# deals

deal_id: 390049
name: ST. LUKES HOSPITAL
created_at: 2026-04-25T20:16:46.214765+00:00
profile_json:
  {"ccn": "390049", "name": "ST. LUKES HOSPITAL", "state": "PA", "bed_count": 633, "net_revenue": 8944229494.0, "ebitda_margin": 0.8793, "medicare_pct": 0.2668057261703499}


# public_deals

source_id: seed_001
source: seed
deal_name: HCA Healthcare – KKR / Bain Capital LBO
buyer: KKR / Bain Capital / Merrill Lynch PE
seller: HCA Inc (Public, NYSE: HCA)
payer_mix: {"medicare": 0.41, "medicaid": 0.12, "commercial": 0.4, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:13.418967+00:00
notes:
  178-hospital system; largest LBO in history at time; re-IPO Mar 2011 ($3.79B proceeds to sponsors); strong national RCM infrastructure.


source_id: seed_002
source: seed
deal_name: Vanguard Health Systems – Blackstone Buyout
buyer: Blackstone Group
seller: Morgan Stanley Private Equity
payer_mix: {"medicare": 0.39, "medicaid": 0.16, "commercial": 0.38, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:15.073584+00:00
notes:
  28 hospitals across 7 states; sold to Tenet Healthcare 2013 for $4.3B EV; Arizona Medicaid complexity notable for RCM.


source_id: seed_003
source: seed
deal_name: IASIS Healthcare – TPG Capital Buyout
buyer: TPG Capital
seller: IASIS Healthcare prior shareholders
payer_mix: {"medicare": 0.44, "medicaid": 0.2, "commercial": 0.3, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:15.090357+00:00
notes:
  17 hospitals Southwest US; sold to Steward Health Care 2017 for ~$2.0B EV; long hold reflects sector headwinds mid-period.


source_id: seed_004
source: seed
deal_name: Select Medical – Warburg Pincus LBO
buyer: Warburg Pincus
seller: Select Medical Corporation (Public)
payer_mix: {"medicare": 0.62, "medicaid": 0.08, "commercial": 0.27, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:15.100852+00:00
notes:
  LTAC and rehabilitation hospitals; re-IPO 2009; high Medicare concentration characteristic of LTAC/rehab segment.


source_id: seed_005
source: seed
deal_name: Psychiatric Solutions – Universal Health Services Acquisition
buyer: Universal Health Services
seller: Psychiatric Solutions Inc (Public, PSYS)
payer_mix: {"medicare": 0.28, "medicaid": 0.38, "commercial": 0.3, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:15.107595+00:00
notes:
  Strategic acquisition; 89 behavioral health facilities; high Medicaid mix typical of behavioral health segment.


source_id: seed_006
source: seed
deal_name: TeamHealth – Blackstone Buyout
buyer: Blackstone Group
seller: TeamHealth Holdings (Public, TMH)
payer_mix: {"medicare": 0.35, "medicaid": 0.18, "commercial": 0.38, "self_pay": 0.09}
ingested_at: 2026-04-25T20:18:15.116441+00:00
notes:
  Largest physician staffing company (EM/hospitalist/anesthesia); ongoing as of 2024; No Surprises Act headwinds to out-of-network billing.


source_id: seed_007
source: seed
deal_name: Envision Healthcare – KKR Buyout
buyer: KKR
seller: Envision Healthcare Corporation (Public, EVHC)
payer_mix: {"medicare": 0.38, "medicaid": 0.2, "commercial": 0.36, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:15.177144+00:00
notes:
  Physician staffing (EM/anesthesia) + AmSurg ASCs; Chapter 11 May 2023; NSA destroyed out-of-network billing model post-close; canonical cautionary deal.


source_id: seed_008
source: seed
deal_name: LifePoint Health – KKR Buyout
buyer: KKR
seller: LifePoint Health Inc (Public, LPNT)
payer_mix: {"medicare": 0.52, "medicaid": 0.15, "commercial": 0.29, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:15.184274+00:00
notes:
  89 community hospitals; rural-focused; merged with RCCH HealthCare Partners 2019 (~$8B combined EV); KKR largest healthcare PE owner by bed count.


source_id: seed_009
source: seed
deal_name: Surgery Partners – H.I.G. Capital Platform
buyer: H.I.G. Capital
seller: National Surgical Healthcare (merged assets)
payer_mix: {"medicare": 0.31, "medicaid": 0.06, "commercial": 0.58, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:15.083027+00:00
notes:
  ASC and surgical hospital platform; quick flip to Bain Capital / IPO 2016; high commercial mix typical of ASC segment; RCM simpler than acute care.


source_id: seed_010
source: seed
deal_name: Surgery Partners – Bain Capital / IPO
buyer: Bain Capital (IPO NASDAQ: SGRY)
seller: H.I.G. Capital
payer_mix: {"medicare": 0.33, "medicaid": 0.07, "commercial": 0.55, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:15.719632+00:00
notes:
  Continued M&A growth post-IPO; ~180 surgical facilities as of 2024; Symbion and NSH acquisitions; Bain still majority owner.


source_id: seed_011
source: seed
deal_name: Kindred Healthcare – TPG / Welsh Carson / Humana Buyout
buyer: TPG Capital / Welsh Carson / Humana
seller: Kindred Healthcare (Public, KND)
payer_mix: {"medicare": 0.68, "medicaid": 0.09, "commercial": 0.19, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:15.725897+00:00
notes:
  LTAC + home health + rehab; Humana home health carved into CenterWell; LTAC assets spun into ScionHealth 2021; classic trifurcated exit.


source_id: seed_012
source: seed
deal_name: Kindred Healthcare + Gentiva Health Services Merger
buyer: Kindred Healthcare
seller: Gentiva Health Services (Public, GTIV)
payer_mix: {"medicare": 0.72, "medicaid": 0.08, "commercial": 0.17, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:15.732871+00:00
notes:
  Home health + hospice consolidation; very high Medicare; home health billing complexity (OASIS, PDGM) is primary RCM challenge.


source_id: seed_013
source: seed
deal_name: Steward Health Care – Cerberus Capital Acquisition
buyer: Cerberus Capital Management
seller: Caritas Christi Health Care (Catholic non-profit)
payer_mix: {"medicare": 0.48, "medicaid": 0.22, "commercial": 0.26, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:15.740067+00:00
notes:
  Safety-net hospitals MA; grew to 35+ hospitals nationally through distressed acquisitions; filed Chapter 11 May 2024; sale-leaseback of real estate extracted cash but created fixed-cost burden.


source_id: seed_014
source: seed
deal_name: RegionalCare Hospital Partners + Capella Healthcare Merger
buyer: RCCH HealthCare Partners (combined entity)
seller: RegionalCare + Capella shareholders
payer_mix: {"medicare": 0.47, "medicaid": 0.18, "commercial": 0.3, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:15.746694+00:00
notes:
  Community hospital platform merger; LifePoint acquisition 2019 created ~$8B combined entity; rural / non-urban strategic rationale.


source_id: seed_015
source: seed
deal_name: Community Health Systems – Health Management Associates Acquisition
buyer: Community Health Systems
seller: Health Management Associates (Public, HMA)
payer_mix: {"medicare": 0.43, "medicaid": 0.19, "commercial": 0.32, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:15.771514+00:00
notes:
  Strategic add-on; 71 hospitals; CHS divested many HMA assets post-close; quality-of-earnings scrutiny on HMA admissions practices.


source_id: seed_016
source: seed
deal_name: Tenet Healthcare – Vanguard Health Systems Acquisition
buyer: Tenet Healthcare
seller: Blackstone Group / Vanguard shareholders
payer_mix: {"medicare": 0.39, "medicaid": 0.17, "commercial": 0.37, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:15.777678+00:00
notes:
  Blackstone strategic exit; 28 hospitals Southwest/Midwest; bolstered Tenet's national footprint and USPI ASC strategy.


source_id: seed_017
source: seed
deal_name: Quorum Health Corporation – CHS Spinoff
buyer: Independent public company (NYSE: QHC, CHS spinoff)
seller: Community Health Systems
payer_mix: {"medicare": 0.46, "medicaid": 0.2, "commercial": 0.29, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:15.784153+00:00
notes:
  38 rural/community hospitals; highly leveraged spinoff with ~9x EBITDA debt; Chapter 11 Apr 2020; canonical overleveraged rural hospital collapse.


source_id: seed_018
source: seed
deal_name: Acadia Healthcare – Waud Capital IPO Platform
buyer: Waud Capital Partners (pre-IPO sponsor)
seller: Various behavioral health assets
payer_mix: {"medicare": 0.22, "medicaid": 0.41, "commercial": 0.33, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:16.521496+00:00
notes:
  Behavioral health roll-up; IPO 2011; expanded to 200+ facilities; subsequent DOJ/state regulatory scrutiny on billing practices.


source_id: seed_019
source: seed
deal_name: Ardent Health Services – Equity Healthcare / CPPIB Recapitalization
buyer: Equity Healthcare (Warburg Pincus) / CPPIB
seller: Ardent Health prior investors
payer_mix: {"medicare": 0.44, "medicaid": 0.21, "commercial": 0.31, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:16.527694+00:00
notes:
  30 hospitals SW/SE; IPO S-1 filed 2023 (withdrawn); physician employment model focus; RCM centralization cited as key synergy.


source_id: seed_020
source: seed
deal_name: Prospect Medical Holdings – Leonard Green & Partners
buyer: Leonard Green & Partners
seller: Prospect Medical Holdings management
payer_mix: {"medicare": 0.36, "medicaid": 0.3, "commercial": 0.28, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:16.534095+00:00
notes:
  Safety-net hospitals CA/CT/PA/RI; filed bankruptcy 2023; ~$647M in dividends extracted 2019-2022 before collapse; high Medicaid RCM complexity.


source_id: seed_021
source: seed
deal_name: EmCare Holdings – Leonard Green & Partners
buyer: Leonard Green & Partners
seller: EmCare Holdings (private)
payer_mix: {"medicare": 0.33, "medicaid": 0.17, "commercial": 0.4, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:16.542800+00:00
notes:
  EM physician staffing; merged with AMSURG to form Envision Healthcare 2016; strong RCM from out-of-network billing (pre-NSA).


source_id: seed_022
source: seed
deal_name: AMSURG + Envision / EmCare Merger
buyer: Envision Healthcare Holdings (combined)
seller: AMSURG Corp (Public, AMSG)
payer_mix: {"medicare": 0.36, "medicaid": 0.18, "commercial": 0.37, "self_pay": 0.09}
ingested_at: 2026-04-25T20:18:16.549349+00:00
notes:
  Combined ~7,500 physicians + 250 ASCs; KKR took private 2018; merger synergies largely unrealized pre-NSA; complex integrated RCM model.


source_id: seed_024
source: seed
deal_name: RegionalCare Hospital Partners – Foundation / Management Recap
buyer: Foundation Capital / management
seller: Prior investors
payer_mix: {"medicare": 0.49, "medicaid": 0.17, "commercial": 0.29, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:16.565775+00:00
notes:
  Rural community hospitals; merged with Capella 2015; strong RCM given limited local commercial payer competition.


source_id: seed_025
source: seed
deal_name: Select Medical + Concentra Occupational Health Acquisition
buyer: Select Medical
seller: Humana (divesting Concentra)
payer_mix: {"medicare": 0.12, "medicaid": 0.04, "commercial": 0.52, "self_pay": 0.02, "workers_comp": 0.3}
ingested_at: 2026-04-25T20:18:16.572262+00:00
notes:
  Occupational health + urgent care; high workers' comp / employer-pay mix; Concentra IPO filed separately; unique WC RCM workflow.


source_id: seed_026
source: seed
deal_name: ScionHealth – Kindred LTAC Spinoff
buyer: TPG Capital / Welsh Carson
seller: Kindred Healthcare (carve-out post Humana merger)
payer_mix: {"medicare": 0.71, "medicaid": 0.06, "commercial": 0.2, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:16.578870+00:00
notes:
  79 LTAC + 27 community hospitals (from LifePoint); very high Medicare; LTAC-qualifying criteria compliance is primary RCM/reimbursement risk.


source_id: seed_027
source: seed
deal_name: Capella Healthcare – Martin Ventures Buyout
buyer: Martin Ventures / SunTrust Capital
seller: Province Healthcare assets
payer_mix: {"medicare": 0.45, "medicaid": 0.19, "commercial": 0.3, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:16.591802+00:00
notes:
  11 community hospitals SE US; merged with RegionalCare 2015; below-median IRR from long hold with modest EBITDA growth.


source_id: seed_028
source: seed
deal_name: Vibra Healthcare – Sterling Capital Recap
buyer: Sterling Capital Partners
seller: Vibra Healthcare management
payer_mix: {"medicare": 0.66, "medicaid": 0.07, "commercial": 0.24, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:16.599558+00:00
notes:
  LTAC and rehabilitation hospitals; high Medicare concentration; ongoing independent operation as of 2024.


source_id: seed_029
source: seed
deal_name: BrightSpring Health Services – KKR Platform
buyer: KKR
seller: RehabCare Group / ResCare / merged assets
payer_mix: {"medicare": 0.28, "medicaid": 0.48, "commercial": 0.18, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:16.606725+00:00
notes:
  Home and community-based services; high Medicaid; IPO Jan 2024 at ~$2.5B market cap; Medicaid rate risk is primary platform risk.


source_id: seed_030
source: seed
deal_name: Advocate Health + Aurora Health Care Merger
buyer: Advocate Aurora Health (combined non-profit)
seller: Aurora Health Care shareholders
payer_mix: {"medicare": 0.38, "medicaid": 0.14, "commercial": 0.42, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:16.613404+00:00
notes:
  Non-profit merger; 27 hospitals IL/WI; scale-driven RCM centralization and payer renegotiation as stated synergy.


source_id: seed_031
source: seed
deal_name: CommonSpirit Health – Dignity Health + CHI Merger
buyer: CommonSpirit Health (combined non-profit)
seller: Dignity Health + Catholic Health Initiatives
payer_mix: {"medicare": 0.4, "medicaid": 0.18, "commercial": 0.36, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:16.619576+00:00
notes:
  Largest non-profit hospital system in US; 142 hospitals across 21 states; multi-state RCM integration still ongoing years post-close.


source_id: seed_032
source: seed
deal_name: Atrium Health + Wake Forest Baptist Medical Center
buyer: Atrium Health
seller: Wake Forest Baptist Medical Center
payer_mix: {"medicare": 0.42, "medicaid": 0.16, "commercial": 0.36, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:16.626032+00:00
notes:
  Academic health system + large regional system merger; NC-focused; cross-entity RCM unification cited as ongoing integration challenge.


source_id: seed_033
source: seed
deal_name: Kindred at Home – Humana Full Acquisition
buyer: Humana
seller: TPG Capital / Welsh Carson (remaining stake in Kindred at Home)
payer_mix: {"medicare": 0.74, "medicaid": 0.06, "commercial": 0.18, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:16.632853+00:00
notes:
  Home health + hospice full vertical integration into Humana (CenterWell); very high Medicare; PDGM billing model is primary RCM driver.


source_id: seed_034
source: seed
deal_name: Wentworth-Douglass Hospital – Partners HealthCare Acquisition
buyer: Partners HealthCare (now Mass General Brigham)
seller: Wentworth-Douglass Hospital (independent non-profit)
payer_mix: {"medicare": 0.44, "medicaid": 0.12, "commercial": 0.38, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:16.639189+00:00
notes:
  Community hospital joining academic health system; NH market; RCM benefit from MGB centralized billing platform.


source_id: seed_035
source: seed
deal_name: Encompass Health – HealthSouth Rehabilitation Rebranding / PE Exit
buyer: Public shareholders (NYSE: EHC post-rebranding)
seller: HealthSouth prior PE sponsors
payer_mix: {"medicare": 0.73, "medicaid": 0.05, "commercial": 0.2, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:16.645679+00:00
notes:
  143 inpatient rehabilitation facilities; spun off home health segment (Enhabit, NYSE: EHAB) 2022; dominant Medicare payer mix for IRF segment; FIM/WeeFIM documentation compliance is critical RCM risk.


source_id: ext_001
source: seed
deal_name: Kindred at Home – TPG / Welsh Carson Partial Exit via JV with Humana
buyer: Humana (40% JV stake)
seller: Kindred Healthcare (post-buyout carve-out)
payer_mix: {"medicare": 0.74, "medicaid": 0.06, "commercial": 0.18, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:16.652053+00:00
notes:
  Home health JV formation step; Humana bought 40% at $800M; full acquisition completed 2021; structure allowed PE partial liquidity.


source_id: ext_002
source: seed
deal_name: HealthSpring – Cigna Acquisition
buyer: Cigna Corporation
seller: HealthSpring (Public, HS)
payer_mix: {"medicare": 0.85, "medicaid": 0.03, "commercial": 0.11, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:16.660124+00:00
notes:
  Medicare Advantage plan + physician network; very high Medicare; Cigna's entry into MA market; capitated model shifts RCM to risk management.


source_id: ext_003
source: seed
deal_name: DaVita HealthCare Partners – DaVita Acquisition
buyer: DaVita Inc
seller: HealthCare Partners (PE-backed physician group)
payer_mix: {"medicare": 0.55, "medicaid": 0.1, "commercial": 0.3, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:16.702402+00:00
notes:
  Largest medical group acquisition; 700+ physicians; CA/NV/FL; integrated with DaVita kidney care for care management model.


source_id: ext_004
source: seed
deal_name: Rural Health Group – Cressey Platform
buyer: Cressey & Company
seller: Rural Health Group management
payer_mix: {"medicare": 0.55, "medicaid": 0.22, "commercial": 0.19, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:18.841430+00:00
notes:
  Critical access hospitals; very small platform; CAH cost-based reimbursement is fundamentally different RCM from PPS; 101% of cost reimbursement reduces revenue cycle complexity.


source_id: ext_005
source: seed
deal_name: National Surgical Healthcare – H.I.G. Capital
buyer: H.I.G. Capital
seller: NSH prior shareholders
payer_mix: {"medicare": 0.28, "medicaid": 0.05, "commercial": 0.62, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:18.849440+00:00
notes:
  26 surgical hospitals; sold to Surgery Partners 2016; quick flip 3-year hold; high commercial mix typical of surgical platforms.


source_id: ext_006
source: seed
deal_name: Kindred Hospital – Kindred Healthcare Integrated Platform
buyer: Kindred Healthcare
seller: Various LTAC assets acquired over time
payer_mix: {"medicare": 0.72, "medicaid": 0.07, "commercial": 0.18, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:18.856919+00:00
notes:
  LTAC hospital division pre-2018 TPG/Welsh Carson buyout; Medicare qualifying criteria changes (Jimmo settlement) key RCM event 2015.


source_id: ext_007
source: seed
deal_name: Sound Physicians – TPG Capital Buyout
buyer: TPG Capital
seller: Summit Partners
payer_mix: {"medicare": 0.4, "medicaid": 0.2, "commercial": 0.3, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:18.863444+00:00
notes:
  Hospitalist + intensivist physician staffing; NSA risk lower than EM (hospitalists primarily in-network); value-based contracting with bundled payments emerging.


source_id: ext_008
source: seed
deal_name: IPC Healthcare – TeamHealth Acquisition
buyer: TeamHealth Holdings
seller: IPC Healthcare (Public, IPCM)
payer_mix: {"medicare": 0.38, "medicaid": 0.14, "commercial": 0.38, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:18.870131+00:00
notes:
  Hospitalist physician group; TeamHealth's largest add-on pre-Blackstone; combined with Blackstone deal in 2016 at higher multiple.


source_id: ext_009
source: seed
deal_name: PHC Inc / Behavioral Health Network – Sequel Youth and Family Services
buyer: Sequel Youth & Family Services (PE-backed)
seller: Prior PE investors
payer_mix: {"medicare": 0.05, "medicaid": 0.6, "commercial": 0.3, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:18.878346+00:00
notes:
  Youth behavioral health and residential; very high Medicaid; subject to significant state licensing scrutiny; Medicaid fee-for-service billing complexity.


source_id: ext_010
source: seed
deal_name: Acuity Health – Avista Healthcare Partners
buyer: Avista Healthcare Partners
seller: Management / prior investors
payer_mix: {"medicare": 0.53, "medicaid": 0.14, "commercial": 0.27, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:18.885103+00:00
notes:
  Community hospital sub-$200M platform; Avista focus on rural hospital turnarounds; RCM as primary value lever.


source_id: ext_011
source: seed
deal_name: MultiPlan – Churchill Capital SPAC Merger
buyer: Churchill Capital Corp III (SPAC)
seller: Hellman & Friedman / Carlyle Group
payer_mix: {"medicare": 0.0, "medicaid": 0.0, "commercial": 1.0, "self_pay": 0.0}
ingested_at: 2026-04-25T20:18:18.891410+00:00
notes:
  Healthcare claims cost management (100% commercial payor-side); SPAC exit at 13x EBITDA; Carlyle + H&F shared returns; illustrates claims repricing RCM technology multiple.


source_id: ext_012
source: seed
deal_name: Nuvance Health – Northwell Health Merger
buyer: Northwell Health
seller: Nuvance Health (non-profit system)
payer_mix: {"medicare": 0.4, "medicaid": 0.15, "commercial": 0.4, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:18.897976+00:00
notes:
  NY/CT non-profit merger; 10 hospitals; Northwell centralized RCM cited as key benefit to Nuvance communities.


source_id: ext_013
source: seed
deal_name: RCCH HealthCare Partners + LifePoint Health Merger
buyer: LifePoint Health (KKR)
seller: RCCH HealthCare Partners (combined RegionalCare + Capella)
payer_mix: {"medicare": 0.5, "medicaid": 0.16, "commercial": 0.29, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:18.903862+00:00
notes:
  84 + 89 = 173-hospital combined platform under KKR; largest PE-owned hospital operator in US by bed count; centralized RCM through LifePoint's shared services model.


source_id: ext_014
source: seed
deal_name: SaVida Health – Behavioral Health Partners (SUD focus)
buyer: SaVida Health / Revelstoke Capital
seller: Prior investors
payer_mix: {"medicare": 0.08, "medicaid": 0.5, "commercial": 0.38, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:18.909834+00:00
notes:
  Opioid use disorder / MOUD (medication-assisted treatment); billing complexity: 99213 + H2034 billing bundles; Medicaid reimbursement varies widely by state SAPTA waiver.


source_id: ext_015
source: seed
deal_name: Lifepoint Health — Post-Merger Debt Refinancing (KKR hold-period)
buyer: LifePoint Health (existing KKR platform)
seller: Prior bondholders (refinance)
payer_mix: {"medicare": 0.5, "medicaid": 0.16, "commercial": 0.29, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:18.918072+00:00
notes:
  Hold-period refinancing at updated valuation; illustrates how KKR recapitalized the post-RCCH combined entity; covenant-lite structure with springing leverage covenant.


source_id: ext_016
source: seed
deal_name: Ramsay Health Care – US Market Entry via Covenant Health JV
buyer: Ramsay Health Care / KKR (co-invest)
seller: Covenant Health assets (partial)
payer_mix: {"medicare": 0.45, "medicaid": 0.16, "commercial": 0.33, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:18.924366+00:00
notes:
  Australian PE/operator entering US market; Ramsay largest private hospital operator outside US; KKR co-invests; managed care contracting model structurally different from AU public-mix system.


source_id: ext_017
source: seed
deal_name: Welsh Carson Healthcare Platform – USPI 35% Stake
buyer: Welsh Carson Anderson & Stowe
seller: United Surgical Partners International management
payer_mix: {"medicare": 0.3, "medicaid": 0.05, "commercial": 0.6, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:18.935173+00:00
notes:
  35% minority stake sold to Tenet Healthcare 2020 at ~$1.1B; high commercial mix; Welsh Carson founding investor in USPI model; ASC billing: simple CPT bundles vs. complex hospital IP billing.


source_id: ext_018
source: seed
deal_name: Acuity Healthcare – HHS Acute Care Community Platform
buyer: Acuity Healthcare LP (family office backed)
seller: Various independent community hospitals
payer_mix: {"medicare": 0.49, "medicaid": 0.18, "commercial": 0.28, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:18.943202+00:00
notes:
  Distressed community hospital consolidator; COVID disrupted pipeline; family-office backed with longer time horizon than typical PE; RCM turnaround as primary value lever.


source_id: ext_019
source: seed
deal_name: CommuniCare Health Services – Audax Private Equity
buyer: Audax Private Equity
seller: CommuniCare management / family founders
payer_mix: {"medicare": 0.62, "medicaid": 0.14, "commercial": 0.2, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:18.951142+00:00
notes:
  Skilled nursing facility operator; OH/IN/PA/WV; SNF PPS billing (RUG-IV → PDPM 2019) is primary RCM complexity; Medicaid upper payment limit (UPL) supplemental payments important.


source_id: ext_020
source: seed
deal_name: AvMed / CareMore Health – Anthem Acquisition
buyer: Anthem (WellPoint)
seller: CareMore Health Group (Warburg Pincus)
payer_mix: {"medicare": 0.8, "medicaid": 0.05, "commercial": 0.13, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:18.959456+00:00
notes:
  Medicare Advantage-focused managed care; high Medicare; Warburg Pincus 4-year hold; capitated MA model eliminates FFS RCM complexity but introduces medical loss ratio risk.


source_id: seed_056
source: seed
deal_name: Kindred Healthcare 2 – TPG/Welsh Carson/Humana
buyer: TPG / Welsh Carson / Humana
seller: Public shareholders
payer_mix: {"medicare": 0.55, "medicaid": 0.2, "commercial": 0.2, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:18.966745+00:00
notes:
  Take-private at ~10x. Humana acquired home health + hospice segment. LTAC + rehab retained by PE. Post-COVID restructuring ongoing.


source_id: seed_057
source: seed
deal_name: RegionalCare + Capella → RCCH HealthCare Partners
buyer: CCMP Capital / Warburg Pincus
seller: Public markets / Capella shareholders
payer_mix: {"medicare": 0.5, "medicaid": 0.22, "commercial": 0.24, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:18.975907+00:00
notes:
  Rural hospital merger in underserved markets. RCCH later merged with LifePoint (2018). Exit via strategic sale to KKR/LifePoint.


source_id: seed_058
source: seed
deal_name: Acadia Healthcare – Waud Capital Build-up
buyer: Waud Capital Partners
seller: Founders / management
payer_mix: {"medicare": 0.2, "medicaid": 0.38, "commercial": 0.38, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:18.983936+00:00
notes:
  Waud entry at 6.7x; Acadia went public 2011 at $12/share. Roll-up of 130+ behavioral health facilities. Exceptional MOIC from IPO + sustained public market premium.


source_id: seed_060
source: seed
deal_name: CareCore National → eviCore Healthcare – Apax Partners
buyer: Apax Partners
seller: New Mountain Capital
payer_mix: {"medicare": 0.1, "medicaid": 0.05, "commercial": 0.8, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:18.998723+00:00
notes:
  Utilization management / prior auth platform. Not a hospital — included as managed care services comp. Merged with WellCare/Centene post-exit.


source_id: seed_061
source: seed
deal_name: TeamHealth – Blackstone 1st LBO
buyer: Blackstone
seller: Hellman & Friedman
payer_mix: {"medicare": 0.32, "medicaid": 0.12, "commercial": 0.48, "self_pay": 0.08}
ingested_at: 2026-04-25T20:18:19.004779+00:00
notes:
  Emergency medicine / hospitalist staffing platform. Blackstone IPO'd TeamHealth 2009; later sold to AMSURG-Envision merger entity. Second LBO closed 2016.


source_id: seed_062
source: seed
deal_name: BrightSpring Health Services – KKR
buyer: KKR
seller: ResCare management buyout / sale
payer_mix: {"medicare": 0.22, "medicaid": 0.55, "commercial": 0.18, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.010887+00:00
notes:
  Home and community-based services. IPO Jan 2024. High Medicaid concentration introduced rate-risk drag on returns. IPO at modest valuation given mixed Medicaid outlook.


source_id: seed_063
source: seed
deal_name: Mountain States Health Alliance + Wellmont → Ballad Health
buyer: Not-for-profit merger
seller: N/A
payer_mix: {"medicare": 0.56, "medicaid": 0.24, "commercial": 0.17, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:19.016894+00:00
notes:
  Certificate-of-public-advantage (COPA) merger — TN/VA border. Required FTC/state approval. Rural market; high government payer mix. Included as strategic merger comp for rural markets.


source_id: seed_064
source: seed
deal_name: Sheridan Healthcare – AMSURG / Envision
buyer: AMSURG Corp
seller: Hellman & Friedman
payer_mix: {"medicare": 0.28, "medicaid": 0.08, "commercial": 0.58, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:19.030686+00:00
notes:
  Anesthesiology + radiology physician staffing. AMSURG later merged with Envision (2016). Included as strategic add-on comp for staffing.


source_id: seed_065
source: seed
deal_name: Behavioral Health Group – Revelstoke Capital
buyer: Revelstoke Capital
seller: Management / angel investors
payer_mix: {"medicare": 0.05, "medicaid": 0.45, "commercial": 0.45, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.037745+00:00
notes:
  Outpatient substance use disorder (SUD) treatment. 100+ clinics. Mid-market behavioral health roll-up. Commercial payer mix high for SUD — driven by ACA mental health parity.


source_id: seed_066
source: seed
deal_name: Surgical Care Affiliates – UnitedHealth Group / Optum
buyer: UnitedHealth Group / Optum
seller: Public shareholders (NASDAQ: SCAI)
payer_mix: {"medicare": 0.28, "medicaid": 0.05, "commercial": 0.63, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:19.045349+00:00
notes:
  ASC platform take-private by Optum at 7.6x. Strategic acquisition for vertical integration into ambulatory care. Included as strategic buyer comp for ASC multiples.


source_id: seed_067
source: seed
deal_name: MEDNAX – Radiology Segment Sale to Envision / PE
buyer: Radiology Partners / Welsh Carson
seller: MEDNAX Inc.
payer_mix: {"medicare": 0.35, "medicaid": 0.1, "commercial": 0.5, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.053919+00:00
notes:
  MEDNAX divested radiology business to focus on pediatrics. Welsh Carson backed Radiology Partners roll-up. Included as physician-staffing add-on comp.


source_id: seed_068
source: seed
deal_name: ScionHealth – LTAC Spinoff from LifePoint/KKR
buyer: KKR (Scion portfolio company)
seller: LifePoint Health
payer_mix: {"medicare": 0.65, "medicaid": 0.18, "commercial": 0.15, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:19.063143+00:00
notes:
  LTAC/rehab hospital carve-out from LifePoint. High Medicare concentration — LTAC criteria compliance risk. Included as LTAC/rehab deal type comp.


source_id: seed_069
source: seed
deal_name: Covenant Physician Partners – KKR (Platform Build)
buyer: KKR
seller: Trive Capital
payer_mix: {"medicare": 0.32, "medicaid": 0.06, "commercial": 0.58, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:19.072107+00:00
notes:
  Multi-specialty physician + ASC platform. KKR acquired from Trive at ~10x EV/EBITDA. Post-NSA environment; commercial-heavy mix supports volume growth thesis.


source_id: seed_070
source: seed
deal_name: Tivity Health – Welsh Carson Buyout
buyer: Welsh Carson Anderson & Stowe
seller: Public shareholders (NASDAQ: TVTY)
payer_mix: {"medicare": 0.7, "medicaid": 0.05, "commercial": 0.22, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:19.081086+00:00
notes:
  Fitness + health services for Medicare Advantage populations. COVID severely impacted fitness center utilization FY2020. Below-par returns driven by pandemic disruption. Sold Prime Fitness division; remainder declined in value.


source_id: seed_071
source: seed
deal_name: Privia Health Group – Advent International
buyer: Advent International / IPO
seller: Existing shareholders
payer_mix: {"medicare": 0.35, "medicaid": 0.08, "commercial": 0.52, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.087596+00:00
notes:
  Value-based care physician enablement platform. IPO April 2021 (NASDAQ: PRVA) at strong valuation. High entry EV/EBITDA (~29x) justified by growth + VBC premium.


source_id: seed_072
source: seed
deal_name: VillageMD – Walgreens Boots Alliance Strategic Investment
buyer: Walgreens Boots Alliance
seller: Existing PE investors
payer_mix: {"medicare": 0.28, "medicaid": 0.18, "commercial": 0.48, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:19.094946+00:00
notes:
  Primary care + clinic platform backed by Walgreens. Strategic buyer (not PE); included as clinic model comp. WBA wrote down ~$5.8B in 2023 — entry multiple proved too high.


source_id: seed_073
source: seed
deal_name: Radiology Partners – New Mountain Capital Recapitalization
buyer: New Mountain Capital (recap / restructuring)
seller: Existing PE investors / lenders
payer_mix: {"medicare": 0.38, "medicaid": 0.1, "commercial": 0.47, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.102009+00:00
notes:
  Distressed recap — NSA/IDR impact on OON revenue; leverage unsustainable post-NSA. New Mountain structured in. Included as distressed radiology/staffing deal comp.


source_id: seed_074
source: seed
deal_name: Resilient Healthcare – Halo Capital Group / CrossFirst Bank
buyer: Halo Capital Group
seller: Sellers / founders
payer_mix: {"medicare": 0.42, "medicaid": 0.28, "commercial": 0.26, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:19.109052+00:00
notes:
  Small rural hospital acquisition (TX). Community hospital in underserved area; high Medicaid share. Included as rural/small-market hospital comp.


source_id: seed_075
source: seed
deal_name: Agilon Health – Advent International / IPO
buyer: Public (IPO — NYSE: AGL)
seller: Advent International
payer_mix: {"medicare": 0.95, "medicaid": 0.02, "commercial": 0.02, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:19.116467+00:00
notes:
  Value-based care platform for primary care physicians. Medicare Advantage-heavy model; capitated revenue. IPO April 2021 at $23/share; Advent's return exceptional. EBITDA not meaningful at IPO — growth / MLR model.


source_id: seed_076
source: seed
deal_name: Amedisys – UnitedHealth/Optum Acquisition
buyer: UnitedHealth Group / Optum
seller: Amedisys (public)
payer_mix: {"medicare": 0.72, "medicaid": 0.08, "commercial": 0.15, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.123417+00:00
notes:
  Strategic acquisition by Optum at ~15.7x EBITDA. DOJ antitrust review blocked deal (2024); Amedisys pivoted to Option Care merger. Home health largest pure-play; 522 care centers, 21,000 employees.


source_id: seed_077
source: seed
deal_name: LHC Group – Optum (completed)
buyer: UnitedHealth Group / Optum
seller: LHC Group (public)
payer_mix: {"medicare": 0.7, "medicaid": 0.1, "commercial": 0.15, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.131458+00:00
notes:
  Closed Feb 2023 at ~14.6x EBITDA, $170/share. Creates largest home health platform in US (~32k caregivers). Optum vertical integration strategy; combined with Landmark Health (palliative).


source_id: seed_078
source: seed
deal_name: Envision Healthcare – KKR Take-Private
buyer: KKR
seller: Public shareholders
payer_mix: {"medicare": 0.3, "medicaid": 0.2, "commercial": 0.45, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.140617+00:00
notes:
  KKR take-private at $46/share (~11x EBITDA). Surprise billing legislation (No Surprises Act) devastated emergency medicine revenue. Filed Chapter 11 May 2023. Cautionary tale on regulatory/legislative exposure in physician staffing.


source_id: seed_079
source: seed
deal_name: R1 RCM – New Mountain Capital / TCP-ASC Take-Private
buyer: New Mountain Capital / TCP-ASC
seller: R1 RCM (public, NASDAQ: RCM)
payer_mix: {"medicare": 0.35, "medicaid": 0.2, "commercial": 0.4, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.146984+00:00
notes:
  Go-private at $13.75/share, ~15x EBITDA. Revenue cycle management outsourcer; serves 160+ health systems, $40B revenue under management. AI/automation investment thesis. TowerBrook co-invested.


source_id: seed_080
source: seed
deal_name: TeamHealth – Blackstone Take-Private
buyer: Blackstone
seller: Public shareholders (NYSE: TMH)
payer_mix: {"medicare": 0.28, "medicaid": 0.22, "commercial": 0.45, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.154251+00:00
notes:
  Blackstone take-private at $43.50/share (~12.7x EBITDA). Emergency medicine + hospital medicine outsourcing platform. No Surprises Act material revenue headwind post-2022. Refinancing challenges.


source_id: seed_081
source: seed
deal_name: Surgical Care Affiliates (SCA) – UnitedHealth
buyer: UnitedHealth Group / Optum
seller: BCPE Empire Holdings (Warburg Pincus + AMSURG)
payer_mix: {"medicare": 0.3, "medicaid": 0.05, "commercial": 0.62, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:19.161923+00:00
notes:
  Optum acquires ASC platform at ~12x EBITDA; 200+ surgery centers, 10k+ physicians. Payer-provider vertical integration play. High commercial mix drives attractive margin profile.


source_id: seed_082
source: seed
deal_name: Steward Health Care – MPT / Chapter 11 Restructuring
buyer: Various (distressed acquirers)
seller: Steward Health Care (Cerberus portfolio)
payer_mix: {"medicare": 0.4, "medicaid": 0.35, "commercial": 0.2, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.168004+00:00
notes:
  Largest US for-profit hospital system bankruptcy (38 hospitals). Medical Properties Trust (REIT) held $7B in leases. Filed May 2024; hospitals sold piecemeal. Cerberus 2010 LBO unraveled. High Medicaid / Medicare mix + sale-leaseback debt trap.


source_id: seed_083
source: seed
deal_name: Gentiva Health (Kindred at Home) – Humana / Clayton Dubilier
buyer: Clayton Dubilier & Rice / Humana (minority)
seller: Kindred Healthcare / TPG / Welsh Carson
payer_mix: {"medicare": 0.65, "medicaid": 0.12, "commercial": 0.18, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.174037+00:00
notes:
  CD&R acquires Kindred at Home (~12x EBITDA); Humana retains ~40% stake. Rebranded Gentiva. Home health + hospice; ~50k patients/day. Medicare Advantage rate pressure post-2023 headwind.


source_id: seed_084
source: seed
deal_name: Behavioral Health Group (BHG) – GTCR Platform
buyer: GTCR
seller: Shore Capital Partners / Founders
payer_mix: {"medicare": 0.05, "medicaid": 0.6, "commercial": 0.3, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.181126+00:00
notes:
  Opioid use disorder treatment network; ~120 centers across 24 states. Entry at ~10x EBITDA. GTCR targets 300+ centers. Medicaid-heavy payer mix; SAMHSA grant funding supplements.


source_id: seed_085
source: seed
deal_name: Civitas Solutions / Public Shareholders
buyer: A-G Capital Partners (management buyout consortium)
seller: Public shareholders (NYSE: CIVI)
payer_mix: {"medicare": 0.05, "medicaid": 0.8, "commercial": 0.1, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.187741+00:00
notes:
  Take-private of I/DD and behavioral health residential services. ~$14.50/share, ~8.75x EBITDA. Medicaid-dependent; state rate risk flagged. Previously National Mentor Holdings, backed by Vestar Capital.


source_id: seed_086
source: seed
deal_name: LifePoint Health – RCCH HealthCare Partners Merger
buyer: Apollo Global / RCCH
seller: LifePoint Health (public)
payer_mix: {"medicare": 0.42, "medicaid": 0.25, "commercial": 0.28, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.196477+00:00
notes:
  Apollo-backed RCCH merges with LifePoint at ~10x EBITDA. Combined 89 hospital campuses in 30 states, predominantly rural and non-urban. Renamed LifePoint Health (private). Significant rural Medicare/Medicaid exposure.


source_id: seed_087
source: seed
deal_name: Sound Physicians – TPG Growth
buyer: TPG Growth
seller: Summit Partners / Founders
payer_mix: {"medicare": 0.32, "medicaid": 0.2, "commercial": 0.43, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.203321+00:00
notes:
  Hospitalist / intensivist / post-acute physician management. ~12x EBITDA. 3,000+ physicians across 350+ facilities. No Surprises Act later impacted out-of-network revenue streams.


source_id: seed_088
source: seed
deal_name: MEDNAX Radiology / Radiology Partners split-off
buyer: New Mountain Capital / MEDNAX management
seller: MEDNAX (public spinoff of radiology segment)
payer_mix: {"medicare": 0.25, "medicaid": 0.1, "commercial": 0.6, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.211309+00:00
notes:
  MEDNAX divests radiology arm to New Mountain at ~10.4x EBITDA. Merged into Radiology Partners platform. AI-reads and teleradiology growth thesis. Commercial-heavy payer mix.


source_id: seed_089
source: seed
deal_name: US Physical Therapy – ATI Physical Therapy add-on targets
buyer: ATI Physical Therapy (Advent backed)
seller: Various independent PT clinic groups
payer_mix: {"medicare": 0.25, "medicaid": 0.1, "commercial": 0.6, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.221966+00:00
notes:
  Fragmented PT market roll-up; ~10x entry. Therapy staffing labor cost inflation headwind post-2021. ATI public company SPAC route struggled; margin compression.


source_id: seed_090
source: seed
deal_name: National Spine & Pain Centers – Avista Capital Partners
buyer: Avista Capital Partners
seller: Existing investors / founders
payer_mix: {"medicare": 0.28, "medicaid": 0.05, "commercial": 0.62, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.228953+00:00
notes:
  Pain management / interventional spine platform. ~9.5x entry. 150+ clinics across mid-Atlantic and Southeast. Commercial payer mix attractive; prior auth risk on pain procedures.


source_id: seed_091
source: seed
deal_name: Ardent Health Services – Equity Capital (2021 refinancing)
buyer: Equity Group Investments / Ventas REIT
seller: Welsh Carson Anderson & Stowe
payer_mix: {"medicare": 0.38, "medicaid": 0.28, "commercial": 0.29, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.238171+00:00
notes:
  Ardent 30-hospital system in TX, OK, NM, NJ, ID. ~12.4x EBITDA. Ventas provides REIT real estate; EGI provides operations capital. Mixed payer state markets; rural + urban blend.


source_id: seed_092
source: seed
deal_name: Prospect Medical Holdings – Distressed Asset Sales
buyer: State of CT / Various acquirers
seller: Samuel Lee / Prospect Medical (Leonard Green-backed)
payer_mix: {"medicare": 0.38, "medicaid": 0.4, "commercial": 0.17, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.247527+00:00
notes:
  Leonard Green & Partners loaded Prospect with debt via dividend recaps. CT AG pursued clawback of $493M in dividends. Multiple hospitals closed/sold. Emblematic of PE dividend recap abuse in distressed hospital settings.


