity firm recently announced their investment in Athletico, the Chicago-based physical therapy business with 80 clinics throughout Illinois, Indiana and Wisconsin.   >>Read more

Commenting on the partnership, Athletico's President Mark Kaufman noted:

"We chose Harvest as our partner because they support and share Athletico’s goal of providing excellent preventative care… The partnership will bring this mission to new markets via continued organic growth and strategic acquisitions.” 

Harvest has partnered with other healthcare companies within the last few years.  See AxelaCare Finds Harvest Home

PE Firm Set to Acquire Wound Care Ctrs

Healogics Holding Corp., headquartered in Jacksonville, FL, operates more than 500 hospital outpatient Wound Care Centers® across the U.S.  Last year, the company with $300M in sales treated over 215,000 patients.  The company's specialized wound care services are clearly in sync with today's trend of hospital outsourcing.  Wound care treatment aids payors in minimizing medical costs associated with wound-related incidents.

Clayton, Dubilier & Rice (based in New York) will acquire the wound care services provider from Metalmark Capital and Scale Venture Partners with an estimated close in Q2 or Q3.  >>Read more

American CareSource Enters Urgent Care

In 2013, Urgent Care industry revenue topped $14B.  By 2018, revenue is projected to increase to approximately $19B.  Not surprising then...that American CareSource, a network of ancillary healthcare providers, is moving into the urgent care market space.  Their foray begins with the acquisition of two urgent care clinics in the Atlanta metro area.  The Locust Grove and Decatur clinics were previously owned by CorrectMed, LLC.  >>Read more

With the completed acquisition, Dr. Richard Turner, American CareSource CEO, affirms,  

"…we have taken our first important step in entering the urgent care market.  The two centers will be the centerpiece of our strategy to become the high-quality, patient-centric provider of conveniently available affordable urgent care…"

Related:  More Regular Care = Urgent Care Growth

More Expansion in Dermatology Specialty

Dermatology Associates (Tyler, TX) is moving North…

The portfolio company of  Candescent Partners is combining with Kansas City-based Dermatology & Skin Cancer Center (DSCC).  Together, the organization of 25 physicians will provide services to patients from 14 locations in Texas, Kansas and Missouri.  Geoff Wayne will serve as CEO for the combined practices.  >>Read more     

Related:  Dermatology Associates of Tyler Get a Partner

The Dermatology Associates acquisition follows another healthcare-related deal by the PE firm completed earlier this year.  Candescent Healing, a Candescent Partners portfolio company, merged with a subsidiary of RestorixHealth in January.  The two companies, operating under the name RestorixHealth, will continue its focus in the development and management of wound care treatment centers.  (The transaction represented an exit for Candescent Healing, its investors and its management team.)

Derm Platform Continues Buying Spree

Advanced Dermatology & Cosmetic Surgery, the Maitland, Florida-based "Derm" Giant, followed up an early January Midwest acquisition with a few more this year.  Their most recent buys will further strengthen the firm's presence in their home state and include: 

1. South Florida:  Miramar Dermatology founded by Dr. Jay Gottlieb  >>Read more 
2. West Florida:  Albergo Palm Harbor Dermatology founded by Dr. Robert Albergo  >>Read more 
3. North Florida:   North Florida Dermatology Associates founded by Dr. Frank Schiavone and grew to four offices  >>Read more

Advanced Dermatology & Cosmetic Surgery was established by Dr. Matt Leavitt in 1989 and has grown to over 75 locations with presence on both coasts and in the Midwest.  The firm also provides billing & coding services under the Ameriderm™ trade name.

Related:  Nationwide Derm Practice Adds Midwest Clinic

Rite Aid Acquires RediClinic

Step aside CVS and Walgreens…Rite Aid will also 
offer consumers a convenient alternative to a long doctor's office wait.   The recent acquisition of RediClinic, a pioneer in the retail clinic industry, bolsters Rite Aid's health and wellness strategy.  RediClinic services include basic physical exams, screenings, immunizations.