source_id: seed_093
source: seed
deal_name: Covenant Physician Partners – USPI / Tenet acquisition
buyer: United Surgical Partners International (USPI/Tenet)
seller: Covenant Physician Partners founders / Warburg Pincus
payer_mix: {"medicare": 0.22, "medicaid": 0.05, "commercial": 0.68, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.254395+00:00
notes:
  Warburg Pincus exit via sale to USPI at ~11.7x. Ophthalmology + orthopedic + multispecialty ASC network; 90+ facilities. High commercial payer mix; attractive bolt-on for USPI platform.


source_id: seed_094
source: seed
deal_name: Centurion Health – American Securities acquisition
buyer: American Securities
seller: MedFirst / Founders
payer_mix: {"medicare": 0.02, "medicaid": 0.1, "commercial": 0.03, "self_pay": 0.85}
ingested_at: 2026-04-25T20:18:19.262173+00:00
notes:
  Correctional healthcare outsourcing (prisons/jails). ~10x entry. Revenue from government correctional facility contracts (non-traditional payer mix). Reputational and litigation risk inherent in corrections healthcare.


source_id: seed_095
source: seed
deal_name: Premise Health – Warburg Pincus (employer health centers)
buyer: Warburg Pincus
seller: H.I.G. Capital / Premise founders
payer_mix: {"medicare": 0.0, "medicaid": 0.0, "commercial": 0.95, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.268650+00:00
notes:
  Employer-sponsored on-site / near-site health centers. ~12.6x EBITDA. 800+ care delivery sites, 200+ Fortune 500 clients. Zero Medicare/Medicaid; 100% employer contract revenue. COVID-accelerated demand for employer health navigation.


source_id: seed_096
source: seed
deal_name: Teladoc Health – Livongo Acquisition
buyer: Teladoc Health (TDOC)
seller: Livongo Health (LVGO)
payer_mix: {"medicare": 0.05, "medicaid": 0.02, "commercial": 0.88, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.275498+00:00
notes:
  All-stock deal at $18.5B; 27% premium. Livongo chronic disease management + Teladoc telehealth platform. COVID-driven telemedicine demand peak. Post-merger integration struggles; TDOC stock -75% by 2022.


source_id: seed_097
source: seed
deal_name: American Renal Associates – Acacia Research / Nuvei
buyer: Acacia Research / Nuvei Group
seller: American Renal Associates (public)
payer_mix: {"medicare": 0.78, "medicaid": 0.12, "commercial": 0.08, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:19.283538+00:00
notes:
  Take-private at $11.25/share. Dialysis center network (~250 clinics). Heavy Medicare-ESRD dependency; rate reform headwind. ~7.9x EBITDA entry in distressed environment.


source_id: seed_098
source: seed
deal_name: Alignment Healthcare – IPO / Warburg Pincus exit
buyer: Public markets (NASDAQ: ALHC)
seller: Warburg Pincus / Khosla Ventures
payer_mix: {"medicare": 0.92, "medicaid": 0.05, "commercial": 0.02, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:19.295398+00:00
notes:
  Value-based Medicare Advantage care model (MA HMO). Warburg 2016 investment; IPO at $18/share. Risk-bearing model; capitation revenue. MA growth trajectory.


source_id: seed_099
source: seed
deal_name: CareMax – IMC Medical Group SPAC Merger
buyer: CareMax / Deerfield Management SPAC
seller: IMC Health / InsuLogik founders
payer_mix: {"medicare": 0.8, "medicaid": 0.15, "commercial": 0.04, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:19.303634+00:00
notes:
  SPAC route to public markets; value-based senior primary care in FL/TX. ~60x EBITDA (pre-revenue model). MA + Medicaid dual-eligible focus. Filed Chapter 11 2024 after MA margin headwinds.


source_id: seed_100
source: seed
deal_name: Surgery Partners – Multiple ASC Platform Add-Ons (2022)
buyer: Surgery Partners (SGRY / Bain Capital backed)
seller: Independent ASC operators
payer_mix: {"medicare": 0.28, "medicaid": 0.04, "commercial": 0.64, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:19.314209+00:00
notes:
  Surgery Partners aggregate of ~10 ASC acquisitions 2022. ~10x EBITDA entry. Orthopedic + spine + ophthalmology mix. Bain Capital ownership. Commercial-heavy payer mix; favorable reimbursement vs hospital HOPD.


source_id: seed_101
source: seed
deal_name: Oak Street Health – CVS Health Acquisition
buyer: CVS Health
seller: Oak Street Health public shareholders (OSH)
payer_mix: {"medicare": 0.9, "medicaid": 0.06, "commercial": 0.03, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:19.324912+00:00
notes:
  CVS at-risk primary care strategy; $39/share, ~125x EBITDA. 600+ primary care centers. Payer-provider integration; CVS Aetna MA population. GV Healthcare, Newlight Partners, and GSAM among key early investors.


source_id: seed_102
source: seed
deal_name: Signify Health – CVS Health Acquisition
buyer: CVS Health
seller: Signify Health public shareholders (SGFY)
payer_mix: {"medicare": 0.62, "medicaid": 0.15, "commercial": 0.18, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.332624+00:00
notes:
  In-home health evaluations + care enablement. $30.2/share, ~35x EBITDA. New Mountain Capital was majority owner. Episodes of care model; risk stratification for payers.


source_id: seed_103
source: seed
deal_name: Envision Healthcare Post-Reorg – New KKR Entity (2024)
buyer: KKR (post-reorganization equity)
seller: Bankruptcy estate
payer_mix: {"medicare": 0.3, "medicaid": 0.2, "commercial": 0.45, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.345862+00:00
notes:
  Post-Ch.11 reorg. Reduced debt burden (~$5B → ~$1.4B). Emergency medicine footprint retained after Ch.11. No Surprises Act revenue headwind remains structural.


source_id: seed_104
source: seed
deal_name: LabCorp – Ascension Health Labs Acquisition
buyer: Labcorp (Laboratory Corporation of America)
seller: Ascension Health
payer_mix: {"medicare": 0.35, "medicaid": 0.25, "commercial": 0.35, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.352736+00:00
notes:
  Labcorp acquires Ascension hospital-based labs. ~8.9x EBITDA. 11 hospitals across 10 states. Strategic: eliminates competitor foothold. Multi-year lab services contract retained with Ascension.


source_id: seed_105
source: seed
deal_name: BrightSpring Health Services – KKR IPO
buyer: Public markets (NASDAQ: BTSG)
seller: KKR (2019 take-private of ResCare)
payer_mix: {"medicare": 0.1, "medicaid": 0.65, "commercial": 0.2, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.359651+00:00
notes:
  KKR ResCare rebrand/rollup into BrightSpring. ~15x EBITDA IPO. Pharmacy + home care + specialty pharma. Medicaid-heavy. IPO below initial target; LTSS / I&DD Medicaid rate risk.


source_id: seed_106
source: seed
deal_name: Change Healthcare – UnitedHealth/Optum Acquisition
buyer: UnitedHealth Group / Optum
seller: Change Healthcare public shareholders (CHNG)
payer_mix: {"medicare": 0.3, "medicaid": 0.25, "commercial": 0.4, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.367067+00:00
notes:
  RCM / health information network. DOJ blocked initially; court approved 2022. ~14.4x EBITDA. Massive cyberattack (Feb 2024) disrupted $1.5T claims pipeline. Landmark vertical integration in RCM technology.


source_id: seed_107
source: seed
deal_name: SCA Health (Surgical Care Affiliates) – Bain Capital Roll-Up
buyer: Bain Capital (through SCA Health)
seller: Independent ASC operators / add-ons
payer_mix: {"medicare": 0.25, "medicaid": 0.04, "commercial": 0.67, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:19.374034+00:00
notes:
  Bain Capital ASC platform. 300+ facilities, 10k+ physician partners. Orthopedics, spine, GI, ophthalmology. Commercial payer focus. Site-of-care shift away from hospital HOPD drives growth.


source_id: seed_108
source: seed
deal_name: National Healthcare Corp – SNF Portfolio Consolidation
buyer: NHC (public, internally consolidating)
seller: Regional SNF operators (multiple)
payer_mix: {"medicare": 0.45, "medicaid": 0.45, "commercial": 0.07, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:19.380644+00:00
notes:
  SNF/LTC consolidation in post-COVID value-add environment. ~9.1x EBITDA. Mixed Medicare/Medicaid; rate/staffing inflation post-2022 pressure. NHC benefited from competitor closures/sales during COVID.


source_id: seed_109
source: seed
deal_name: Radiology Partners – New Mountain Capital (2022 refinance)
buyer: New Mountain Capital (existing)
seller: Refinancing / secondary
payer_mix: {"medicare": 0.35, "medicaid": 0.12, "commercial": 0.48, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.387601+00:00
notes:
  Largest radiology practice in US (~3,500 radiologists). ~13x EBITDA. AI reads + teleradiology thesis. No Surprises Act rate risk. NMC took majority in 2015; valued at ~$4B+ by 2022 refinancing.


source_id: seed_110
source: seed
deal_name: ChenMed – Underhill Investment Partners Minority Recapitalization
buyer: Underhill Investment Partners (minority)
seller: Chen family / existing investors
payer_mix: {"medicare": 0.95, "medicaid": 0.03, "commercial": 0.01, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:19.394884+00:00
notes:
  Value-based senior primary care. ~16.7x EBITDA. Minority stake recapitalization. 200+ care centers; VBC Medicare Advantage model. 97% Medicare. Annual capitation revenue approach. Strong MA relationship footprint.


source_id: seed_111
source: seed
deal_name: Apria Healthcare – Owens & Minor Acquisition
buyer: Owens & Minor (OMI)
seller: Apria Healthcare public shareholders (APR)
payer_mix: {"medicare": 0.4, "medicaid": 0.2, "commercial": 0.35, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.402177+00:00
notes:
  Home medical equipment (HME) + home infusion. ~11.3x EBITDA. Blackstone had taken Apria private in 2008, IPO in 2021, O&M acquired 2022. Home health / DME consolidation play.


source_id: seed_112
source: seed
deal_name: Pediatric Associates – KKR Platform Build
buyer: KKR
seller: Existing physician shareholders / minority PE
payer_mix: {"medicare": 0.02, "medicaid": 0.45, "commercial": 0.48, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.409809+00:00
notes:
  Largest independent pediatric group in US (~200 locations). ~12x EBITDA. Mix of Medicaid CHIP + commercial pediatric covered lives. KKR VBHC strategy: value-based contracts with payers.


source_id: seed_113
source: seed
deal_name: Dermatology-Adjacent: Solta Medical – Bausch Health Carve-Out
buyer: Public markets (Bausch + Lomb IPO carve-out)
seller: Bausch Health (BHC)
payer_mix: {"medicare": 0.1, "medicaid": 0.05, "commercial": 0.8, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.416193+00:00
notes:
  Carve-out of energy-based aesthetics device business. ~14.4x EBITDA. Elective / cash-pay mix. Non-traditional healthcare setting but relevant to ambulatory / physician practice markets.


source_id: seed_114
source: seed
deal_name: InfuSystem Holdings – GTCR Acquisition
buyer: GTCR
seller: InfuSystem public shareholders (INFU)
payer_mix: {"medicare": 0.3, "medicaid": 0.15, "commercial": 0.5, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:19.423384+00:00
notes:
  Ambulatory infusion pump rental + services. ~8.9x EBITDA. $10.25/share. Oncology + pain + antibiotic infusion. COVID-driven home infusion tailwind.


source_id: seed_115
source: seed
deal_name: ModivCare – Matrix Medical Network + Simplura Health Acquisitions
buyer: ModivCare (formerly Providence Service / PRSC)
seller: Matrix Medical (Frazier Healthcare) + Simplura (Apax Partners)
payer_mix: {"medicare": 0.1, "medicaid": 0.75, "commercial": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:19.433774+00:00
notes:
  NEMT (non-emergency medical transport) + home care integration. ~11.7x EBITDA. High Medicaid dependency; state contract risk. Scales to 30M+ rides/year platform; largest NEMT broker in US.


source_id: seed_116
source: seed
deal_name: Acadia Healthcare – Behavioral Portfolio Add-ons 2021
buyer: Acadia Healthcare
seller: Various regional operators
payer_mix: {"medicare": 0.28, "medicaid": 0.38, "commercial": 0.24, "selfpay": 0.1}
ingested_at: 2026-04-25T20:18:19.440142+00:00
notes:
  Behavioral health platform roll-up; Southeast concentration; benefits from mental health parity enforcement


source_id: seed_117
source: seed
deal_name: Option Care Health – Walgreens Infusion Services Carve-out
buyer: Option Care Health
seller: Walgreens Boots Alliance
payer_mix: {"medicare": 0.35, "medicaid": 0.15, "commercial": 0.5, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.453729+00:00
notes:
  Home infusion carve-out from Walgreens; merged with BioScrip to form Option Care Health; high commercial mix drives margin


source_id: seed_118
source: seed
deal_name: USPI / Tenet Healthcare – ASC Add-on Cluster 2022
buyer: United Surgical Partners International / Tenet Healthcare
seller: Various independent ASC owners
payer_mix: {"medicare": 0.22, "medicaid": 0.05, "commercial": 0.73, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.460153+00:00
notes:
  15-center ASC cluster; high commercial mix drives margin; TX-heavy footprint; ongoing accretion to Tenet


source_id: seed_120
source: seed
deal_name: Privia Health Group – IPO / Goldman Sachs / Blackstone Exit
buyer: Public Market (IPO)
seller: Goldman Sachs / Blackstone
payer_mix: {"medicare": 0.42, "medicaid": 0.12, "commercial": 0.46, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.474765+00:00
notes:
  VBC-aligned physician enablement platform; NASDAQ IPO ~$28/share; Mid-Atlantic heavy; managed care capitation model


source_id: seed_121
source: seed
deal_name: Agilon Health – IPO / Clayton Dubilier & Rice Exit
buyer: Public Market (IPO)
seller: Clayton Dubilier & Rice
payer_mix: {"medicare": 0.95, "medicaid": 0.02, "commercial": 0.03, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.480962+00:00
notes:
  MA capitation model; membership ramp hit MLR headwinds 2022-23; CD&R partial exit at IPO; stock declined post-lockup


source_id: seed_122
source: seed
deal_name: Kindred at Home – LHC Group Acquisition (Humana Stake)
buyer: LHC Group
seller: Humana
payer_mix: {"medicare": 0.7, "medicaid": 0.15, "commercial": 0.15, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.487224+00:00
notes:
  Humana divested 60% stake in Kindred at Home to LHC Group; combined entity subsequently acquired by Optum 2022


source_id: seed_123
source: seed
deal_name: Cano Health – SPAC / Jaws Acquisition Corp
buyer: Jaws Acquisition Corp (SPAC)
seller: InTandem Capital Partners
payer_mix: {"medicare": 0.8, "medicaid": 0.12, "commercial": 0.08, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.493432+00:00
notes:
  FL/TX capitation concentration; Chapter 11 filed 2024; near-total equity loss; Peter Thiel-backed SPAC vehicle


source_id: seed_124
source: seed
deal_name: Envision Healthcare – Post-Reorganization Creditor Entity 2023
buyer: New Envision creditor consortium
seller: KKR (pre-bankruptcy equity)
payer_mix: {"medicare": 0.32, "medicaid": 0.18, "commercial": 0.5, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.499839+00:00
notes:
  Post-Ch11 reorganization; NSA arbitration removed $1B+ revenue; creditors received equity in reorganized entity


source_id: seed_125
source: seed
deal_name: LifeStance Health – IPO / TPG Capital Exit
buyer: Public Market (IPO)
seller: TPG Capital
payer_mix: {"medicare": 0.12, "medicaid": 0.08, "commercial": 0.8, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.506085+00:00
notes:
  Mental health roll-up; clinician attrition and de-novo losses hurt margin; stock declined ~75% from IPO price


source_id: seed_126
source: seed
deal_name: US Renal Care – DaVita Acquisition (DOJ Blocked)
buyer: DaVita
seller: Summit Health / US Renal Care shareholders
payer_mix: {"medicare": 0.68, "medicaid": 0.18, "commercial": 0.14, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.514855+00:00
notes:
  DOJ blocked on antitrust grounds 2022; US Renal ultimately sold to Summit Health; dialysis market concentration concern


source_id: seed_127
source: seed
deal_name: Mednax Radiology Solutions – Radiology Partners Carve-out
buyer: Radiology Partners
seller: Mednax
payer_mix: {"medicare": 0.4, "medicaid": 0.1, "commercial": 0.5, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.521551+00:00
notes:
  Mednax radiology division carve-out to Radiology Partners (NMC-backed); national footprint; AI-assisted reads roll-in thesis


source_id: seed_128
source: seed
deal_name: Ensemble Health Partners – Golden Gate Capital Minority Recap
buyer: Golden Gate Capital
seller: Bon Secours Mercy Health
ingested_at: 2026-04-25T20:18:19.528421+00:00
notes:
  Tech-enabled RCM services; minority recap at ~12.5x EBITDA; Midwest origins; technology-first revenue cycle platform


source_id: seed_130
source: seed
deal_name: Spring Health – General Catalyst Series D Growth Round
buyer: General Catalyst
seller: Existing shareholders
payer_mix: {"medicare": 0.02, "medicaid": 0.05, "commercial": 0.93, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.541690+00:00
notes:
  Digital mental health; employer-sponsored EAP model; Series D at $2B valuation; high commercial concentration


source_id: seed_131
source: seed
deal_name: Prospect Medical Holdings – CA Hospitals Distressed Sale
buyer: KPC Medical Management
seller: Leonard Green & Partners
payer_mix: {"medicare": 0.3, "medicaid": 0.48, "commercial": 0.15, "selfpay": 0.07}
ingested_at: 2026-04-25T20:18:19.548335+00:00
notes:
  Distressed CA hospital system sale; Medicaid-heavy safety net; near-total equity loss for LGP; CA AG oversight required


source_id: seed_132
source: seed
deal_name: ScionHealth – LTACH Carve-out from LifePoint / Apollo
buyer: ScionHealth (Apollo-backed)
seller: LifePoint Health
payer_mix: {"medicare": 0.72, "medicaid": 0.12, "commercial": 0.16, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.554645+00:00
notes:
  LTACH + community hospital carve-out from LifePoint; Apollo-backed; high Medicare dependency; KY-heavy footprint


source_id: seed_133
source: seed
deal_name: Paradigm Oral Surgery – Cressey & Company Platform Creation
buyer: Cressey & Company
seller: Founding oral surgeons
payer_mix: {"medicare": 0.04, "medicaid": 0.18, "commercial": 0.65, "selfpay": 0.13}
ingested_at: 2026-04-25T20:18:19.562646+00:00
notes:
  Oral surgery DSO platform; de novo + tuck-in strategy; Midwest concentration; Cressey specialty-healthcare focus


source_id: seed_134
source: seed
deal_name: Ovation Healthcare – Delphi Private Equity LBO
buyer: Delphi Private Equity
seller: Ovation management
payer_mix: {"medicare": 0.45, "medicaid": 0.3, "commercial": 0.22, "selfpay": 0.03}
ingested_at: 2026-04-25T20:18:19.569824+00:00
notes:
  Rural critical access + community hospital management; 340B dependency; Southeast concentration; TN-based


source_id: seed_135
source: seed
deal_name: National Oncology Ventures – US Oncology / McKesson Add-on
buyer: US Oncology / McKesson
seller: General Atlantic
payer_mix: {"medicare": 0.55, "medicaid": 0.08, "commercial": 0.37, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.576105+00:00
notes:
  Oncology clinic roll-up via US Oncology network; drug margin supports EBITDA; TX-heavy; McKesson strategic distribution synergy


source_id: seed_136
source: seed
deal_name: R1 RCM – Cloudmed Acquisition
buyer: R1 RCM
seller: New Mountain Capital / Cloudmed management
ingested_at: 2026-04-25T20:18:19.586122+00:00
notes:
  RCM platform consolidation; Cloudmed revenue intelligence SaaS; New Mountain Capital exit; ~14x EBITDA


source_id: seed_137
source: seed
deal_name: Acuity Eye Group – FFL Partners Platform
buyer: FFL Partners
seller: Founding ophthalmologists
payer_mix: {"medicare": 0.48, "medicaid": 0.08, "commercial": 0.44, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.593321+00:00
notes:
  Ophthalmology DSO platform; Southwest concentration; FFL Partners specialty healthcare focus; retina + cataract mix


source_id: seed_139
source: seed
deal_name: Carbon Health – Blackstone Growth Equity
buyer: Blackstone Growth
seller: Existing shareholders
payer_mix: {"medicare": 0.15, "medicaid": 0.12, "commercial": 0.68, "selfpay": 0.05}
ingested_at: 2026-04-25T20:18:19.606682+00:00
notes:
  Tech-enabled urgent care + primary care; $3.3B valuation at Series D; Blackstone Growth equity commitment; rapid de-novo expansion


source_id: seed_140
source: seed
deal_name: Integrated Medical Group – Virtus Investment Partner
buyer: Virtus Medical Group Holdings
seller: Independent physician group
payer_mix: {"medicare": 0.42, "medicaid": 0.1, "commercial": 0.48, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.612686+00:00
notes:
  Physician practice management acquisition; primary care + specialty; value-based contract alignment; MA-market upside


source_id: seed_141
source: seed
deal_name: Concentra Group Holdings – Humana Exit / Select Medical IPO
buyer: Public Market (IPO) / Humana
seller: Select Medical / Humana joint venture
payer_mix: {"medicare": 0.12, "medicaid": 0.05, "commercial": 0.8, "selfpay": 0.03}
ingested_at: 2026-04-25T20:18:19.619832+00:00
notes:
  Occupational health + urgent care; Humana partial exit via IPO; employer-sponsored workers comp concentration


source_id: seed_142
source: seed
deal_name: Labcorp – Ascension Health Laboratory Services Acquisition
buyer: Labcorp
seller: Ascension Health
payer_mix: {"medicare": 0.45, "medicaid": 0.2, "commercial": 0.35, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.626528+00:00
notes:
  Health system lab divestiture; Labcorp strategic national lab expansion; 15-year PSA included; ~10x EBITDA


source_id: seed_143
source: seed
deal_name: Upstream Rehabilitation – Goldner Hawn / GTCR
buyer: GTCR
seller: Goldner Hawn
payer_mix: {"medicare": 0.28, "medicaid": 0.08, "commercial": 0.62, "selfpay": 0.02}
ingested_at: 2026-04-25T20:18:19.633118+00:00
notes:
  PT/OT/SLP outpatient rehab; GTCR buyout ~10.8x; 900+ clinics; commercial payer concentration; de-novo growth model


source_id: seed_144
source: seed
deal_name: ProgenyHealth – Neonatal Care Management Platform
buyer: General Atlantic
seller: Existing investors
payer_mix: {"medicare": 0.05, "medicaid": 0.4, "commercial": 0.55, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.639915+00:00
notes:
  NICU care management platform; value-based Medicaid contracts; General Atlantic growth investment; outcomes-driven model


source_id: seed_145
source: seed
deal_name: EviCore Healthcare – Restructured AIM Specialty Health
buyer: Cigna / eviCore
seller: UnitedHealth Group
ingested_at: 2026-04-25T20:18:19.646198+00:00
notes:
  Specialty benefit management / prior auth platform; Cigna strategic consolidation; $1.8B utilization management deal


source_id: seed_146
source: seed
deal_name: Alignment Healthcare – TPG Secondary Block Sale
buyer: Block purchasers
seller: TPG Capital
payer_mix: {"medicare": 0.9, "medicaid": 0.05, "commercial": 0.05, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.652855+00:00
notes:
  TPG secondary sale at loss; MA capitation headwinds 2022-23; MLR overage compressed investor returns


source_id: seed_147
source: seed
deal_name: Steward Medical Group – Optum Physician Group Acquisition
buyer: Optum
seller: Steward Health Care (distressed)
payer_mix: {"medicare": 0.38, "medicaid": 0.32, "commercial": 0.28, "selfpay": 0.02}
ingested_at: 2026-04-25T20:18:19.660061+00:00
notes:
  Distressed Steward physician group divestiture to Optum; pre-bankruptcy asset sale; TX/FL concentration


source_id: seed_148
source: seed
deal_name: Gainwell Technologies – Veritas Capital / DXC Carve-out
buyer: Veritas Capital
seller: DXC Technology
ingested_at: 2026-04-25T20:18:19.667200+00:00
notes:
  Medicaid IT / MMIS carve-out from DXC; Veritas government IT expertise; multi-state Medicaid management contracts; ~13x EBITDA


source_id: seed_149
source: seed
deal_name: Pediatric Associates – KKR Platform Investment
buyer: KKR
seller: Pediatric Associates physicians
payer_mix: {"medicare": 0.08, "medicaid": 0.45, "commercial": 0.45, "selfpay": 0.02}
ingested_at: 2026-04-25T20:18:19.673863+00:00
notes:
  Pediatric primary care platform; KKR physician practice investment; FL/southeast concentration; Medicaid-commercial mix


source_id: seed_150
source: seed
deal_name: NephroStar – Dialysis Clinic Roll-up
buyer: Warburg Pincus
seller: Independent dialysis operators
payer_mix: {"medicare": 0.7, "medicaid": 0.18, "commercial": 0.12, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.679960+00:00
notes:
  Dialysis clinic roll-up; Warburg Pincus platform creation; ESRD payment reform risk; competing with DaVita/Fresenius duopoly


source_id: seed_151
source: seed
deal_name: Absolute Care – UnitedHealth Group / Optum Acquisition
buyer: UnitedHealth Group / Optum
seller: Absolute Care management
payer_mix: {"medicare": 0.72, "medicaid": 0.15, "commercial": 0.13, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.685948+00:00
notes:
  Value-based primary care; MA-centric model; Optum strategic acquisition; favorable capitation economics drove strong returns


source_id: seed_152
source: seed
deal_name: Apria Healthcare – Owens & Minor Acquisition
buyer: Owens & Minor
seller: Apria Healthcare shareholders (public)
payer_mix: {"medicare": 0.65, "medicaid": 0.12, "commercial": 0.23, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.693090+00:00
notes:
  Home respiratory therapy + DME; Owens & Minor strategic diversification; Medicare DME competitive bidding pressure; ~8.9x EBITDA


source_id: seed_153
source: seed
deal_name: Integrated Oncology Network – BDT Capital Platform
buyer: BDT Capital Partners
seller: Independent radiation oncology operators
payer_mix: {"medicare": 0.55, "medicaid": 0.08, "commercial": 0.37, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.699856+00:00
notes:
  Radiation oncology + infusion platform; BDT Capital; site-of-care shift thesis from hospital to freestanding


source_id: seed_154
source: seed
deal_name: Clearway Pain Solutions – Pain Management Platform
buyer: Serent Capital
seller: Clearway founders
payer_mix: {"medicare": 0.35, "medicaid": 0.1, "commercial": 0.52, "selfpay": 0.03}
ingested_at: 2026-04-25T20:18:19.705778+00:00
notes:
  Interventional pain management; Serent Capital lower-middle-market; workers comp and commercial concentration; procedure-driven model


source_id: seed_155
source: seed
deal_name: Gentiva Health Services – Clayton Dubilier & Rice LBO
buyer: Clayton Dubilier & Rice
seller: Kindred Healthcare / Humana
payer_mix: {"medicare": 0.82, "medicaid": 0.1, "commercial": 0.08, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.711803+00:00
notes:
  Hospice + palliative care LBO from Humana/Kindred; CD&R; ~13.6x EBITDA; Medicare hospice cap risk; one of the largest hospice transactions on record


source_id: seed_156
source: seed
deal_name: Change Healthcare – UnitedHealth Group / Optum Acquisition
buyer: UnitedHealth Group / Optum
seller: Change Healthcare shareholders (public)
ingested_at: 2026-04-25T20:18:19.717963+00:00
notes:
  DOJ challenged; cleared by courts 2022; largest healthcare IT acquisition; HCIT network integration + clearinghouse synergies; ~19x EBITDA


source_id: seed_157
source: seed
deal_name: Shields Health Solutions – Walgreens Boots Alliance Majority Stake
buyer: Walgreens Boots Alliance
seller: Summit Partners / existing investors
payer_mix: {"medicare": 0.38, "medicaid": 0.22, "commercial": 0.4, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.723977+00:00
notes:
  Specialty pharmacy embedded in health systems; WBA acquired majority stake; Summit Partners strong return at ~15x entry


source_id: seed_159
source: seed
deal_name: Tivity Health – Foley & Lardner / Spire Capital LBO
buyer: Spire Capital Partners
seller: Tivity Health shareholders (public)
payer_mix: {"medicare": 0.82, "medicaid": 0.05, "commercial": 0.13, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.736578+00:00
notes:
  SilverSneakers MA fitness benefit; take-private from Nasdaq; COVID disrupted gym utilization 2020; recovered via digital engagement


source_id: seed_160
source: seed
deal_name: SCA Health – Bain Capital Secondary LBO
buyer: Bain Capital
seller: UnitedHealth Group / Optum
payer_mix: {"medicare": 0.2, "medicaid": 0.04, "commercial": 0.76, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.742705+00:00
notes:
  Second LBO of SCA; Optum divested to Bain under antitrust pressure; ~11.5x EBITDA; commercial-heavy ASC operator


source_id: seed_161
source: seed
deal_name: Lifepoint Health – Kindred Rehab Add-on Portfolio
buyer: LifePoint Health / Apollo
seller: Kindred Healthcare
payer_mix: {"medicare": 0.72, "medicaid": 0.1, "commercial": 0.18, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.750495+00:00
notes:
  IRF + LTACH portfolio add-on; LifePoint / Apollo post-acute strategy; high Medicare IRF dependency; SE geographic concentration


source_id: seed_162
source: seed
deal_name: ATI Physical Therapy – Advent International SPAC / Viant
buyer: Public Market (SPAC) / Advent International
seller: Advent International (partial)
payer_mix: {"medicare": 0.2, "medicaid": 0.06, "commercial": 0.72, "selfpay": 0.02}
ingested_at: 2026-04-25T20:18:19.758075+00:00
notes:
  PT SPAC merger with Halo SPAC; de-novo growth burn exceeded commercial margin recovery; stock declined >90% post-SPAC; near-total equity loss


source_id: seed_163
source: seed
deal_name: Paladina Health – DaVita Primary Care Spin / Village MD
buyer: Various (management buyout)
seller: DaVita
payer_mix: {"medicare": 0.3, "medicaid": 0.1, "commercial": 0.6, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.764419+00:00
notes:
  DaVita divested primary care division; VBC primary care subscription model; employer-sponsored market focus


source_id: seed_165
source: seed
deal_name: Pathgroup – Genoptix / Sonic Healthcare Pathology Add-on
buyer: Sonic Healthcare
seller: Various pathology practices
payer_mix: {"medicare": 0.45, "medicaid": 0.1, "commercial": 0.45, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.798194+00:00
notes:
  Pathology practice roll-up; Sonic Healthcare US expansion; anatomic pathology + clinical lab consolidation


source_id: seed_166
source: seed
deal_name: National Spine & Pain Centers – Sentinel Capital Platform
buyer: Sentinel Capital Partners
seller: NSPC management
payer_mix: {"medicare": 0.35, "medicaid": 0.08, "commercial": 0.55, "selfpay": 0.02}
ingested_at: 2026-04-25T20:18:19.814593+00:00
notes:
  Interventional pain + spine platform; Sentinel Capital; commercial concentration; 100+ clinic footprint


source_id: seed_167
source: seed
deal_name: Steward Health Care – Texas Hospital Portfolio Sale
buyer: Various (Stewardship Health / STHS)
seller: Steward Health Care (bankruptcy)
payer_mix: {"medicare": 0.32, "medicaid": 0.4, "commercial": 0.22, "selfpay": 0.06}
ingested_at: 2026-04-25T20:18:19.821177+00:00
notes:
  Bankruptcy §363 sale of TX hospitals; distressed; high Medicaid; Leonard Green & Partners total loss; buyer assumes pension liabilities


source_id: seed_168
source: seed
deal_name: Landmark Health – UnitedHealth Group Acquisition
buyer: UnitedHealth Group
seller: Landmark Health / WCAS
payer_mix: {"medicare": 0.88, "medicaid": 0.08, "commercial": 0.04, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.828573+00:00
notes:
  Home-based primary care for complex elderly; Optum-acquired; WCAS strong return on MA capitation thesis; ~17.9x EBITDA


source_id: seed_169
source: seed
deal_name: Global Medical Response – KKR / Ardian Acquisition
buyer: KKR / Ardian
seller: American Securities
payer_mix: {"medicare": 0.35, "medicaid": 0.25, "commercial": 0.3, "selfpay": 0.1}
ingested_at: 2026-04-25T20:18:19.834500+00:00
notes:
  Air + ground ambulance; KKR / Ardian $6.5B deal; NSA balance billing reform risk; ~11.2x EBITDA; largest air medical transport operator


source_id: seed_170
source: seed
deal_name: Sound Physicians – TPG Capital Secondary Investment
buyer: TPG Capital
seller: Optum / prior investors
payer_mix: {"medicare": 0.38, "medicaid": 0.18, "commercial": 0.44, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.840782+00:00
notes:
  Hospitalist / intensivist / nocturnist staffing platform; TPG secondary investment; NSA exposure on commercial splits


source_id: seed_171
source: seed
deal_name: Bright Health Group – IPO / New Enterprise Associates Exit
buyer: Public Market (IPO)
seller: New Enterprise Associates / existing investors
payer_mix: {"medicare": 0.7, "medicaid": 0.1, "commercial": 0.2, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.847065+00:00
notes:
  MA carrier IPO; multi-state expansion imploded on MLR losses; exited individual markets; stock declined >95%; near-total loss


source_id: seed_172
source: seed
deal_name: Enhabit Home Health & Hospice – Encompass Health Spin-off
buyer: Public Market (spin-off)
seller: Encompass Health
payer_mix: {"medicare": 0.75, "medicaid": 0.12, "commercial": 0.13, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.853456+00:00
notes:
  Encompass spun home health & hospice segment; standalone public company; PDGM rate pressure pressured post-spin valuation


source_id: seed_173
source: seed
deal_name: Fresenius Medical Care – NephroCare Dialysis Add-ons
buyer: Fresenius Medical Care
seller: Independent dialysis operators
payer_mix: {"medicare": 0.72, "medicaid": 0.16, "commercial": 0.12, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.859908+00:00
notes:
  Fresenius strategic consolidation of independent dialysis centers; ESRD payment reform headwinds; duopoly market dynamics


source_id: seed_174
source: seed
deal_name: Array Behavioral Care – Telepsychiatry Platform Growth
buyer: Warburg Pincus
seller: Previous investors
payer_mix: {"medicare": 0.25, "medicaid": 0.45, "commercial": 0.3, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.866075+00:00
notes:
  Telepsychiatry platform; hospital + ED contract model; Warburg Pincus; high Medicaid exposure via state behavioral health contracts


source_id: seed_175
source: seed
deal_name: Surgical Notes – ASC Revenue Cycle SaaS Platform
buyer: GTCR
seller: Surgical Notes management
ingested_at: 2026-04-25T20:18:19.872483+00:00
notes:
  ASC-specific revenue cycle software; GTCR healthcare IT strategy; SaaS ARR base; add-on to broader RCM platform thesis


source_id: seed_176
source: seed
deal_name: Diversicare Healthcare – PE Recapitalization
buyer: Diversicare management / LP investors
seller: Public shareholders
payer_mix: {"medicare": 0.3, "medicaid": 0.55, "commercial": 0.12, "selfpay": 0.03}
ingested_at: 2026-04-25T20:18:19.884147+00:00
notes:
  SNF operator take-private; high Medicaid concentration; staffing cost inflation and minimum wage risk; Southeast-heavy


source_id: seed_177
source: seed
deal_name: Evolent Health – National Imaging Associates Acquisition
buyer: Evolent Health
seller: Magellan Health / Centene
ingested_at: 2026-04-25T20:18:19.895499+00:00
notes:
  Specialty care management + imaging prior auth; Evolent strategic; utilization management platform expansion; ~14x EBITDA


source_id: seed_178
source: seed
deal_name: InfuSystem – GTCR Secondary Buyout
buyer: GTCR
seller: Bain Capital Double Impact
payer_mix: {"medicare": 0.3, "medicaid": 0.1, "commercial": 0.6, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.904610+00:00
notes:
  Ambulatory infusion services; GTCR secondary buyout; chemotherapy + pain management infusion; commercial-heavy


source_id: seed_179
source: seed
deal_name: Hazel Health – School-Based Health Platform Growth
buyer: Owl Ventures
seller: Existing investors
payer_mix: {"medicare": 0.0, "medicaid": 0.6, "commercial": 0.35, "selfpay": 0.05}
ingested_at: 2026-04-25T20:18:19.914630+00:00
notes:
  School-based telehealth; Medicaid-funded student health services; Owl Ventures Series C; 28-state expansion


source_id: seed_180
source: seed
deal_name: Amedisys – UnitedHealth Group / Optum Acquisition
buyer: UnitedHealth Group / Optum
seller: Amedisys shareholders (public)
payer_mix: {"medicare": 0.78, "medicaid": 0.12, "commercial": 0.1, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.922446+00:00
notes:
  Largest home health acquisition; DOJ challenged + cleared; ~19.6x EBITDA; Optum home-based care strategy anchor


source_id: seed_181
source: seed
deal_name: Behavioral Health Group – Webster Equity Platform LBO
buyer: Webster Equity Partners
seller: BHG management
payer_mix: {"medicare": 0.1, "medicaid": 0.55, "commercial": 0.3, "selfpay": 0.05}
ingested_at: 2026-04-25T20:18:19.929485+00:00
notes:
  Opioid addiction treatment (OTP) platform; Medicaid-heavy; SAMHSA compliance requirements; Webster Equity specialty behavior focus


source_id: seed_182
source: seed
deal_name: CenterWell Senior Primary Care – Humana Internal Build
buyer: Humana (internal)
seller: Various acquired practices
payer_mix: {"medicare": 0.9, "medicaid": 0.05, "commercial": 0.05, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.936398+00:00
notes:
  Humana de-novo + acquired MA-centric primary care network; capitation model; investment in member health outcomes


source_id: seed_183
source: seed
deal_name: GI Alliance – Ares Management / HGGC Acquisition
buyer: Ares Management / HGGC
seller: HarbourVest Partners
payer_mix: {"medicare": 0.32, "medicaid": 0.05, "commercial": 0.63, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.942907+00:00
notes:
  GI physician practice management; ~12.7x EBITDA; commercial-heavy; colonoscopy + IBD procedure volume


source_id: seed_184
source: seed
deal_name: WRS Health / Bizmatics – Ambulatory EHR Roll-up
buyer: Thoma Bravo
seller: Bizmatics management
ingested_at: 2026-04-25T20:18:19.954810+00:00
notes:
  Ambulatory EHR platform roll-up; Thoma Bravo healthcare IT thesis; SaaS ARR base; specialty-specific workflow differentiation


source_id: seed_185
source: seed
deal_name: VillageMD – Walgreens Boots Alliance Majority Stake
buyer: Walgreens Boots Alliance
seller: Village Practice Management (existing investors)
payer_mix: {"medicare": 0.28, "medicaid": 0.15, "commercial": 0.57, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.962672+00:00
notes:
  Clinic-in-pharmacy model; Walgreens majority stake at $5.2B; unit economics failed at scale; WBA divested 2024 at steep loss


source_id: seed_186
source: seed
deal_name: Maven Clinic – Women's Health Platform Series E
buyer: General Atlantic
seller: Existing investors
payer_mix: {"medicare": 0.02, "medicaid": 0.1, "commercial": 0.88, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.970079+00:00
notes:
  Digital women's health; maternity + fertility benefits platform; employer-sponsored; General Atlantic Series E at $1B valuation


source_id: seed_187
source: seed
deal_name: Signify Health – CVS Health / Aetna Acquisition
buyer: New Mountain Capital
seller: New Mountain Capital / public shareholders
payer_mix: {"medicare": 0.85, "medicaid": 0.08, "commercial": 0.07, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.979782+00:00
notes:
  Home-based assessments + provider enablement; CVS Health / Aetna was the strategic acquirer at $8B; New Mountain Capital is the exiting PE sponsor realizing this MOIC/IRR. ACKO/SDOH integration thesis; ~44x EBITDA premium.


source_id: seed_188
source: seed
deal_name: Tenet Healthcare – USPI Control Stake Acquisition
buyer: Tenet Healthcare
seller: Welsh Carson / USPI minority shareholders
payer_mix: {"medicare": 0.22, "medicaid": 0.06, "commercial": 0.72, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.986178+00:00
notes:
  Tenet acquired remaining USPI minority; ~9x EBITDA; commercial ASC concentration; Welsh Carson realized strong return


source_id: seed_189
source: seed
deal_name: Nexus Health Systems – Kelso & Company IRF Platform
buyer: Kelso & Company
seller: Nexus management
payer_mix: {"medicare": 0.7, "medicaid": 0.1, "commercial": 0.2, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.993041+00:00
notes:
  Inpatient rehabilitation + LTACH platform; Kelso; Medicare IRF classification compliance risk; national expansion


source_id: seed_190
source: seed
deal_name: One Medical (1Life Healthcare) – Amazon Acquisition
buyer: Amazon
seller: 1Life Healthcare shareholders (public)
payer_mix: {"medicare": 0.1, "medicaid": 0.05, "commercial": 0.85, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:19.999274+00:00
notes:
  Membership-based primary care; Amazon acquisition; employer benefit + Prime integration; loss-making at acquisition


source_id: seed_191
source: seed
deal_name: Nuance Communications – Microsoft Acquisition
buyer: Microsoft
seller: Nuance shareholders (public)
ingested_at: 2026-04-25T20:18:20.006204+00:00
notes:
  AI clinical documentation / Dragon Medical; Microsoft $19.7B deal; healthcare AI + ambient voice documentation thesis; ~63x EBITDA


source_id: seed_192
source: seed
deal_name: Cotiviti – Veritas Capital Secondary LBO
buyer: Veritas Capital
seller: Veritas (recap)
ingested_at: 2026-04-25T20:18:20.017553+00:00
notes:
  Payer analytics + risk adjustment platform; Veritas $15B recapitalization; ~13.6x EBITDA; government + commercial payer client base


source_id: seed_193
source: seed
deal_name: Carrum Health – Episode-Based Surgery Platform
buyer: Health Assurance Acquisition / health system partners
seller: Carrum founders
payer_mix: {"medicare": 0.08, "medicaid": 0.02, "commercial": 0.9, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:20.027359+00:00
notes:
  Value-based surgery benefit management; bundled payment model; employer-sponsored; commercial-only concentration


source_id: seed_194
source: seed
deal_name: ResCare / BrightSpring Health Services – KKR IPO
buyer: Public Market (IPO)
seller: KKR
payer_mix: {"medicare": 0.25, "medicaid": 0.6, "commercial": 0.15, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:20.044844+00:00
notes:
  Home + community-based services; KKR IPO at ~10.8x; high Medicaid; Medicaid rate reform and minimum wage exposure


source_id: seed_195
source: seed
deal_name: Pearl Health – Primary Care ACO-REACH Platform
buyer: a16z / General Catalyst
seller: Existing investors
payer_mix: {"medicare": 0.95, "medicaid": 0.03, "commercial": 0.02, "selfpay": 0.0}
ingested_at: 2026-04-25T20:18:20.051751+00:00
notes:
  ACO REACH primary care enablement; a16z / GC investment; Medicare FFS to value conversion model; risk adjustment dependency


source_id: seed_244
source: seed
deal_name: Doctor on Demand / Grand Rounds Merger
buyer: Included Health (merged)
seller: Founders / Investors
payer_mix: {"medicare": 0.05, "medicaid": 0.1, "commercial": 0.82, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:20.453648+00:00
notes:
  Virtual primary care + specialty; employer-sponsored model; COVID tailwind + post-COVID normalization


source_id: seed_255
source: seed
deal_name: NVA (National Veterinary Associates) / JAB Holding
buyer: JAB Holding Company
seller: Ares Management
payer_mix: {"medicare": 0.0, "medicaid": 0.0, "commercial": 0.2, "self_pay": 0.8}
ingested_at: 2026-04-25T20:18:20.536677+00:00
notes:
  Veterinary hospital roll-up; adjacent to healthcare PE playbook; high self-pay; pet insurance growth


source_id: seed_270
source: seed
deal_name: Invitae / GeneDx Merger
buyer: Invitae
seller: Bio-Reference / OPKO Health (GeneDx)
payer_mix: {"medicare": 0.3, "medicaid": 0.1, "commercial": 0.58, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:21.493532+00:00
notes:
  Pediatric/rare disease genetic testing; Invitae acquired at inflated SPAC price; rapid value destruction


source_id: seed_275
source: seed
deal_name: Calibrate Health / AXA Venture Partners
buyer: AXA Venture Partners
seller: Founders
payer_mix: {"medicare": 0.02, "medicaid": 0.02, "commercial": 0.6, "self_pay": 0.36}
ingested_at: 2026-04-25T20:18:21.525910+00:00
notes:
  GLP-1 metabolic health; obesity drug access platform; employer benefit model; rapid GLP-1 cost pressure


source_id: seed_293
source: seed
deal_name: Lyra Health / General Atlantic
buyer: General Atlantic
seller: Founders
payer_mix: {"medicare": 0.02, "medicaid": 0.05, "commercial": 0.85, "self_pay": 0.08}
ingested_at: 2026-04-25T20:18:21.648031+00:00
notes:
  Employer mental health benefit platform; 500+ employer clients; 80+ countries; $4.6B Series F valuation


source_id: seed_295
source: seed
deal_name: Sabra Health Care REIT / Holiday Retirement
buyer: Sabra Health Care REIT
seller: Fortress Investment Group
payer_mix: {"medicare": 0.05, "medicaid": 0.08, "commercial": 0.07, "self_pay": 0.8}
ingested_at: 2026-04-25T20:18:21.660627+00:00
notes:
  Senior living REIT portfolio; 240+ independent/AL communities; COVID occupancy risk; high private pay


source_id: seed_303
source: seed
deal_name: IVX Health / Pharmos Capital
buyer: Pharmos Capital
seller: Founders
payer_mix: {"medicare": 0.15, "medicaid": 0.1, "commercial": 0.72, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:21.715131+00:00
notes:
  Ambulatory infusion centers; biologics/immunology; commercial payer mix; office vs hospital rate arb


source_id: seed_308
source: seed
deal_name: RadNet / Imaging Center Acquisitions
buyer: RadNet Inc. (Nasdaq: RDNT)
seller: Independent radiologists
payer_mix: {"medicare": 0.42, "medicaid": 0.12, "commercial": 0.43, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:21.753992+00:00
notes:
  Largest independent outpatient radiology operator; AI-assisted mammography; site-of-care shift thesis


source_id: seed_316
source: seed
deal_name: Kindred at Home Hospice & Home Health Carve-Out
buyer: Welsh Carson Anderson & Stowe
seller: Kindred Healthcare
payer_mix: {"medicare": 0.72, "medicaid": 0.1, "commercial": 0.14, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:21.803494+00:00
notes:
  Carve-out of Kindred's home health and hospice division; merged with Humana home health assets post-acquisition.


source_id: seed_317
source: seed
deal_name: Behavioral Health Group (BHG) LBO
buyer: Frazier Healthcare Partners
payer_mix: {"medicare": 0.05, "medicaid": 0.55, "commercial": 0.3, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:21.810075+00:00
notes:
  Opioid treatment / medication-assisted treatment network; strong unit economics driven by Medicaid reimbursement expansion.


source_id: seed_318
source: seed
deal_name: Smile Brands Dental Group Recapitalization
buyer: Gryphon Investors
seller: Smile Brands (prior sponsors)
payer_mix: {"medicare": 0.02, "medicaid": 0.18, "commercial": 0.55, "self_pay": 0.25}
ingested_at: 2026-04-25T20:18:21.817401+00:00
notes:
  Secondary buyout of DSO platform; COVID disruption and integration challenges compressed returns below expectations.


source_id: seed_319
source: seed
deal_name: US Renal Care Dialysis LBO
buyer: Summit Partners
payer_mix: {"medicare": 0.68, "medicaid": 0.12, "commercial": 0.18, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:21.824845+00:00
notes:
  Independent dialysis clinic operator; rolled up regional chains across Sun Belt and Midwest; exited via secondary to CDPQ consortium.


source_id: seed_320
source: seed
deal_name: RadNet Radiology Take-Private
buyer: Leonard Green & Partners
seller: Public shareholders (RDNT)
payer_mix: {"medicare": 0.38, "medicaid": 0.08, "commercial": 0.5, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:21.830584+00:00
notes:
  Take-private of outpatient imaging chain; reimbursement cuts and leverage made exit difficult; partial loss on equity.


source_id: seed_321
source: seed
deal_name: Acadia Healthcare Behavioral Health IPO
buyer: Waud Capital Partners
payer_mix: {"medicare": 0.12, "medicaid": 0.4, "commercial": 0.42, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:21.836683+00:00
notes:
  IPO of inpatient psychiatric hospital chain assembled through aggressive M&A; Waud distributed shares post-lockup at significant premium.


source_id: seed_322
source: seed
deal_name: Envision Healthcare Physician Staffing Merger
buyer: KKR
seller: AmSurg / Envision public shareholders
payer_mix: {"medicare": 0.3, "medicaid": 0.15, "commercial": 0.5, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:21.842937+00:00
notes:
  Landmark disaster; surprise billing legislation (No Surprises Act) gutted ED staffing economics; filed Chapter 11 in 2023.


source_id: seed_323
source: seed
deal_name: Greenway Health RCM / EHR Platform LBO
buyer: Vista Equity Partners
seller: Greenway Medical Technologies
ingested_at: 2026-04-25T20:18:21.849331+00:00
notes:
  Ambulatory EHR and RCM SaaS platform serving independent physician groups; DOJ False Claims Act settlement modestly impacted exit multiple.


source_id: seed_324
source: seed
deal_name: National Veterinary Associates Add-On to QVCP
buyer: KKR
seller: None
ingested_at: 2026-04-25T20:18:21.857627+00:00
notes:
  Add-on platform expansion of KKR's veterinary thesis; bolt-on to existing portfolio; COVID pet adoption tailwind accelerated growth.


source_id: seed_325
source: seed
deal_name: Surgery Partners ASC Rollup LBO
buyer: H.I.G. Capital
seller: NovaBay / founder
payer_mix: {"medicare": 0.35, "medicaid": 0.05, "commercial": 0.56, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:21.864107+00:00
notes:
  Multi-specialty ASC platform; IPO'd on NASDAQ in 2015; H.I.G. achieved strong exit via public market distribution.


source_id: seed_326
source: seed
deal_name: Genoptix Oncology Diagnostics Carve-Out
buyer: New Mountain Capital
seller: Novartis
payer_mix: {"medicare": 0.45, "medicaid": 0.08, "commercial": 0.44, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:21.870206+00:00
notes:
  Hematology/oncology specialized lab carved from Novartis; faced Medicare reimbursement headwinds on molecular diagnostics.


source_id: seed_327
source: seed
deal_name: Cornerstone OnDemand / Healtheon Telehealth Growth Equity
buyer: TA Associates
payer_mix: {"medicare": 0.15, "medicaid": 0.1, "commercial": 0.6, "self_pay": 0.15}
ingested_at: 2026-04-25T20:18:21.877929+00:00
notes:
  Telehealth SaaS platform serving employers and payers; COVID tailwind boosted growth but market normalization compressed exit multiple.


source_id: seed_328
source: seed
deal_name: BrightSpring Health Services Home & Community Care LBO
buyer: KKR
seller: RehabCare / Kindred
payer_mix: {"medicare": 0.18, "medicaid": 0.58, "commercial": 0.18, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:21.888901+00:00
notes:
  Large home and community-based services platform for complex populations; IPO'd in January 2024 on NASDAQ (BTSG).


source_id: seed_329
source: seed
deal_name: Integrated Oncology Network Add-On
buyer: Ridgemont Equity Partners
payer_mix: {"medicare": 0.52, "medicaid": 0.08, "commercial": 0.36, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:21.894904+00:00
notes:
  Community oncology practice management organization; added radiation oncology and infusion capabilities as add-ons.


source_id: seed_330
source: seed
deal_name: Comfort Systems / Rotech Healthcare DME LBO
buyer: Apax Partners
seller: Lincare Holdings
payer_mix: {"medicare": 0.62, "medicaid": 0.14, "commercial": 0.2, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:21.900858+00:00
notes:
  Home respiratory and DME platform; competitive bidding rounds slashed Medicare reimbursement and impaired equity value.


source_id: seed_331
source: seed
deal_name: Aspirion Health RCM Distressed Debt-to-Equity
buyer: Clearlake Capital Group
seller: Senior lenders (distressed)
ingested_at: 2026-04-25T20:18:21.907509+00:00
notes:
  Distressed takeover of complex claims recovery RCM platform; operational improvements and strategic sale to Waystar drove outsized return.


source_id: seed_332
source: seed
deal_name: TeamHealth Physician Staffing Take-Private
buyer: Blackstone
seller: Public shareholders (TMH)
payer_mix: {"medicare": 0.28, "medicaid": 0.14, "commercial": 0.52, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:21.915127+00:00
notes:
  Emergency medicine and hospitalist staffing; No Surprises Act severely impacted out-of-network revenue; Blackstone trapped in investment.


source_id: seed_333
source: seed
deal_name: CarepathRx Specialty Pharmacy Joint Venture
buyer: Warburg Pincus
payer_mix: {"medicare": 0.3, "medicaid": 0.2, "commercial": 0.48, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:21.921950+00:00
notes:
  Hospital-based specialty pharmacy JV with health systems; integrated closed-door pharmacy model with health system partners.


source_id: seed_334
source: seed
deal_name: Lifepoint Health LTACH / Rehabilitation Secondary
buyer: Apollo Global Management
seller: RCCH HealthCare Partners / RegionalCare
payer_mix: {"medicare": 0.55, "medicaid": 0.18, "commercial": 0.24, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:21.929651+00:00
notes:
  Apollo took Lifepoint private; combined with RCCH community hospitals; exit via re-IPO; COVID disruption weighed on near-term margins.


source_id: seed_335
source: seed
deal_name: Women's Care Enterprises OB/GYN Rollup
buyer: Shore Capital Partners
payer_mix: {"medicare": 0.1, "medicaid": 0.25, "commercial": 0.6, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:21.941010+00:00
notes:
  OB/GYN practice management platform; rapid de novo and acquisition growth across FL and SE; sold to Unified Women's Healthcare at premium.


source_id: seed_336
source: seed
deal_name: Kindred Healthcare / TPG + Humana LBO
buyer: TPG Capital / Humana
seller: Public shareholders
payer_mix: {"medicare": 0.7, "medicaid": 0.15, "commercial": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:21.950431+00:00
notes:
  Largest LTACH operator take-private; split into home health (Kindred at Home) and hospital divisions


source_id: seed_339
source: seed
deal_name: Envision Healthcare / KKR bankruptcy exit
buyer: KKR (exit via restructuring)
seller: KKR
payer_mix: {"medicare": 0.35, "medicaid": 0.2, "commercial": 0.38, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:21.971031+00:00
notes:
  KKR $9.9B take-private destroyed by surprise billing legislation (NSA) and COVID; filed Ch.11 May 2023


source_id: seed_340
source: seed
deal_name: ATI Physical Therapy / Advent SPAC
buyer: Advent International via Fortress SPAC
seller: Advent International
payer_mix: {"medicare": 0.25, "medicaid": 0.1, "commercial": 0.58, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:21.978340+00:00
notes:
  Alt-view of seed_162 (ATI SPAC 2021). Realized MOIC/IRR cleared to prevent double-counting in the sponsor league table. PT SPAC disaster; labor inflation + coding changes crushed margins; stock fell 95% post-merger.


source_id: seed_342
source: seed
deal_name: US Renal Care / Summit Partners LBO
buyer: Summit Partners
seller: Management
payer_mix: {"medicare": 0.75, "medicaid": 0.12, "commercial": 0.1, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:21.991750+00:00
notes:
  Third-largest US dialysis operator; ESRD-heavy Medicare dependency; growth via de novo and acquisition


source_id: seed_345
source: seed
deal_name: LifeStance Health / TPG growth equity + IPO
buyer: TPG Capital / public IPO
seller: Various
payer_mix: {"medicare": 0.1, "medicaid": 0.15, "commercial": 0.7, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.010632+00:00
notes:
  Outpatient mental health roll-up IPO; over-expanded, burned cash; stock down 70% from peak IPO price


source_id: seed_347
source: seed
deal_name: Cano Health / InTandem Capital SPAC + Humana JV
buyer: InTandem Capital Partners via SPAC
seller: Barry Shevach (founder)
payer_mix: {"medicare": 0.75, "medicaid": 0.15, "commercial": 0.08, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:22.022705+00:00
notes:
  MA-focused primary care SPAC disaster; filed Ch.11 Feb 2024 after failing to achieve capitation targets


source_id: seed_348
source: seed
deal_name: US Acute Care Solutions / Welsh Carson LBO
buyer: Welsh Carson Anderson & Stowe
seller: Sheridan Healthcare / Amsurg legacy
payer_mix: {"medicare": 0.3, "medicaid": 0.22, "commercial": 0.4, "self_pay": 0.08}
ingested_at: 2026-04-25T20:18:22.029662+00:00
notes:
  Hospitalist + EM physician group; NSA surprise billing reform impacted repricing; sold to private buyer 2021


source_id: seed_349
source: seed
deal_name: Apria Healthcare / Blackstone take-private + re-IPO
buyer: Blackstone Group
seller: Public shareholders
payer_mix: {"medicare": 0.55, "medicaid": 0.1, "commercial": 0.3, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.038256+00:00
notes:
  Largest US home respiratory therapy/DME provider; Blackstone IPO'd again in 2020; acquired by Owens & Minor 2022


source_id: seed_350
source: seed
deal_name: Dental Care Alliance / Harvest Partners LBO
buyer: Harvest Partners
seller: KKR / founders
payer_mix: {"medicare": 0.02, "medicaid": 0.25, "commercial": 0.6, "self_pay": 0.13}
ingested_at: 2026-04-25T20:18:22.045081+00:00
notes:
  Southeast dental DSO; 300+ locations; Aspen Dental management company model; sold to Solaris Health 2022


source_id: seed_352
source: seed
deal_name: Matrix Medical Network / Frazier Healthcare LBO
buyer: Frazier Healthcare Partners
seller: ABRY Partners
payer_mix: {"medicare": 0.7, "medicaid": 0.08, "commercial": 0.2, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:22.058587+00:00
notes:
  In-home health risk assessments for MA plans; COVID drove demand for at-home assessments; sold to Centene JV


source_id: seed_355
source: seed
deal_name: AccordantHealth / Humana spinout (Evolent Health predecessor)
buyer: TPG Capital / UPMC
seller: Humana spinout
payer_mix: {"medicare": 0.45, "medicaid": 0.2, "commercial": 0.3, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.077531+00:00
notes:
  Population health management spinout; became Evolent Health; IPO 2015; value-based care technology platform


source_id: seed_356
source: seed
deal_name: Steward Health Care / Cerberus Capital LBO
buyer: Cerberus Capital Management
seller: Caritas Christi Health Care
payer_mix: {"medicare": 0.45, "medicaid": 0.3, "commercial": 0.2, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.083855+00:00
notes:
  First for-profit conversion of Catholic hospital system; massive geographic overexpansion; filed Ch.11 May 2024


source_id: seed_357
source: seed
deal_name: Amedisys / Optum (UHG) acquisition
buyer: UnitedHealth Group / Optum
seller: Public shareholders (Amedisys)
payer_mix: {"medicare": 0.75, "medicaid": 0.12, "commercial": 0.1, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:22.091528+00:00
notes:
  DOJ blocked on antitrust grounds; Amedisys then agreed to merge with Option Care; home health consolidation wave


source_id: seed_360
source: seed
deal_name: Surgical Care Affiliates / United Surgical Partners merger
buyer: Tenet Healthcare / USPI
seller: H.I.G. Capital / management
payer_mix: {"medicare": 0.3, "medicaid": 0.05, "commercial": 0.62, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:22.109549+00:00
notes:
  ASC platform merger with Tenet USPI; site-of-care shift from hospital ORs to ASCs drove premium multiple


source_id: seed_362
source: seed
deal_name: InfuSystem / ABRY Partners LBO
buyer: ABRY Partners
seller: Kohlberg & Company
payer_mix: {"medicare": 0.35, "medicaid": 0.1, "commercial": 0.5, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.122640+00:00
notes:
  Oncology infusion pump rental + specialty pharmacy; IPO'd post-exit; durable MOIC from oncology tailwinds


source_id: seed_364
source: seed
deal_name: Interim HealthCare / Caring Brands International LBO
buyer: Caring Brands (Levine Leichtman)
seller: Franchise Finance Company
payer_mix: {"medicare": 0.5, "medicaid": 0.2, "commercial": 0.25, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.134956+00:00
notes:
  Home health + staffing franchise model; Medicare home health rate stability supported steady returns


source_id: seed_365
source: seed
deal_name: Envision Physician Services / AmSurg / AMSURG merger
buyer: AmSurg + Envision Healthcare
seller: Clayton Dubilier & Rice
payer_mix: {"medicare": 0.32, "medicaid": 0.2, "commercial": 0.4, "self_pay": 0.08}
ingested_at: 2026-04-25T20:18:22.140840+00:00
notes:
  CD&R created Envision via AMSURG+EVHC merger; KKR then took private for $9.9B; surprise billing NSA killed value


source_id: seed_366
source: seed
deal_name: Netsmart Technologies / GI Partners LBO
buyer: GI Partners
seller: Harris Corporation / public
ingested_at: 2026-04-25T20:18:22.147372+00:00
notes:
  Behavioral health + post-acute EHR; care continuum SaaS; sold to Hearst Health / GI Partners recap 2021


source_id: seed_367
source: seed
deal_name: IntelliSource / Cotiviti merger (Connecture era)
buyer: Veritas Capital
seller: Advent International
ingested_at: 2026-04-25T20:18:22.154045+00:00
notes:
  Payer analytics SaaS; Veritas merged Cotiviti + Connecture; IPO at $6.4B then Veritas acquired back private


source_id: seed_368
source: seed
deal_name: National Imaging Associates / Magellan Health carve-out
buyer: Magellan Health
seller: AIM Specialty Health (Anthem)
payer_mix: {"medicare": 0.2, "medicaid": 0.1, "commercial": 0.65, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.160122+00:00
notes:
  Radiology benefits management / prior auth platform; Magellan acquired NIA then sold full company to Centene 2022


source_id: seed_369
source: seed
deal_name: Smile Direct Club / Clayton Dubilier & Rice growth equity
buyer: Clayton Dubilier & Rice
seller: Jordan Wright (founder)
payer_mix: {"medicare": 0.0, "medicaid": 0.0, "commercial": 0.1, "self_pay": 0.9}
ingested_at: 2026-04-25T20:18:22.166952+00:00
notes:
  D2C aligner disaster; ADA + dentist lobbying, quality lawsuits, COVID; filed Ch.7 liquidation Sept 2023


source_id: seed_370
source: seed
deal_name: Carecore National / AIM Specialty Health merger
buyer: Anthem / AIM
seller: General Atlantic / founders
ingested_at: 2026-04-25T20:18:22.173510+00:00
notes:
  Radiology + musculoskeletal benefit management for payers; GA acquired for $305M sold to AIM for $2.4B


source_id: seed_371
source: seed
deal_name: Gentiva Health Services / Kindred at Home merger
buyer: Kindred Healthcare / TPG Capital
seller: Public shareholders
payer_mix: {"medicare": 0.72, "medicaid": 0.13, "commercial": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:22.179477+00:00
notes:
  Created largest US home health + hospice company; Medicare home health cuts partially offset by hospice growth


source_id: seed_373
source: seed
deal_name: US Physical Therapy / Kelso & Company add-on wave
buyer: Kelso & Company
seller: Management buyout from founders
payer_mix: {"medicare": 0.3, "medicaid": 0.1, "commercial": 0.55, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.193730+00:00
notes:
  PT roll-up; labor inflation + COVID closures + coding changes compressed returns; sold back to management team


source_id: seed_374
source: seed
deal_name: Acadia Healthcare / Waud Capital LBO
buyer: Waud Capital Partners
seller: Management / physician owners
payer_mix: {"medicare": 0.2, "medicaid": 0.35, "commercial": 0.42, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:22.199904+00:00
notes:
  BH hospital roll-up; IPO 2011 at $620M; grew to $3.5B market cap by 2015; one of best healthcare PE outcomes ever


source_id: seed_375
source: seed
deal_name: ModivCare (Providence Service) / Coliseum Capital LBO
buyer: Coliseum Capital Management
seller: Providence Service shareholders
payer_mix: {"medicare": 0.15, "medicaid": 0.72, "commercial": 0.1, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:22.205913+00:00
notes:
  NEMT + personal care platform; rebranded ModivCare; benefited from Medicaid managed care outsourcing trend


source_id: seed_378
source: seed
deal_name: DaVita Medical Group / Optum carve-out (VillageMD era)
buyer: Optum / UnitedHealth Group
seller: DaVita Inc.
payer_mix: {"medicare": 0.8, "medicaid": 0.1, "commercial": 0.08, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:22.223948+00:00
notes:
  Value-based primary care for MA patients; capitation model for complex patients; Optum absorbed into integrated delivery


source_id: seed_379
source: seed
deal_name: MedQuist / Nuance Communications health IT acquisition
buyer: Nuance Communications / Microsoft acquisition
seller: MedQuist Holdings
ingested_at: 2026-04-25T20:18:22.230208+00:00
notes:
  Clinical documentation + CDI SaaS; AI-assisted medical transcription; Microsoft acquired Nuance for $19B in 2022


source_id: seed_380
source: seed
deal_name: Bright Health / New Enterprise Associates growth equity
buyer: New Enterprise Associates / multiple VCs
seller: Founders
payer_mix: {"medicare": 0.6, "medicaid": 0.1, "commercial": 0.3, "self_pay": 0.0}
ingested_at: 2026-04-25T20:18:22.236408+00:00
notes:
  MA plan startup disaster; expanded too fast; raised $1.5B+ total; delisted 2023 after stock fell 99%


source_id: seed_381
source: seed
deal_name: CONMED Corporation / Gyrus Medical acquisition
buyer: CONMED Corporation strategic
seller: Olympus / Gyrus Medical
payer_mix: {"medicare": 0.25, "medicaid": 0.05, "commercial": 0.65, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.242951+00:00
notes:
  Surgical instruments + electrosurgical platform; ASC site-of-care shift drove capital equipment demand


source_id: seed_383
source: seed
deal_name: EXL Health / Outsourced RCM division growth
buyer: EXL Service Holdings
seller: Various hospital clients
ingested_at: 2026-04-25T20:18:22.254727+00:00
notes:
  Healthcare BPO + RCM outsourcing for payers and providers; value-based contract analytics drove premium retention


source_id: seed_384
source: seed
deal_name: Advanced ICU Care / WindRose Health Investors growth equity
buyer: WindRose Health Investors
seller: Mercy Health (legacy investor)
payer_mix: {"medicare": 0.55, "medicaid": 0.15, "commercial": 0.28, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:22.268197+00:00
notes:
  Tele-ICU + critical care telemedicine; COVID dramatically expanded demand for remote intensivist coverage


source_id: seed_385
source: seed
deal_name: United Behavioral Health / Optum BH carve-out
buyer: Optum / UnitedHealth Group
seller: UBH public division
payer_mix: {"medicare": 0.15, "medicaid": 0.35, "commercial": 0.45, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.274836+00:00
notes:
  Largest US managed BH carve-out; integration with PCP practices for collaborative care; DOJ scrutiny on network adequacy


source_id: seed_386
source: seed
deal_name: Adreima / Revenue Cycle Management add-on (Ensemble Health)
buyer: Ensemble Health Partners / Golden Gate Capital
seller: OhioHealth system spinout
ingested_at: 2026-04-25T20:18:22.280857+00:00
notes:
  Health system RCM spinout; Ensemble Health grew rapidly through health system outsourcing; recapitalized at >$5B


source_id: seed_387
source: seed
deal_name: Ardent Health Services / Equity Group Investments LBO
buyer: Equity Group Investments (Zell)
seller: Universal Health Services legacy
payer_mix: {"medicare": 0.4, "medicaid": 0.25, "commercial": 0.3, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.286977+00:00
notes:
  Regional hospital chain; IPO'd 2024 at ~$4B valuation; disciplined geographic focus on OK, TX, NM, ID markets


source_id: seed_388
source: seed
deal_name: Sound Physicians / Summit Partners LBO
buyer: Summit Partners
seller: Optum / Physician management legacy
payer_mix: {"medicare": 0.4, "medicaid": 0.22, "commercial": 0.33, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.293332+00:00
notes:
  Hospitalist + nocturnist + intensivist group; NSA headwinds partially offset by hospital outsourcing demand growth


source_id: seed_389
source: seed
deal_name: Quartet Health / Oak HC/FT growth equity
buyer: Oak HC/FT Partners
seller: Founders
payer_mix: {"medicare": 0.1, "medicaid": 0.3, "commercial": 0.55, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.299212+00:00
notes:
  Collaborative care tech for PCP-BH integration; scaled slowly; merged with Iora Health / One Medical orbit


source_id: seed_390
source: seed
deal_name: Pivot Health / Deerfield acquisition + platform build
buyer: Deerfield Management
seller: BlueCross seed investors
payer_mix: {"medicare": 0.1, "medicaid": 0.05, "commercial": 0.75, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:22.934764+00:00
notes:
  Short-term health + STM insurance / ACA bridge products; regulatory risk from state surprise billing rules


source_id: seed_391
source: seed
deal_name: National Health Investors / Senior Care REIT strategic acquisition
buyer: National Health Investors (NHI REIT)
seller: Senior Care Centers (SNF operator)
payer_mix: {"medicare": 0.35, "medicaid": 0.5, "commercial": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:22.941779+00:00
notes:
  SNF real estate sale-leaseback; operator defaulted 2020; COVID occupancy collapse triggered lease restructuring


source_id: seed_392
source: seed
deal_name: Inovalon / Nordic Capital + Insight Partners take-private
buyer: Nordic Capital / Insight Partners
seller: Public shareholders
ingested_at: 2026-04-25T20:18:22.948884+00:00
notes:
  Cloud-based data analytics for payers + providers; paid steep growth multiple; profitability turnaround in progress


source_id: seed_393
source: seed
deal_name: Global Indemnity Group / specialty health insurance carve-out
buyer: Warburg Pincus
seller: Fox Paine & Company
payer_mix: {"medicare": 0.05, "medicaid": 0.05, "commercial": 0.85, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:22.955241+00:00
notes:
  Specialty health + dental + vision insurance carve-out; employer group market; consistent but unspectacular returns


source_id: seed_394
source: seed
deal_name: Mednax / NP Pediatrics physician group roll-up
buyer: Mednax (Physician Partners acquirer)
seller: Various pediatric groups
payer_mix: {"medicare": 0.05, "medicaid": 0.4, "commercial": 0.52, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:22.963283+00:00
notes:
  NICU + pediatric subspecialty roll-up; Medicaid rate risk + hospital exclusivity contract disputes compressed returns


source_id: seed_395
source: seed
deal_name: Vitas Healthcare / Chemed Corporation acquisition
buyer: Chemed Corporation (strategic)
seller: Vitas Group founders / private shareholders
payer_mix: {"medicare": 0.85, "medicaid": 0.08, "commercial": 0.05, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:23.799210+00:00
notes:
  Largest US hospice operator; Medicare hospice rate stability + aging population drove 20-yr compounding return


source_id: seed_396
source: seed
deal_name: Prospect Medical Holdings / Leonard Green take-private
buyer: Leonard Green & Partners
seller: Public shareholders
payer_mix: {"medicare": 0.38, "medicaid": 0.35, "commercial": 0.22, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:23.805194+00:00
notes:
  Safety-net hospital chain; California Medicaid dependency; filed Ch.11 July 2023; hospital viability crisis


source_id: seed_397
source: seed
deal_name: CareMore Health / Anthem acquisition
buyer: Anthem / WellPoint
seller: CareMore founders / physician shareholders
payer_mix: {"medicare": 0.95, "medicaid": 0.05, "commercial": 0.0, "self_pay": 0.0}
ingested_at: 2026-04-25T20:18:23.813067+00:00
notes:
  MA plan + care delivery for complex elderly; high-risk Medicare frailty model; strong evidence of cost reduction


source_id: seed_399
source: seed
deal_name: Surgical Directions / Waud Capital LBO
buyer: Waud Capital Partners
seller: Founders / management team
payer_mix: {"medicare": 0.25, "medicaid": 0.05, "commercial": 0.65, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:23.828154+00:00
notes:
  ASC consulting + management; hospital OR efficiency partnership model; COVID site-of-care shift drove demand


source_id: seed_400
source: seed
deal_name: Staywell Health / Carient / Population health JV
buyer: Centene Corporation
seller: StayWell Health Management founders
payer_mix: {"medicare": 0.2, "medicaid": 0.5, "commercial": 0.28, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:23.833931+00:00
notes:
  Disease management + health coaching platform; Centene absorbed into Medicaid + commercial wellness programs


source_id: seed_401
source: seed
deal_name: Heritage Healthcare / ABRY Partners add-on roll-up
buyer: ABRY Partners
seller: Seller-owned chains
payer_mix: {"medicare": 0.68, "medicaid": 0.18, "commercial": 0.11, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:23.840342+00:00
notes:
  Home health multi-state roll-up; Medicare home health reimbursement episodic cuts managed via visit optimization


source_id: seed_402
source: seed
deal_name: Physicians Endoscopy / Blue Wolf Capital LBO
buyer: Blue Wolf Capital Partners
seller: Physician founders / management
payer_mix: {"medicare": 0.35, "medicaid": 0.05, "commercial": 0.58, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:23.846897+00:00
notes:
  GI / endoscopy ASC platform; site-of-care shift from hospital to ASC for colonoscopy drove strong returns


source_id: seed_403
source: seed
deal_name: National Western Life / Aon Hewitt benefits carve-out
buyer: Lightyear Capital
seller: National Western Life Group
payer_mix: {"medicare": 0.1, "medicaid": 0.05, "commercial": 0.82, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:23.853363+00:00
notes:
  Employee benefits administration carve-out; TPA + COBRA + FSA platform; steady but undifferentiated returns


source_id: seed_404
source: seed
deal_name: TeamHealth / IPC Healthcare merger (pre-KKR)
buyer: Blackstone Group
seller: Warburg Pincus / management
payer_mix: {"medicare": 0.32, "medicaid": 0.2, "commercial": 0.4, "self_pay": 0.08}
ingested_at: 2026-04-25T20:18:23.859552+00:00
notes:
  Emergency + hospital medicine giant; NSA surprise billing reform destroyed payor-neutral pricing model


source_id: seed_405
source: seed
deal_name: Omada Health / Andreessen Horowitz growth equity
buyer: Andreessen Horowitz / Cigna Ventures
seller: Founders
payer_mix: {"medicare": 0.05, "medicaid": 0.1, "commercial": 0.6, "self_pay": 0.25}
ingested_at: 2026-04-25T20:18:23.865527+00:00
notes:
  Digital diabetes prevention program; CDC DPP covered by Medicare/commercial; IPO filed 2025 at ~$1.8B valuation


source_id: seed_406
source: seed
deal_name: Altus Healthcare + Rehab / Revelstoke Capital add-on
buyer: Revelstoke Capital Partners
seller: Regional PT owners
payer_mix: {"medicare": 0.28, "medicaid": 0.08, "commercial": 0.58, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:23.871625+00:00
notes:
  Texas PT roll-up; multiple coding audits navigated; sold to ATI precursor prior to ATI SPAC at a premium


source_id: seed_407
source: seed
deal_name: InCompass Health / Elevation Oncology merger
buyer: Nautic Partners
seller: Oncology founders
payer_mix: {"medicare": 0.55, "medicaid": 0.1, "commercial": 0.32, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:23.878512+00:00
notes:
  Radiation oncology + medical oncology platform; site-neutral payment risk offset by drug margin on 340B program


source_id: seed_408
source: seed
deal_name: LHC Group / Almost Family merger
buyer: LHC Group (LHCG public)
seller: Almost Family public shareholders
payer_mix: {"medicare": 0.74, "medicaid": 0.12, "commercial": 0.11, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:23.884550+00:00
notes:
  Home health + hospice roll-up; UHG/Optum acquired for $6B in 2022 at 5x+ entry; Medicare home health anchor


source_id: seed_409
source: seed
deal_name: Hanger Prosthetics / Rehabilitation Centers acquisition
buyer: Welsh Carson Anderson & Stowe
seller: Public shareholders (Hanger Inc.)
payer_mix: {"medicare": 0.5, "medicaid": 0.12, "commercial": 0.33, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:23.891685+00:00
notes:
  Largest US prosthetics + orthotics provider; DOJ settlement on billing; Medicare reimbursement audit compressed margins


source_id: seed_410
source: seed
deal_name: Acuity Brands Healthcare / Industrial lighting spin
buyer: TPG Capital / Searchlight Capital
seller: Kindred legacy assets
payer_mix: {"medicare": 0.72, "medicaid": 0.12, "commercial": 0.13, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:23.897700+00:00
notes:
  LTACH + IRF post-acute carve-out from Kindred; COVID recovery unit demand drove higher-than-expected census


source_id: seed_411
source: seed
deal_name: WellCare / Centene merger (second deal)
buyer: Centene Corporation
seller: Public WellCare shareholders
payer_mix: {"medicare": 0.55, "medicaid": 0.38, "commercial": 0.06, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:23.923275+00:00
notes:
  Created largest Medicaid managed care company; Medicare Part D leadership; ACA/Medicaid expansion tailwind


source_id: seed_412
source: seed
deal_name: Emergency Communications Network / TriZetto merger
buyer: Cognizant Technology Solutions
seller: Francisco Partners / management
ingested_at: 2026-04-25T20:18:23.930792+00:00
notes:
  Payer core admin + claims processing SaaS; Francisco Partners acquired for $720M, sold to Cognizant for $2.7B


source_id: seed_413
source: seed
deal_name: HAH / Home at Home pediatric nursing (Pediatric Specialty Care)
buyer: BelHealth Investment Partners
seller: Regional pediatric nurses founders
payer_mix: {"medicare": 0.02, "medicaid": 0.85, "commercial": 0.12, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:23.937188+00:00
notes:
  Pediatric home health nursing for medically complex children; Medicaid waiver + TEFRA dependency; labor-intensive


source_id: seed_415
source: seed
deal_name: Tivity Health / Donaldson Lufkin Jenrette secondary
buyer: Marlin Equity Partners
seller: Public shareholders (Tivity Health)
payer_mix: {"medicare": 0.8, "medicaid": 0.05, "commercial": 0.14, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:23.951478+00:00
notes:
  SilverSneakers fitness benefit for Medicare seniors; COVID gym closure decimated enrollment 50%+ then recovered


source_id: seed_416
source: seed
deal_name: Surgical Care Affiliates (SCA) / Frist & KKR LBO
buyer: KKR / Frist family
seller: HCA Healthcare / legacy SCA
payer_mix: {"medicare": 0.28, "medicaid": 0.04, "commercial": 0.64, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:23.958548+00:00
notes:
  ASC platform with HCA co-investment model; site-of-care shift pre-COVID; merged with Tenet/USPI 2017


source_id: seed_418
source: seed
deal_name: Nant Health / Patrick Soon-Shiong growth equity
buyer: Patrick Soon-Shiong / various VCs
seller: Founders
ingested_at: 2026-04-25T20:18:23.982921+00:00
notes:
  AI + genomics + care delivery vanity project; IPO'd 2016 at $2.6B then declined 90%; burned cash without product traction


source_id: seed_419
source: seed
deal_name: IASIS Healthcare / TPG Capital LBO
buyer: TPG Capital
seller: Jordan Industries legacy
payer_mix: {"medicare": 0.38, "medicaid": 0.28, "commercial": 0.28, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:23.990463+00:00
notes:
  Community hospital chain AZ/TX/UT/NV; sold to Steward Health 2017; steady returns from Sun Belt market growth


source_id: seed_421
source: seed
deal_name: BioTelemetry / Philips Healthcare acquisition
buyer: Philips Healthcare
seller: Public shareholders
payer_mix: {"medicare": 0.6, "medicaid": 0.08, "commercial": 0.28, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:24.005695+00:00
notes:
  Remote cardiac monitoring (MCT/Holter); Philips paid 28x EBITDA; cardiac digital health premium justified by CPT codes


source_id: seed_422
source: seed
deal_name: Acadia Healthcare Florida/Tennessee BH hospital cluster
buyer: Acadia Healthcare (ACHC)
seller: Regional system carve-outs
payer_mix: {"medicare": 0.22, "medicaid": 0.38, "commercial": 0.38, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:24.013894+00:00
notes:
  Acadia bolt-on BH hospital cluster; Medicaid managed care penetration risk offset by commercial mix improvement


source_id: seed_423
source: seed
deal_name: Navicent Health / Atrium Health merger
buyer: Atrium Health
seller: Navicent Health System nonprofit
payer_mix: {"medicare": 0.42, "medicaid": 0.28, "commercial": 0.25, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:24.023173+00:00
notes:
  Georgia regional health system strategic affiliation; synergies from supply chain + IT shared services


source_id: seed_424
source: seed
deal_name: Capio AB / Ramsay Health Care acquisition
buyer: Ramsay Health Care
seller: Fresenius / Nordic PE consortium
payer_mix: {"medicare": 0.3, "medicaid": 0.1, "commercial": 0.55, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:24.032202+00:00
notes:
  European hospital operator; Ramsay cross-border expansion; international healthcare PE benchmark deal


source_id: seed_425
source: seed
deal_name: IPC Systems / CareMore merger (telehealth ICU era)
buyer: Teladoc Health
seller: InTouch Health / investors
payer_mix: {"medicare": 0.35, "medicaid": 0.15, "commercial": 0.45, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:24.040146+00:00
notes:
  Telehealth platform pre-COVID; COVID accelerated adoption; pricing pressure post-pandemic normalization


source_id: seed_426
source: seed
deal_name: Curo Health Services / FC/Patriot Capital add-ons
buyer: Patriot Capital / founding team
seller: Regional hospice operators
payer_mix: {"medicare": 0.86, "medicaid": 0.09, "commercial": 0.04, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:24.046421+00:00
notes:
  Hospice roll-up in underserved rural Southeast markets; hospice benefited from aging demographics + COVID family preferences


source_id: seed_427
source: seed
deal_name: CHC Healthcare / CareFlight Air Medical acquisition
buyer: Global Medical Response (AMR/Air Methods)
seller: KKR / legacy aviation investors
payer_mix: {"medicare": 0.45, "medicaid": 0.18, "commercial": 0.3, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:24.053113+00:00
notes:
  Air ambulance + ground EMS mega-merger; NSA surprise billing reform eliminated air ambulance balance-billing premium


source_id: seed_428
source: seed
deal_name: NovaBay Pharmaceuticals / Wound care spinout
buyer: SWK Holdings / specialty finance
seller: NovaBay Pharma shareholders
payer_mix: {"medicare": 0.4, "medicaid": 0.1, "commercial": 0.45, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:24.061257+00:00
notes:
  Specialty wound care antimicrobial; FDA delay + hospital formulary penetration challenges; equity value evaporated


source_id: seed_429
source: seed
deal_name: Spring Health / General Catalyst growth equity
buyer: General Catalyst / Kinnevik
seller: Founders
payer_mix: {"medicare": 0.05, "medicaid": 0.1, "commercial": 0.7, "self_pay": 0.15}
ingested_at: 2026-04-25T20:18:24.070978+00:00
notes:
  Employer-facing mental health benefits platform; $3.3B valuation at Series E; employer mental health benefits acceleration


source_id: seed_430
source: seed
deal_name: Fresenius Kabi / NxStage Medical acquisition
buyer: Fresenius Medical Care
seller: NxStage public shareholders
payer_mix: {"medicare": 0.78, "medicaid": 0.1, "commercial": 0.1, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:24.078121+00:00
notes:
  Home hemodialysis device + services; ESRD TPEP home dialysis push + Fresenius integration created value


source_id: seed_431
source: seed
deal_name: Nexus Health Systems / RehabCare Group add-on
buyer: ABRY Partners / RehabCare management
seller: Kindred Healthcare legacy
payer_mix: {"medicare": 0.7, "medicaid": 0.14, "commercial": 0.13, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:24.086384+00:00
notes:
  LTACH + SNF in Texas; Medicare site-neutral payment advocacy risk; sold to Kindred at Home rebundling 2022


source_id: seed_432
source: seed
deal_name: Healtheon / WebMD Health merger (original digital health)
buyer: WebMD Health / Emdeon Communications
seller: Netscape / Jim Clark
ingested_at: 2026-04-25T20:18:24.092885+00:00
notes:
  Dot-com era health IT mega-merger; first digital health bubble; eventually became profitable Emdeon under KKR


source_id: seed_433
source: seed
deal_name: AmSurg / AMSURG + Envision Premerger physician group
buyer: Sheridan Healthcare / AmSurg
seller: Sheridan management buyout
payer_mix: {"medicare": 0.28, "medicaid": 0.15, "commercial": 0.5, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:24.099121+00:00
notes:
  ASC + anesthesia platform pre-mega-merger; AmSurg + Sheridan = $5.6B combined; then KKR AMSURG disaster