The new parent will support Houston-based RediClinic's expansion in its home state of Texas and into select Rite Aid markets.  RediClinic opened in 2005 and currently operates 30 locations.  Rite Aid operates 4600 stores in 31 states.  >>Read more

Facebook and PT?

What do they have in common? 
On the surface…not much.
However, Facebook's interest in Oculus, a virtual reality company, could do much to spur the adoption of telemedicine in a variety of specialties, including physical therapy.  >>Read more

“After games, we’re going to make Oculus a platform for many other experiences. Imagine… consulting with a doctor face-to-face — just by putting on goggles in your home.”       ~Mark Zuckerberg, Facebook Co-founder

VR therapy for phantom pain

The potential virtual reality application in physical therapy would address the phantom pain experienced by roughly 70% of amputees.  Current treatments include drugs, acupuncture, hypnosis and "mirror therapy" but don't always work.  VR therapies have been developed and tests conducted with more clinical studies needed to better assess the effectiveness.   >>Learn more about the VR approach to reducing phantom pain.

Telemedicine Interest Surges

Telemedicine is gaining a stronger foothold in the U.S. healthcare ecosystem thanks to its lower cost to patients, employers and insurers.  With the advent of smartphones and tablets…this healthcare delivery option is getting recognition as a time-saver too.

A greater number of large employers are covering telemedicine costs - an increase from 12% to 17% in 2013, according to HR consultancy Mercer.   Even more striking is the spike in interest among companies considering telemedicine coverage - from 33% to 43%.  The American Telemedicine Association CEO, Jonathan Linkous noted, "Telemedicine is increasing access, improving quality and decreasing costs…"  View the map for the number of states legislating telemedicine coverage.

How will the increased interest in telemedicine impact primary care physicians, urgent care centers, ERs?  Not.  With the influx of 7.1M newly insured Americans, it's likely that these traditional providers will continue to have a steady stream of patients.  What do you think?   >>Read more
 
Click for more information on telemedicine and telemedicine's niche markets.

Huron's Dental Platform Stronger

Huron Capital, recognized for its buy-and-build approach, is all smiles these days…
The firm strengthened their healthcare platform with the acquisition of a Richmond, VA dental practice.  Huron's portfolio company, Dynamic Dental Partners Group, is a leading dental practice management company providing centralized back-office services to a network of fee-for-service dental practices.  The latest acquisition increases Dynamic's network to 32 locations across Virginia, Florida and Arizona.

Linden Capital is another private equity firm with a dental platform.  Click here for more info.

Almost Family…Continues Buying Spree

Louisville-based Almost Family is planning to fold yet another home health facility into its operation of over 240 home health locations.  The organization entered into an agreement to acquire a 25-bed facility from Caldwell Medical Center in western Kentucky.  Almost Family operates two subsidiaries:  Visiting Nurse (home health nursing, physical therapy, etc.) and Personal Care (custodial and personal care services) with a presence in 14 midwest and eastern states.  The acquisition is expected to close before May.  Read more 

The latest purchase follows the SunCrest Healthcare acquisition in December.  Click here for more information.

Adult Day Care Back on Track?

The adult day care industry growth slowed during the recent economic slowdown.  However, the Affordable Care Act through an increase in private health insurance coverage is expected to generate increased funding for this sector.  Recovery in disposable income levels will also spur growth as households will be better able to afford the services again.

What is Adult Day Care?  Services provided during normal business hours at a center (not the home) include social and basic health assistance, including transportation, meals, personal hygiene and therapeutic activities, to the elderly and individuals with mental or physical disabilities.

Active Day/Senior Care, Inc., a Clearview Capital portfolio company, stands tall in the roughly $6B highly fragmented market adult day care industry.  The company created by the 2011 merger of Active Day and Senior Care Centers of America is the largest adult day service provider in the U.S.  The company operates 75 centers in 11 states:  Connecticut, Delaware, Indiana, Massachusetts, Kentucky, Ohio, Maryland, Mississippi, New Jersey, Pennsylvania, South Carolina.