source_id: seed_434
source: seed
deal_name: ModivCare / Providence Service add-on (personal care)
buyer: Modivcare Inc. (public)
seller: Personal care operators
payer_mix: {"medicare": 0.05, "medicaid": 0.82, "commercial": 0.1, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:24.105881+00:00
notes:
  Personal care + NEMT add-ons; Medicaid redetermination unwinding 2023 pressured volumes; macro labor inflation


source_id: seed_435
source: seed
deal_name: One Oncology / General Atlantic + US Oncology merger
buyer: General Atlantic / US Oncology Network
seller: Existing oncology practice investors
payer_mix: {"medicare": 0.55, "medicaid": 0.08, "commercial": 0.34, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:24.112209+00:00
notes:
  Oncology management services + 340B program integration; site-neutral payment risk; drug margin sustains economics


source_id: seed_436
source: seed
deal_name: Encompass Health / HealthSouth IRF spin + rebrand
buyer: HealthSouth Corp (public strategic)
seller: Legacy HME division buyers
payer_mix: {"medicare": 0.72, "medicaid": 0.09, "commercial": 0.16, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:24.118329+00:00
notes:
  Largest US IRF operator; rebrand from HealthSouth eliminated scandal premium; Medicare IRF rate stability


source_id: seed_437
source: seed
deal_name: LifePoint Health / RCCH merge + Province Healthcare rollup
buyer: Apollo Global Management
seller: Public shareholders (LifePoint Health)
payer_mix: {"medicare": 0.42, "medicaid": 0.22, "commercial": 0.3, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:24.124339+00:00
notes:
  Apollo rural hospital roll-up; merged with RCCH post-close; COVID reimbursement support stabilized thesis


source_id: seed_438
source: seed
deal_name: Molina Healthcare / Joseph Molina family buyout
buyer: Public company (NASDAQ: MOH)
seller: Molina family legacy / management
payer_mix: {"medicare": 0.1, "medicaid": 0.82, "commercial": 0.06, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:24.130197+00:00
notes:
  Medicaid MCO with new management team; operational turnaround + ACA marketplace expansion; 5x stock run


source_id: seed_440
source: seed
deal_name: Radiology Partners / New Enterprise Associates Series B-D
buyer: New Enterprise Associates / ADIA
seller: RadPartners founders
payer_mix: {"medicare": 0.4, "medicaid": 0.12, "commercial": 0.42, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:24.145035+00:00
notes:
  Radiology hospital contract platform; grew to $2B+ revenue; NSA impact on radiology professional billing pending


source_id: seed_441
source: seed
deal_name: R1 RCM / TowerBrook + Ascension health system partnership
buyer: TowerBrook Capital Partners + Ascension
seller: Accretive Health / Ascension JV
ingested_at: 2026-04-25T20:18:24.151680+00:00
notes:
  RCM SaaS + outsourced services; health system RCM outsourcing secular trend; IPO and M&A premium exit


source_id: seed_443
source: seed
deal_name: National Staffing Group / healthcare staffing PE
buyer: Ridgemont Equity Partners
seller: Founder / management
ingested_at: 2026-04-25T20:18:24.164138+00:00
notes:
  Healthcare temp staffing; COVID nursing shortage created massive demand spike; travel nurse margin explosion


source_id: seed_444
source: seed
deal_name: Cotiviti / Veritas Capital secondary (post-Healtheon)
buyer: Carlyle Group
seller: Veritas Capital
ingested_at: 2026-04-25T20:18:24.175499+00:00
notes:
  Payer analytics + payment integrity SaaS secondary buyout; Cotiviti growing at 15%+ annually; Carlyle hold


source_id: seed_445
source: seed
deal_name: MEDNAX / Sheridan Anesthesiology merger
buyer: MEDNAX Inc (public strategic)
seller: AmSurg / Sheridan investors
payer_mix: {"medicare": 0.28, "medicaid": 0.16, "commercial": 0.49, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:24.182138+00:00
notes:
  MEDNAX expanded into anesthesia; synergies not realized; NSA impacted commercial; divestitures followed


source_id: seed_446
source: seed
deal_name: Ankura Consulting / FTI Health group carve-out
buyer: Bain Capital Special Situations
seller: FTI Consulting Group
ingested_at: 2026-04-25T20:18:23.202765+00:00
notes:
  Healthcare advisory/consulting carve-out; value-based care transitions drove demand for external expertise


source_id: seed_447
source: seed
deal_name: Community Health Systems / Quorum Health distressed spin
buyer: CHS management / new equity
seller: Community Health Systems (CHS)
payer_mix: {"medicare": 0.4, "medicaid": 0.28, "commercial": 0.26, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:24.239951+00:00
notes:
  CHS worst-performing hospitals spun into Quorum Health; filed Ch.11 2020; rural hospital distressed investing failure


source_id: seed_448
source: seed
deal_name: MedBridge / TA Associates physical therapy digital
buyer: TA Associates
seller: Founders + earlier angels
payer_mix: {"medicare": 0.05, "medicaid": 0.05, "commercial": 0.55, "self_pay": 0.35}
ingested_at: 2026-04-25T20:18:24.248337+00:00
notes:
  PT digital content + remote therapeutic monitoring; COVID drove telehealth physical therapy adoption and platform demand


source_id: seed_449
source: seed
deal_name: PharMerica / BrightSpring merger (KKR + Walgreens)
buyer: KKR / Walgreens Boots Alliance
seller: KKR / PharMerica shareholders
payer_mix: {"medicare": 0.6, "medicaid": 0.25, "commercial": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:24.257053+00:00
notes:
  LTC pharmacy + HCBS merger; BrightSpring IPO at $4.1B in 2024; specialty Rx dispensing growth offset SNF volumes


source_id: seed_451
source: seed
deal_name: Pediatric Home Service / Stellus Capital specialty
buyer: Stellus Capital Management
seller: Founders / management
payer_mix: {"medicare": 0.03, "medicaid": 0.88, "commercial": 0.09, "self_pay": 0.0}
ingested_at: 2026-04-25T20:18:24.272424+00:00
notes:
  Pediatric home respiratory therapy + nursing for vent-dependent kids; TEFRA/Medicaid waiver; sold to Bayada 2022


source_id: seed_452
source: seed
deal_name: Caliber Imaging / pathology AI growth equity
buyer: General Atlantic / Bessemer Venture Partners
seller: Founders
payer_mix: {"medicare": 0.4, "medicaid": 0.1, "commercial": 0.45, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:24.232845+00:00
notes:
  Confocal moxifloscopy + digital pathology AI; FDA De Novo clearance 2018; real-time skin cancer diagnosis


source_id: seed_453
source: seed
deal_name: Amedisys / LHC Group strategic position building
buyer: LHC Group / UnitedHealth Group
seller: Amedisys public shareholders
payer_mix: {"medicare": 0.73, "medicaid": 0.12, "commercial": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.268977+00:00
notes:
  Home health + hospice scale play; PDGM reform navigated through clinical operations investment; premium exit multiple


source_id: seed_454
source: seed
deal_name: US Dermatology Partners / BBH (Brockton) roll-up
buyer: BBH Capital Partners
seller: Dermatologist founders
payer_mix: {"medicare": 0.22, "medicaid": 0.06, "commercial": 0.62, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:25.274882+00:00
notes:
  Texas dermatology platform; biologic + cosmetic revenue; Mohs surgery complexity drives margin; sold to USDP 2021


source_id: seed_455
source: seed
deal_name: Nuvance Health / Northwell Health affiliation
buyer: Northwell Health (nonprofit strategic)
seller: Western CT Health Network + Health Quest
payer_mix: {"medicare": 0.44, "medicaid": 0.18, "commercial": 0.32, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:25.281439+00:00
notes:
  Hudson Valley health system affiliation; Northwell scale + purchasing power synergies for regional nonprofit


source_id: seed_456
source: seed
deal_name: Envision Healthcare — KKR Take-Private (post-IPO re-LBO)
buyer: KKR
seller: AMSURG / Envision Public Shareholders
payer_mix: {"medicare": 0.38, "medicaid": 0.12, "commercial": 0.46, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:25.287563+00:00
notes:
  Emergency medicine + anesthesia MSO; NSA surprise billing legislation destroyed revenue model post-close; filed Ch.11 May 2023. Entry EV/EBITDA ~11.6x; complete write-off for KKR equity.


source_id: seed_457
source: seed
deal_name: Kindred at Home — Humana Majority Buyout
buyer: Humana / TPG Capital / WCAS
seller: Kindred Healthcare
payer_mix: {"medicare": 0.72, "medicaid": 0.1, "commercial": 0.16, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:25.293803+00:00
notes:
  Largest U.S. home health/hospice provider; Humana acquired remaining stake 2021 for $5.7B EV; strong Medicare home health demand during COVID. TPG/WCAS earned ~2.4x on 3-year hold; Humana strategic rationale.


source_id: seed_458
source: seed
deal_name: DaVita Medical Group — UnitedHealth Group Acquisition
buyer: UnitedHealth Group / Optum
seller: DaVita Inc
payer_mix: {"medicare": 0.35, "medicaid": 0.08, "commercial": 0.52, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.299634+00:00
notes:
  Strategic acquisition by Optum; ~300 clinics, 1.7M patients in VBC arrangements; EV/EBITDA ~17.5x; not a PE deal but benchmark for physician MSO valuations. Regulatory scrutiny from FTC; closed Sept 2019.


source_id: seed_459
source: seed
deal_name: CareMore Health — Anthem Strategic Acquisition
buyer: Anthem (WellPoint)
seller: Warburg Pincus
payer_mix: {"medicare": 0.85, "medicaid": 0.05, "commercial": 0.08, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:25.305890+00:00
notes:
  Medicare Advantage / PACE integrated model; Warburg entry ~2006 at $85M EV. CareMore pioneered high-touch Medicare risk model; 2011 exit to Anthem at $800M EV. Strong HCC coding sophistication.


source_id: seed_460
source: seed
deal_name: Aspen Dental — Leonard Green & Partners Recap
buyer: Leonard Green & Partners
seller: Ares Management (secondary)
payer_mix: {"medicare": 0.02, "medicaid": 0.12, "commercial": 0.55, "self_pay": 0.31}
ingested_at: 2026-04-25T20:18:25.312446+00:00
notes:
  Dental DSO with de novo-driven growth model; LGP exit 2018 to ARES/Genstar at ~$3.8B EV. Scaled to 900+ locations; strong de novo unit economics. Minimal Medicare exposure; strong commercial and self-pay mix.


source_id: seed_461
source: seed
deal_name: Emergency Medical Services (EMSC) — Onex Take-Private
buyer: Onex Corporation
seller: EMSC Public Shareholders (NASDAQ: EMSC)
payer_mix: {"medicare": 0.3, "medicaid": 0.15, "commercial": 0.48, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:25.319210+00:00
notes:
  Emergency care + air medical transport; Onex sold to Envision 2016 for $8.2B EV. EV/EBITDA expansion from ~12x to ~16x on EBITDA growth. One of largest ever ambulatory services transactions at that time.


source_id: seed_462
source: seed
deal_name: Healogics — Waud Capital Buyout
buyer: Waud Capital Partners
seller: HIG Capital
payer_mix: {"medicare": 0.65, "medicaid": 0.1, "commercial": 0.22, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.326222+00:00
notes:
  Wound care management; de novo hospital-based wound center model; sold to Warburg Pincus 2016 at ~$1.2B EV. 600+ centers nationwide. Medicare-heavy but defensible CPT billing in wound care.


source_id: seed_463
source: seed
deal_name: BrightSpring Health Services — KKR Take-Private
buyer: KKR
seller: ResCare (public)
payer_mix: {"medicare": 0.35, "medicaid": 0.48, "commercial": 0.12, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.335535+00:00
notes:
  Home-based services for individuals with disabilities; IPO Jan 2024 at ~$3.2B EV. High Medicaid mix creates reimbursement risk but defensible given HCBS waiver dynamics. KKR added pharmacy segment (PharMerica) during hold.


source_id: seed_464
source: seed
deal_name: Smile Brands — OMERS / Gryphon Investors Buyout
buyer: OMERS Private Equity / Gryphon Investors
seller: Francisco Partners
payer_mix: {"medicare": 0.01, "medicaid": 0.18, "commercial": 0.5, "self_pay": 0.31}
ingested_at: 2026-04-25T20:18:25.341997+00:00
notes:
  Multi-brand dental DSO (~600 offices); COVID disrupted 2020 performance; filed Ch.11 2021 to restructure debt; recapitalized and relisted 2023. Ultimately partial recovery but not the original equity thesis.


source_id: seed_465
source: seed
deal_name: Zotec Partners — Court Square Capital Buyout
buyer: Court Square Capital Partners
seller: Zotec Management
payer_mix: {"medicare": 0.55, "medicaid": 0.12, "commercial": 0.3, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.347998+00:00
notes:
  Radiology / physician group RCM platform; sold to R1 RCM 2021. Court Square thesis: professional billing tech in radiology is defensible moat. Strong RCM platform with cross-sell into new physician specialties.


source_id: seed_466
source: seed
deal_name: Apria Healthcare — Blackstone Take-Private (2nd)
buyer: Blackstone Group
seller: Apria Inc Public Shareholders
payer_mix: {"medicare": 0.6, "medicaid": 0.08, "commercial": 0.28, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:25.354111+00:00
notes:
  Home respiratory therapy / DME; sold to Cardinal Health 2022 for $3.3B EV. COVID drove oxygen/ventilator demand; 2-year hold earned strong IRR. Blackstone's second ownership of Apria (previously held 2008-2012).


source_id: seed_467
source: seed
deal_name: Ardent Health Services — Equity Group Investments Acquisition
buyer: Equity Group Investments (Zell)
seller: Ventas REIT
payer_mix: {"medicare": 0.45, "medicaid": 0.18, "commercial": 0.32, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.360966+00:00
notes:
  8-hospital community health system in NM/NJ/TX/OK; IPO June 2024 at ~$3.6B EV. Long hold (9 yrs); Ardent scale acquisitions drove EBITDA growth. Real estate monetized via sale-leaseback to Ventas during hold.


source_id: seed_468
source: seed
deal_name: Surgery Partners — H.I.G. Capital Buyout
buyer: H.I.G. Capital / NSH Partners
seller: NSH Surgical
payer_mix: {"medicare": 0.45, "medicaid": 0.08, "commercial": 0.44, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.367008+00:00
notes:
  Surgery Partners IPO Sept 2015 on NASDAQ at ~$900M EV; H.I.G. partial exit at IPO. One of fastest PE→IPO timelines in ASC sector; H.I.G. retained ~60% post-IPO. Subsequent Bain Capital stake acquisition 2017 at $19/share.


source_id: seed_469
source: seed
deal_name: PharMerica — KKR Acquisition (from BrightSpring carve-out)
buyer: KKR
seller: BrightSpring Health / Public
payer_mix: {"medicare": 0.4, "medicaid": 0.4, "commercial": 0.18, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:25.373114+00:00
notes:
  LTC pharmacy platform serving SNFs and ALFs; KKR bundled with BrightSpring. BrightSpring IPO 2024 includes PharMerica; combined EV ~$3.5B. High Medicaid/Medicare mix typical for institutional pharmacy segment.


source_id: seed_470
source: seed
deal_name: Mednax — Sheridan Healthcare Integration
buyer: MEDNAX Inc (Public)
seller: Sheridan Healthcare / Warburg Pincus
payer_mix: {"medicare": 0.32, "medicaid": 0.22, "commercial": 0.42, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:25.379234+00:00
notes:
  Strategic bolt-on; Sheridan (anesthesia + women's care) + MEDNAX (neonatology). Warburg exit at ~12.6x EV/EBITDA; MEDNAX later divested Sheridan 2020. Post-NSA, both platforms faced physician billing pressure.


source_id: seed_471
source: seed
deal_name: WebMD Health — Internet Brands / KKR Take-Private
buyer: Internet Brands / KKR
seller: WebMD Health Corp (Public, NASDAQ: WBMD)
payer_mix: {"medicare": 0.0, "medicaid": 0.0, "commercial": 0.1, "self_pay": 0.9}
ingested_at: 2026-04-25T20:18:25.385079+00:00
notes:
  Health information and physician/payer media platform; sold to Hellman & Friedman 2020 for ~$9.8B EV. COVID amplified health info demand. Internet Brands / KKR 3-year hold: ~3.5x on strong organic growth + ad revenues.


source_id: seed_472
source: seed
deal_name: American Renal Associates — Centerbridge Take-Private
buyer: Centerbridge Partners
seller: American Renal Associates (NYSE: ARA)
payer_mix: {"medicare": 0.66, "medicaid": 0.08, "commercial": 0.24, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:25.391258+00:00
notes:
  ~250-center dialysis network; Centerbridge $9.75/share take-private. Smaller dialysis footprint vs DaVita/Fresenius allows niche differentiation. CMS ESRD Prospective Payment System rate risk embedded in Medicare ~66%.


source_id: seed_473
source: seed
deal_name: Greenway Health — Vista Equity Buyout
buyer: Vista Equity Partners
seller: Greenway Health (Public, NYSE: GWY)
payer_mix: {"medicare": 0.1, "medicaid": 0.05, "commercial": 0.7, "self_pay": 0.15}
ingested_at: 2026-04-25T20:18:25.397207+00:00
notes:
  EHR + RCM SaaS for ambulatory practices; Vista take-private at $11.35/share. Competitor EHR pressure (Epic / Athena) limited upsell; ARPU growth constrained. Vista sold to Thoma Bravo 2023 at modest uplift; steady but not stellar.


source_id: seed_474
source: seed
deal_name: National Mentor — Centerbridge / Vistria Group Acquisition
buyer: Centerbridge Partners / Vistria Group
seller: Vestar Capital Partners
payer_mix: {"medicare": 0.08, "medicaid": 0.72, "commercial": 0.15, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.403080+00:00
notes:
  IDD/ABI residential and day services; strong HCBS waiver cash flows. Medicaid-dependent but politically defensible (disability community advocacy). Rebranded Sevita; sold to Cinven 2024 at ~$5.1B EV.


source_id: seed_475
source: seed
deal_name: Acute Care / TeamHealth — Blackstone Recap / Secondary
buyer: Blackstone Group
seller: Hellman & Friedman / IPC Holdings
payer_mix: {"medicare": 0.35, "medicaid": 0.12, "commercial": 0.47, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:25.409236+00:00
notes:
  Emergency medicine / hospitalist / anesthesia staffing MSO. NSA surprise billing ban devastated commercial rate leverage; lost major health system contracts post-regulation. Blackstone entry at ~12.7x; struggled to exit at acceptable returns.


source_id: seed_476
source: seed
deal_name: Viad Medical Centers — Warburg Pincus Investment
buyer: Warburg Pincus
seller: Founders / Management
payer_mix: {"medicare": 0.58, "medicaid": 0.05, "commercial": 0.34, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.415103+00:00
notes:
  Oncology network in Southeast; radiation therapy + medical oncology. Sold to American Oncology Network (AON) 2021. Strong Medicare oncology fee schedule despite 340B pharmacy pressure.


source_id: seed_477
source: seed
deal_name: US Oncology — McKesson Strategic Acquisition
buyer: McKesson Corporation
seller: Welsh Carson Anderson & Stowe
payer_mix: {"medicare": 0.55, "medicaid": 0.07, "commercial": 0.35, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.421508+00:00
notes:
  Largest oncology management services organization; WCAS entry 2005 at ~$760M EV. McKesson paid ~11.7x EBITDA; consolidation of oncology practice management. Drug distribution synergies drove McKesson strategic rationale.


source_id: seed_478
source: seed
deal_name: Lifespace Communities — Senior Living REITization
buyer: Welltower / Lifespace JV
seller: Lutheran Services in America
payer_mix: {"medicare": 0.22, "medicaid": 0.28, "commercial": 0.3, "self_pay": 0.2}
ingested_at: 2026-04-25T20:18:25.427767+00:00
notes:
  15 senior living campuses; Welltower REIT took majority ownership. Sale-leaseback structure; not a traditional PE deal but benchmark for senior living valuations (~16.7x EBITDA).


source_id: seed_479
source: seed
deal_name: Landmark Health — Optum Acquisition
buyer: Optum (UnitedHealth)
seller: WCAS / Landmark Founders
payer_mix: {"medicare": 0.9, "medicaid": 0.03, "commercial": 0.05, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:25.434244+00:00
notes:
  High-risk patient home visit model for frail elderly; WCAS entry 2016. COVID accelerated home-based care adoption; Optum strategic fit obvious. Near-100% Medicare mix justified by patient acuity; strong HCC coding.


source_id: seed_480
source: seed
deal_name: ExamWorks — Leonard Green & Partners LBO
buyer: Leonard Green & Partners
seller: Genoptix / ExamWorks Public (NYSE: EXAM)
payer_mix: {"medicare": 0.2, "medicaid": 0.05, "commercial": 0.65, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:25.442106+00:00
notes:
  IME/peer review services for workers' comp and disability insurers. Defensible niche in managed care utilization management; LGP sold to Verisk Health 2021. Non-Medicare primary revenue base.


source_id: seed_481
source: seed
deal_name: Concentra — Select Medical / Humana JV
buyer: Humana / Select Medical
seller: Concentra (previously THC)
payer_mix: {"medicare": 0.1, "medicaid": 0.06, "commercial": 0.45, "self_pay": 0.39}
ingested_at: 2026-04-25T20:18:25.450370+00:00
notes:
  Occupational health / urgent care clinics at employer worksites. Workers' comp and group health primary payer; not Medicare-heavy. Select Medical IPO Concentra 2023 at ~$3.0B EV.


source_id: seed_482
source: seed
deal_name: Gastro Health — Audax Private Equity Buyout
buyer: Audax Private Equity
seller: Founders / Management
payer_mix: {"medicare": 0.5, "medicaid": 0.08, "commercial": 0.38, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:25.456919+00:00
notes:
  GI physician group in Florida; de novo + acquisition growth model. Sold to KKR 2022 at ~$1.3B EV; excellent 4-year return. Colonoscopy volumes resilient; ASC co-location drives EBITDA margin.


source_id: seed_483
source: seed
deal_name: Alignment Healthcare — General Atlantic Investment
buyer: General Atlantic
seller: Alignment Founders
payer_mix: {"medicare": 0.95, "medicaid": 0.02, "commercial": 0.02, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:25.463691+00:00
notes:
  PALM population health MA plan in CA/NC/AZ; IPO 2021 at ~$3.5B EV. GA invested $110M at $1.2B post-money; NASDAQ: ALHC. Medicare Advantage at-risk model with proprietary clinical tech platform.


source_id: seed_484
source: seed
deal_name: Strive Health — General Atlantic / WCAS
buyer: General Atlantic / WCAS
seller: Strive Health Founders
payer_mix: {"medicare": 0.7, "medicaid": 0.1, "commercial": 0.18, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:25.470269+00:00
notes:
  Value-based kidney care model (CKCC/ESRD); Series C at $700M valuation. CMS ESRD capitated model; competing with DaVita/Fresenius on VBC. Still private as of 2024; high optionality if ESRD VBC scales.


source_id: seed_485
source: seed
deal_name: TeamHealth — Blackstone Exit via Sponsor Secondary
buyer: Blackstone (continued hold)
seller: N/A (secondary refinancing)
payer_mix: {"medicare": 0.35, "medicaid": 0.12, "commercial": 0.47, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:25.484784+00:00
notes:
  Emergency medicine / hospitalist staffing; NSA legislation drove major revenue shortfall vs. underwriting model. Blackstone still holding. Prior H&F exit at ~$6.1B EV; Blackstone secondary re-leveraged the structure.


source_id: seed_486
source: seed
deal_name: Option Care Health — HC Group Holdings / BioScrip Merger
buyer: Walgreens / Madison Dearborn (via HC Group)
seller: HC Group / BioScrip
payer_mix: {"medicare": 0.42, "medicaid": 0.08, "commercial": 0.46, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:25.490943+00:00
notes:
  Home infusion therapy platform; combined HC Group + BioScrip NASDAQ: OPCH. Madison Dearborn partial exit at ~$4.5B EV 2023; COVID drove IV infusion demand. Specialty pharmacy + home infusion is durable category vs. pure PBM.


source_id: seed_487
source: seed
deal_name: Covenant Physician Partners — Ares Management Buyout
buyer: Ares Management
seller: Covenant Founders / Sverica
payer_mix: {"medicare": 0.48, "medicaid": 0.06, "commercial": 0.43, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.496702+00:00
notes:
  Multispecialty ASC + physician practice platform (ophthalmology, GI, pain). Ares sold to AmSurg (Envision) 2024. ASC sector valuations elevated post-COVID on site-of-care shift thesis.


source_id: seed_488
source: seed
deal_name: Ortho Clinical Diagnostics — Carlyle LBO / IPO
buyer: Carlyle Group
seller: Johnson & Johnson
payer_mix: {"medicare": 0.15, "medicaid": 0.04, "commercial": 0.65, "self_pay": 0.16}
ingested_at: 2026-04-25T20:18:25.502698+00:00
notes:
  Clinical diagnostics instruments + reagents (hospital lab segment). Carlyle J&J carve-out at ~12.2x; IPO 2021 (NASDAQ: OCDX) at ~$6.8B EV. Niche immunohematology + critical care testing moat; long hold reflects capital intensity and sales cycle.


source_id: seed_489
source: seed
deal_name: EyeCare Partners — FFL Partners Buyout
buyer: FFL Partners
seller: EyeCare Partners Founders
payer_mix: {"medicare": 0.45, "medicaid": 0.1, "commercial": 0.42, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.508972+00:00
notes:
  Ophthalmology + optometry practice group; de novo + M&A in midwest/south. Sold to Ares / European PE 2020 at ~$2.2B EV; strong 3-year return. Routine vs. surgical ophthalmology mix drives economics.


source_id: seed_490
source: seed
deal_name: United Surgical Partners International — Optum Majority Acquisition
buyer: UnitedHealth Group / Optum
seller: USPI Public Shareholders / Tenet
payer_mix: {"medicare": 0.45, "medicaid": 0.06, "commercial": 0.46, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.515135+00:00
notes:
  460+ ambulatory surgery centers in partnership with health systems; Optum acquiring from Tenet Healthcare for $3.6B (partial interest). ASC EV/EBITDA ~11.3x; strategic integration into UHG care delivery network.


source_id: seed_491
source: seed
deal_name: Acute Care Staffing (AMN Healthcare) — AMN Acquisition
buyer: AMN Healthcare (Public)
seller: NovaPro / Syntrax
payer_mix: {"medicare": 0.28, "medicaid": 0.1, "commercial": 0.55, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:25.521634+00:00
notes:
  Healthcare staffing technology bolt-on; not a standalone PE deal. Benchmark: staffing tech valuations ~9.5x EBITDA at deal time. COVID drove nursing staffing demand surge that inflated AMN revenue.


source_id: seed_492
source: seed
deal_name: Summit Pacific Medical Center — Rural Hospital Distressed Sale
buyer: Quorum Health Group
seller: Community Health Systems
payer_mix: {"medicare": 0.52, "medicaid": 0.28, "commercial": 0.16, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:25.527825+00:00
notes:
  Rural Washington State hospital; high Medicaid/Medicare mix typical of rural. CHS rural divestiture; Quorum operational struggles led to bankruptcy 2020. Rural hospital M&A benchmark: distressed at sub-10x EBITDA.


source_id: seed_493
source: seed
deal_name: NovaBay Pharmaceuticals / Perrigo — Consumer Health Tuck-in
buyer: Perrigo Company
seller: NovaBay Pharmaceuticals
payer_mix: {"medicare": 0.05, "medicaid": 0.03, "commercial": 0.3, "self_pay": 0.62}
ingested_at: 2026-04-25T20:18:25.535843+00:00
notes:
  OTC/consumer health tuck-in; not healthcare PE. Benchmark for consumer health transactions: ~11x EBITDA. Self-pay dominant.


source_id: seed_494
source: seed
deal_name: ModivCare (Providence Service) — HCBS Platform
buyer: ModivCare Management (strategic recap)
seller: Public Shareholders
payer_mix: {"medicare": 0.1, "medicaid": 0.65, "commercial": 0.22, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.542769+00:00
notes:
  Non-emergency medical transportation + home care + remote monitoring. NEMT heavily Medicaid-dependent; rate adequacy risk from state budget cycles. Public company (NASDAQ: MODV); strategic recap at $34/share then rose to $85.


source_id: seed_495
source: seed
deal_name: Genoptix Medical Laboratory — Novartis Acquisition
buyer: Novartis AG
seller: Genoptix (NASDAQ: GXDX)
payer_mix: {"medicare": 0.6, "medicaid": 0.05, "commercial": 0.32, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.549037+00:00
notes:
  Specialty hematology / oncology lab; Novartis strategic acquisition for $470M EV (~9.4x). Oncology molecular diagnostics (MRD testing) increasingly tied to drug companion. Benchmark: specialty oncology lab EV/EBITDA ~10-15x.


source_id: seed_496
source: seed
deal_name: AFC Urgent Care — Warburg Pincus Investment
buyer: Warburg Pincus
seller: AFC Urgent Care Founders
payer_mix: {"medicare": 0.12, "medicaid": 0.08, "commercial": 0.62, "self_pay": 0.18}
ingested_at: 2026-04-25T20:18:25.554822+00:00
notes:
  Franchise-based urgent care (260+ centers); Warburg growth capital round. COVID testing surge drove 2020-21 volumes; franchisee model de-risks capex. Self-pay and commercial dominant; minimal Medicare fee-schedule exposure.


source_id: seed_497
source: seed
deal_name: American Family Care — Deerfield Management Investment
buyer: Deerfield Management
seller: American Family Care Founders / PAFG
payer_mix: {"medicare": 0.15, "medicaid": 0.1, "commercial": 0.6, "self_pay": 0.15}
ingested_at: 2026-04-25T20:18:25.560703+00:00
notes:
  Largest urgent care franchise in U.S. (~350 locations); Deerfield growth equity. Franchisee and company-owned mix; COVID testing and flu season drive volatility. Sold majority to WestBridge Capital 2023.


source_id: seed_498
source: seed
deal_name: ATI Physical Therapy — Advent International LBO
buyer: Advent International
seller: Warburg Pincus
payer_mix: {"medicare": 0.42, "medicaid": 0.1, "commercial": 0.45, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.566651+00:00
notes:
  2nd largest physical therapy chain; Advent bought from Warburg at ~12.5x. Went public via SPAC (Compass Horizon) 2021; stock collapsed on labor cost surge. PT sector fragile on labor economics; therapist shortage drove margin compression.


source_id: seed_499
source: seed
deal_name: Select Physical Therapy — Welsh Carson LBO
buyer: Welsh Carson Anderson & Stowe
seller: Select Medical Holdings / Kforce
payer_mix: {"medicare": 0.48, "medicaid": 0.08, "commercial": 0.41, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.574659+00:00
notes:
  800+ outpatient PT clinics; WCAS de-merged from Select Medical. Steady Medicare demand for MSK / orthopedic rehab; therapist labor stable. Eventually sold to ATI Physical Therapy 2024.


source_id: seed_500
source: seed
deal_name: RadNet — Significant Acquisition / Growth
buyer: RadNet Management (Public, NASDAQ: RDNT)
seller: Various regional radiology groups
payer_mix: {"medicare": 0.52, "medicaid": 0.08, "commercial": 0.38, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:25.584869+00:00
notes:
  Largest U.S. radiology platform (350+ centers); acquisitive NASDAQ strategy. AI diagnostics integration (iCAD) differentiates vs. independent centers. Medicare fee schedule risk on outpatient imaging; site-of-care shift benefits RadNet.


source_id: seed_501
source: seed
deal_name: Shields Health Solutions — Oak HC/FT Buyout
buyer: Oak HC/FT
seller: Shields Health Solutions Founders
payer_mix: {"medicare": 0.35, "medicaid": 0.05, "commercial": 0.55, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.591063+00:00
notes:
  Specialty pharmacy management platform embedded in hospitals; SCA Health (Optum/Surgical Care Affiliates) acquired 2022 at ~$1.6B EV. Specialty drug margin expansion thesis; hospital capture of lucrative specialty Rx.


source_id: seed_502
source: seed
deal_name: Nomi Health — Blackstone Growth Equity
buyer: Blackstone Growth
seller: Nomi Health Founders
payer_mix: {"medicare": 0.2, "medicaid": 0.1, "commercial": 0.65, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.598853+00:00
notes:
  Direct-to-employer healthcare platform; $1.0B valuation. COVID testing infrastructure + employer health center model. Still private 2024; employer health trend thesis intact but scaling difficult.


source_id: seed_503
source: seed
deal_name: MedExpress Urgent Care — Optum Acquisition
buyer: Optum (UnitedHealth)
seller: New Enterprise Associates (NEA)
payer_mix: {"medicare": 0.1, "medicaid": 0.1, "commercial": 0.65, "self_pay": 0.15}
ingested_at: 2026-04-25T20:18:25.604932+00:00
notes:
  200+ urgent care centers; NEA entry ~2010 at $300M EV. Optum acquired to build employer-sponsored care network. NEA 7-year hold produced ~4x on strong organic growth + Optum premium.


source_id: seed_504
source: seed
deal_name: Comprehensive Pain Management — Acadia / GTCR Rollup
buyer: Acadia Healthcare / GTCR
seller: Regional Founders
payer_mix: {"medicare": 0.38, "medicaid": 0.22, "commercial": 0.35, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.611638+00:00
notes:
  Substance use disorder / MAT clinic rollup; GTCR/Acadia co-investment. Opioid epidemic drove demand surge for MAT services (buprenorphine/methadone). High Medicaid dependency but 1115 waiver protections provided reimbursement floor.


source_id: seed_505
source: seed
deal_name: Pacific Dental Services — NMS Capital Take-Private
buyer: NMS Capital
seller: Pacific Dental Services Founders
payer_mix: {"medicare": 0.01, "medicaid": 0.08, "commercial": 0.6, "self_pay": 0.31}
ingested_at: 2026-04-25T20:18:25.619803+00:00
notes:
  Dental support organization (DSO) in western U.S. (750+ offices). NMS long hold enabled massive de novo / acquisition scaling. Sold to Ontario Teachers' Pension Plan 2015 at ~$1.5B EV. DSO model strong: dentist recruitment + payer contracting leverage.


source_id: seed_506
source: seed
deal_name: Castle Biosciences — Dermatology Diagnostics (Growth)
buyer: Canaan Partners
seller: Castle Biosciences Founders
payer_mix: {"medicare": 0.6, "medicaid": 0.05, "commercial": 0.33, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:25.626808+00:00
notes:
  Molecular diagnostics for cutaneous oncology (melanoma risk stratification). IPO 2019 (NASDAQ: CSTL) at ~$600M EV; Canaan 2-year hold. Proprietary gene expression test; defensive niche in oncology diagnostics.


source_id: seed_507
source: seed
deal_name: Surgical Notes — Providence Equity Buyout
buyer: Providence Equity Partners
seller: Surgical Notes Founders
payer_mix: {"medicare": 0.42, "medicaid": 0.06, "commercial": 0.48, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:25.633880+00:00
notes:
  ASC coding + billing outsourcing (RCM tech for outpatient surgery). Providence sold to MedBridge / Audax 2023 at ~$920M EV. ASC-focused RCM tech is high-margin SaaS with strong switching costs.


source_id: seed_508
source: seed
deal_name: Kindred Healthcare — Humana Full Acquisition
buyer: Humana
seller: Kindred Healthcare Public Shareholders
payer_mix: {"medicare": 0.62, "medicaid": 0.12, "commercial": 0.22, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:25.640196+00:00
notes:
  Full Kindred Healthcare take-private by Humana + TPG + WCAS at $9/share. Then split: home health/hospice (Kindred at Home) retained; hospital segment sold. Strategic benchmark: ~14.1x EBITDA for integrated LTAC/HH.


source_id: seed_509
source: seed
deal_name: Sutter Health / Catholic Health — Non-Profit Benchmark
buyer: N/A (not-for-profit affiliation)
seller: N/A
payer_mix: {"medicare": 0.42, "medicaid": 0.2, "commercial": 0.34, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:25.646396+00:00
notes:
  Not a PE deal; California not-for-profit hospital system operational benchmark. Sutter Health antitrust settlement ($575M) illuminates commercial payer leverage. EV/EBITDA proxy ~17x for large integrated non-profit California system.


source_id: seed_510
source: seed
deal_name: Premise Health — Warburg Pincus Growth Equity
buyer: Warburg Pincus
seller: Premise Health Founders
payer_mix: {"medicare": 0.05, "medicaid": 0.03, "commercial": 0.85, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:25.653382+00:00
notes:
  On-site employer health clinics; acquired Work-Site Medical + Integra. Sold to Clayton Dubilier & Rice 2022 at ~$1.9B EV. Employer health trend is secular; minimal government reimbursement exposure.


source_id: seed_511
source: seed
deal_name: Viant Medical / Integer Holdings — Medical Device Mfg LBO
buyer: Clayton Dubilier & Rice
seller: GTCR / KKR
payer_mix: {"medicare": 0.3, "medicaid": 0.08, "commercial": 0.55, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:25.659578+00:00
notes:
  Medical device contract manufacturer; not healthcare services but benchmark. CD&R industrial + healthcare mix; supply chain resilience post-COVID essential. Device manufacturing EV/EBITDA ~9x at time of deal.


source_id: seed_512
source: seed
deal_name: Curation Health (formerly Medicomp) — TA Associates
buyer: TA Associates
seller: Medicomp Founders
payer_mix: {"medicare": 0.65, "medicaid": 0.08, "commercial": 0.25, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:25.665832+00:00
notes:
  HCC coding tech for Medicare Advantage plans; risk adjustment + prospective coding. TA Associates sold to Veradigm 2023 at ~$800M EV. Medicare Advantage risk adjustment is a durable, compliance-driven niche.


source_id: seed_513
source: seed
deal_name: InVentiv Health — Thomas H. Lee Buyout
buyer: Thomas H. Lee Partners
seller: inVentiv Health Group / Advent International
payer_mix: {"medicare": 0.1, "medicaid": 0.05, "commercial": 0.75, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:25.671752+00:00
notes:
  CRO / commercial pharma services (clinical + commercial outsourcing). Merged with INC Research to form Syneos Health 2017; THL 2-year hold strong IRR. CRO demand driven by pharma R&D outsourcing trend.


source_id: seed_514
source: seed
deal_name: Sound Physicians — Fresenius Medical Care Acquisition
buyer: Fresenius Medical Care NA
seller: Summit Partners
payer_mix: {"medicare": 0.55, "medicaid": 0.12, "commercial": 0.3, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.680135+00:00
notes:
  Hospitalist + intensivist staffing group (600+ hospitals); Summit entry ~2012. Summit 6-year hold, sold to Fresenius strategic at ~12.9x EBITDA. Hospitalist model: value-based care alignment drives hospital partnership.


source_id: seed_515
source: seed
deal_name: Radiation Therapy Inc (21st Oncology) — Vistria / WCAS
buyer: Vistria Group / WCAS
seller: 21st Century Oncology / Radiation Therapy Partners
payer_mix: {"medicare": 0.6, "medicaid": 0.08, "commercial": 0.29, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.686411+00:00
notes:
  Radiation therapy / freestanding cancer center rollup. 21st Century Oncology went Ch.11; spun out radiation-only segment. CMS IMRT/SBRT reimbursement stable; radiation therapy defensible sub-sector.


source_id: seed_516
source: seed
deal_name: Veracyte — TPG Investment / IPO
buyer: TPG Biotech / Public
seller: Veracyte Founders
payer_mix: {"medicare": 0.65, "medicaid": 0.04, "commercial": 0.28, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.695582+00:00
notes:
  Thyroid genomic classifier diagnostics; NASDAQ: VCYT IPO 2013. TPG Biotech invested at $65M post-money; IPO at ~$300M mkt cap. Defensible CPT-code moat: thyroid FNA reflex test; payer coverage well established.


source_id: seed_517
source: seed
deal_name: Myriad Genetics — Oncology Diagnostics Leader (Benchmark)
buyer: Myriad Genetics (Public, NASDAQ: MYGN)
seller: Various oncology genomics acquisitions
payer_mix: {"medicare": 0.5, "medicaid": 0.05, "commercial": 0.42, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.701945+00:00
notes:
  Hereditary cancer genomics (BRCA1/2); public benchmark for oncology Dx EV/EBITDA. BRCA patent expiry risk; 2016-2020 competitive pressure drove multiple compression. Benchmark: large oncology Dx platform ~13x EBITDA at peak.


source_id: seed_518
source: seed
deal_name: InfuCare Rx — Frazier Healthcare Buyout
buyer: Frazier Healthcare Partners
seller: InfuCare Rx Founders
payer_mix: {"medicare": 0.45, "medicaid": 0.06, "commercial": 0.46, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.715540+00:00
notes:
  Home infusion pharmacy (specialty IV drugs); sold to Option Care Health 2019. Rare specialty infusion drugs (immune globulin, hemophilia) have pricing power. Frazier 4-year hold: strong returns on specialty drug + home infusion combo.


source_id: seed_519
source: seed
deal_name: Cotiviti — Veritas Capital LBO
buyer: Veritas Capital
seller: Connecture / HMS Holdings spinout
payer_mix: {"medicare": 0.3, "medicaid": 0.1, "commercial": 0.55, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.721773+00:00
notes:
  Payment accuracy / claims analytics SaaS for health plans. Veritas sold to Verscend / Advent 2019 at $4.9B EV (~30.6x EBITDA). Payment integrity is a mission-critical SaaS category; strong switching costs.


source_id: seed_520
source: seed
deal_name: Beacon Health Options — FCP Euro / Anthem
buyer: Anthem (BCBS)
seller: Bain Capital / Value Options
payer_mix: {"medicare": 0.15, "medicaid": 0.5, "commercial": 0.3, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.728733+00:00
notes:
  Managed behavioral health organization (MBHO); Bain entry ~2014. Anthem acquired for vertical integration into BH benefits management. High Medicaid mix; strong 1115 waiver revenue tied to SUD/MH mandates.


source_id: seed_521
source: seed
deal_name: LIFE Course (Enable Healthcare) — Summit Partners Growth
buyer: Summit Partners
seller: Founders / Seed Investors
payer_mix: {"medicare": 0.8, "medicaid": 0.08, "commercial": 0.1, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:25.739461+00:00
notes:
  Value-based care / MSSP/ACO model; Summit growth capital. ACO REACH program participation; high Medicare alignment. Still private 2024; VBC scaling model depends on ACO shared savings.


source_id: seed_522
source: seed
deal_name: Akumin — Imaging Tech LBO
buyer: CBRE Caledon / Management
seller: Various outpatient imaging groups
payer_mix: {"medicare": 0.5, "medicaid": 0.08, "commercial": 0.39, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.746980+00:00
notes:
  Outpatient radiology rollup (150+ centers); NASDAQ: AKU. Went public via RTO 2018; filed Ch.11 2023 on leveraged balance sheet. Radiology reimbursement cuts + labor inflation + over-leverage = disaster formula.


source_id: seed_523
source: seed
deal_name: CHA Health Systems — Korean PE Acquisition
buyer: MBK Partners (Korean PE)
seller: CHA Health Systems Founders
payer_mix: {"medicare": 0.38, "medicaid": 0.25, "commercial": 0.3, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:25.753795+00:00
notes:
  Korean health system with U.S. fertility clinic footprint. MBK cross-border PE benchmark; global PE expansion into U.S. healthcare. Fertility + women's health defensible sub-sector vs. broader hospital.


source_id: seed_524
source: seed
deal_name: Multiplan — Hellman & Friedman LBO
buyer: Hellman & Friedman
seller: Starwood Capital Group / Multiplan
payer_mix: {"medicare": 0.1, "medicaid": 0.05, "commercial": 0.8, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.760575+00:00
notes:
  Out-of-network claims repricing SaaS; NASDAQ: MPLN via SPAC 2020. NSA surprise billing law undermined core commercial OON revenue model. H&F exit via SPAC at ~1.7x; legislative risk destroyed thesis.


source_id: seed_525
source: seed
deal_name: Netsmart Technologies — GI Partners LBO
buyer: GI Partners
seller: Netsmart Public Shareholders
payer_mix: {"medicare": 0.2, "medicaid": 0.45, "commercial": 0.25, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:25.766569+00:00
notes:
  EHR + care coordination SaaS for behavioral health and post-acute. GI Partners sold to Broadview subsidiary 2021. Medicaid-heavy payer mix but SaaS model de-risks direct reimbursement exposure.


source_id: seed_526
source: seed
deal_name: Accolade Health — Cigna Investment / IPO
buyer: Cigna Ventures / Carrick Capital
seller: Accolade Health Founders
payer_mix: {"medicare": 0.05, "medicaid": 0.03, "commercial": 0.88, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:25.772757+00:00
notes:
  Employer health navigation + benefits advocacy; NASDAQ: ACCD 2020. COVID accelerated employer demand for mental health + benefits navigation. B2B SaaS model eliminates direct payer reimbursement risk.


source_id: seed_527
source: seed
deal_name: Global Indemnity Group — Starr Companies Acquisition
buyer: Starr Companies
seller: Global Indemnity (NASDAQ: GBLI)
payer_mix: {"medicare": 0.05, "medicaid": 0.02, "commercial": 0.9, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:25.778507+00:00
notes:
  Health insurance runoff / specialty lines; not a classic PE deal. Benchmark: specialty insurance EV/EBITDA ~10.6x. Included for managed care benchmarking context.


source_id: seed_528
source: seed
deal_name: HealthMarket / eHealth — Insurance Distribution Platform
buyer: General Atlantic / Blackstone
seller: HealthMarket Founders
payer_mix: {"medicare": 0.35, "medicaid": 0.08, "commercial": 0.52, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.784372+00:00
notes:
  Medicare Advantage + individual ACA insurance distribution marketplace. SEP and OEP enrollment volatility creates revenue lumpiness. GA/Blackstone sold to eHealth subsidiary 2022; MA broker distribution is durable.


source_id: seed_529
source: seed
deal_name: Azul Senior Care — WCAS SNF Platform
buyer: Welsh Carson Anderson & Stowe
seller: Azul Senior Care Founders
payer_mix: {"medicare": 0.28, "medicaid": 0.55, "commercial": 0.12, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.790485+00:00
notes:
  Skilled nursing facility platform in mid-Atlantic; WCAS buy-and-build. Medicaid rate risk primary concern; 55% Medicaid mix is above-average exposure. PDPM transition (2019) added Medicare skilled rate complexity.


source_id: seed_530
source: seed
deal_name: Enclara Pharmacia — Bankers Life LBO
buyer: HarbourVest Partners / Management
seller: Enclara Founders
payer_mix: {"medicare": 0.4, "medicaid": 0.3, "commercial": 0.25, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.796272+00:00
notes:
  Hospice pharmacy PBM + distribution; sold to Humana 2019 for $685M EV. Hospice drug management is defensible niche (formulary + mail order). Humana acquired to integrate with Kindred at Home hospice platform.


source_id: seed_531
source: seed
deal_name: Imagine Health — Blackstone Growth Equity
buyer: Blackstone Growth
seller: Imagine Health Founders / Oak HC/FT
payer_mix: {"medicare": 0.75, "medicaid": 0.05, "commercial": 0.18, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:25.802268+00:00
notes:
  Medicare Supplement + MA insurance distribution; Blackstone growth round. MA enrollment tail-wind: 50% of Medicare beneficiaries in MA by 2025. Still private; insurance distribution horizontal is consolidating.


source_id: seed_532
source: seed
deal_name: Central Logic / Appriss Health — Roper Technologies
buyer: Roper Technologies (Public, NASDAQ: ROP)
seller: Francisco Partners
payer_mix: {"medicare": 0.35, "medicaid": 0.15, "commercial": 0.45, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.815046+00:00
notes:
  Patient transfer logistics + prescription drug monitoring SaaS. Francisco Partners 5-year hold from ~2014 PE at ~$400M EV. Roper acquisition at ~10.8x EBITDA; health IT acquirer roll-up model.


source_id: seed_533
source: seed
deal_name: Tivity Health (Healthways) — Kelso & Company
buyer: Kelso & Company
seller: Tivity Health (NASDAQ: TVTY)
payer_mix: {"medicare": 0.8, "medicaid": 0.02, "commercial": 0.16, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:25.825195+00:00
notes:
  SilverSneakers wellness program for MA members; Kelso take-private at ~9.3x. Nutrisystem acquisition debt strained balance sheet. COVID shut gym access → SilverSneakers membership losses. Below-median return.


source_id: seed_534
source: seed
deal_name: Meditrina — General Catalyst VC Backed
buyer: General Catalyst
seller: Meditrina Founders
payer_mix: {"medicare": 0.2, "medicaid": 0.1, "commercial": 0.65, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:25.833817+00:00
notes:
  AI-powered clinical documentation for ambulatory. Ambient AI documentation sector: Dragon Ambient eXperience (DAX) + others. Not a PE deal; VC benchmark for health IT ambient AI at ~$250M early valuation.


source_id: seed_535
source: seed
deal_name: Teladoc Health — Blackstone / HHBF Acquisition
buyer: Teladoc Health (NASDAQ: TDOC) + Livongo merger
seller: Livongo Health Shareholders
payer_mix: {"medicare": 0.1, "medicaid": 0.05, "commercial": 0.75, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:25.840892+00:00
notes:
  Teladoc/Livongo merger at peak COVID telehealth hype ($18.5B EV). $6.6B goodwill write-down 2022; stock declined 85% from merger peak. Pre-revenue SaaS multiples (92x EBITDA!) unwound as growth decelerated. Warning: telehealth EV/revenue multiples unsustainable without EBITDA path.


source_id: seed_536
source: seed
deal_name: American Addiction Centers — BlackRock / Deerfield
buyer: BlackRock / Deerfield Management
seller: American Addiction Centers (NYSE: AAC)
payer_mix: {"medicare": 0.08, "medicaid": 0.35, "commercial": 0.48, "self_pay": 0.09}
ingested_at: 2026-04-25T20:18:25.847251+00:00
notes:
  Largest for-profit addiction treatment company; filed Ch.11 2020. Payer mix shift from commercial to Medicaid as commercial coverage lapsed. Over-leveraged at entry; EBITDA collapse from census decline + COVID.


source_id: seed_537
source: seed
deal_name: Recovery Centers of America — Healthcare Royalty Partners
buyer: Healthcare Royalty Partners / Management
seller: Founders
payer_mix: {"medicare": 0.1, "medicaid": 0.28, "commercial": 0.55, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:27.083747+00:00
notes:
  Inpatient substance use disorder / detox; commercial mix protects margins. ASAM level of care (3.1/3.7) reimbursement improving as payers recognize SUD costs. HCRP royalty + equity structure; sold to Acadia Healthcare 2023.


source_id: seed_538
source: seed
deal_name: Oak Street Health — General Atlantic / Anchor Growth
buyer: General Atlantic (secondary)
seller: Oak Street Health Founders / Newlight
payer_mix: {"medicare": 0.92, "medicaid": 0.03, "commercial": 0.03, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:27.090185+00:00
notes:
  Value-based primary care for Medicare Advantage patients; IPO 2020 (NYSE: OSH). GA invested in secondary at ~$2.7B post-money; IPO at $4.8B EV. CVS acquired 2023 at $9.5B (2.2x from IPO); medical loss ratio discipline critical.


source_id: seed_539
source: seed
deal_name: Iora Health — Humana Acquisition
buyer: One Medical (NASDAQ: ONEM)
seller: Iora Health Founders / Khosla Ventures / Flatiron Health
payer_mix: {"medicare": 0.9, "medicaid": 0.04, "commercial": 0.04, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:27.096722+00:00
notes:
  Value-based primary care for Medicare patients; 40+ clinics. One Medical acquired at ~30x revenue; Khosla 6-year hold ~3.0x. Amazon then acquired One Medical + Iora for $3.9B in 2023.


source_id: seed_540
source: seed
deal_name: Compassus — Warburg Pincus Majority Investment
buyer: Warburg Pincus (secondary with Ascension)
seller: Tenet Healthcare / Compassus Management
payer_mix: {"medicare": 0.88, "medicaid": 0.04, "commercial": 0.06, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:27.103552+00:00
notes:
  Home health + hospice platform; Warburg recapitalized alongside Ascension JV. COVID elevated hospice utilization; strong Medicare ADC trends. Sold to LHC Group 2024; hospice JV model with health systems increasingly common.


source_id: seed_541
source: seed
deal_name: NovaBay / Wellvibe — Wound Care Rx
buyer: Woundtech / WCAS
seller: Management
payer_mix: {"medicare": 0.62, "medicaid": 0.1, "commercial": 0.25, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.110004+00:00
notes:
  Advanced wound care + hyperbaric oxygen platform. Medicare wound care reimbursement relatively stable (APCs); hospital outpatient wound center model leverages facility fees. WCAS sold to SCA Health 2023.


source_id: seed_542
source: seed
deal_name: SCA Health (Surgical Care Affiliates) — Optum
buyer: UnitedHealth / Optum
seller: H.I.G. Capital / SCA Management
payer_mix: {"medicare": 0.42, "medicaid": 0.07, "commercial": 0.48, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.119065+00:00
notes:
  200+ ASCs in partnership with health systems. H.I.G. entry ~2013 at $1.1B EV; sold to Optum at ~$2.3B strategic premium. Optum ASC thesis: site-of-care shift from HOPD to freestanding ASC.


source_id: seed_543
source: seed
deal_name: US Dermatology Partners — BBAI / KKR Platform
buyer: KKR (secondary)
seller: BBAI / Harvest Partners
payer_mix: {"medicare": 0.38, "medicaid": 0.05, "commercial": 0.52, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.129452+00:00
notes:
  300+ dermatology practices; KKR secondary from Harvest Partners. Dermatology Mohs + cosmetic mix drives strong commercial payer revenue. Site-of-service consolidation from solo practices to DSO model.


source_id: seed_544
source: seed
deal_name: DocuSystems / Nuvolo — HCIT CMMS Platforms
buyer: Warburg Pincus
seller: Nuvolo Founders
payer_mix: {"medicare": 0.15, "medicaid": 0.05, "commercial": 0.7, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:27.136424+00:00
notes:
  Healthcare facility management SaaS (asset tracking + work orders). Critical hospital infrastructure software; switching cost very high. Warburg sold to ServiceNow 2023 at ~$1.2B EV.


source_id: seed_545
source: seed
deal_name: Ardent Health Services IPO — 2024
buyer: IPO / Equity Group Investments (continued)
seller: EGI / Ardent Public Shareholders
payer_mix: {"medicare": 0.46, "medicaid": 0.18, "commercial": 0.32, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:27.145548+00:00
notes:
  Ardent IPO June 2024 at ~$3.6B EV (NYSE: ARDT); EV/EBITDA ~11.6x at IPO. 8 hospitals in NM/NJ/TX/OK; Zell-era portfolio IPO at 9-year hold. Community hospital system benchmark: mid-single-digit EBITDA margins.


source_id: seed_546
source: seed
deal_name: IntelliSource Health — Frazier Healthcare Partners
buyer: Frazier Healthcare Partners
seller: IntelliSource Founders
payer_mix: {"medicare": 0.3, "medicaid": 0.1, "commercial": 0.55, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.154086+00:00
notes:
  Clinical decision support / pharmacy analytics SaaS for PBMs. Sold to Surescripts 2021 at ~$575M EV. PBM analytics is defensible SaaS with mission-critical formulary management.


source_id: seed_547
source: seed
deal_name: Aveanna Healthcare — Bain Capital LBO
buyer: Bain Capital
seller: Epic Health Services / PSA Healthcare
payer_mix: {"medicare": 0.2, "medicaid": 0.65, "commercial": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.160081+00:00
notes:
  Pediatric home health + adult skilled nursing (1,400+ locations). IPO 2021 (NASDAQ: AVAH) at $1.1B EV; below entry EV. High Medicaid dependency + labor inflation + high leverage = below-target returns.


source_id: seed_548
source: seed
deal_name: myClinicalExchange — HealthStream Acquisition
buyer: HealthStream (NASDAQ: HSTM)
seller: myClinicalExchange Founders / Investors
payer_mix: {"medicare": 0.25, "medicaid": 0.05, "commercial": 0.6, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:27.166478+00:00
notes:
  Clinical rotation scheduling SaaS for nursing schools + hospitals. Tuck-in acquisition; benchmark for small health IT workflow SaaS at ~9x EBITDA. Clinical education scheduling is a defensible niche.


source_id: seed_549
source: seed
deal_name: Thyme Care — Andreessen Horowitz Growth
buyer: a16z / General Catalyst
seller: Thyme Care Founders
payer_mix: {"medicare": 0.55, "medicaid": 0.05, "commercial": 0.38, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:27.178382+00:00
notes:
  Oncology care navigation / value-based care; $50M Series B. Oncology VBC: oncology-specific ACO REACH + employer cancer benefit programs. Pre-revenue at Series B; VC benchmark for oncology navigation at $350M post.


source_id: seed_550
source: seed
deal_name: National Emergency Medical Services Authority — AMR
buyer: American Medical Response (KKR)
seller: Envision Healthcare (Emergency Transport)
payer_mix: {"medicare": 0.32, "medicaid": 0.18, "commercial": 0.4, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:27.185007+00:00
notes:
  Ground ambulance + air medical transport; KKR via AMR. Government contracts provide revenue floor; NSA limited transport billing less. KKR sold to Envision 2018 as part of Envision take-private transaction.


source_id: seed_551
source: seed
deal_name: Northwell Health — Bond Issuance Benchmark
buyer: Northwell Health (Bond Market)
seller: N/A
payer_mix: {"medicare": 0.4, "medicaid": 0.25, "commercial": 0.3, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.191094+00:00
notes:
  Largest non-profit health system in NY ($15B revenue); bond issuance benchmark. Not a PE deal; credit market implied EV ~14.2x EBITDA for large integrated NFP. Comparison point for large health system M&A valuation.


source_id: seed_552
source: seed
deal_name: Acrisure Health — Advent International
buyer: Advent International
seller: Acrisure Founders / Ryan Specialty
payer_mix: {"medicare": 0.15, "medicaid": 0.05, "commercial": 0.75, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.198438+00:00
notes:
  Insurance distribution broker with health specialty; Advent growth equity. Specialty insurance distribution + health benefits brokerage consolidation. Not a traditional healthcare services deal but health segment benchmark.


source_id: seed_553
source: seed
deal_name: MedBridge — Summit Partners Buyout
buyer: Summit Partners
seller: MedBridge Founders / InVision
payer_mix: {"medicare": 0.35, "medicaid": 0.08, "commercial": 0.5, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:27.204997+00:00
notes:
  Physical therapy / rehabilitation digital education + HEP SaaS. Summit acquired Surgical Notes simultaneously for RCM + PT tech bundle. PT digital health: home exercise program adherence tech is defensible.


source_id: seed_554
source: seed
deal_name: Aledade — Andreessen Horowitz / Health Care Service
buyer: a16z / HCSC / Alphabet Ventures
seller: Aledade Founders
payer_mix: {"medicare": 0.7, "medicaid": 0.1, "commercial": 0.18, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:27.211665+00:00
notes:
  Independent primary care ACO management; largest ACO in Medicare MSSP. Series F at $3B valuation; $300M+ shared savings in 2023. ACO SaaS model: pure software + care management margin; defensible moat.


source_id: seed_555
source: seed
deal_name: aptihealth — Nuvation Growth Fund / VCAS
buyer: Nuvation Growth Fund / Welsh Carson
seller: aptihealth Founders
payer_mix: {"medicare": 0.2, "medicaid": 0.35, "commercial": 0.4, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.217997+00:00
notes:
  Telepsychiatry platform embedded in primary care / health systems. WCAS growth equity; co-located virtual + in-person BH in PCP workflow. BH integration in primary care: $20B+ market opportunity.


source_id: seed_556
source: seed
deal_name: Carbon Health — Dragoneer / OMERS Growth Equity
buyer: Dragoneer Investment Group / OMERS
seller: Carbon Health Founders
payer_mix: {"medicare": 0.1, "medicaid": 0.12, "commercial": 0.65, "self_pay": 0.13}
ingested_at: 2026-04-25T20:18:27.226392+00:00
notes:
  Digital-first primary care + urgent care (135+ clinics). COVID testing drove inflated 2021 valuations; fundamental unit economics under pressure. Raised at $3B in 2021; subsequent down-round financing at lower valuation.


source_id: seed_557
source: seed
deal_name: Forward — SoftBank / Founders Fund
buyer: SoftBank Vision Fund 2
seller: Forward Health Founders
payer_mix: {"medicare": 0.02, "medicaid": 0.02, "commercial": 0.85, "self_pay": 0.11}
ingested_at: 2026-04-25T20:18:27.233220+00:00
notes:
  Subscription primary care with sensor technology; raised $225M at $800M in 2021. Shut down November 2023 — complete write-off for investors. B2C subscription healthcare model failed on unit economics; SoftBank disaster.


source_id: seed_558
source: seed
deal_name: Privia Health — Goldman Sachs / Vestar Capital IPO
buyer: IPO / Existing Investors
seller: Goldman Sachs / Vestar Capital
payer_mix: {"medicare": 0.42, "medicaid": 0.1, "commercial": 0.45, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.239275+00:00
notes:
  Physician enablement + VBC management for independent practices. Vestar/Goldman entry ~2016 at ~$900M EV; IPO 2021 NASDAQ: PRVA at $3.2B. MSO model for VBC: physicians retain independence, Privia provides infrastructure.


source_id: seed_559
source: seed
deal_name: Nomi Health Direct Care — TPG / Goldman Growth
buyer: TPG / Goldman Sachs Growth
seller: Nomi Health Founders
payer_mix: {"medicare": 0.15, "medicaid": 0.08, "commercial": 0.7, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:27.246915+00:00
notes:
  Direct-to-employer primary care + COVID testing; TPG growth round. COVID testing windfall inflated 2021-22 revenue. Employer-sponsored health center model: Walmart Health benchmark.


source_id: seed_560
source: seed
deal_name: Walmart Health — Walmart (Strategic) Shutdown
buyer: Walmart (Internal Investment)
seller: N/A
payer_mix: {"medicare": 0.2, "medicaid": 0.15, "commercial": 0.5, "self_pay": 0.15}
ingested_at: 2026-04-25T20:18:27.253163+00:00
notes:
  Walmart invested ~$2.5B in primary care clinics (100+ locations by 2024). Shutdown April 2024 — complete write-off. Unit economics never worked: self-pay dominant, below-market pricing, labor cost unsustainable. Direct retail healthcare benchmark: employer cannot subsidize primary care at scale.


source_id: seed_561
source: seed
deal_name: Amazon One Medical — Amazon Acquisition
buyer: Amazon
seller: One Medical (NASDAQ: ONEM)
payer_mix: {"medicare": 0.18, "medicaid": 0.08, "commercial": 0.62, "self_pay": 0.12}
ingested_at: 2026-04-25T20:18:27.259251+00:00
notes:
  Amazon acquisition of One Medical at $18/share ($3.9B EV). One Medical IPO 2020 at $1.7B EV; Amazon premium ~2.3x from IPO. Benchmark: tech-enabled primary care M&A; ~65x EBITDA confirms strategic premium.


source_id: seed_562
source: seed
deal_name: Spring Health — Teachers' VC / General Catalyst
buyer: Teachers' Venture Growth / General Catalyst
seller: Spring Health Founders
payer_mix: {"medicare": 0.05, "medicaid": 0.08, "commercial": 0.8, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:27.271565+00:00
notes:
  Employer mental health benefits platform ($2B valuation 2021). Precision mental health matching; employer-sponsored EAP replacement. Still private 2024; digital BH employer segment growing but crowded.


source_id: seed_563
source: seed
deal_name: Hims & Hers Health — Oaktree / Clients
buyer: Public (NYSE: HIMS) via SPAC
seller: Oaktree Capital / Tresalia Capital
payer_mix: {"medicare": 0.03, "medicaid": 0.02, "commercial": 0.25, "self_pay": 0.7}
ingested_at: 2026-04-25T20:18:27.283247+00:00
notes:
  DTC telehealth + prescription platform (hair loss, ED, mental health, weight loss). SPAC at $1.6B Jan 2021; stock hit $0.90 in 2022 then recovered on GLP-1 tailwind. DTC healthcare: self-pay dominant; GLP-1 weight loss prescriptions drove 2023 recovery.


source_id: seed_564
source: seed
deal_name: Acuitas Health — Symphony Health / IQVia
buyer: Symphony Health / IQVIA
seller: Acuitas Health Founders
payer_mix: {"medicare": 0.2, "medicaid": 0.08, "commercial": 0.65, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:27.289867+00:00
notes:
  Pharmacy analytics + specialty prescribing data SaaS. IQVIA tuck-in at ~9.5x; pharma market data is recurring and defensible. GLP-1 prescribing data particularly valuable post-2022.


source_id: seed_565
source: seed
deal_name: Zing Health — General Catalyst / HCSC
buyer: General Catalyst / Health Care Service Corporation
seller: Zing Health Founders
payer_mix: {"medicare": 0.95, "medicaid": 0.02, "commercial": 0.02, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:27.295961+00:00
notes:
  Underserved community Medicare Advantage plan in IL/IN/TX. HCSC partnership; targets dual-eligible (DSNP) members. Dual-eligible MA is high-complexity but high-revenue segment.


source_id: seed_566
source: seed
deal_name: Interwell Health / Cricket Health Merger — KKR
buyer: KKR
seller: Interwell / Cricket Founders
payer_mix: {"medicare": 0.72, "medicaid": 0.08, "commercial": 0.18, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:27.302813+00:00
notes:
  VBC kidney care merger; merged Interwell (nephrologist network) + Cricket Health. KKR platform to compete in CKCC/ESRD VBC programs vs. DaVita/Fresenius. ESRD value-based care: $800 PMPM shared savings potential per patient.


source_id: seed_567
source: seed
deal_name: Papa Inc — Comcast / Tiger Global
buyer: Comcast / Tiger Global
seller: Papa Inc Founders
payer_mix: {"medicare": 0.85, "medicaid": 0.08, "commercial": 0.05, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:27.309164+00:00
notes:
  Senior companionship + social determinants of health for MA plans. Raised $150M at $1.4B in 2021 (Tiger Global led). SDOH services increasingly covered by Medicare Advantage supplemental benefits.


source_id: seed_568
source: seed
deal_name: DispatchHealth — Echo Health Ventures / Humana
buyer: Echo Health Ventures / Humana
seller: DispatchHealth Founders
payer_mix: {"medicare": 0.55, "medicaid": 0.1, "commercial": 0.3, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.315114+00:00
notes:
  On-demand home-based acute care (avoiding ED visits); raised $330M 2020-21. Humana strategic; avoidable ED admission reduction is MA MLR management tool. Home acute care: 30-40% cheaper than ED visit for qualifying conditions.


source_id: seed_569
source: seed
deal_name: CVS Health / Signify Health — Strategic Acquisition
buyer: CVS Health
seller: New Mountain Capital / Signify Health (NYSE: SGFY)
payer_mix: {"medicare": 0.8, "medicaid": 0.05, "commercial": 0.13, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:27.321720+00:00
notes:
  In-home health evaluations for MA plans + ACO analytics. CVS acquired at $8.0B March 2023; the PE realization for this transaction is tracked under seed_187 where New Mountain Capital (entry ~2019 at ~$1.5B EV) exited at 4.5x / 46% IRR.


source_id: seed_570
source: seed
deal_name: Trean Corporation — Insurance Specialty Health
buyer: Public / Sponsor Partial Exit
seller: Altaris Capital
payer_mix: {"medicare": 0.08, "medicaid": 0.04, "commercial": 0.82, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:27.328770+00:00
notes:
  Specialty casualty insurance MGA; Altaris partial exit at IPO. Healthcare specialty insurance: workers' comp + liability program manager. Altaris 5-year hold on specialty casualty platform near healthcare PE.


source_id: seed_571
source: seed
deal_name: naviHealth — Optum Acquisition
buyer: Optum / UnitedHealth
seller: Cardinal Health / naviHealth Management
payer_mix: {"medicare": 0.75, "medicaid": 0.05, "commercial": 0.18, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:27.335555+00:00
notes:
  Post-acute care management / clinical decision support for payers. Cardinal Health entry ~2015 at $750M; Optum acquired at ~$2.5B. Post-acute optimization: SNF day authorization tool reduces unnecessary spend.


source_id: seed_572
source: seed
deal_name: Cedar Gate Technologies — Warburg Pincus
buyer: Warburg Pincus
seller: Cedar Gate Founders
payer_mix: {"medicare": 0.4, "medicaid": 0.1, "commercial": 0.45, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.342961+00:00
notes:
  VBC analytics + financial management SaaS for ACOs and risk-bearing entities. Warburg growth equity; Cedar Gate powers ACO REACH financial reconciliation. VBC infrastructure SaaS: mission-critical for shared savings reporting.


source_id: seed_573
source: seed
deal_name: Nuvation Bio — ARCH Venture / RTW Investments
buyer: RTW Investments / ARCH
seller: Nuvation Founders
payer_mix: {"medicare": 0.65, "medicaid": 0.04, "commercial": 0.29, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:27.349422+00:00
notes:
  Clinical-stage oncology; SPAC merger 2022 at $2.6B EV. Biopharma benchmark: oncology platform valuations even pre-revenue very high. Not a traditional PE deal; biotech-as-healthcare-services comparison.


source_id: seed_574
source: seed
deal_name: Mochi Health — 8VC / Peterson
buyer: 8VC / Peterson Ventures
seller: Mochi Founders
payer_mix: {"medicare": 0.08, "medicaid": 0.03, "commercial": 0.4, "self_pay": 0.49}
ingested_at: 2026-04-25T20:18:27.359246+00:00
notes:
  GLP-1 (semaglutide) prescribing platform for weight management. Series A $10M; valuation at ~$150M pre-money. GLP-1 tailwind 2023-2024: telehealth prescribing of compounded semaglutide.


source_id: seed_575
source: seed
deal_name: Array Behavioral Care — General Catalyst / Summit
buyer: Summit Partners / General Catalyst
seller: Array Behavioral Care Founders
payer_mix: {"medicare": 0.22, "medicaid": 0.38, "commercial": 0.35, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.365471+00:00
notes:
  Telepsychiatry services embedded in hospitals and ED. Summit/GC growth equity in psychiatric consultation-liaison model. Emergency telepsychiatry: acute psychiatric crisis coverage for hospitals.


source_id: seed_578
source: seed
deal_name: NorthStar Anesthesia / KKR
buyer: KKR
seller: Welsh Carson
payer_mix: {"commercial": 0.55, "medicare": 0.35, "medicaid": 0.07, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.383990+00:00
notes:
  Anesthesia rollup including Covenant; NSA fee schedule risk partially mitigated by hospital-employed mix


source_id: seed_579
source: seed
deal_name: apree health / Welsh Carson
buyer: Welsh Carson Anderson & Stowe
seller: Castlight Health spinoff / management
payer_mix: {"commercial": 1.0}
ingested_at: 2026-04-25T20:18:27.389803+00:00
notes:
  Employer-direct health navigation; combines Castlight + Vera Whole Health; value-based care for self-insured employers


source_id: seed_580
source: seed
deal_name: Comprehensive Pharmacy Services / OMERS
buyer: OMERS Private Equity
seller: Management / institutional shareholders
payer_mix: {"medicare": 0.45, "commercial": 0.35, "medicaid": 0.18, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:27.397422+00:00
notes:
  Long-term care pharmacy; hospital and SNF channel; DIR fee headwind partially offset by GPO contracts


source_id: seed_581
source: seed
deal_name: VillageMD / Walgreens Health
buyer: Walgreens Boots Alliance (strategic)
seller: VillageMD / Kinsey Hill / management
payer_mix: {"commercial": 0.5, "medicare": 0.3, "medicaid": 0.15, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.403578+00:00
notes:
  Strategic disaster — Walgreens wrote down $5.8B; retail clinic model failed at scale; 160 clinics closed 2024


source_id: seed_582
source: seed
deal_name: BrightSpring Health Services / KKR
buyer: KKR
seller: RehabCare Group / PharMerica combined entity
payer_mix: {"medicaid": 0.55, "medicare": 0.25, "commercial": 0.15, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.412106+00:00
notes:
  IPO at $13/share Feb 2024; Medicaid-heavy home care + pharmacy services; COVID-era disruptions; below-expectations exit


source_id: seed_584
source: seed
deal_name: Arcadian Management Services / Nautic Partners
buyer: Nautic Partners
seller: Management / founders
payer_mix: {"medicaid": 0.6, "commercial": 0.25, "medicare": 0.1, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.424858+00:00
notes:
  Outpatient behavioral IOP/PHP; telehealth expansion during COVID drove strong growth; sold to Acadia Healthcare


source_id: seed_585
source: seed
deal_name: Acadia Healthcare Acquisition Program / Waud Capital
buyer: Waud Capital Partners
seller: Various regional behavioral health operators
payer_mix: {"medicaid": 0.5, "commercial": 0.3, "medicare": 0.15, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.431403+00:00
notes:
  Residential + acute psychiatric; consolidating fragmented behavioral market; regulatory/state-rate dependency


source_id: seed_586
source: seed
deal_name: ModivCare / WCG (exit via public markets)
buyer: Public markets
seller: Providence Service Corp founders
payer_mix: {"medicaid": 0.75, "medicare": 0.15, "commercial": 0.1}
ingested_at: 2026-04-25T20:18:27.437452+00:00
notes:
  NEMT broker; Medicaid state contracts; rebranded from LogistiCare; public market exit at peak healthcare services multiple


source_id: seed_587
source: seed
deal_name: National Spine & Pain Centers / Waud Capital
buyer: Waud Capital Partners
seller: Management / founders
payer_mix: {"commercial": 0.55, "medicare": 0.3, "medicaid": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.445513+00:00
notes:
  200+ interventional pain locations; NSA partially offset by high commercial mix; sold to Valor Equity


source_id: seed_589
source: seed
deal_name: Cano Health / SPAC / Chapter 11
buyer: InTandem Capital / SPAC
seller: Cano Health founders
payer_mix: {"medicare": 0.7, "medicaid": 0.2, "commercial": 0.1}
ingested_at: 2026-04-25T20:18:27.457621+00:00
notes:
  Medicare Advantage primary care; Chapter 11 filed March 2024; execution failures + SPAC valuation overreach


source_id: seed_590
source: seed
deal_name: Quartet Health / Oak HC/FT
buyer: Oak HC/FT (growth)
seller: Management / early investors
payer_mix: {"commercial": 0.65, "medicare": 0.2, "medicaid": 0.15}
ingested_at: 2026-04-25T20:18:27.464208+00:00
notes:
  Mental health network coordination SaaS; merged into Headway competitor; modest return vs risk profile


source_id: seed_591
source: seed
deal_name: LifeScan / Platinum Equity
buyer: Platinum Equity
seller: Johnson & Johnson
payer_mix: {"commercial": 0.5, "medicare": 0.35, "medicaid": 0.1, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.471107+00:00
notes:
  BGM market secular decline → CGM (Dexcom/Abbott); classic incumbent disruption; near-total value destruction


source_id: seed_592
source: seed
deal_name: LifeStance Health / TPG SPAC
buyer: TPG / SPAC public
seller: Summit Partners / management
payer_mix: {"commercial": 0.75, "medicare": 0.1, "medicaid": 0.1, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.477350+00:00
notes:
  Outpatient mental health 900+ locations; IPO at $18 → fell to $4; therapist turnover + unit economics; recovery underway 2024


source_id: seed_593
source: seed
deal_name: nThrive RCM / Clearlake Capital
buyer: Clearlake Capital Group
seller: MedAssets / GE Healthcare IT
payer_mix: {"commercial": 0.6, "medicare": 0.25, "medicaid": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.483689+00:00
notes:
  Hospital RCM outsourcing + coding platform; sold to Waystar; consistent but unspectacular value creation


source_id: seed_594
source: seed
deal_name: Waystar / EQT Partners
buyer: EQT Partners
seller: Bain Capital / HGGC
payer_mix: {"commercial": 0.65, "medicare": 0.22, "medicaid": 0.1, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.489908+00:00
notes:
  Healthcare payments network; IPO June 2024 at $21/share; Change Healthcare outage created short-term tailwind


source_id: seed_595
source: seed
deal_name: Ensemble Health Partners / CD&R
buyer: Clayton, Dubilier & Rice
seller: Golden Gate Capital (partial)
payer_mix: {"commercial": 0.55, "medicare": 0.28, "medicaid": 0.14, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.496973+00:00
notes:
  Full outsource RCM for health systems; AI-assisted coding + denials; primary competitor to Optum360, R1 RCM


source_id: seed_596
source: seed
deal_name: EyeCare Partners / FFL Partners II
buyer: FFL Partners
seller: EyeCare Partners founders
payer_mix: {"commercial": 0.55, "medicare": 0.4, "medicaid": 0.04, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:27.503015+00:00
notes:
  400+ ophthalmology locations; cataract + retina; Medicare-heavy payer mix with ASC conversion tailwind


source_id: seed_600
source: seed
deal_name: Shields Health Solutions / Summit Partners exit
buyer: Summit Partners
seller: Summit Partners
payer_mix: {"commercial": 0.55, "medicare": 0.3, "medicaid": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.526825+00:00
notes:
  Hospital-based specialty pharmacy integrator; Walgreens Boots Alliance was the strategic acquirer; realized MOIC/IRR on this row belongs to Summit Partners (the exiting PE sponsor), not Walgreens.


source_id: seed_601
source: seed
deal_name: The Oncology Institute / Advent International
buyer: Advent International
seller: Management / founders
payer_mix: {"commercial": 0.4, "medicare": 0.45, "medicaid": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.532698+00:00
notes:
  SPAC via Lifesci and Advent; value-based oncology; execution challenges; stock collapse to near zero


source_id: seed_602
source: seed
deal_name: InfuSystem / BCPE Empire Holdings
buyer: BCPE Empire Holdings (Bain Capital JV)
seller: Public market shareholders
payer_mix: {"commercial": 0.45, "medicare": 0.4, "medicaid": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.539052+00:00
notes:
  Outpatient infusion pump services; oncology + pain infusion; hospital-to-home model with recurring revenue


source_id: seed_603
source: seed
deal_name: InnovAge Holding / Welsh Carson (PACE platform)
buyer: Welsh Carson Anderson & Stowe
seller: Management / founders
payer_mix: {"medicare": 0.5, "medicaid": 0.4, "commercial": 0.1}
ingested_at: 2026-04-25T20:18:27.546789+00:00
notes:
  PACE model aggregates capitated Medicare + Medicaid; IPO 2021 at $21/share; strong value-based care platform


source_id: seed_604
source: seed
deal_name: Athletico Physical Therapy / BDT & MSD
buyer: BDT & MSD Partners
seller: PE prior investor
payer_mix: {"commercial": 0.65, "medicare": 0.2, "medicaid": 0.1, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:27.552705+00:00
notes:
  900+ PT clinics; sports medicine partnership with Bears/Cubs; worker compensation + employer contracts


source_id: seed_605
source: seed
deal_name: OrthoAmerica Spine / Clearfield Capital
buyer: Clearfield Capital
seller: Strategic investors
payer_mix: {"commercial": 0.62, "medicare": 0.28, "medicaid": 0.07, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.558780+00:00
notes:
  Spine device + surgical services; COVID disruption offset by elective recovery 2021-2022; solid exit


source_id: seed_606
source: seed
deal_name: Paladin / Endo device spinoff
buyer: CPPIB / management
seller: Endo International
payer_mix: {"commercial": 0.6, "medicare": 0.28, "medicaid": 0.08, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:27.565125+00:00
notes:
  Pain management devices; post-opioid regulatory shift toward device alternatives; stable recurring revenue


source_id: seed_608
source: seed
deal_name: Apria Healthcare / Blackstone → Owens & Minor
buyer: Owens & Minor (strategic)
seller: Blackstone
payer_mix: {"medicare": 0.55, "commercial": 0.3, "medicaid": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.580394+00:00
notes:
  Home respiratory + DME; long hold required to work through post-IPO issues; adequate but not spectacular return


source_id: seed_609
source: seed
deal_name: Help at Home / Centerbridge Partners
buyer: Centerbridge Partners
seller: Earlier PE investors
payer_mix: {"medicaid": 0.7, "medicare": 0.15, "commercial": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.586893+00:00
notes:
  IHSS / Medicaid personal care; heavy labor cost exposure; COVID essential designation; state rate escalators key


source_id: seed_610
source: seed
deal_name: PatientPoint / Warburg Pincus
buyer: Warburg Pincus
seller: Arsenal Capital
payer_mix: {"commercial": 1.0}
ingested_at: 2026-04-25T20:18:26.183325+00:00
notes:
  Waiting room patient engagement / pharma advertising; SaaS + media model; pharma ad budget cyclical risk


source_id: seed_611
source: seed
deal_name: Alignment Healthcare / Warburg Pincus → IPO
buyer: Public market investors
seller: Warburg Pincus
payer_mix: {"medicare": 0.9, "commercial": 0.08, "medicaid": 0.02}
ingested_at: 2026-04-25T20:18:27.719871+00:00
notes:
  MA plan model; CMS rate resets created headwind; underwhelming IPO return; pivoting to profitability 2024


source_id: seed_612
source: seed
deal_name: ChenMed / Welsh Carson
buyer: Welsh Carson Anderson & Stowe
seller: Chen family (partial)
payer_mix: {"medicare": 0.8, "commercial": 0.1, "medicaid": 0.08, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:27.725822+00:00
notes:
  Senior-focused primary care concierge; capitation model; 100+ centers; genuine quality outcomes track record


source_id: seed_613
source: seed
deal_name: Agiliti / Thomas H. Lee Partners
buyer: Thomas H. Lee Partners
seller: J2 Global Communications (strategic)
payer_mix: {"commercial": 0.55, "medicare": 0.3, "medicaid": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.732659+00:00
notes:
  Hospital equipment repair + fleet management; mission critical but labor-intensive; PE sponsor had two prior holds


source_id: seed_614
source: seed
deal_name: Kindred Healthcare / TPG + Welsh Carson
buyer: TPG Capital + Welsh Carson
seller: Public shareholders (take-private)
payer_mix: {"medicare": 0.6, "medicaid": 0.25, "commercial": 0.12, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:27.746977+00:00
notes:
  LTAC + rehab split; divested home health to Humana JV (Kindred at Home); LTAC census recovery + COVID disruption


source_id: ext35_001
source: seed
deal_name: BioReference Laboratories – Genoptix Acquisition
buyer: Genoptix (OPKO Health)
seller: BioReference Laboratories
payer_mix: {"medicare": 0.38, "medicaid": 0.12, "commercial": 0.44, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:29.209708+00:00
notes:
  Large clinical reference laboratory; OPKO integrated into national diagnostics platform; COVID testing later boosted volumes. RCM complexity from payer-specific lab billing rules.


source_id: ext35_002
source: seed
deal_name: LabCorp – Covance CRO Acquisition
buyer: Laboratory Corporation of America
seller: Covance Inc (public)
payer_mix: diversified CRO/lab mix
ingested_at: 2026-04-25T20:18:29.216703+00:00
notes:
  Transformative acquisition combining clinical diagnostics with CRO capabilities. Created fully integrated drug development and diagnostic platform.


source_id: ext35_003
source: seed
deal_name: Advanced Dermatology and Cosmetic Surgery – ABRY Partners
buyer: ABRY Partners
seller: Management / founder
payer_mix: {"medicare": 0.28, "medicaid": 0.08, "commercial": 0.58, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:29.222961+00:00
notes:
  Largest dermatology DSO in US at time of sale; 150+ locations SE/FL/TX; sold to Harvest Partners 2022. Medical-cosmetic mix supported premium reimbursement.


source_id: ext35_004
source: seed
deal_name: Healogics – Wound Care Management Platform
buyer: Clayton, Dubilier & Rice
seller: DFW Capital / management
payer_mix: {"medicare": 0.62, "medicaid": 0.1, "commercial": 0.24, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:29.230923+00:00
notes:
  Largest wound care management company; hospital outpatient department model. Medicare-heavy creates reimbursement risk; eventual restructuring 2022 due to COVID volume loss.


source_id: ext35_005
source: seed
deal_name: BrightSpring Health Services – KKR Buyout
buyer: KKR
seller: Onex Corporation
payer_mix: {"medicare": 0.38, "medicaid": 0.42, "commercial": 0.16, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:29.236933+00:00
notes:
  Provider of home- and community-based services for adults with IDD/behavioral health; IPO 2024. High Medicaid exposure requires strong state-specific RCM capabilities.


source_id: ext35_006
source: seed
deal_name: Apria Healthcare – Blackstone Take-Private
buyer: Blackstone Group
seller: Apria Healthcare Group (NYSE: AHG)
payer_mix: {"medicare": 0.55, "medicaid": 0.15, "commercial": 0.26, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:29.244453+00:00
notes:
  Home respiratory and infusion therapy; prolonged hold due to regulatory headwinds on HME reimbursement cuts; sold to Option Care Health 2022 for $1.45B.


source_id: ext35_007
source: seed
deal_name: MEDNAX – Pediatrix Medical Group Stake
buyer: Ares Management
seller: MEDNAX Inc (minority block)
payer_mix: {"medicare": 0.18, "medicaid": 0.32, "commercial": 0.46, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:29.251031+00:00
notes:
  National neonatology and anesthesiology staffing; physician advisory and contract model. Valuation pressure from hospital facility consolidation and managed care rate compression.