The latest Active Day/Senior Care branded center is in New Jersey with the early March acquisition of a well-established center in Brick.  Acquisition is likely to remain a key component of the company's growth strategy.  >>Read more

Professional Pleased with Gold Coast PT

Is Adam Elberg from Professional Orthopedic and Sports Physical Therapy happy?  More than that… 

"We're thrilled to welcome Gold Coast to the Professional family," said Elberg, CEO of the leading provider of rehabilitation services in the New York metro area.    

With the acquisition, Professional brings four Long Island clinics under the firm's well-established umbrella.  Key Gold Coast personnel will also come on as partners.  Professional, founded in 1998, increases it outpatient clinic total to 27.   >>Read more

Acquisition Ensures Growth for Travel Nursing Pioneer

Fastaff Travel Nursing and U.S. Nursing Corporation now have the financial backing to ensure expansion - thanks to the recent acquisition by Healthcare Staffing Services, LLC.  

The Rapid Response travel nurse concept was pioneered 25 years ago by Fastaff.  Their goal...to provide urgent and temporary nurses to hospitals nationwide to ensure continuous, quality patient care.  Since 1989, U.S. Nursing's business focus was offering staffing solutions during labor disputes to various healthcare facilities.  With deeper access to quality nurses, it's a winning partnership for Healthcare Staffing Services and the newly acquired Greenwood Village, CO companies. >>Read more

Urgent Care Chain Plans Expansion

PM Pediatrics is looking to expand…thanks to its recent investment from Scopio Capital Management.  The pediatric urgent care chain, founded in 2005, has 9 clinics located in greater New York and Northern New Jersey.   Co-founder Steven Katz suggested that 6-7 more offices could open by the end of 2014.  Click here for more information. 

Another AxelaCare Acquisition

Following the late 2013 acquisition of Sirona Infusion, AxelaCare is already bringing another company into its fold.  Backed by PE firm Harvest Partners, AxelaCare will strengthen its presence in California with the acquisition of privately owned ARC Infusion.  ARC specializes in providing infusion and injectable medications and supplies to patients in Southern California (Los Angeles and Orange, San Bernardino, Riverside counties).

Recognizing that managed care companies are looking to partners for national coverage and product diversity, it appears that growth is an AxelaCare priority.  Future announcements are likely based on a quote from AxelaCare CEO Ted Kramm:

"We are continuing to actively pursue acquisitions in California as well as other states to increase our geographic and product line diversification."

>>Read more

More on AxelaCare

Healthcare Slips but Dominates Top Ten

The latest U.S. News & World Report Best Jobs list is out.  While a few technology jobs moved to the top of the 2014 ranking, healthcare titles dominate the Top Ten again.  Click here for rest of the list. 

More Fish in the Net...

U.S. Anesthesia Partners (USAP) cast a wider net - adding 2 more founding partners in January, 2014.  USAP, formed in 2012, by healthcare private equity firm, Welsh Carson Anderson & Stowe is a single-specialty physician services organization.  The new partners include Pinnacle Anesthesia (Dallas, TX) and JLR Medical Group (Orlando, FL) who join Greater Houston Anesthesiology (GHA).  The three groups cover more than 1000 anesthesiologists. >>Read more  According to USAP President and CEO, Kris Bratberg:

"USAP’s growth strategy is to invest in and partner with the nation’s leading anesthesia groups, positioning them for continued success and growth in a dynamic healthcare environment.”

The New Year also saw several regional anesthesia groups merge to form ONE Anesthesia.  ONE, a management services organization (MSO), will provide management infrastructure, leadership, enhanced IT support to better meet the needs of patients and health system partners.  The merger included Williams and Wagner, PSC; Anesthesia Associates of Louisville, PSC; Anesthesia Associates of Clark County, PSC and Southern Indiana Anesthesia Consultants, LLC. 
 >>Read more

Nationwide Derm Practice Adds Midwest Clinic

Advanced Dermatology & Cosmetic Surgery (ADCS) is poised to increase its Ohio footprint.  The nationwide practice, founded by Dr. Matt Leavitt and headquartered in Maitland, Florida offers extensive dermatological services at its 70+ U.S. clinics.  The latest acquisition, targeted to close during the first quarter is Mason Dermatology in Mason, OH. >>Read more