source_id: ext35_008
source: seed
deal_name: US Physical Therapy – Centre Partners Growth
buyer: Centre Partners Management
seller: Existing shareholders
payer_mix: {"medicare": 0.31, "medicaid": 0.09, "commercial": 0.55, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:29.258754+00:00
notes:
  538 outpatient PT/OT clinics in 39 states; de novo + tuck-in M&A strategy. Commercial mix supports clean-claim rates; workers' comp adds billing complexity.


source_id: ext35_009
source: seed
deal_name: Addiction Centers of America – Crestview Partners
buyer: Crestview Partners
seller: Management
payer_mix: {"medicare": 0.12, "medicaid": 0.35, "commercial": 0.48, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:29.265038+00:00
notes:
  Addiction treatment centers across Southeast; benefited from SUD parity laws and ACA expansion. Revenue cycle driven by prior auth intensive commercial managed care contracts.


source_id: ext35_010
source: seed
deal_name: CRC Health Group – Bain Capital Portfolio
buyer: Bain Capital
seller: Canaccord Genuity / prior PE
payer_mix: {"medicare": 0.14, "medicaid": 0.4, "commercial": 0.38, "self_pay": 0.08}
ingested_at: 2026-04-25T20:18:29.272694+00:00
notes:
  Largest behavioral health provider at acquisition; 145 facilities, SUD + mental health. Sold to Acadia Healthcare 2015 for $1.175B. TRICARE military exposure notable.


source_id: ext35_011
source: seed
deal_name: InfuSystem Holdings – ABRY Partners Buyout
buyer: ABRY Partners
seller: Public shareholders (NYSE: INFU)
payer_mix: {"medicare": 0.42, "medicaid": 0.08, "commercial": 0.45, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:29.278895+00:00
notes:
  Ambulatory infusion pump rental and services; specialty pharmacy adjacent. Competitive prior auth in oncology infusion; re-listed NYSE 2018.


source_id: ext35_012
source: seed
deal_name: Pacific Dental Services – Perot Investments Growth
buyer: Perot Investments
seller: Management / founder
payer_mix: {"medicare": 0.02, "medicaid": 0.18, "commercial": 0.68, "self_pay": 0.12}
ingested_at: 2026-04-25T20:18:29.285161+00:00
notes:
  Largest dentist-owned DSO model; private practice partnership vs. employment. Strong commercial mix; Medicaid Denti-Cal adds complexity in California market.


source_id: ext35_013
source: seed
deal_name: Smile Brands – Francisco Partners Buyout
buyer: Francisco Partners
seller: Ontario Teachers' Pension Plan
payer_mix: {"medicare": 0.01, "medicaid": 0.32, "commercial": 0.58, "self_pay": 0.09}
ingested_at: 2026-04-25T20:18:29.292150+00:00
notes:
  400+ dental offices Midwest/West; Medicaid-heavy in certain markets. COVID-related closures 2020 created temporary revenue disruption; filed Chapter 11 briefly.


source_id: ext35_014
source: seed
deal_name: Kindred Healthcare – Humana Take-Private
buyer: Humana / TPG / Welsh Carson
seller: Kindred Healthcare (NYSE: KND)
payer_mix: {"medicare": 0.72, "medicaid": 0.12, "commercial": 0.14, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:29.298111+00:00
notes:
  Largest home health and hospice provider; Humana acquired home health segment. Long-term care hospitals and LTACH segment sold separately. Heavy Medicare creates PPS rate risk.


source_id: ext35_015
source: seed
deal_name: NovaBay Pharmaceuticals – Wound Care Division Sale
buyer: DFB Healthcare Acquisitions
seller: NovaBay Pharmaceuticals
payer_mix: {"medicare": 0.54, "medicaid": 0.11, "commercial": 0.3, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:29.304274+00:00
notes:
  Advanced wound care biologics and cellular tissue products; CTP reimbursement via HCPCS. Medicare coverage policy changes create reimbursement cliff risk.


source_id: ext36_001
source: seed
deal_name: DaVita Kidney Care – Welsh Carson Minority Stake
buyer: Welsh Carson Anderson & Stowe
seller: DaVita Inc (secondary block)
payer_mix: {"medicare": 0.68, "medicaid": 0.08, "commercial": 0.2, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:29.310805+00:00
notes:
  Largest dialysis operator in the US; Medicare ESRD bundled payment conversion in 2011 dramatically reshaped RCM — transitioning from separate Part A/B billing to prospective bundled rate required complete re-engineering of claim submission and secondary-payer coordination workflows. Welsh Carson's deep dialysis history facilitated rapid integration of the new payment model.


source_id: ext36_002
source: seed
deal_name: American Renal Associates – Centerbridge Buyout
buyer: Centerbridge Partners
seller: Management / founder
payer_mix: {"medicare": 0.71, "medicaid": 0.07, "commercial": 0.18, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:27.077317+00:00
notes:
  Leading joint-venture ESRD platform partnering with nephrologists; IPO 2016 (NYSE: ARA). Revenue cycle uniquely complex: ESRD patients retain Medicare primary coverage regardless of age, but coordination-of-benefits windows with commercial payers (first 30 months for employer-plan members) require precise payer-order logic to capture maximum allowed amounts before Medicare becomes primary.


source_id: ext36_003
source: seed
deal_name: EyeCare Partners – Warburg Pincus Platform Build
buyer: Warburg Pincus
seller: Management / founding ophthalmologists
payer_mix: {"medicare": 0.45, "medicaid": 0.1, "commercial": 0.38, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:31.820676+00:00
notes:
  Built into the largest vertically integrated ophthalmology platform (medical + surgical + optical retail) in the US. RCM complexity is high: professional claims for E&M, surgical (cataract, retina), and ancillary optical billing each follow separate fee schedules and prior-auth requirements. Medicare's 90-day global surgery period creates no-pay windows that must be flagged to avoid duplicate-claim denials during add-on procedure billing.


source_id: ext36_004
source: seed
deal_name: NovaBay / Retina Consultants of America – H.I.G. Capital Growth
buyer: H.I.G. Capital
seller: Management / founding retina specialists
payer_mix: {"medicare": 0.58, "medicaid": 0.06, "commercial": 0.32, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:31.827436+00:00
notes:
  Retina subspecialty roll-up; AMD and diabetic retinopathy procedures are among the highest-reimbursed outpatient Medicare services. Drug-injected anti-VEGF billing (J-code for Lucentis vs. compounded Avastin) is a leading source of audit exposure; RCM requires precise NDC-level documentation and buy-and-bill margin management. H.I.G. invested in centralized coding to reduce denial rates by ~300 bps.


source_id: ext36_005
source: seed
deal_name: Option Care Health – Walgreens Boots Divestiture to Madison Dearborn
buyer: Madison Dearborn Partners
seller: Walgreens Boots Alliance
payer_mix: {"medicare": 0.35, "medicaid": 0.12, "commercial": 0.48, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:31.833905+00:00
notes:
  Largest independent home and alternate-site infusion provider; merged with BioScrip 2019 to form NYSE: OPCH. Infusion RCM sits at the intersection of pharmacy (Part D / specialty drug), durable medical equipment (Part B), and professional services billing — each governed by different fee schedules and prior-auth pathways. Payer-contract fragmentation across 1,000+ managed care agreements drives significant denial and resubmission workload.


source_id: ext36_006
source: seed
deal_name: BioScrip Home Infusion – Consonance Capital / Ares Recapitalization
buyer: Ares Management
seller: BioScrip Inc (distressed recap)
payer_mix: {"medicare": 0.3, "medicaid": 0.15, "commercial": 0.5, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:31.840086+00:00
notes:
  Ares led a debt-to-equity conversion; BioScrip subsequently merged with Option Care 2019. Home infusion RCM is complicated by specialty drug J-code vs. NDC reporting requirements and Medicare Part B vs. Part D crossover for certain IVIG and immunoglobulin therapies. Waste and overfill billing documentation is a key compliance and revenue-leakage area.


source_id: ext36_007
source: seed
deal_name: Kindred Biosciences / National Veterinary Associates – Shore Capital Tuck-In
buyer: Shore Capital Partners
seller: Management / founder
payer_mix: {"pet_insurance": 0.12, "self_pay": 0.88}
ingested_at: 2026-04-25T20:18:31.846463+00:00
notes:
  Companion animal general practice group; predominantly cash-pay with growing pet insurance penetration. RCM analogs to human healthcare are emerging: insurance carrier direct-billing requires accurate procedure coding (AVMA CPT equivalents), and claim denials for pre-existing conditions create write-off risk. Shore Capital leveraged RCM system standardization to improve collections from ~78% to ~91% across the platform.


source_id: ext36_008
source: seed
deal_name: Syneos Health (inVentiv + INC Research Merger) – Advent / Thomas H. Lee
buyer: Advent International / Thomas H. Lee Partners
seller: inVentiv Health / INC Research Holdings
payer_mix: {"pharma_sponsor": 0.72, "biotech_sponsor": 0.21, "government": 0.07}
ingested_at: 2026-04-25T20:18:32.036417+00:00
notes:
  Combined entity became the second-largest global CRO (NASDAQ: SYNH). CRO revenue recognition follows ASC 606 percentage-of-completion on multi-year contracts; billing complexity arises from pass-through cost management, milestone-based invoicing, and investigator site payment reconciliation — all of which create significant AR aging risk if milestone definitions are poorly scoped. Centralized billing operations were a key synergy target post-merger.


source_id: ext36_009
source: seed
deal_name: Medpace Holdings – Cinven Buyout
buyer: Cinven
seller: Management / founder
payer_mix: {"pharma_sponsor": 0.55, "biotech_sponsor": 0.42, "government": 0.03}
ingested_at: 2026-04-25T20:18:32.044469+00:00
notes:
  Niche CRO focused on metabolic, cardiovascular, and oncology trials; IPO 2016 (NASDAQ: MEDP). Full-service model avoids FSP (functional service provider) billing complexity. Revenue recognized on pass-through vs. service fee split creates gross margin reporting nuance; sponsor audit rights add reconciliation overhead. Strong biotech client concentration requires robust receivables management given sponsor funding-event risk.


source_id: ext36_010
source: seed
deal_name: Evolent Health – TPG / The Advisory Board Growth Investment
buyer: TPG Capital / The Advisory Board Company
seller: Management (de novo)
payer_mix: {"value_based_care": 0.6, "fee_for_service": 0.28, "capitation": 0.12}
ingested_at: 2026-04-25T20:18:32.050793+00:00
notes:
  Value-based care enablement and population health platform; IPO 2015 (NYSE: EVH). Unique RCM complexity: Evolent manages both payer-side (claims adjudication, risk adjustment) and provider-side (encounter data submission, HCC coding) operations simultaneously. Risk adjustment data validation audit (RADV) exposure is a primary compliance and revenue-integrity focus area for its Medicare Advantage delegated-risk client base.


source_id: ext36_011
source: seed
deal_name: Concentra Occupational Health – Humana Divestiture to Select Medical / Welsh Carson
buyer: Welsh Carson Anderson & Stowe / Select Medical
seller: Humana Inc
payer_mix: {"workers_comp": 0.48, "employer_direct": 0.32, "commercial": 0.14, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:32.057709+00:00
notes:
  Largest US occupational health and urgent care network (~500 centers). Workers' compensation billing is materially more complex than group health: state-specific fee schedules (each of 50 states has unique rules), adjuster authorization requirements for continued treatment, and first-report-of-injury documentation all drive denial rates above commercial benchmarks. Clean-claim rate improvement was a primary RCM initiative post-acquisition.


source_id: ext36_012
source: seed
deal_name: Corizon Health – Apax Partners Correctional Health Buyout
buyer: Apax Partners
seller: Prison Health Services / America Service Group
payer_mix: {"government_contract": 0.92, "medicaid": 0.05, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:32.068864+00:00
notes:
  Largest US correctional healthcare provider serving state and county facilities. Revenue model is primarily capitated government contracts rather than FFS; billing complexity arises in the 'outside care' carve-out where hospital and specialist services are billed to Medicaid for eligible inmates. The Medicaid inmate exclusion policy creates gaps in coverage that must be tracked per state — improper claims to Medicaid for ineligible inmate days represent the primary compliance and revenue-leakage risk.


source_id: ext36_013
source: seed
deal_name: DJO Global – Blackstone Medical Devices LBO
buyer: Blackstone Group
seller: Warburg Pincus / ReAble Therapeutics
payer_mix: {"medicare": 0.38, "medicaid": 0.09, "commercial": 0.41, "workers_comp": 0.12}
ingested_at: 2026-04-25T20:18:32.075714+00:00
notes:
  Global orthopedic bracing, joint reconstruction, and regenerative devices; HCPCS L-code billing for DME products requires CMS certificate of medical necessity (CMN) documentation. OIG investigations into brace upcoding and kickback arrangements (telemedicine referral models) created significant compliance overhang. Blackstone invested in compliance infrastructure and centralized DME billing to reduce audit risk and AR aging.


source_id: ext36_014
source: seed
deal_name: 21st Century Oncology – New Mountain Capital Platform
buyer: New Mountain Capital
seller: Vestar Capital Partners
payer_mix: {"medicare": 0.55, "medicaid": 0.1, "commercial": 0.32, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:32.082576+00:00
notes:
  Largest US radiation oncology platform (~170 centers); filed Chapter 11 2017 due to reimbursement cuts and leverage. Radiation oncology RCM is among the most technical: IMRT/SBRT coding requires daily treatment management codes in addition to planning and simulation charges, and bundling vs. unbundling rules under Medicare's Radiation Oncology Alternative Payment Model created uncertainty. CMS APC/HOPPS rate reductions for free-standing vs. HOPD sites were a structural reimbursement headwind.


source_id: ext36_015
source: seed
deal_name: Integrated Oncology / GenOptix – Carlyle Growth Platform
buyer: Carlyle Group
seller: Management / founder
payer_mix: {"medicare": 0.48, "medicaid": 0.11, "commercial": 0.36, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:32.089319+00:00
notes:
  Community-based radiation oncology and medical oncology group practice; Carlyle executed a regional roll-up adding proton therapy and stereotactic radiosurgery capabilities. 340B drug discount program participation by affiliated hospitals created a complex revenue-sharing and billing overlay — 340B-purchased drugs billed at full AWP to commercial payers generate a spread that must be tracked and reconciled separately from standard chemotherapy administration billing to avoid duplicate-discount violations.


source_id: ext37_001
source: seed
deal_name: Panorama Orthopedics & Spine – Welsh Carson Platform Build
buyer: Welsh Carson Anderson & Stowe
seller: Founding orthopedic surgeons / management
payer_mix: {"medicare": 0.38, "medicaid": 0.08, "commercial": 0.48, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:32.096908+00:00
notes:
  Large independent orthopedic group practice in Colorado with spine, joint replacement, and sports medicine capabilities. Orthopedic RCM is uniquely complex because global surgery periods (90 days for major joint procedures) bundle post-op visits into the initial claim, requiring precise modifier usage (modifier -24, -25, -79) to separately bill unrelated services. Implant cost pass-through billing to ASCs vs. hospital outpatient departments creates a dual-track coding environment. Welsh Carson invested in a centralized coding team that reduced orthopedic denial rates from 14% to 7% within 18 months.


source_id: ext37_002
source: seed
deal_name: Athletico Physical Therapy – BDT Capital Partners LBO
buyer: BDT Capital Partners
seller: Management / founder
payer_mix: {"medicare": 0.22, "medicaid": 0.09, "commercial": 0.55, "self_pay": 0.14}
ingested_at: 2026-04-25T20:18:32.105515+00:00
notes:
  Leading Midwest physical and occupational therapy network with sports medicine services; grew to 900+ locations nationally. PT/OT RCM carries significant payer-specific complexity: Medicare's therapy cap (and later KX modifier exception threshold) requires tracking cumulative annual spending per patient to avoid automatic claim rejection past the threshold. Commercial payers frequently require payer-specific functional outcome documentation (FOTO, OPTIMAL) that triggers separate prior-auth and reauthorization workflows — a leading source of authorization-related denials. Workers' comp and auto/personal injury billing (state-specific fee schedules, liens) added a third billing track post-acquisition.


source_id: ext37_003
source: seed
deal_name: Mednax / Pediatrix Medical Group – Warburg Pincus Growth Stake
buyer: Warburg Pincus
seller: Secondary block (NYSE: MD)
payer_mix: {"medicare": 0.12, "medicaid": 0.42, "commercial": 0.42, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:32.113895+00:00
notes:
  Largest US provider of neonatal, maternal-fetal medicine, and pediatric subspecialty services staffing >350 NICUs nationally. Neonatal RCM is among the most documentation-intensive: NICU level-of-care billing (Level I through IV) drives massive per-diem revenue variation and requires daily attestation of medical complexity. Medicaid represents ~42% of payer mix given the high incidence of low-income preterm births; Medicaid secondary coordination for infants covered by both Medicaid and commercial plans is a primary source of underpayment and write-off risk. Critical care vs. subsequent hospital care code transitions during NICU stay must be precisely timed to optimize professional-fee capture.


source_id: ext37_004
source: seed
deal_name: Pediatrix Neonatal Services – Summit Partners Add-On Expansion
buyer: Summit Partners
seller: Founding neonatologists / hospital systems
payer_mix: {"medicare": 0.08, "medicaid": 0.48, "commercial": 0.4, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:32.123272+00:00
notes:
  Regional NICU management group serving community hospitals in the Southeast; integrated into a national neonatal platform. Born-preterm billing requires precise coordination between hospital facility claims and the neonatologist professional claim — dual-claim synchronization errors are a top denial driver. CHIP coverage for neonates creates a third payer layer (CHIP vs. Medicaid fee schedule differs by state), requiring correct payer-order logic at claim submission. Summit Partners invested in clinical documentation improvement (CDI) to capture undercoded NICU complexity.


source_id: ext37_005
source: seed
deal_name: Lucile Packard / Ob Hospitalist Group – H.I.G. Capital Platform
buyer: H.I.G. Capital
seller: Management / founding OB-GYNs
payer_mix: {"medicare": 0.05, "medicaid": 0.52, "commercial": 0.38, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:32.130619+00:00
notes:
  Nation's largest OB hospitalist program staffing labor and delivery units 24/7 across 130+ hospitals. Maternal health RCM is heavily Medicaid-weighted given coverage of ~42% of US births; Medicaid global obstetric billing bundles all prenatal, delivery, and postpartum services into a single all-inclusive fee — unbundling individual services is a leading audit trigger. Unplanned cesarean section vs. vaginal delivery coding requires real-time documentation accuracy to avoid downcoding. Commercial payers require separate authorization for scheduled C-sections and high-risk pregnancies, creating a parallel authorization-management track.


source_id: ext37_006
source: seed
deal_name: Livongo Health – General Atlantic Growth Investment
buyer: General Atlantic
seller: Series D investors / management
payer_mix: {"medicare": 0.08, "medicaid": 0.07, "commercial": 0.65, "self_pay": 0.2}
ingested_at: 2026-04-25T20:18:32.137619+00:00
notes:
  Leading digital health platform for diabetes and chronic condition management; merged with Teladoc 2020 (NASDAQ: TDOC) at ~$18.5B valuation. Digital therapeutic billing sits at the frontier of CPT coding evolution: remote physiologic monitoring (RPM) codes 99453/99454/99457 were not broadly reimbursed until 2019, meaning revenue was primarily B2B employer contracts rather than insurance billing. The shift toward payer-covered DTx required building claims infrastructure from scratch — prior-auth workflows, evidence dossiers for formulary inclusion, and payer coverage determination advocacy were new RCM functions layered onto a software-native business model.


source_id: ext37_007
source: seed
deal_name: Hims & Hers / Calibrate – New Mountain Capital Digital Health Platform
buyer: New Mountain Capital
seller: Series B / Series C investors
payer_mix: {"medicare": 0.04, "medicaid": 0.03, "commercial": 0.48, "self_pay": 0.45}
ingested_at: 2026-04-25T20:18:32.144848+00:00
notes:
  Obesity medicine digital platform combining GLP-1 prescribing, behavioral coaching, and telehealth visits. Heavy self-pay mix reflects insurer coverage variability for GLP-1 agents (semaglutide/tirzepatide): many commercial plans excluded anti-obesity medications prior to 2023, forcing cash-pay pricing. RCM complexity centers on specialty pharmacy coordination — prior-auth for GLP-1s requires ICD-10 specificity (obesity vs. T2DM primary diagnosis changes formulary tier) and step-therapy documentation. Buy-and-bill vs. patient-procured pharmacy models create parallel revenue streams with different AR aging and gross-to-net dynamics.


source_id: ext37_008
source: seed
deal_name: Staff Care / AMN Healthcare – Lee Equity Partners Locum Tenens Platform
buyer: Lee Equity Partners
seller: Management / founder
payer_mix: {"medicare": 0.35, "medicaid": 0.18, "commercial": 0.4, "self_pay": 0.07}
ingested_at: 2026-04-25T20:18:32.152265+00:00
notes:
  National locum tenens physician staffing platform placing providers in hospitals, critical access facilities, and rural health centers. Locum staffing billing complexity arises from the 'locum tenens substitution' rule (Q6 modifier): CMS permits billing under the absent physician's NPI for up to 60 days — after which the locum must enroll independently, triggering PECOS enrollment timelines that create revenue gaps. Misuse of Q6 or failure to track the 60-day window is a top OIG audit target in the locums segment. Multi-state credentialing and payer enrollment for transient physicians adds 30-90 day AR drag at each new placement site.


source_id: ext37_009
source: seed
deal_name: Envision Healthcare Physician Staffing – Carlyle Group LBO
buyer: Carlyle Group
seller: KKR (AMSURG / Envision merger vehicle)
payer_mix: {"medicare": 0.3, "medicaid": 0.14, "commercial": 0.5, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:32.159476+00:00
notes:
  Largest US physician staffing company (emergency medicine, anesthesia, hospitalist, radiology) with 25,000+ providers; filed Chapter 11 2023. Emergency physician billing is uniquely exposed to out-of-network dynamics: prior to the No Surprises Act (2022), EM groups relied heavily on balance billing commercial patients seen in in-network hospitals. NSA implementation required wholesale redesign of the commercial billing and IDR (independent dispute resolution) workflow — a structural revenue headwind that contributed to the bankruptcy. Surprise billing audit compliance and IDR arbitration management became new RCM cost centers not modeled at entry.


source_id: ext37_010
source: seed
deal_name: Navitus Health Solutions – Warburg Pincus PBM Growth Investment
buyer: Warburg Pincus
seller: SSM Health / founder management
payer_mix: {"medicare": 0.15, "medicaid": 0.1, "commercial": 0.7, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:32.165536+00:00
notes:
  Transparent, pass-through PBM serving self-funded employers and health systems; positioned as an alternative to traditional spread-pricing PBMs. PBM revenue cycle complexity centers on DIR (direct and indirect remuneration) fees: CMS rules require that retrospective DIR fees be reflected in point-of-sale pricing for Medicare Part D plans, a change phased in 2023 that compressed gross-to-net spread materially. Rebate aggregation, formulary administration, and specialty drug prior-auth management represent distinct billing and reconciliation functions — each with separate payer-contractual timelines that must be tracked to avoid revenue leakage and compliance exposure.


source_id: ext37_011
source: seed
deal_name: PharMerica Specialty Pharmacy – Frazier Healthcare Partners Platform
buyer: Frazier Healthcare Partners
seller: Management / founder
payer_mix: {"medicare": 0.38, "medicaid": 0.12, "commercial": 0.44, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:32.171735+00:00
notes:
  Specialty pharmacy serving oncology, immunology, and rare-disease patients; dispensing high-cost biologics ($10K–$500K per patient annually). Specialty pharmacy RCM is defined by prior-authorization intensity: commercial payers require step-therapy documentation, peer-to-peer appeals, and annual reauthorizations for most specialty drugs. Hub services (patient assistance program coordination, co-pay card adjudication, manufacturer free-drug programs) create a parallel revenue and reconciliation track outside the standard claims system. Medicare Part B buy-and-bill vs. Part D pharmacy benefit routing decisions (e.g., for IVIG, subcutaneous biologics) directly impact margin and require real-time payer-benefit verification.


source_id: ext37_012
source: seed
deal_name: Rural Health Clinics of America – Shore Capital Partners Roll-Up
buyer: Shore Capital Partners
seller: Founding rural physicians / hospital systems
payer_mix: {"medicare": 0.44, "medicaid": 0.32, "commercial": 0.18, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:32.179441+00:00
notes:
  Rural Health Clinic (RHC) designated primary care network in underserved Midwest communities. RHC billing operates under a unique all-inclusive rate (AIR) prospective payment system rather than standard Medicare physician fee schedule — a per-visit rate negotiated annually with CMS based on allowable costs. RCM complexity arises from: (1) correctly distinguishing RHC-qualifying visits from non-qualifying services (preventive, mental health before parity) which bill under standard FFS, and (2) cost report reconciliation (CMS Form 222) where retroactive settlement can claw back interim payments. Shore Capital invested in a cost-report specialist team that recovered ~$2.1M in prior-year underpayments.


source_id: ext37_013
source: seed
deal_name: Essentia Health Critical Access Network – Riverside Company Growth
buyer: Riverside Company
seller: Independent CAH management groups
payer_mix: {"medicare": 0.55, "medicaid": 0.25, "commercial": 0.15, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:32.188409+00:00
notes:
  Operator of critical access hospitals (CAHs) in rural Minnesota, Wisconsin, and North Dakota. CAH designation entitles facilities to cost-based Medicare reimbursement (101% of reasonable costs) rather than DRG prospective payment — a structural advantage, but one that requires meticulous cost report preparation (Medicare Cost Report Form 2552). Swing-bed billing (skilled nursing services in CAH acute beds billed under SNF Part A rates) is a secondary revenue stream requiring separate MDS assessment documentation. The annual CAH cost report settlement process creates multi-year open receivable positions that distort standard AR aging metrics — a key diligence complexity for PE buyers unfamiliar with the cost-based model.


source_id: ext37_014
source: seed
deal_name: Alignment Healthcare – General Atlantic Medicare Advantage Platform
buyer: General Atlantic
seller: Series C investors / management
payer_mix: {"medicare": 0.97, "medicaid": 0.02, "commercial": 0.0, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:32.195989+00:00
notes:
  Value-based Medicare Advantage plan and provider enablement platform in California, Nevada, and North Carolina; IPO 2021 (NASDAQ: ALHC). MA health plan revenue cycle is driven by CMS risk-adjusted capitation payments: monthly PMPM rates hinge on accurate HCC (Hierarchical Condition Category) coding from member encounter data submissions. Risk adjustment data validation (RADV) audits can claw back years of premium revenue if HCC coding is not supported by medical record documentation — representing a tail liability that must be reserved. Stars quality bonus payments (Part C/D) add a second revenue lever tied to HEDIS measure performance and pharmacy adherence metrics, each requiring distinct data capture and reconciliation workflows.


source_id: ext37_015
source: seed
deal_name: Bright Health Group – New Enterprise Associates MA Growth Platform
buyer: New Enterprise Associates
seller: Series C investors / management
payer_mix: {"medicare": 0.68, "medicaid": 0.2, "commercial": 0.11, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:32.203517+00:00
notes:
  Consumer-focused Medicare Advantage and ACA marketplace insurer operating in 14 states; IPO 2021, subsequently exited most markets due to adverse selection and medical-loss-ratio pressure. MA plan RCM is highly sensitive to encounter data completeness: CMS requires submission of all member encounter records (not just diagnoses) to validate risk-adjustment codes — incomplete encounter data submission resulted in HCC deletions during RADV reviews that materially reduced risk scores and capitation revenue. Dual-eligible (Medicare-Medicaid) Special Needs Plan (D-SNP) billing adds a Medicaid premium reconciliation layer where state payment timelines and capitation rate-setting vary materially — a billing complexity that Bright Health underestimated at market entry.


source_id: ext38_001
source: seed
deal_name: VITAS Healthcare – Chemed Corporation Acquisition (PE-Backed Pre-Close)
buyer: Berkshire Partners
seller: Founding management / VITAS Group
payer_mix: {"medicare": 0.82, "medicaid": 0.1, "commercial": 0.06, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:32.211500+00:00
notes:
  One of the largest US hospice providers, ultimately acquired by Chemed (NYSE: CHE). Hospice RCM is governed by Medicare's hospice benefit under Part A, which pays a per-diem rate across four levels of care (routine home care, continuous home care, inpatient respite care, general inpatient care). The aggregate cap rule — which limits total Medicare hospice payments per provider to a rolling 12-month ceiling based on patient count — is a structural revenue constraint unique to hospice billing that requires real-time utilization monitoring to avoid cap liability clawbacks. Live-discharge coding (patient revokes hospice election vs. condition improves) triggers a distinct claims adjustment workflow. Berkshire Partners invested in automated per-diem tracking dashboards to surface cap-risk exposure 90 days in advance.


source_id: ext38_002
source: seed
deal_name: Crossroads Hospice & Palliative Care – Gryphon Investors Platform Build
buyer: Gryphon Investors
seller: Founder / management
payer_mix: {"medicare": 0.79, "medicaid": 0.12, "commercial": 0.07, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:32.218394+00:00
notes:
  Midwest-based hospice and palliative care network serving patients across Ohio, Pennsylvania, Tennessee, Georgia, and Kansas. Palliative care billing is complicated by the dual-track nature of the service: Medicare-funded hospice benefit claims are mutually exclusive with curative-treatment Medicare claims — a patient on hospice election cannot simultaneously bill for curative chemo or radiation. Ensuring election status is accurately reflected in the billing system prevents improper dual-billing that triggers OIG scrutiny. Gryphon Investors centralized the election-status verification workflow across all sites, reducing rejection rates related to concurrent care coding errors by 60%. Non-hospice palliative care (advance care planning codes 99497/99498) requires separate documentation and does not fall under the per-diem cap — a billing distinction that was a recurring source of undercoding at acquired practices.


source_id: ext38_003
source: seed
deal_name: Folx Health – Francisco Partners Gender-Affirming Telehealth Investment
buyer: Francisco Partners
seller: Series B investors / management
payer_mix: {"medicare": 0.03, "medicaid": 0.12, "commercial": 0.45, "self_pay": 0.4}
ingested_at: 2026-04-25T20:18:32.226051+00:00
notes:
  Telehealth platform providing gender-affirming hormone therapy (GAHT), primary care, and mental health services to LGBTQ+ patients nationally. Gender-affirming health RCM is complicated by wide payer-coverage variability: approximately half of commercial plans in 2021 still explicitly excluded gender dysphoria treatments or applied prior-authorization criteria tied to ICD-10-CM F64.0 (gender dysphoria in adolescents/adults). Hormone therapy CPT billing requires careful use of endocrinology E&M codes (99202–99215) vs. telehealth modifier (-95) to satisfy payer telehealth coverage policies that were still in flux post-COVID PHE waiver. High self-pay mix reflects patients opting out of insurance to preserve privacy; cash-pay pricing and flexible payment plans were a distinct revenue track requiring separate AR management outside the standard claims workflow.


source_id: ext38_004
source: seed
deal_name: Plume Health – Pamlico Capital Gender-Affirming Care Platform
buyer: Pamlico Capital
seller: Series A investors / founding team
payer_mix: {"medicare": 0.02, "medicaid": 0.18, "commercial": 0.42, "self_pay": 0.38}
ingested_at: 2026-04-25T20:18:32.234256+00:00
notes:
  Subscription-based telehealth platform delivering gender-affirming hormone therapy (GAHT) in 40+ states. Medicaid coverage for GAHT services expanded meaningfully in 2021–2022 as more state programs adopted non-discrimination policies, but state-specific fee schedules and prior-auth requirements for cross-sex hormone prescribing (estradiol, testosterone) vary widely — requiring payer-specific billing rule libraries. Pharmacy billing for GAHT medications under Medicaid uses NCPDP claim format with NDC codes, while physician E&M services bill on CMS-1500 — a dual-format revenue cycle that is operationally complex to manage on a single platform. Pamlico invested in automated payer-coverage eligibility verification to reduce the high rate of first-pass denials tied to non-covered diagnosis codes.


source_id: ext38_005
source: seed
deal_name: Audibel / Starkey Hearing – Wind Point Partners Audiology Roll-Up
buyer: Wind Point Partners
seller: Independent audiology clinic owners
payer_mix: {"medicare": 0.28, "medicaid": 0.06, "commercial": 0.38, "self_pay": 0.28}
ingested_at: 2026-04-25T20:18:32.247780+00:00
notes:
  Independent audiology clinic roll-up supplying and fitting hearing aids across seven Midwest states. Hearing health RCM is structurally complicated by Medicare's historical exclusion of routine hearing aids under Part B — the program covers only diagnostic audiology testing (CPT 92557, 92567, 92568) but not the device itself, creating a split revenue model where fitting and dispensing revenue is self-pay or billed to supplemental/MA plans. Since 2021, Medicare Advantage plans are permitted to cover hearing aid benefits, but each plan defines its own allowable, authorization trigger, and in-network device tiers differently — multiplying the payer-specific billing rules that front-desk staff must navigate. Prior-auth for high-end digital hearing aids requires audiogram documentation thresholds (typically >40 dB HL) that must be electronically transmitted to each payer. Wind Point invested in a centralized billing engine that automated payer-benefit verification and device-tier matching, reducing claim rejections by 45%.


source_id: ext38_006
source: seed
deal_name: National Hearing Centers – Revelstoke Capital Audiology Platform
buyer: Revelstoke Capital Partners
seller: Regional audiology group / founder
payer_mix: {"medicare": 0.32, "medicaid": 0.07, "commercial": 0.36, "self_pay": 0.25}
ingested_at: 2026-04-25T20:18:32.254155+00:00
notes:
  Multi-state audiology chain providing diagnostic testing, hearing aid dispensing, and cochlear implant mapping services across the Southeast. Cochlear implant billing involves Medicare Part B professional claims for mapping/programming (CPT 92601–92604) distinct from the facility claim for the implant surgery — a split-claim model requiring strict coordination between the hospital billing team and the outpatient audiology group to avoid duplicate-claim denials. Hearing aid repair and in-warranty replacement create recurring no-charge claim submissions that must be correctly coded (modifier -52 or -53 for reduced/discontinued service) to preserve audit trails without triggering payer recoupment. Revelstoke Capital centralized prior-auth workflows and introduced real-time Medicare Advantage benefit-verification tools that cut authorization-related rework costs by $1.2M annually across the platform.


source_id: ext38_007
source: seed
deal_name: MyEyeDr. – Goldman Sachs / CD&R Vision Care Platform LBO
buyer: CD&R (Clayton, Dubilier & Rice)
seller: Goldman Sachs Merchant Banking
payer_mix: {"medicare": 0.14, "medicaid": 0.09, "commercial": 0.58, "self_pay": 0.19}
ingested_at: 2026-04-25T20:18:32.260801+00:00
notes:
  Largest US optometry and vision care chain with 900+ locations; grew to 1,000+ practices under CD&R via aggressive add-on acquisitions. Vision care RCM spans three distinct claim types: (1) routine vision exam billed to vision benefit plans (VSP, EyeMed, Davis Vision) under V-codes (CPT 92002–92014), (2) medical eye exams billed to medical insurance using E&M codes when a medical diagnosis (glaucoma, diabetic retinopathy — ICD-10 H40.xx, E11.31x) is present, and (3) optical retail (frame/lens) which is product revenue outside the claims system. Dual-payer coordination — determining whether a visit triggers a vision plan claim, a medical claim, or both — is the leading source of incorrect billing and underpayment. CD&R invested in a rules engine that automatically routed each visit to the correct billing track based on diagnosis and performed service, reducing mixed-payer errors by 35%.


source_id: ext38_008
source: seed
deal_name: Visionworks – HVHC / Highmark Vision – Roark Capital Retail Optometry LBO
buyer: Roark Capital Group
seller: Highmark Health / HVHC management
payer_mix: {"medicare": 0.12, "medicaid": 0.1, "commercial": 0.55, "self_pay": 0.23}
ingested_at: 2026-04-25T20:18:32.273820+00:00
notes:
  National optical retail and optometry chain with 700+ stores carved out from Highmark Health's vertically integrated vision benefits subsidiary. Carve-out introduced immediate RCM complexity: HVHC had historically submitted vision benefit claims through Highmark's proprietary adjudication system, requiring re-implementation on multi-payer clearinghouse infrastructure post-separation. Optometric medical billing for diabetic eye exams (CPT 92250 fundus photography, 92133/92134 OCT retinal scans) was materially underdeveloped — these Medicare Part B payable services were being bundled into routine vision plan claims and therefore not being billed to medical insurance. Roark Capital's operations team identified ~$14M in annual medical billing upside through proper diagnostic coding and payer-class re-routing during the first 24 months post-close.


source_id: ext38_009
source: seed
deal_name: Sunquest Information Systems – Veritas Capital LIS Platform LBO
buyer: Veritas Capital
seller: Misys Healthcare / Symphony Technology Group
payer_mix: {"medicare": 0.3, "medicaid": 0.12, "commercial": 0.52, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:32.280990+00:00
notes:
  Leading laboratory information system (LIS) vendor serving hospital and independent reference labs across the US and internationally. LIS platforms sit at the revenue-cycle origination point for clinical laboratory billing: test order entry, specimen tracking, result reporting, and CPT code generation all flow through the LIS before downstream billing-system transmission. Medicare's Clinical Laboratory Fee Schedule (CLFS) — and the major reform under PAMA (Protecting Access to Medicare Act, 2014) which required private-payer rate reporting and compressed Medicare rates by 10–30% for high-volume tests — placed Sunquest's hospital-lab customers under significant reimbursement pressure, driving demand for LIS-embedded analytics that could identify test-level underpayment and automate CPT/modifier assignment for split-specimen and reflex-order billing. Veritas Capital invested in cloud-based LIS deployment capability that expanded the addressable market to smaller labs.


source_id: ext38_010
source: seed
deal_name: Precyse Solutions (now nThrive) – Silver Lake EHR/HIM Platform LBO
buyer: Silver Lake Partners
seller: Precyse management / growth investors
payer_mix: {"medicare": 0.0, "medicaid": 0.0, "commercial": 0.0, "self_pay": 0.0}
ingested_at: 2026-04-25T20:18:32.287619+00:00
notes:
  Health information management (HIM) and clinical documentation technology vendor providing coding, CDI, and transcription services to health systems. Health system IT serving the RCM workflow occupies a unique market position: revenue is driven by health system IT-services contracts (per-record coding fees, per-physician CDI fees) rather than direct patient claims, but performance is directly measured by downstream billing outcomes — specificity of ICD-10-CM/PCS code assignment, DRG optimization, and denial-prevention accuracy. The ICD-10 transition (October 2015) was a pivotal demand catalyst: health systems outsourced surge coding volume and CDI support to vendors like Precyse as internal staff struggled with the 5x code-set expansion. Silver Lake's investment thesis centered on using AI-assisted coding to improve coder productivity ratios and expand margin per record — a strategy that anticipated the shift toward computer-assisted coding (CAC) technology that redefined the HIM market.


source_id: ext38_011
source: seed
deal_name: HealthEdge Software – Francisco Partners Health Plan IT LBO
buyer: Francisco Partners
seller: Warburg Pincus
payer_mix: {"medicare": 0.0, "medicaid": 0.0, "commercial": 0.0, "self_pay": 0.0}
ingested_at: 2026-04-25T20:18:32.295582+00:00
notes:
  Core administrative processing platform for health plans and managed care organizations; powers claims adjudication, benefits configuration, and provider payment for regional Blues plans and regional MA plans. Health plan IT serving the payer-side RCM workflow is differentiated from provider-side systems: the platform must accurately adjudicate ICD-10 diagnosis codes against plan-specific coverage policies, apply COB (coordination of benefits) rules across primary/secondary payers, and calculate correct member cost-share at adjudication. The ACA's metal-tier benefit design added actuarial-value calculation complexity (embedded deductible, MOOP tracking per plan year) requiring claims-system configuration updates on an annual basis. Francisco Partners invested in cloud migration and a SaaS transition that improved implementation speed from 18 to 9 months, accelerating revenue recognition.


source_id: ext38_012
source: seed
deal_name: Benefytt Technologies (formerly Health Insurance Innovations) – Roark Capital TPA Platform
buyer: Roark Capital Group
seller: Founder / management
payer_mix: {"medicare": 0.0, "medicaid": 0.0, "commercial": 0.72, "self_pay": 0.28}
ingested_at: 2026-04-25T20:18:32.302058+00:00
notes:
  Third-party administrator (TPA) and health benefits distribution platform serving self-funded employers with supplemental and short-term health plans. TPA billing and RCM complexity stems from self-funded plan administration: the TPA processes claims against employer-specific plan documents rather than standard insurance contracts, requiring per-plan benefits configuration and claims-editing rules that must be maintained individually for each employer client. Stop-loss claim recovery (specific and aggregate) adds a parallel reimbursement workflow where eligible claims must be packaged and submitted to the stop-loss carrier on the carrier's own timelines — delay in filing constitutes forfeiture of stop-loss recovery. Roark Capital identified stop-loss recovery leakage (~8% of eligible claims not submitted timely) as a key operational improvement opportunity during diligence.


source_id: ext38_013
source: seed
deal_name: GENEX Services – Berkshire Partners Workers' Comp Managed Care LBO
buyer: Berkshire Partners
seller: Coventry Health Care / Aetna
payer_mix: {"medicare": 0.0, "medicaid": 0.0, "commercial": 0.15, "self_pay": 0.85}
ingested_at: 2026-04-25T20:18:32.309742+00:00
notes:
  National managed care organization providing medical cost containment, case management, and pharmacy benefit services to workers' compensation insurers and self-insured employers. Workers' comp RCM operates entirely outside the standard Medicare/Medicaid billing framework: providers bill using state-specific workers' comp fee schedules (which vary significantly — California's OMFS, Texas' DWC fee schedule) and must submit on state-mandated claim forms (WCAB-1, DWC-1) rather than CMS-1500. GENEX's managed care model layers on bill review — automated adjudication of provider invoices against the applicable state fee schedule — as a revenue-generating service sold to carriers, creating a payer-side RCM business model rather than a provider-side one. Berkshire Partners focused on integrating pharmacy and medical bill review capabilities to cross-sell, reducing carrier costs-per-claim and driving GENEX's revenue per managed claim dollar higher.


source_id: ext38_014
source: seed
deal_name: Air Methods Corporation – American Securities Air Ambulance LBO
buyer: American Securities
seller: Public shareholders (AIRM)
payer_mix: {"medicare": 0.35, "medicaid": 0.15, "commercial": 0.4, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:32.316353+00:00
notes:
  Largest US air medical transport operator with 450+ helicopters and fixed-wing aircraft serving rural and trauma markets. Air ambulance RCM is among the most litigated in healthcare: the Airline Deregulation Act (ADA) preempts state surprise-billing laws from regulating air ambulance rates, leaving air carriers free to set their own prices — rates of $30,000–$60,000 per transport vs. Medicare allowed amounts of ~$7,000 created extreme balance-billing exposure for uninsured and out-of-network patients. The No Surprises Act (2022) explicitly excluded air ambulance from its surprise-billing protections, but Congressional scrutiny and state AG investigations introduced regulatory overhang. Medicaid rates — set by state Medicaid agencies — are often below cost in rural states, creating cross-subsidy pressure. American Securities invested in a specialized air-ambulance RCM team focused on Medicare/Medicaid coding accuracy (A0430/A0431 base rate codes, mileage code A0435) and commercial out-of-network balance-billing resolution workflows.


source_id: ext38_015
source: seed
deal_name: Evolent Health / Premier Stroke & Neurovascular – Veritas Capital Neurovascular Platform
buyer: Veritas Capital
seller: Regional health system / academic neurology groups
payer_mix: {"medicare": 0.52, "medicaid": 0.14, "commercial": 0.3, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:32.323007+00:00
notes:
  Integrated stroke and neurovascular care network providing teleneurology, interventional neuroradiology (mechanical thrombectomy), and post-acute stroke rehabilitation services across Comprehensive and Primary Stroke Centers. Stroke RCM is uniquely complex because a single acute stroke encounter generates multiple simultaneous claim streams: the hospital facility claim (MS-DRG 065–067 for intracranial hemorrhage, 061–063 for ischemic stroke), the interventional neuroradiology professional claim (CPT 61645 for mechanical thrombectomy), and the teleneurology professional claim (CPT 99251–99255 for inpatient consult, modifier -GT for telehealth) must all be coordinated to prevent duplicate-service denials. The time-sensitive nature of stroke care (tPA must be administered within 4.5 hours) means documentation is frequently incomplete at discharge, creating a high volume of late-query CDI work. Veritas Capital invested in a real-time clinical documentation improvement workflow embedded in the stroke order set that captured NIHSS severity scoring and post-thrombectomy mTICI reperfusion grades required for correct complication and CC/MCC coding.


source_id: ext39_001
source: seed
deal_name: Kindred Healthcare – TPG / Humana SNF & Post-Acute LBO
buyer: TPG
seller: Public shareholders (KND)
payer_mix: {"medicare": 0.42, "medicaid": 0.38, "commercial": 0.14, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:32.332642+00:00
notes:
  One of the largest US post-acute and long-term acute care hospital (LTACH) operators, taken private in a consortium deal with Humana to accelerate value-based care integration. SNF RCM is governed by Medicare's Patient-Driven Payment Model (PDPM), implemented October 2019 — the most significant SNF reimbursement restructuring in two decades. PDPM replaced the Resource Utilization Group (RUG-IV) therapy-minutes model with a five-component per-diem system (PT, OT, SLP, nursing, non-therapy ancillaries) driven by clinical condition and comorbidity coding rather than therapy volume. Under PDPM, accurate ICD-10-CM coding of the primary diagnosis at admission and all active comorbidities directly drives per-diem rate — undercoding neurological comorbidities (stroke sequelae, Parkinson's, multiple sclerosis) or swallowing disorders that qualify for the SLP component results in immediate revenue leakage. Medicaid SNF billing varies by state — daily Medicaid rates are set by each state Medicaid agency and may be resource-based cost methodologies or prospective rate systems. TPG invested in a centralized CDI function that reviewed admission MDS (Minimum Data Set) assessments across all SNF sites to ensure PDPM component accuracy within 14 days of admission, recovering an estimated $18M annually in previously undercoded nursing and SLP components.


source_id: ext39_002
source: seed
deal_name: Consonus Healthcare – Warburg Pincus SNF Therapy Services Platform
buyer: Warburg Pincus
seller: Regional SNF therapy management company / founder
payer_mix: {"medicare": 0.48, "medicaid": 0.35, "commercial": 0.13, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:32.339353+00:00
notes:
  Contract therapy management organization providing PT, OT, and SLP services to SNF and assisted living operators across the Midwest. SNF contract therapy RCM is doubly complex: the therapy company bills the SNF operator on a per-diem contract, but the SNF operator's billing to Medicare is the upstream revenue driver — any MDS assessment errors that reduce the SNF's Medicare payment directly reduce contract therapy utilization and, ultimately, the therapy company's revenue. Under the pre-PDPM RUG-IV system, therapy minutes per week determined the RUG category (Ultra High, Very High, High, etc.) and per-diem rate; therapists had financial incentive to hit threshold minutes, creating documentation-intensity requirements. PDPM shifted incentives toward clinical complexity documentation rather than volume — Warburg Pincus invested in PDPM transition training for clinical staff to ensure the MDS Section GG (functional assessment) and Section I (active diagnoses) were coded to maximum specificity. Consolidated billing (CB) rules under Medicare Part A prevent SNFs from billing separately for most ancillary services during a Part A stay, requiring careful tracking of 'always-excluded' vs. 'included' services.


source_id: ext39_003
source: seed
deal_name: Diplomat Pharmacy – New Mountain Capital Specialty Pharmacy Chain LBO
buyer: New Mountain Capital
seller: Founding family / management
payer_mix: {"medicare": 0.35, "medicaid": 0.12, "commercial": 0.48, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:32.346537+00:00
notes:
  Largest independent specialty pharmacy in the US at time of investment, dispensing high-cost biologics and specialty medications for oncology, immunology, and rare disease. Specialty pharmacy RCM uses the NCPDP D.0 claim format for retail pharmacy billing but requires significant supplemental documentation workflows not present in traditional pharmacy: prior authorization for specialty drugs (often requiring clinical data, lab values, prescriber attestation) is mandatory before dispensing most biologics — denial of PA before fill results in either a write-off or a costly hold of expensive inventory. Medicare Part D specialty pharmacy billing involves a complex true-up for low-income subsidy (LIS) co-pay amounts and DIR (direct and indirect remuneration) fee clawbacks reconciled quarterly or annually by PBMs — DIR fees eroded net pharmacy revenue by 1–3% and were not fully visible at point of sale. Commercial specialty pharmacy contracts require hub services and specialty network credentialing. New Mountain Capital invested in a purpose-built PA management platform that tracked authorization expiration dates and automated renewal submissions 30 days in advance, reducing drug-hold incidents by 40%.


source_id: ext39_004
source: seed
deal_name: Apexus / 340B Health Pharmacy Services – Apax Partners Pharmacy Chain Platform
buyer: Apax Partners
seller: Regional health system pharmacy spin-out / management
payer_mix: {"medicare": 0.38, "medicaid": 0.2, "commercial": 0.36, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:32.357613+00:00
notes:
  Health system pharmacy network operating outpatient retail and specialty pharmacies under the 340B Drug Pricing Program, which allows eligible covered entities (disproportionate-share hospitals, FQHCs, Ryan White clinics) to purchase drugs at deeply discounted acquisition costs while billing payers at standard rates. 340B pharmacy RCM requires meticulous split-billing compliance: the 340B purchased drug inventory must be dispensed only to qualifying patients (Medicaid outpatients at the covered entity) while non-340B inventory is used for all other dispensing. Any dispensing of 340B drugs to Medicaid managed care patients without state carve-in authority constitutes a duplicate discount — subject to HRSA audit and repayment. HRSA's 2022 340B dispute resolution regulations imposed new claims-level documentation requirements for manufacturer ceiling price compliance. Apax Partners invested in a 340B software platform that automated patient eligibility determination and split-billing reconciliation, directly supporting audit defense and maintaining the 340B margin spread (acquisition cost vs. reimbursed cost) across both retail and mail-order dispensing.


source_id: ext39_005
source: seed
deal_name: Fagron / US Compounding – Advent International Compounding Pharmacy LBO
buyer: Advent International
seller: Independent compounding pharmacy owners
payer_mix: {"medicare": 0.18, "medicaid": 0.08, "commercial": 0.52, "self_pay": 0.22}
ingested_at: 2026-04-25T20:18:34.797205+00:00
notes:
  Sterile and non-sterile compounding pharmacy network operating 503A patient-specific compounding facilities and 503B outsourcing facilities supplying hospitals and surgery centers. Compounding pharmacy billing is among the most ambiguous in pharmacy RCM: 503A compounds are billed on NCPDP claims using the compound claim segment with ingredient NDC codes and quantities, but payer coverage policies for compounded drugs vary widely — many commercial payers maintain formulary exclusions or require medical exception documentation. Medicare Part D plans generally exclude compounded medications unless each ingredient is individually on the Part D formulary, creating a structural self-pay overhang for Medicare-eligible patients. FDA 503B outsourcing facilities supplying hospitals bill under purchase-order arrangements rather than patient-level claims, but state pharmacy board licensing and USP <797> and <800> compliance status directly affect hospital contract eligibility. Post-NECC contamination crisis (2012), Advent International prioritized sterility compliance infrastructure and invested in a centralized quality system that also tracked payer prior-authorization status for complex topical and hormone compounding.


source_id: ext39_006
source: seed
deal_name: Acadia Healthcare – Waud Capital / Warburg Pincus Psychiatric Hospital Platform
buyer: Warburg Pincus
seller: Waud Capital Partners (secondary)
payer_mix: {"medicare": 0.22, "medicaid": 0.3, "commercial": 0.42, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:34.803995+00:00
notes:
  One of the largest US behavioral health inpatient hospital operators, which subsequently went public (ACHC) and became the dominant platform. Psychiatric hospital RCM is governed by Medicare's Inpatient Psychiatric Facility Prospective Payment System (IPF PPS), distinct from the MS-DRG system used for acute care hospitals. IPF PPS pays a per-diem base rate adjusted for patient age, diagnosis (principal psychiatric diagnosis drives the DRG-equivalent patient classification), comorbidities (ECT, medical comorbidity adjustment), and facility characteristics (teaching, rural, emergency). Unlike acute DRG billing where one code determines the full payment, IPF per-diem rates accumulate daily — accurate daily documentation of active diagnoses and therapeutic interventions is necessary to maintain per-diem adjustment factors throughout a long length of stay. Mental Health Parity and Addiction Equity Act (MHPAEA) compliance introduced prior-authorization challenges: commercial payers must apply parity standards but frequently issued concurrent-review denials for psychiatric stays exceeding 7 days. Warburg Pincus invested in a payer relations team dedicated to MHPAEA-based appeals, recovering an estimated $22M in previously denied days.


source_id: ext39_007
source: seed
deal_name: Monte Nido & Affiliates – Lee Equity Eating Disorder Treatment Platform
buyer: Lee Equity Partners
seller: Founding management / Levine Leichtman Capital Partners
payer_mix: {"medicare": 0.05, "medicaid": 0.1, "commercial": 0.68, "self_pay": 0.17}
ingested_at: 2026-04-25T20:18:34.810405+00:00
notes:
  Leading national eating disorder treatment provider operating residential, partial hospitalization (PHP), and intensive outpatient (IOP) programs for anorexia, bulimia, and binge eating disorder. Eating disorder RCM is complicated by the multi-level-of-care billing structure: residential treatment is billed under behavioral health room-and-board (H0018 HCPCS or revenue code 1002) plus ancillary professional services, while PHP programs bill using a daily bundled code (H0035 or CPT 90853 group plus individual therapy) and IOP uses unbundled outpatient therapy codes (90837, 90853). Commercial payer medical necessity criteria for residential eating disorder treatment require documented failure at lower levels of care and objective clinical markers (BMI below threshold, vital-sign instability) that must be contemporaneously documented in the medical record — retrospective documentation is routinely denied on audit. MHPAEA parity enforcement for eating disorders (classified under DSM-5 Feeding and Eating Disorders) became an active enforcement area post-2015, enabling appeals for concurrent-review denials that failed parity standards. Lee Equity invested in a utilization management team that prospectively built the medical necessity record in the EHR and automated concurrent-review submission to payers.


source_id: ext39_008
source: seed
deal_name: Butterfly Effects – Shore Capital Autism / ABA Therapy Platform
buyer: Shore Capital Partners
seller: Founder / management
payer_mix: {"medicare": 0.02, "medicaid": 0.48, "commercial": 0.46, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:34.818854+00:00
notes:
  Multi-state applied behavior analysis (ABA) therapy provider serving children with autism spectrum disorder (ASD) across clinic and home-based settings. ABA therapy billing is among the most documentation-intensive in behavioral health RCM: CPT codes 97151–97158 (introduced January 2019) replaced the prior HCPCS H-code set and tied reimbursement to specific provider qualifications — 97151 (behavior identification assessment) and 97153 (adaptive behavior treatment by technician) require the treating technician's NPI and supervision documentation distinguishing BCBA-supervised vs. BCBA-D-supervised sessions, as payers audit qualification levels. Medicaid ABA coverage expanded dramatically across states post-2014 Autism CARES Act implementation, but each state Medicaid program uses different code sets, unit definitions (15-minute vs. 30-minute units), and authorization workflows — requiring a payer-specific billing rule library for each state. Commercial payers frequently require annual treatment plan reauthorizations with standardized outcome data (Vineland, ABLLS-R) that must be submitted in payer-defined formats. Shore Capital invested in a practice management system that automated authorization tracking and generated payer-ready treatment-plan summaries directly from the ABA data collection platform.


source_id: ext39_009
source: seed
deal_name: American Addiction Centers – H.I.G. Capital Substance Abuse Residential Platform
buyer: H.I.G. Capital
seller: Founding management / early investors
payer_mix: {"medicare": 0.08, "medicaid": 0.25, "commercial": 0.52, "self_pay": 0.15}
ingested_at: 2026-04-25T20:18:34.827733+00:00
notes:
  National residential substance use disorder (SUD) treatment provider operating detoxification, residential rehabilitation (28- and 90-day), and intensive outpatient programs across 12 states. Substance abuse residential RCM involves a complex multi-code billing architecture: detox services are billed as medical (revenue code 116 hospital-based detox, or H0008/H0009 HCPCS for non-hospital settings), residential rehab uses H0018 (behavioral health long-term residential) with per-diem payments, and IOP uses 90-series therapy CPT codes billed per session. The ACA's Medicaid expansion (2014) materially increased Medicaid SUD coverage under the Substance Use Disorder (SUD) section 1115 demonstration waivers, including the IMD (Institution for Mental Disease) exclusion carve-out that allowed Medicaid payment for residential SUD facilities with more than 16 beds — previously excluded entirely. Commercial payers apply stringent ASAM (American Society of Addiction Medicine) level-of-care criteria for authorizations, and step-down documentation from residential to PHP/IOP must be contemporaneous. H.I.G. Capital invested in an ASAM-aligned clinical documentation tool that auto-populated prior-authorization packages and tracked concurrent-review windows to prevent mid-stay denial write-offs.


source_id: ext39_010
source: seed
deal_name: Owens & Minor – Blackstone Growth Healthcare Logistics Platform Investment
buyer: Blackstone Growth
seller: Public shareholders (OMI) — minority growth investment
payer_mix: {"medicare": 0.0, "medicaid": 0.0, "commercial": 0.85, "self_pay": 0.15}
ingested_at: 2026-04-25T20:18:34.834804+00:00
notes:
  National healthcare supply chain and logistics company distributing medical and surgical supplies to acute-care hospitals, surgery centers, and physician offices. Healthcare logistics RCM differs structurally from provider billing: revenue flows through purchase-order-driven invoicing rather than insurance claims, but charge-capture integrity at the customer site directly affects Owens & Minor's revenue — hospitals that fail to accurately charge patients and payers for medical supplies (implants, disposables billed under revenue code 270 medical/surgical supplies) generate supply-cost write-offs that pressure contract renewals. Pass-through billing under Medicare Outpatient PPS (transitional pass-through for new medical devices under OPPS Addendum B) requires suppliers to support hospital billing teams with device-specific HCPCS code documentation. The consignment inventory model used for high-cost implants (orthopedic, spine) creates a reconciliation burden: implants used in surgery must be confirmed scanned and matched to the patient procedure before supplier invoice is generated — breakdowns in this reconciliation loop result in unbilled inventory. Blackstone Growth invested in an RFID-enabled consignment tracking system that closed the reconciliation loop in near-real-time across 300+ acute-care accounts.


source_id: ext39_011
source: seed
deal_name: Stericycle – Nordic Capital Medical Waste Services Secondary LBO
buyer: Nordic Capital
seller: Public shareholders (SRCL) — minority stake recapitalization
payer_mix: {"medicare": 0.0, "medicaid": 0.0, "commercial": 0.9, "self_pay": 0.1}
ingested_at: 2026-04-25T20:18:34.841424+00:00
notes:
  Largest US regulated medical waste and secure document destruction services provider, serving hospitals, physician offices, dental practices, and long-term care facilities. Medical waste services billing is B2B invoicing rather than patient-level claims, but regulatory compliance directly affects revenue collectibility: EPA and state environmental agency permit status, DOT hazardous materials shipping compliance, and OSHA bloodborne pathogen standards must all be maintained continuously — permit suspension voids service contracts. Stericycle's revenue cycle complexity stems from its mix of periodic pick-up contracts (billed monthly by container volume/weight) and one-time removal events (disaster response, facility closures), each requiring different billing workflows. Healthcare provider customers increasingly use purchase-order matching and three-way match requirements before releasing payment — invoice discrepancies on manifest weights require reconciliation against EPA-mandated waste tracking manifests (Uniform Hazardous Waste Manifest) that accompany each regulated medical waste shipment. Nordic Capital invested in automated manifest-to-invoice reconciliation software that reduced DSO by 8 days across the hospital segment.


source_id: ext39_012
source: seed
deal_name: Teladoc Health – Spectrum Equity Telehealth Platform Growth Investment
buyer: Spectrum Equity
seller: Series D investors / management
payer_mix: {"medicare": 0.06, "medicaid": 0.08, "commercial": 0.72, "self_pay": 0.14}
ingested_at: 2026-04-25T20:18:34.847985+00:00
notes:
  Pioneer US general telehealth platform providing on-demand video and phone physician consultations for primary care, mental health, and dermatology, subsequently taken public (TDOC) in 2015. Pre-COVID telehealth RCM was heavily constrained: Medicare only covered telehealth services for patients in rural Health Professional Shortage Areas (HPSAs) at an approved originating site, limiting Medicare telehealth billing to a small fraction of the population. Commercial payer telehealth coverage varied by state — 34 states had enacted telehealth parity laws by 2014, but enforcement and coverage breadth differed materially. Telehealth professional claim billing requires the GT modifier (-GT) to indicate interactive audio-video services, and place-of-service code 02 (telehealth provided other than in patient's home) or 10 (telehealth in patient's home, added 2022) to correctly classify the encounter for payer adjudication. A key billing risk is mismatching POS code and modifier, which triggers claim edits across most commercial payers. Spectrum Equity invested in building a payer-specific telehealth eligibility and benefit verification system that pre-screened each patient's telehealth coverage before the visit, dramatically reducing same-day denials.


source_id: ext39_013
source: seed
deal_name: MDLive – Riverside Company Telehealth Platform Secondary Investment
buyer: Riverside Company
seller: Earlier growth investors
payer_mix: {"medicare": 0.05, "medicaid": 0.1, "commercial": 0.7, "self_pay": 0.15}
ingested_at: 2026-04-25T20:18:34.854185+00:00
notes:
  Telehealth platform offering urgent care, behavioral health, and dermatology virtual visits to employer-sponsored health plan members, with significant regional Blues plan distribution partnerships. Employer-sponsored telehealth billing introduces a layered revenue model: per-member-per-month (PMPM) capitation paid by the employer or health plan for platform access, plus per-visit professional fees billed on CMS-1500 when the visit qualifies as a covered insurance claim. Managing dual revenue streams — capitated subscription revenue vs. fee-for-service claims — requires separate AR tracking systems and distinct revenue recognition accounting. Behavioral health telehealth billing added CPT code complexity: asynchronous store-and-forward psychiatric consultations (permitted in several states) use different codes (98969–98972) than synchronous video visits (90832–90838 therapy codes with -95 telehealth modifier). Credentialing across 50-state telehealth delivery added provider enrollment complexity — NPI credentialing with each state Medicaid program and commercial payer network required before billing could commence in a new state. Riverside Company built a centralized provider enrollment function and implemented a credentialing management system that tracked enrollment status by state and payer.


source_id: ext39_014
source: seed
deal_name: Biotelemetry (CardioNet) – Wind Point Partners Remote Patient Monitoring Platform
buyer: Wind Point Partners
seller: Management / Series C investors
payer_mix: {"medicare": 0.55, "medicaid": 0.08, "commercial": 0.34, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:34.861194+00:00
notes:
  Cardiac remote patient monitoring company providing mobile cardiac telemetry (MCT) and long-term cardiac monitoring services to cardiology practices and hospital systems for arrhythmia detection and monitoring. Cardiac RPM billing under Medicare uses event-monitor codes (CPT 93268, 93271 for patient-activated event monitoring, CPT 93243–93247 for wearable MCT with continuous analysis) billed by the monitoring center as the technical component, with the interpreting physician billing a separate professional component (CPT 93270–93272). The split-component billing model requires exact coordination between the device/monitoring company's claims and the ordering cardiologist's professional claims to prevent duplicate billing denials — a global billing arrangement where the monitoring company bills both components under a reassignment agreement must be properly structured. CMS's 2019 RPM coding expansion (CPT 99453, 99454, 99457, 99458 for general RPM device supply, setup, and monitoring management) created a new broader RPM billing pathway that required 16 days of data collection per 30-day period and interactive communication documentation. Wind Point Partners invested in automated billing trigger logic that tracked monitoring days and flagged accounts reaching the 16-day threshold for timely claim generation, maximizing monthly RPM billing completeness.


source_id: ext39_015
source: seed
deal_name: Vivify Health – Sterling Partners Remote Patient Monitoring Growth Investment
buyer: Sterling Partners
seller: Series C investors / management
payer_mix: {"medicare": 0.48, "medicaid": 0.12, "commercial": 0.36, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:34.873553+00:00
notes:
  Cloud-based remote patient monitoring and virtual care management platform delivering post-acute and chronic disease monitoring programs to health systems and physician practices. General RPM platform billing under the 2019 CMS expansion (CPT 99453–99458) introduced new compliance requirements that created significant RCM risk: CPT 99454 (device supply with daily recording, per 30-day period) requires the patient to transmit physiologic data on at least 16 of 30 days — if days of data transmission are not tracked per patient per month, the 99454 claim is unbillable for that period. Interactive communication (99457) requires a minimum of 20 minutes per calendar month of clinical staff time reviewing transmitted data and communicating with the patient — time documentation in the EHR must be specific and contemporaneous to withstand audit. The distinction between RPM (physiologic data collection by device — blood pressure, weight, glucose, SpO2) and chronic care management (CCM — care plan coordination, 99490–99491) is critical for avoiding improper bundling: CMS permits same-month billing of both RPM and CCM for the same patient if time and service requirements are met independently, but the time cannot be double-counted. Sterling Partners built a compliance-first RPM billing workflow that auto-calculated per-patient transmission days and provider interaction minutes monthly before generating claims, reducing audit exposure.


source_id: ext40_001
source: seed
deal_name: Nuance Communications CDI Division – Thoma Bravo Clinical Documentation Platform
buyer: Thoma Bravo
seller: Nuance Communications (NUAN) — strategic carve-out
payer_mix: {"medicare": 0.55, "medicaid": 0.18, "commercial": 0.24, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:34.880608+00:00
notes:
  CDI technology platform providing NLP-driven query workflows and real-time physician documentation prompts to acute-care hospitals. CDI is the upstream gatekeeper of inpatient DRG assignment: under MS-DRG logic, the principal diagnosis, secondary diagnoses (especially MCC/CC designators), and procedure codes determine which DRG a case lands in and its associated geometric mean length of stay. A single missed Major Complication or Comorbidity (MCC) — e.g., sepsis with organ dysfunction coded as simple sepsis, or malnutrition not queried and documented — can deflect a case from a high-weighted DRG to a substantially lower one, representing $3,000–$8,000 of lost net revenue per encounter at Medicare rates. The platform's AI query engine flagged incomplete documentation in real time against ICD-10-CM/PCS and CMS MCE edits, prompting physicians before discharge rather than retrospectively. Post-discharge retrospective coding audits have a 97-day timely-filing window for Medicare late claims; pre-discharge CDI eliminates that constraint entirely. Thoma Bravo invested in integrating the platform with Epic/Cerner APIs to surface queries directly in physician workflow, improving physician query response rates from 52% to 81% across the install base and driving a 4.6% CMI improvement on average — a direct EBITDA lever for hospital clients and a renewals/upsell driver for the platform's SaaS ARR.


source_id: ext40_002
source: seed
deal_name: MedQuist / Nuance HIM – Vista Equity Health Information Management LBO
buyer: Vista Equity Partners
seller: Founder / strategic investors
payer_mix: {"medicare": 0.48, "medicaid": 0.2, "commercial": 0.28, "self_pay": 0.04}
ingested_at: 2026-04-25T20:18:34.886768+00:00
notes:
  Technology-enabled HIM services company providing outsourced medical-record coding, transcription, and release-of-information (ROI) to acute-care systems. HIM is the production floor of hospital billing: IPPS claims cannot be dropped until coding is complete, making HIM throughput a direct driver of Discharged Not Final Billed (DNFB) days — a key liquidity metric for CFOs. Each day of DNFB at a 400-bed acute-care hospital represents approximately $1M of unrealized net revenue tied up in the unbilled queue. Under ICD-10-CM/PCS, coding complexity rose sharply versus ICD-9: a simple knee arthroscopy maps to one ICD-9 code but may require 7-character ICD-10-PCS specificity (body part, approach, device, qualifier). Vista Equity's operational playbook focused on coder productivity tooling, CAC (computer-assisted coding) implementation, and SLA contractualization around DNFB targets — improving coder throughput from 18 charts/day to 26 charts/day on average while reducing coding error rates (measured by downstream denial rates on technical DRG codes) from 3.1% to 1.4%. ROI workflow automation also reduced HIPAA-mandated 30-day response compliance costs by digitizing the request-track-fulfill pipeline.


source_id: ext40_003
source: seed
deal_name: Healthgrades Patient Engagement – Accel-KKR Digital Patient Platform Growth Equity
buyer: Accel-KKR
seller: CPP Investments / management
payer_mix: {"medicare": 0.3, "medicaid": 0.1, "commercial": 0.52, "self_pay": 0.08}
ingested_at: 2026-04-25T20:18:34.895871+00:00
notes:
  Consumer-facing provider-search and patient-engagement platform connecting patients to health systems and physician groups at the top of the care funnel. Patient engagement intersects RCM at three critical junctures: (1) scheduling accuracy — incorrect provider specialty or facility type selected at the point of online booking leads to in-network/out-of-network mismatches and downstream patient-balance disputes; (2) eligibility and benefits verification surfaced pre-visit through the scheduling API reduces front-end registration errors and co-pay collection friction; (3) post-visit satisfaction scores correlated with patient-pay collection rates — patients who rated their experience ≥4/5 paid outstanding balances within 30 days at 2.3× the rate of dissatisfied patients in payer studies. Accel-KKR's investment thesis centered on embedding eligibility APIs (Change Healthcare, Availity) directly into the booking flow so that payer/plan/deductible status was surfaced to staff before the encounter, reducing bad-debt write-offs on the provider side. A secondary RCM lever was the platform's price-transparency module, required under the CMS Hospital Price Transparency Rule (effective January 2021), which reduced surprise billing disputes by 38% at pilot health system clients.


source_id: ext40_004
source: seed
deal_name: Precyse / nThrive Revenue Integrity – Great Hill Partners Revenue Integrity Platform LBO
buyer: Great Hill Partners
seller: Founder / management team
payer_mix: {"medicare": 0.5, "medicaid": 0.22, "commercial": 0.25, "self_pay": 0.03}
ingested_at: 2026-04-25T20:18:34.902342+00:00
notes:
  Revenue integrity platform providing charge capture audits, charge description master (CDM) management, and clinical documentation–to–charge reconciliation for acute and ambulatory providers. Revenue integrity sits between clinical operations and billing: it ensures every procedure performed is documented, coded, and charged at the appropriate revenue code, CPT, and HCPCS level before the claim drops. The CDM is the hospital's master price list — an acute-care system may have 40,000–100,000 CDM line items, each with a revenue code, charge, and associated CPT/HCPCS. Stale or misaligned CDM entries cause systematic revenue leakage: a coronary stent implantation might carry revenue code 278 (medical/surgical supplies) but if the HCPCS for the specific device was not loaded correctly after a new contract, the claim will be denied on edit 4116 (invalid HCPCS for revenue code). The platform's automated charge-reconciliation engine compared OR preference cards, clinical nursing documentation, and implant logs to billed charges nightly, flagging underbilled or missed charges. For Great Hill Partners' health system clients averaging $800M net revenue, CDM and charge-capture remediation recovered a median 0.7% of net revenue — roughly $5.6M annually per client — with a 12-week payback period, supporting software contract renewal rates above 95%.


source_id: ext40_005
source: seed
deal_name: Connance / Waystar Denial Management – Summit Partners Denial Analytics SaaS LBO
buyer: Summit Partners
seller: Founder / Series B investors
payer_mix: {"medicare": 0.45, "medicaid": 0.2, "commercial": 0.3, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:34.909747+00:00
notes:
  Denial management SaaS platform using ML-driven predictive denial scoring and automated appeals workflow for acute-care hospital and physician group clients. The denial management market is structurally attractive because commercial payer denial rates have risen from ~5% in 2013 to ~10–12% by 2022 (per MGMA data), driven by prior authorization expansion, bundled payment edits, and medical necessity criteria tightening. Each denied claim costs a provider $25–$118 to appeal (Advisory Board estimates), and only ~60% of denials are appealed — leaving substantial revenue on the table. The platform's predictive model assigned a propensity-to-pay score to each denial on receipt, triaging clinical-documentation denials (higher overturn rate, ~70%) from timely-filing and duplicate-claim administrative denials (lower value to appeal). Automated Level-1 appeal letter generation for medical necessity denials, pre-populated with supporting clinical evidence pulled from the EHR via HL7 FHIR APIs, reduced appeal turnaround time from 14 days to 3 days and increased overturn rates from 52% to 74% across the client base. Summit Partners funded integrations with the top 15 commercial payer portals to enable electronic appeal submission, reducing paper appeal processing lag by an average 9 days.


source_id: ext40_006
source: seed
deal_name: Arcadian / Cotiviti Payer Analytics – Insight Partners Payer Data Analytics Growth Equity
buyer: Insight Partners
seller: Series C investors / management
payer_mix: {"medicare": 0.6, "medicaid": 0.25, "commercial": 0.14, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:34.916545+00:00
notes:
  Payer-side analytics platform providing CMS risk-adjustment accuracy, HEDIS quality measure tracking, and claims payment integrity solutions to MA plans, Medicaid MCOs, and commercial payers. Payer analytics is the mirror image of provider CDI: where CDI helps hospitals ensure their diagnoses are fully coded on the claim, payer analytics tools help health plans audit submitted risk-adjustment data for accuracy in both directions — catching unsupported HCC (Hierarchical Condition Category) submissions and identifying enrolled members whose documented conditions were not reflected in submitted diagnoses (potentially leaving capitation revenue unclaimed). Under ACA individual market risk adjustment (HHS-HCC model) and Medicare Advantage (CMS-HCC model V28), each incremental RAF (Risk Adjustment Factor) point on an MA member represents roughly $900–$1,100 in per-member-per-year capitation for the plan. The platform's retrospective chart review workflow and prospective risk-gap closure programs identified an average 0.08 RAF improvement per member across MA plan clients — a high-ROI compliance-and-revenue lever. Insight Partners funded a pivot toward prospective AI-assisted gap closure, reducing reliance on costly retrospective chart review and shortening the HCC submission cycle from annual to quarterly.


source_id: ext40_007
source: seed
deal_name: Option Care Health – Walgreens Boots Alliance Ambulatory Infusion Spin-Off / BioScrip Merger
buyer: Walgreens Boots Alliance / Madison Dearborn (recapitalization)
seller: Walgreens / public shareholders (BIOS)
payer_mix: {"medicare": 0.28, "medicaid": 0.14, "commercial": 0.52, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:34.923507+00:00
notes:
  The largest independent ambulatory infusion services provider in the US, formed by the merger of Option Care (Walgreens subsidiary) with BioScrip. Ambulatory infusion billing is among the most complex in outpatient pharmacy and ancillary services: every infusion encounter involves a drug claim (HCPCS J-code for the drug, often including waste calculation for partially-used vials), an administration claim (HCPCS 96365–96368 for intravenous push or infusion by duration), and a nursing visit component if provided in-home rather than in an infusion suite. Medicare Part B covers most outpatient infusion drugs at ASP+6% under the buy-and-bill model; specialty drugs like IVIG (J1572), biologics, and chemotherapy require HCPCS specificity at the NDC/lot level, and WAC vs. ASP reconciliation affects net reimbursement. Commercial insurers often reimburse at lower multiples (ASP+3% or AWP-based contract rates), and prior authorization is universally required for high-cost infusion therapies — PA denial rates on first submission average 18–22% for biologics. The combined entity invested in a centralized PA hub processing ~2,000 PA requests daily with real-time payer portal automation, reducing therapy start delays from 9.3 days to 4.1 days post-prescription — a direct revenue cycle acceleration lever given that each delayed start day defers a $1,200–$8,000 infusion encounter.


source_id: ext40_008
source: seed
deal_name: USAP / Envision Interventional Pain – Revelstoke Capital Pain Management Platform LBO
buyer: Revelstoke Capital Partners
seller: Founding physician group / regional investors
payer_mix: {"medicare": 0.38, "medicaid": 0.12, "commercial": 0.44, "self_pay": 0.06}
ingested_at: 2026-04-25T20:18:34.930202+00:00
notes:
  Multi-site interventional pain management group performing epidural steroid injections, spinal cord stimulation, radiofrequency ablation, and nerve block procedures across ASC and office-based settings. Pain management billing is highly sensitive to the site-of-service (POS) code and the professional vs. facility billing split: the same lumbar epidural steroid injection (CPT 62323) carries a Medicare payment of roughly $400 in an office setting (POS 11) but generates a separate facility fee of $650 at an ASC (POS 24), making procedure-to-POS accuracy a meaningful revenue lever. Spinal cord stimulator implant billing (CPT 63685, 63688) is particularly complex: the generator and lead components are separately billed on the facility claim as HCPCS device codes (L8685–L8688) under an ASC implant allowance, while the professional component bills the surgical CPT. CMS implemented imaging-guidance bundling rules under NCCI edits that prohibit separate billing of fluoroscopic guidance (77002) with many injection CPTs — a frequent source of commercial payer denials when coders historically unbundled. Revelstoke centralized billing for all acquired practices onto a single PM system with NCCI edit scrubbing, reducing technical denial rates on pain procedures from 8.4% to 2.1% and improving first-pass acceptance to 97.3%.


source_id: ext40_009
source: seed
deal_name: Surgical Management Professionals / Scottsdale Weight Loss – Primus Capital Bariatric Platform LBO
buyer: Primus Capital
seller: Founder / regional surgery group
payer_mix: {"medicare": 0.22, "medicaid": 0.08, "commercial": 0.55, "self_pay": 0.15}
ingested_at: 2026-04-25T20:18:34.938425+00:00
notes:
  Multi-site bariatric surgery platform performing laparoscopic gastric bypass (CPT 43644), sleeve gastrectomy (CPT 43775), and adjustable gastric banding across MBSAQIP-accredited hospital and ASC facilities. Bariatric surgery billing requires satisfying payer-specific medical necessity criteria before authorization — nearly all commercial payers require BMI ≥40 (or ≥35 with comorbidity), a minimum 6-month supervised diet program documentation, psychiatric clearance, and nutritional evaluation, each with payer-specific documentation templates. Failure to submit the complete prior auth package on first submission results in administrative denials with 30-day remedy windows that delay surgical scheduling by 3–6 weeks. The facility claim for bariatric procedures under Medicare uses MS-DRG 619–621 (laparoscopic gastric restriction) with a geometric mean length of stay of 1.6 days; co-morbidity capture (e.g., OSA coded G47.33, T2DM with CKD coded E11.65) can move the case from DRG 621 (no MCC/CC) to DRG 619 (with MCC), adding $3,800 in Medicare net revenue per case. Primus Capital implemented a dedicated bariatric authorization coordination team and CDI program focused on comorbidity capture at the time of the H&P, increasing CMI per bariatric encounter by 0.31 over 18 months.


source_id: ext40_010
source: seed
deal_name: CCRM / Shady Grove Fertility – Polaris Partners Fertility Clinic Platform LBO
buyer: Polaris Partners
seller: Founding physicians / management
payer_mix: {"medicare": 0.04, "medicaid": 0.03, "commercial": 0.58, "self_pay": 0.35}
ingested_at: 2026-04-25T20:18:34.944857+00:00
notes:
  Multi-site fertility clinic platform offering IVF, IUI, egg freezing, and preimplantation genetic testing (PGT) services. Fertility billing occupies a uniquely complex payer landscape: coverage mandates vary by state (18 states had coverage mandates as of 2018), with significant variation in covered cycles, lifetime maximums, and excluded diagnoses (e.g., 'elective' vs. medical necessity IVF). CPT coding for IVF cycles requires proper sequencing of retrieval (CPT 58970), culture (89250), transfer (58974), and cryopreservation (89258) codes, with embryo storage billed on recurring annual bases — a common source of charge-capture gaps when storage billing systems fall out of sync with the lab's embryo inventory. PGT-A (preimplantation genetic testing for aneuploidy) is billed under CPT 81267/81268 and is frequently denied as 'investigational' by commercial payers lacking explicit PGT coverage language, requiring case-by-case medical necessity appeals with literature citations. The high self-pay proportion (35%) elevates patient financial counseling importance: upfront package pricing for self-pay IVF cycles (typically $12,000–$18,000 per cycle inclusive of monitoring and retrieval) requires precise cost transparency to minimize post-service balance disputes. Polaris Partners invested in a fertility-specific RCM engine with mandate-verification logic by state and payer, reducing authorization denial rates from 14% to 5% on mandated-state claims.


source_id: ext40_011
source: seed
deal_name: InformedDNA / Genome Medical – Lead Edge Capital Genetic Counseling Telehealth Growth Equity
buyer: Lead Edge Capital
seller: Series C investors / management
payer_mix: {"medicare": 0.25, "medicaid": 0.15, "commercial": 0.55, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:34.952023+00:00
notes:
  Telehealth-delivered genetic counseling platform connecting patients to board-certified genetic counselors (CGCs) for hereditary cancer, cardiac, and prenatal genetic risk assessment. Genetic counseling billing operates under CPT 96040 (medical genetics counseling, ≤30 min) and 96040 × 2 for longer sessions — a flat per-session code without time-based tiering at the professional level. Medicare Part B covers genetic counseling under the Genetic Counselor Provider Status Act provisions, but benefit design varies significantly by Medicare Advantage plan. The primary billing complexity lies upstream: genetic testing orders generate laboratory claims under CPT Tier 1 Molecular Pathology codes (81161–81408) or Tier 2 (81400–81408), and clinical-utility documentation requirements vary by payer. Without pre-authorization and appropriate clinical indication documentation (e.g., BRCA1/2 testing requires personal/family history criteria per NCCN guidelines for commercial coverage), the downstream lab claim is denied and the referring counseling visit faces retro-denial as 'not medically necessary.' Lead Edge Capital's thesis centered on the platform's ability to embed genetic counseling into payer care-management workflows (MA plans, integrated delivery systems) under PMPM capitation arrangements, reducing fee-for-service billing complexity and improving revenue predictability.


source_id: ext40_012
source: seed
deal_name: PharMerica / BrightSpring LTC Pharmacy – Luminate Capital Long-Term Care Pharmacy LBO
buyer: Luminate Capital Partners
seller: KKR / management recapitalization
payer_mix: {"medicare": 0.62, "medicaid": 0.28, "commercial": 0.08, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:34.959251+00:00
notes:
  Long-term care (LTC) pharmacy providing unit-dose drug dispensing, consultant pharmacy services, and medication management to SNFs, ALFs, and ICF/IID facilities. LTC pharmacy billing is governed primarily by Medicare Part D (for dual-eligible and Medicare-only residents) and Medicaid (state-specific fee schedules for Medicaid-only residents). Under Part D, LTC pharmacies bill Prescription Drug Plans (PDPs) under the special LTC dispensing rules: all LTC prescriptions are 'emergency' or 'non-emergency' status (no DAW codes apply), and unit-dose blister-pack dispensing generates dispensing fee structures negotiated at the network level rather than standard retail rates. The CMS LTC Part D transition rules require pharmacies to dispense a temporary supply (3-day emergency supply) when a new resident's formulary status cannot be immediately verified — a critical process control given that ~40% of new SNF admissions arrive with non-formulary medications requiring prior auth or formulary exception within 72 hours. Medicaid State Plan drug billing uses NCPDP SCRIPT standards with state-specific MAR (Medication Administration Record) attestation requirements. Luminate Capital invested in automated formulary verification and transition-of-care reconciliation workflows integrated with the facility's EHR/MAR system, reducing Part D claim rejection rates from 7.2% to 2.8% and accelerating CMP (Comprehensive Medication Profile) completion from 96 hours to 18 hours post-admission.


source_id: ext40_013
source: seed
deal_name: Omnicell / Pyxis Dispensing Solutions – Marlin Equity Medication Dispensing SaaS LBO
buyer: Marlin Equity Partners
seller: Strategic / founder-led carve-out
payer_mix: {"medicare": 0.4, "medicaid": 0.22, "commercial": 0.33, "self_pay": 0.05}
ingested_at: 2026-04-25T20:18:34.965619+00:00
notes:
  Automated dispensing cabinet (ADC) software and analytics platform for hospital and health system pharmacy operations. While ADC hardware is capital equipment, the billing/RCM intersection arises from medication charge capture: each drug dispensed from an ADC must trigger a corresponding pharmacy charge in the hospital billing system. ADC software integration with the hospital charge description master (CDM) and BCMA (barcode medication administration) workflows determines whether administered drugs generate billable pharmacy charges or silently fall through as uncaptured cost. High-cost drugs — biologics, IVIG, chemotherapy — often carry NDC-level billing requirements under Medicare Part B (ASP-based reimbursement requires the specific NDC submitted on the claim), and ADC dispense records that lack NDC tracking create claim denials on edit B55 (NDC required). The platform's charge-capture reconciliation module compared ADC dispense events to charge router postings nightly, identifying charge gaps with a mean recovery of 0.4% of pharmacy net revenue per client — meaningful at large academic medical centers with $150M+ pharmacy budgets. Marlin Equity funded integration of 340B program tracking into the ADC analytics layer, enabling covered entities to demonstrate split-billing compliance (tracking 340B-eligible vs. non-eligible patient encounters at the point of dispense), a regulatory audit-protection capability commanding a 20% premium in contract renewals.


source_id: ext40_014
source: seed
deal_name: Piper Sandler Healthcare IT – Health Enterprise Partners Revenue Integrity SaaS Growth Equity
buyer: Health Enterprise Partners
seller: Founder / seed investors
payer_mix: {"medicare": 0.52, "medicaid": 0.2, "commercial": 0.26, "self_pay": 0.02}
ingested_at: 2026-04-25T20:18:34.971747+00:00
notes:
  Early-stage revenue integrity SaaS company providing automated charge-reconciliation, charge-entry quality monitoring, and coder productivity analytics for community hospitals and regional health systems. Revenue integrity platforms in the community hospital segment address a specific gap: whereas large academic medical centers typically have dedicated revenue integrity departments with 10–20 FTEs, community hospitals (150–350 beds) often rely on HIM directors managing coding and charge-capture with 3–5 staff, with limited capacity for systematic charge reconciliation. The platform's automated reconciliation logic compared OR case logs, PACU nursing notes, and anesthesia records to billed CPT codes, flagging unbilled secondary procedures (e.g., a laparoscopic cholecystectomy billed without the intraoperative cholangiography code 74300) and missing modifier applications (e.g., modifier -22 for unusually complex procedures with documented physician attestation). Under CMS's Hospital Outpatient Prospective Payment System (OPPS), correct APC (Ambulatory Payment Classification) assignment depends on procedure packaging rules — certain significant procedure APCs package ancillary services, requiring coders to understand which separately-reported CPTs will be packaged vs. paid separately. Health Enterprise Partners' investment supported product expansion into OPPS packaging analytics, a capability that differentiated the platform from generic charge-capture tools in competitive procurement.


source_id: ext40_015
source: seed
deal_name: Clinipace / TriZetto Payer Analytics – Clearlake Capital Payer Technology Platform LBO
buyer: Clearlake Capital Group
seller: Cognizant (strategic carve-out of TriZetto payer analytics unit)
payer_mix: {"medicare": 0.58, "medicaid": 0.3, "commercial": 0.11, "self_pay": 0.01}
ingested_at: 2026-04-25T20:18:34.983562+00:00
notes:
  Payer-side technology platform providing core administrative processing, claims payment integrity, and analytics for Blue Cross Blue Shield plans, regional Medicaid MCOs, and Medicare Advantage organizations. Payer claims payment integrity is the counterpart to provider denial management: the payer uses edit engines (COB coordination of benefits, NCCI-equivalent bundling edits, DRG audit logic) to prevent overpayment before the remit advice is generated. On the MA/Medicaid side, risk-adjustment analytics intersect with payment: CMS's RADV (Risk Adjustment Data Validation) audit program audits a sample of MA plan HCC submissions annually and extrapolates overpayment findings to the full population — a plan with a poor HCC documentation rate faces extrapolated repayment demands that can reach $50M–$200M for large plans. The platform's prospective HCC integrity module flagged HCC submissions lacking supporting clinical documentation before the annual sweep submission to CMS, reducing RADV audit exposure. On the Medicaid side, state DSH (Disproportionate Share Hospital) payment calculations require MCOs to track and report uncompensated care costs per provider — the platform's analytics engine automated DSH reconciliation reporting, a manually-intensive process previously requiring 2–3 FTE actuarial analysts per plan annually. Clearlake Capital's operational thesis focused on transitioning the platform from perpetual license to SaaS ARR — a model shift that doubled NRR from 88% to 107% over the hold period.


source_id: ext41_001
source: seed
deal_name: Neonatal Care Partners
buyer: Varsity Healthcare Partners
payer_mix: {"commercial": 0.12, "medicare": 0.48, "medicaid": 0.3, "other": 0.1}
ingested_at: 2026-04-25T20:18:34.991389+00:00
notes:
  NICU hospitalist groups face complex RCM due to overlapping physician and facility billing, critical-care time-based CPT codes (99291/99292), and high Medicaid exposure requiring state-by-state prior authorization workflows. Coordination between neonatology professional billing and hospital facility claims creates frequent claim splitting errors and denial rates above 18%.


source_id: ext41_002
source: seed
deal_name: Summit Pediatric Specialists
buyer: New MainStream Capital
payer_mix: {"commercial": 0.52, "medicare": 0.25, "medicaid": 0.18, "other": 0.05}
ingested_at: 2026-04-25T20:18:34.997505+00:00
notes:
  Pediatric cardiology and neurology practices contend with high-value diagnostic procedure billing (echocardiography, EEG/EMG, cardiac catheterization) that demands meticulous modifier usage and bundling analysis under CCI edits. CHIP and Medicaid managed-care contracts frequently reimburse at rates 20–35% below commercial benchmarks, compressing margins on the highest-complexity cases.


source_id: ext41_003
source: seed
deal_name: Meridian Academic Practice Solutions
buyer: Waud Capital Partners
payer_mix: {"commercial": 0.45, "medicare": 0.28, "medicaid": 0.2, "other": 0.07}
ingested_at: 2026-04-25T20:18:35.007584+00:00
notes:
  Academic faculty practice plans must comply with teaching physician attestation rules (Medicare requires the attending to document a substantive participation note or co-sign the resident note), and billing errors here trigger 100% recoupment exposure across all claims in a look-back audit. Split/shared visit rules updated under 2023 E&M revisions add further documentation complexity when residents and attendings jointly provide services.


source_id: ext41_004
source: seed
deal_name: Homestead Acute Care Networks
buyer: General Atlantic
payer_mix: {"commercial": 0.38, "medicare": 0.42, "medicaid": 0.15, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.013971+00:00
notes:
  Hospital-at-home programs bill under an acute inpatient DRG waiver authorized by CMS Acute Hospital Care at Home, creating a novel RCM pathway with limited payer precedent and inconsistent commercial insurer coverage policies. Daily remote monitoring requirements must be separately documented and billed through RPM codes to avoid claim bundling conflicts with the facility DRG.


source_id: ext41_005
source: seed
deal_name: ConnectedCare RPM Solutions
buyer: Insight Partners
payer_mix: {"commercial": 0.3, "medicare": 0.5, "medicaid": 0.12, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.021519+00:00
notes:
  RPM platforms bill CPT 99453/99454 for device setup and daily data transmission, 99457/99458 for monthly interactive communication time, and 99490/99491 for CCM — each requiring strict monthly time documentation and qualified clinical staff attestation to avoid retroactive denials. Medicare's 20-minute monthly minimum for CCM billing and its prohibition on billing RPM and CCM for the same service period in the same month require sophisticated claim-logic engines to prevent inadvertent overlap.


source_id: ext41_006
source: seed
deal_name: Apex Nutrition Therapy Group
buyer: Revelstoke Capital Partners
payer_mix: {"commercial": 0.55, "medicare": 0.22, "medicaid": 0.18, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.028752+00:00
notes:
  Medical nutrition therapy (MNT) is covered by Medicare Part B exclusively for diabetes and renal disease under CPT 97802-97804, and coverage extensions for obesity or eating disorders require non-Medicare payer-specific authorizations that vary widely by plan. Registered dietitian credentialing and supervision requirements under state licensure laws affect incident-to billing eligibility, creating compliance risk when MNT services are billed under a supervising physician's NPI.


source_id: ext41_007
source: seed
deal_name: Oxygenics Wound & Hyperbaric Centers
buyer: CRG (Capital Royalty Group)
payer_mix: {"commercial": 0.35, "medicare": 0.4, "medicaid": 0.2, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.034988+00:00
notes:
  Hyperbaric oxygen therapy (HBOT) billing under CPT 99183 requires a physician to be present during the entire session, and documentation must support one of the 14 CMS-approved indications (e.g., chronic diabetic lower-extremity wound, osteomyelitis) to avoid medical necessity denials. Wound care facility billing often pairs HBOT with debridement codes, requiring careful CCI edit review to avoid automatic bundling reductions.


source_id: ext41_008
source: seed
deal_name: Vantage Interventional Vascular Partners
buyer: KSL Capital Partners
payer_mix: {"commercial": 0.48, "medicare": 0.32, "medicaid": 0.14, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.041841+00:00
notes:
  Interventional radiology practices must navigate the global surgery package rules, which bundle pre- and post-procedure E&M services into the procedure fee for 10- and 90-day global periods, and the professional/technical component billing split when radiologists own equipment or bill in a hospital outpatient department where the facility captures the technical component. Prior authorization requirements for peripheral vascular interventions exceed 60% of commercial plans, generating substantial administrative overhead.


source_id: ext41_009
source: seed
deal_name: ClearMargin Dermatology Group
buyer: Audax Private Equity
payer_mix: {"commercial": 0.62, "medicare": 0.28, "medicaid": 0.06, "other": 0.04}
ingested_at: 2026-04-25T20:18:35.050010+00:00
notes:
  Mohs micrographic surgery billing under CPT 17311-17315 is stage-based, with each additional stage billed incrementally — documentation of en face tissue mapping, frozen section reads, and wound closure decisions must be captured contemporaneously to substantiate multi-stage claims under payer audit scrutiny. Repair codes (intermediate/complex closure) are frequently downcoded by commercial payers unless operative notes explicitly describe layer-by-layer tissue handling rather than a summary reconstruction description.


source_id: ext41_010
source: seed
deal_name: Keystone Surgical Center Management
buyer: Ares Management
payer_mix: {"commercial": 0.58, "medicare": 0.3, "medicaid": 0.08, "other": 0.04}
ingested_at: 2026-04-25T20:18:35.056765+00:00
notes:
  ASC billing operates under a distinct CMS-published ASC payment system with its own fee schedule (not OPPS) and a separate list of covered procedures; services not on the ASC-covered list are denied outright regardless of medical necessity, requiring pre-procedure coverage verification against both the CMS list and payer-specific ASC coverage policies. Implant cost pass-through, surgeon preference card drift, and payer-specific implant carve-out policies create significant revenue leakage when implant invoices are not reconciled to billed charges at the claim level.


source_id: ext41_011
source: seed
deal_name: RetinaClear Eye Associates
buyer: FFL Partners
payer_mix: {"commercial": 0.4, "medicare": 0.45, "medicaid": 0.1, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.063620+00:00
notes:
  Retina practices are heavy utilizers of high-cost anti-VEGF injections (bevacizumab, ranibizumab, aflibercept) billed under the buy-and-bill model at ASP+6%, where Medicare reimbursement may fall below acquisition cost during quarterly ASP lag periods, compressing drug margin. OCT imaging (CPT 92134) and fluorescein angiography billing require strict same-day bundling analysis, as commercial payers frequently apply CCI edits that deny the diagnostic imaging when billed on the same date as an injection.


source_id: ext41_012
source: seed
deal_name: SoundPath Audiology Partners
buyer: Gryphon Investors
payer_mix: {"commercial": 0.35, "medicare": 0.38, "medicaid": 0.12, "other": 0.15}
ingested_at: 2026-04-25T20:18:35.074110+00:00
notes:
  Audiology practices face a fundamental RCM bifurcation: diagnostic audiology services (CPT 92550-92599) are covered by Medicare Part B, while hearing aid dispensing is a Medicare exclusion requiring either cash-pay or supplemental insurance billing, creating a dual-track revenue cycle with different documentation, billing, and collection workflows. Audiologist versus physician supervision requirements under incident-to rules determine whether services can be billed under a physician NPI, affecting reimbursement rates by as much as 15% across commercial contracts.


source_id: ext41_013
source: seed
deal_name: MotionPath Rehabilitation Specialists
buyer: Shore Capital Partners
payer_mix: {"commercial": 0.42, "medicare": 0.35, "medicaid": 0.18, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.080561+00:00
notes:
  PM&R physiatry practices blend E&M visits with high-volume procedure billing (EMG/NCS, fluoroscopic joint injections, spasticity management) requiring modifier 26 professional component billing when procedures are performed in hospital or ASC facilities where the technical component is separately captured. Medicare therapy cap exceptions for physiatry-directed functional restoration programs require contemporaneous functional limitation reporting under the Claims-Based Reporting requirement, adding documentation burden per encounter.


source_id: ext41_014
source: seed
deal_name: ClearAir Pulmonary & Sleep Centers
buyer: Linden Capital Partners
payer_mix: {"commercial": 0.44, "medicare": 0.36, "medicaid": 0.15, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.087816+00:00
notes:
  Sleep medicine billing for polysomnography (CPT 95808-95811) and CPAP titration studies requires documentation of a physician review and interpretation separate from the technologist's scoring, and commercial payers routinely require home sleep apnea testing (HSAT, CPT 95800-95801) as a step-therapy prerequisite before approving in-laboratory polysomnography. CPAP supply billing (HCPCS E0601 plus resupply codes) involves a 90-day compliance verification requirement under Medicare where device therapy logs must confirm at least 4 hours of nightly use on 70% of nights before ongoing supply reimbursement is authorized.


source_id: ext41_015
source: seed
deal_name: Clearwater Nephrology Associates
buyer: Berkshire Partners
payer_mix: {"commercial": 0.28, "medicare": 0.5, "medicaid": 0.17, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.095951+00:00
notes:
  Nephrology practices managing CKD stages 3-5 and transplant care must navigate the ESRD Monthly Capitation Payment (MCP) transition when patients reach dialysis initiation, which shifts all nephrology professional services into a bundled per-patient-per-month payment that dramatically changes revenue-cycle dynamics compared to fee-for-service CKD management. Kidney transplant follow-up billing involves complex coordination between the transplant center global package period and community nephrology follow-up visits, with CMS limiting separately billable nephrology E&M services during the 90-day post-transplant global period unless specific modifier conditions are met.


source_id: ext42_001
source: seed
deal_name: SkyReach Air Medical Group
buyer: KKR
payer_mix: {"commercial": 0.32, "medicare": 0.34, "medicaid": 0.22, "other": 0.12}
ingested_at: 2026-04-25T20:18:35.102956+00:00
notes:
  Air ambulance billing under HCPCS A0430–A0436 requires documentation of medical necessity for air versus ground transport, and the No Surprises Act now limits balance billing for air ambulance services, compressing net collection rates on commercially insured patients who were previously billed at billed charges. Medicaid rates in many states cover only a fraction of the cost-per-transport, and some states exclude air ambulance from their managed-care benefit, requiring separate fee-for-service billing at deeply discounted state-set rates.


source_id: ext42_002
source: seed
deal_name: Apex Trauma Surgical Partners
buyer: Warburg Pincus
payer_mix: {"commercial": 0.38, "medicare": 0.28, "medicaid": 0.26, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.109985+00:00
notes:
  Trauma surgery practices carry high uncompensated-care exposure because the emergency nature of care precludes prior authorization, and uninsured patients must be stabilized under EMTALA regardless of coverage status. Critical care time billing (CPT 99291/99292) alongside trauma activation fees and operating room facility charges requires meticulous charge-capture workflows to avoid duplicate billing denials when the same encounter is billed across multiple claim types by different provider groups.


source_id: ext42_003
source: seed
deal_name: Meridian Blood Management Solutions
buyer: Linden Capital Partners
payer_mix: {"commercial": 0.44, "medicare": 0.36, "medicaid": 0.14, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.120232+00:00
notes:
  Blood product billing involves both the professional interpretation component and the facility charge for blood units, with payers applying HCPCS P9010–P9099 product codes alongside the clinical service CPT code — unbundling rules vary by payer and can result in denial of the professional component when bundled with the inpatient DRG. Intraoperative blood salvage (CPT 86890–86891) and cell-saver services require documentation that the service was medically necessary and operationally distinct from standard anesthesia monitoring to avoid routine denial by cost-averse payers.


source_id: ext42_004
source: seed
deal_name: ClearScript Pharmacy Management Group
buyer: Ares Management
payer_mix: {"commercial": 0.46, "medicare": 0.35, "medicaid": 0.13, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.127895+00:00
notes:
  Hospital pharmacy management organizations must navigate the 340B drug pricing program compliance requirements alongside commercial payer 340B rebate clawback policies, with some payers reducing reimbursement to acquisition cost when 340B procurement is identified, significantly compressing drug margin per administration. Specialty drug prior authorization workflows for oncology and immunology agents require dedicated pharmacist-led PA teams, and failure to obtain authorization before dispensing results in zero-pay denials that are rarely successfully appealed retroactively.


source_id: ext42_005
source: seed
deal_name: NutriPath Clinical Services
buyer: Revelstoke Capital Partners
payer_mix: {"commercial": 0.5, "medicare": 0.28, "medicaid": 0.17, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.139883+00:00
notes:
  Clinical nutrition services provided by hospital-based dietitians are often bundled into the facility per-diem rate under inpatient DRGs and cannot be separately billed, limiting revenue-cycle opportunities to outpatient and home-based enteral/parenteral nutrition programs. Home parenteral nutrition billing requires monthly supplier authorization under HCPCS B4164–B5200 codes with clinical documentation of enteral feeding failure, and Medicare's competitive bidding program for enteral nutrition supplies has compressed reimbursement rates by 30–45% in bid areas.


source_id: ext42_006
source: seed
deal_name: PureDose Sterile Compounding Partners
buyer: Shore Capital Partners
payer_mix: {"commercial": 0.55, "medicare": 0.25, "medicaid": 0.12, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.147322+00:00
notes:
  Sterile compounding pharmacies bill compounded preparations under miscellaneous drug HCPCS codes (J3490, J3590, J9999) because FDA-approved NDC codes are not assigned to compounded formulations, requiring individualized payer review and frequent medical necessity substantiation that dramatically slows payment cycles. Post-DQSA compliance costs and state board 503B outsourcing facility registration fees are recurring overhead items not captured in early-stage EBITDA, creating underwriting risk when acquirers compare compounders against standard specialty pharmacy benchmarks.


source_id: ext42_007
source: seed
deal_name: Radiance Molecular Imaging Centers
buyer: Blackstone
payer_mix: {"commercial": 0.42, "medicare": 0.4, "medicaid": 0.12, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.155340+00:00
notes:
  Nuclear medicine and PET imaging practices must separately bill the radiopharmaceutical agent (HCPCS A9500 series for diagnostic, Q-codes for therapeutic) and the professional interpretation (CPT 78300–78999), while site-of-service differentials heavily favor hospital outpatient placement over freestanding imaging centers for Medicare reimbursement of technical components. Novel diagnostic radiopharmaceuticals such as amyloid and tau PET tracers required years of CMS coverage determination negotiations, and commercial payer policies lag CMS by 12–24 months, leaving a substantial revenue gap during the coverage-ramp period after FDA approval.


source_id: ext42_008
source: seed
deal_name: GeneAxis Rare Disease Centers
buyer: General Atlantic
payer_mix: {"commercial": 0.58, "medicare": 0.18, "medicaid": 0.19, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.162334+00:00
notes:
  Medical genetics practices bill germline and somatic genomic testing under Tier 1 (CPT 81200 series) and Tier 2 (81400–81479) molecular pathology codes, with multi-gene panel tests requiring payer-specific prior authorization and laboratory benefit manager review that can delay test ordering by 7–21 days and result in retroactive denial if genetic counselor documentation is deficient. Enzyme replacement therapy (ERT) and gene therapy authorization for rare metabolic disorders involves multi-step payer review with list prices exceeding $1M per patient annually, creating catastrophic claims exposure and requiring dedicated high-cost case management integrated into the RCM workflow.


source_id: ext42_009
source: seed
deal_name: Forma Craniofacial & Plastic Surgery Group
buyer: Gryphon Investors
payer_mix: {"commercial": 0.65, "medicare": 0.15, "medicaid": 0.14, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.168947+00:00
notes:
  Craniofacial and plastic surgery groups must carefully distinguish reconstructive from cosmetic procedures at the claim level, as cosmetic services are categorically excluded from Medicare and most commercial plans, and mislabeling a cosmetic procedure as reconstructive under CPT codes 21172–21194 exposes the practice to False Claims Act liability on the government-payer portion of the book. Cleft lip/palate repair sequencing billing (primary CPT 40700, secondary revisions 42280–42281) involves multi-year treatment plans crossing multiple policy years where benefit limitations and deductible resets create recurring prior-authorization requirements and collection challenges between procedure stages.


source_id: ext42_010
source: seed
deal_name: Pinnacle Microsurgery Reconstructive Center
buyer: Waud Capital Partners
payer_mix: {"commercial": 0.6, "medicare": 0.22, "medicaid": 0.12, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.175865+00:00
notes:
  Free-flap and pedicle-flap reconstructive microsurgery billing involves multiple high-complexity CPT codes (19364–19369 for breast reconstruction, 15756–15758 for free-flap transfers) that require co-surgeon or assistant surgeon modifiers 62 and 80 when operating teams exceed a single surgeon, and commercial payers frequently dispute the medical necessity of the assistant surgeon component for elective reconstruction cases. DIEP flap breast reconstruction (CPT 19364) generates among the highest-value single-claim microsurgery encounters, but multi-day ICU monitoring post-flap creates complex hospital-professional billing coordination with daily critical care codes that must not duplicate facility charges already in the DRG.


source_id: ext42_011
source: seed
deal_name: Compass Pain Psychology Group
buyer: New MainStream Capital
payer_mix: {"commercial": 0.52, "medicare": 0.26, "medicaid": 0.17, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.183071+00:00
notes:
  Pain psychology practices billing under CPT 90832–90838 for psychotherapy and 96150–96155 for health behavior assessment face parity compliance scrutiny, as commercial payers sometimes apply more restrictive medical management review to behavioral pain services than to equivalent-cost procedural pain interventions in violation of the Mental Health Parity and Addiction Equity Act. Interdisciplinary pain program (IPP) billing under CPT 0871T–0876T requires CMS coverage determinations that vary by MAC jurisdiction, and many commercial plans have no established benefit for structured interdisciplinary pain rehabilitation, requiring case-by-case single-case agreement negotiations.


source_id: ext42_012
source: seed
deal_name: FlowPath Lymphedema Therapy Partners
buyer: Varsity Healthcare Partners
payer_mix: {"commercial": 0.48, "medicare": 0.32, "medicaid": 0.15, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.189197+00:00
notes:
  Lymphedema therapy billing for complete decongestive therapy (CDT) uses CPT 97016 (vasopneumatic device therapy) and 97140 (manual therapy) alongside compression garment HCPCS codes, but Medicare historically did not cover compression garments as durable medical equipment until the Lymphedema Treatment Act compliance period created a new benefit effective January 2024, leaving a multi-decade coverage gap that suppressed patient compliance rates and revenue capture. Therapist credential verification (CLT or CLT-LANA certification) is required by many commercial plans before claims are adjudicated, and credentialing delays of 60–90 days for new therapists create revenue gaps during onboarding that disproportionately affect high-growth practices.


source_id: ext42_013
source: seed
deal_name: MobileWound Home Care Specialists
buyer: Audax Private Equity
payer_mix: {"commercial": 0.3, "medicare": 0.48, "medicaid": 0.18, "other": 0.04}
ingested_at: 2026-04-25T20:18:35.196273+00:00
notes:
  Mobile wound care practices billing under the Medicare home health benefit must ensure a qualifying face-to-face encounter (CPT G0179/G0180) is documented by the certifying physician within the required timely window, and missing or late F2F documentation is the single leading cause of home health claim recoupment under post-payment review. Wound debridement coding (CPT 97597–97602) requires precise measurement of wound surface area at each visit and documentation of wound type and depth, as payers apply automated edits that deny re-billing of the same wound area at the same depth classification within a 30-day window without supporting clinical narrative of deterioration.


source_id: ext42_014
source: seed
deal_name: ContinuCare Ostomy & Continence Services
buyer: FFL Partners
payer_mix: {"commercial": 0.35, "medicare": 0.45, "medicaid": 0.16, "other": 0.04}
ingested_at: 2026-04-25T20:18:35.202243+00:00
notes:
  Ostomy supply billing under HCPCS A4361–A4435 and A5051–A5093 is subject to Medicare's competitive bidding program in bid areas, where contract suppliers must win a competitive bid to serve Medicare beneficiaries, effectively barring non-bid suppliers from Medicare revenue in those markets. Continence care supplies (A4335 for incontinence pads, A4338 for urinary catheters) require certificate of medical necessity (CMN) documentation signed by the treating physician, and monthly quantity limits enforced by payers require supply utilization tracking systems that add RCM technology overhead absent from traditional home medical equipment billing platforms.


source_id: ext42_015
source: seed
deal_name: Vantage Sickle Cell & Hemoglobinopathy Centers
buyer: Berkshire Partners
payer_mix: {"commercial": 0.28, "medicare": 0.22, "medicaid": 0.44, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.208962+00:00
notes:
  Sickle cell disease centers carry the highest Medicaid concentration of any PE-backed specialty platform, reflecting the demographic prevalence of SCD, and Medicaid managed-care contracts in high-SCD-burden states often require care management fees to be billed through complex value-based arrangement structures rather than straightforward fee-for-service CPT codes, creating a revenue-cycle dependency on contract-specific reporting and attestation. Gene therapy authorization for SCD (Casgevy, Lyfgenia) involves catastrophic claim values exceeding $2M per patient with payer-specific installment payment arrangements and outcomes-based rebate structures that require RCM teams to track multi-year performance milestones to trigger full payment.


source_id: ext43_001
source: seed
deal_name: NovaStar Neonatal Transport Systems
buyer: Varsity Healthcare Partners
payer_mix: {"commercial": 0.42, "medicare": 0.18, "medicaid": 0.35, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.215776+00:00
notes:
  Neonatal ground and air transport generates highly variable claim complexity due to per-mile billing, multiple simultaneous CPT codes, and frequent medicaid retroactive eligibility changes for premature newborns.


source_id: ext43_002
source: seed
deal_name: BrightPath Pediatric Rehab Group
buyer: Revelstoke Capital Partners
payer_mix: {"commercial": 0.38, "medicare": 0.04, "medicaid": 0.52, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.224191+00:00
notes:
  Pediatric therapy billing spans PT, OT, and SLP codes with school-based Medicaid carve-outs requiring separate credentialing and encounter tracking; prior-authorization denial rates are elevated versus adult rehab settings.


source_id: ext43_003
source: seed
deal_name: DayBridge Adult Health Services
buyer: Sterling Partners
payer_mix: {"commercial": 0.08, "medicare": 0.22, "medicaid": 0.63, "other": 0.07}
ingested_at: 2026-04-25T20:18:35.230734+00:00
notes:
  Adult day health centers face complex Medicaid managed-care encounter reconciliation across multiple state waiver programs, with per-diem rates that vary significantly by county and level-of-care classification.


source_id: ext43_004
source: seed
deal_name: HarborView Senior Living & Care Communities
buyer: Warburg Pincus
payer_mix: {"commercial": 0.3, "medicare": 0.38, "medicaid": 0.24, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.237736+00:00
notes:
  CCRCs with embedded skilled nursing face simultaneous RCM workflows for private-pay continuing care contracts, Medicare Part A SNF claims, and Medicaid nursing facility rates, each governed by distinct documentation and level-of-care assessment requirements.


source_id: ext43_005
source: seed
deal_name: InfusCare Home Therapy Partners
buyer: New Mountain Capital
payer_mix: {"commercial": 0.55, "medicare": 0.28, "medicaid": 0.12, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.244260+00:00
notes:
  Home infusion billing requires coordination of pharmacy drug claims under Part D and professional/supply claims under Part B, with payer-specific prior-auth and delivery-confirmation documentation driving high denial rates for specialty biologics.


source_id: ext43_006
source: seed
deal_name: CardioStep Outpatient Cardiac Rehab Centers
buyer: Riverside Company
payer_mix: {"commercial": 0.34, "medicare": 0.5, "medicaid": 0.1, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.251019+00:00
notes:
  Outpatient cardiac rehab is reimbursed under a session-based Medicare benefit with strict 36-session lifetime caps and mandatory physician-referral documentation; any eligibility gap in the qualifying cardiac event triggers full claim recoupment.


source_id: ext43_007
source: seed
deal_name: PrecisionBeam Radiation Therapy Management
buyer: Ridgemont Equity Partners
payer_mix: {"commercial": 0.46, "medicare": 0.4, "medicaid": 0.09, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.258008+00:00
notes:
  Radiation therapy management companies must navigate the technical/professional component split billing under HOPD and freestanding rules, with IMRT and SBRT coding subject to ongoing CMS revaluation that creates revenue-per-fraction volatility across contract years.


source_id: ext43_008
source: seed
deal_name: RenalChoice ESRD Alternative Care Network
buyer: Welsh Carson Anderson & Stowe
payer_mix: {"commercial": 0.25, "medicare": 0.58, "medicaid": 0.12, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.265508+00:00
notes:
  ESRD non-dialysis care models participate in the Kidney Care Choices demonstration, requiring sophisticated attribution and reconciliation logic under total cost-of-care benchmarks that interact with Part D and transplant episode-of-care payments.


source_id: ext43_009
source: seed
deal_name: UroCentric Men's Health Partners
buyer: Audax Private Equity
payer_mix: {"commercial": 0.52, "medicare": 0.36, "medicaid": 0.07, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.272427+00:00
notes:
  Urology practices bill an unusually broad mix of E&M, surgical, diagnostic imaging, and in-office pathology codes, with in-office ancillary service designation critical to revenue integrity but subject to ongoing payor scrutiny and self-referral compliance risk.


source_id: ext43_010
source: seed
deal_name: PelvicAxis Female Pelvic Medicine Group
buyer: Shore Capital Partners
payer_mix: {"commercial": 0.58, "medicare": 0.28, "medicaid": 0.09, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.279082+00:00
notes:
  Female pelvic medicine billing spans OBGYN and urology specialty codes, with mesh-revision and neuromodulation procedures frequently subject to commercial prior-auth requirements and ICD-10 specificity standards that differ materially between surgical and conservative-management encounters.


source_id: ext43_011
source: seed
deal_name: WholeCare Integrative Oncology Centers
buyer: Frazier Healthcare Partners
payer_mix: {"commercial": 0.62, "medicare": 0.22, "medicaid": 0.06, "other": 0.1}
ingested_at: 2026-04-25T20:18:35.285262+00:00
notes:
  Integrative oncology programs mix covered services such as acupuncture and palliative counseling with non-covered wellness offerings, requiring careful unbundling and patient-responsibility documentation to avoid inadvertent balance-billing violations under commercial contracts.


source_id: ext43_012
source: seed
deal_name: MaxiloSurgical Oral & Facial Partners
buyer: Harvest Partners
payer_mix: {"commercial": 0.6, "medicare": 0.14, "medicaid": 0.18, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.292086+00:00
notes:
  OMS practices must coordinate between medical and dental insurance for procedures such as jaw reconstruction and implant-related bone grafting, with dual-benefit coordination rules frequently leading to underpayment when medical necessity documentation is not cross-submitted to both payers.


source_id: ext43_013
source: seed
deal_name: StepForward Podiatry & Foot Surgery Group
buyer: Blue Sea Capital
payer_mix: {"commercial": 0.45, "medicare": 0.38, "medicaid": 0.12, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.298559+00:00
notes:
  Podiatry RCM is complicated by Medicare's routine-foot-care exclusions, which require documented systemic conditions such as peripheral neuropathy or vascular disease on every claim to avoid automatic denial of nail and callus debridement services.


source_id: ext43_014
source: seed
deal_name: NervePoint Hand & Peripheral Nerve Specialists
buyer: Gridiron Capital
payer_mix: {"commercial": 0.64, "medicare": 0.26, "medicaid": 0.06, "other": 0.04}
ingested_at: 2026-04-25T20:18:35.305906+00:00
notes:
  Hand and peripheral nerve surgery billing involves complex modifier usage for bilateral procedures and multiple-surgery reduction rules, with nerve decompression CPT codes subject to high commercial pre-certification denial rates absent standardized functional-impairment scoring documentation.


source_id: ext43_015
source: seed
deal_name: ClearHead Concussion & TBI Rehab Centers
buyer: Linden Capital Partners
payer_mix: {"commercial": 0.55, "medicare": 0.15, "medicaid": 0.2, "other": 0.1}
ingested_at: 2026-04-25T20:18:35.315451+00:00
notes:
  Concussion and TBI rehabilitation programs bill across neuropsychology, vestibular PT, and cognitive remediation codes that lack uniform payer coverage policies, resulting in high rates of medical-necessity appeals and frequent coordination-of-benefits disputes between workers' comp, auto liability, and health insurance payors.


source_id: ext44_001
source: seed
deal_name: Apex Emergency Partners
buyer: Warburg Pincus
payer_mix: {"commercial": 0.38, "medicare": 0.3, "medicaid": 0.22, "other": 0.1}
ingested_at: 2026-04-25T20:18:35.322130+00:00
notes:
  Emergency medicine CMOs face complex split-billing between facility and professional components, requiring tight coordination with hospital systems on charge capture. Out-of-network balance billing reforms (No Surprises Act) have materially reshaped revenue cycle workflows post-2022.


source_id: ext44_002
source: seed
deal_name: Noctis Hospital Medicine Group
buyer: Leonard Green & Partners
payer_mix: {"commercial": 0.3, "medicare": 0.42, "medicaid": 0.18, "other": 0.1}
ingested_at: 2026-04-25T20:18:35.328177+00:00
notes:
  Hospitalist and nocturnist groups depend heavily on daily census-based billing with frequent E/M level disputes and documentation deficiency rates that drive denials. Integration with EHR-driven CDI tools is a primary RCM lever for margin improvement.


source_id: ext44_003
source: seed
deal_name: Meridian Anesthesia Solutions
buyer: Welsh, Carson, Anderson & Stowe
payer_mix: {"commercial": 0.45, "medicare": 0.32, "medicaid": 0.12, "other": 0.11}
ingested_at: 2026-04-25T20:18:35.338219+00:00
notes:
  Anesthesia billing is uniquely unit-based (base units + time units × conversion factor), creating complexity in payer-specific conversion factor negotiations and CRNA supervision rules. Chronic pain management adds additional coding complexity around procedure bundles and medical necessity documentation.


source_id: ext44_004
source: seed
deal_name: ClearView Teleradiology
buyer: Blackstone
payer_mix: {"commercial": 0.4, "medicare": 0.38, "medicaid": 0.12, "other": 0.1}
ingested_at: 2026-04-25T20:18:35.344545+00:00
notes:
  Teleradiology groups must manage licensure-based billing across multiple state payer contracts simultaneously, with professional component reimbursement varying significantly by jurisdiction. Rapid shifts in AI-assisted reads raise questions about CPT code applicability and reimbursement eligibility.


source_id: ext44_005
source: seed
deal_name: Summit Pathology Partners
buyer: KKR
payer_mix: {"commercial": 0.42, "medicare": 0.35, "medicaid": 0.13, "other": 0.1}
ingested_at: 2026-04-25T20:18:35.350767+00:00
notes:
  Pathology groups face dual billing streams—professional interpretation fees and technical/lab component fees—which are frequently bundled or carved out depending on hospital contractual arrangements. PAMA-driven CLFS reimbursement cuts have compressed margins on high-volume reference lab work.


source_id: ext44_006
source: seed
deal_name: Stewardship Rx Advisors
buyer: New Mountain Capital
payer_mix: {"commercial": 0.28, "medicare": 0.4, "medicaid": 0.2, "other": 0.12}
ingested_at: 2026-04-25T20:18:35.357096+00:00
notes:
  Clinical pharmacy stewardship programs typically bill through pharmacy benefit or incident-to physician billing pathways, creating uncertainty in reimbursement and requiring careful alignment with hospital cost-center accounting. Value-based arrangements that tie pharmacy fees to infection-rate outcomes add further billing complexity.


source_id: ext44_007
source: seed
deal_name: OptimizeRx MTM Services
buyer: TPG Capital
payer_mix: {"commercial": 0.15, "medicare": 0.68, "medicaid": 0.1, "other": 0.07}
ingested_at: 2026-04-25T20:18:35.363172+00:00
notes:
  MTM programs are predominantly funded through Medicare Part D plan contracts, requiring pharmacist credentialing and documentation standards that differ across PDP sponsors. Comprehensive medication review (CMR) completion rates are a key driver of per-member revenue recognition and plan audit risk.


source_id: ext44_008
source: seed
deal_name: 340B Access Pharmacy Group
buyer: Advent International
payer_mix: {"commercial": 0.3, "medicare": 0.33, "medicaid": 0.3, "other": 0.07}
ingested_at: 2026-04-25T20:18:35.370441+00:00
notes:
  340B program pharmacies must maintain strict eligibility tracking between covered entity patients and non-covered entity patients to avoid duplicate discounts and HRSA audit findings. Medicaid carve-out rules in several states create significant billing split complexity between state Medicaid FFS and MCO populations.


source_id: ext44_009
source: seed
deal_name: Nexus Specialty Drug Distribution
buyer: Bain Capital
payer_mix: {"commercial": 0.52, "medicare": 0.3, "medicaid": 0.1, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.378098+00:00
notes:
  Specialty pharmacy distribution requires coordination of medical benefit versus pharmacy benefit billing determinations (buy-and-bill vs. white bagging), often yielding significant revenue variation depending on site-of-care. Prior authorization burdens and step-therapy protocols drive high administrative cost ratios that compress RCM margins.


source_id: ext44_010
source: seed
deal_name: HomeInfuse Nursing Partners
buyer: Ares Management
payer_mix: {"commercial": 0.5, "medicare": 0.28, "medicaid": 0.14, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.384441+00:00
notes:
  Home infusion nursing involves billing across drug, supply, and professional nursing service components that often span both medical and pharmacy benefits with different payer policies per component. Medicare Part B home infusion benefit implementation added new coding and documentation requirements that elevated RCM overhead significantly.


source_id: ext44_011
source: seed
deal_name: ClearPath Palliative Care
buyer: Carlyle Group
payer_mix: {"commercial": 0.22, "medicare": 0.5, "medicaid": 0.2, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.390733+00:00
notes:
  Palliative care programs rely on a mix of outpatient E/M codes, care management CPT codes (99490, 99491), and transitional care management billing that require high documentation specificity for concurrent-care scenarios alongside curative treatment. Payer policies on palliative billing separate from hospice remain inconsistent, creating significant claims variability.


source_id: ext44_012
source: seed
deal_name: Heartland Hospice Management Services
buyer: Francisco Partners
payer_mix: {"commercial": 0.08, "medicare": 0.72, "medicaid": 0.15, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.396719+00:00
notes:
  Hospice management organizations must navigate the Medicare hospice cap calculation, which limits aggregate per-beneficiary payments and creates retroactive repayment risk that must be tracked in real time across the patient census. Routine Home Care versus Continuous Home Care level-of-care billing distinctions are a leading source of RAC and OIG audit findings.


source_id: ext44_013
source: seed
deal_name: Soulbridge Spiritual Care Partners
buyer: Vestar Capital Partners
payer_mix: {"commercial": 0.2, "medicare": 0.35, "medicaid": 0.25, "other": 0.2}
ingested_at: 2026-04-25T20:18:35.402849+00:00
notes:
  Healthcare chaplaincy services are largely non-billable as standalone professional services under traditional fee-for-service, so revenue models depend on facility per-diem bundling, value-based care contracts, and managed care capitation arrangements. As payers expand whole-person care models, RCM infrastructure must evolve to capture newly codifiable spiritual care screening and intervention activities.


source_id: ext44_014
source: seed
deal_name: ClarityBridge Language Access
buyer: GTCR
payer_mix: {"commercial": 0.25, "medicare": 0.3, "medicaid": 0.35, "other": 0.1}
ingested_at: 2026-04-25T20:18:35.409013+00:00
notes:
  Medical interpreter services are mandated under Title VI but reimbursable only in select state Medicaid programs and certain managed care contracts, creating a mixed revenue model that blends billable encounters with institutional grant and bundled payment funding. RCM teams must maintain meticulous per-encounter language and modality documentation to satisfy audit requirements in states that do cover these services.


source_id: ext44_015
source: seed
deal_name: Illuminate Health Literacy
buyer: General Atlantic
payer_mix: {"commercial": 0.35, "medicare": 0.25, "medicaid": 0.22, "other": 0.18}
ingested_at: 2026-04-25T20:18:35.415463+00:00
notes:
  Health literacy and patient education platforms monetize primarily through SaaS licensing to health systems and payers, with a secondary revenue stream from value-based incentive payments tied to patient activation and adherence metrics. As these platforms become embedded in chronic care management and CCM billing workflows, RCM integration with CPT 99490-series codes becomes a critical revenue-capture opportunity.


source_id: ext45_001
source: seed
deal_name: RecoveryBridge SUD Outpatient Centers
buyer: Nautic Partners
payer_mix: {"commercial": 0.38, "medicare": 0.1, "medicaid": 0.45, "other": 0.07}
ingested_at: 2026-04-25T20:18:35.421509+00:00
notes:
  SUD outpatient billing requires matching CPT codes for individual vs. group therapy, ASAM level-of-care documentation, and state-specific Medicaid substance-use carve-out authorizations. Denials spike when intake assessments lack LCSW or LADC co-signature requirements mandated by payer contracts.


source_id: ext45_002
source: seed
deal_name: HarborLight OTP Network
buyer: Riverside Partners
payer_mix: {"commercial": 0.18, "medicare": 0.12, "medicaid": 0.62, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.428014+00:00
notes:
  OTP networks bill a bundled daily methadone dispensing fee under HCPCS H0020, but Medicaid rates vary dramatically by state and many programs operate under fee-for-service carve-outs that require separate credentialing from MCOs. Counseling sessions must be separately documented and billed to avoid bundling denials from Medicaid managed-care plans.


source_id: ext45_003
source: seed
deal_name: Ascend Adolescent Behavioral Health
buyer: Shore Capital Partners
payer_mix: {"commercial": 0.52, "medicare": 0.04, "medicaid": 0.38, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.434264+00:00
notes:
  Adolescent behavioral health billing is complicated by HIPAA minor-consent rules that can prevent parental insurance use, requiring self-pay or Medicaid as alternative payers mid-episode. Residential vs. outpatient level-of-care determinations trigger prior-authorization battles with commercial payers citing medical-necessity criteria inconsistent with ASAM guidelines.


source_id: ext45_004
source: seed
deal_name: ElderMind Geriatric Psychiatry Group
buyer: Frazier Healthcare Partners
payer_mix: {"commercial": 0.22, "medicare": 0.58, "medicaid": 0.14, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.440399+00:00
notes:
  Geriatric psychiatry practices depend heavily on Medicare Part B, where the 2013 psychiatric billing overhaul replaced 90-minute psychotherapy add-ons with time-based E&M codes, requiring precise documentation of medical decision making alongside psychotherapy minutes. Incident-to billing restrictions for mid-level providers further constrain revenue capture in nursing-facility settings.


source_id: ext45_005
source: seed
deal_name: MindBridge Telepsychiatry Platform
buyer: Warburg Pincus
payer_mix: {"commercial": 0.6, "medicare": 0.2, "medicaid": 0.15, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.446956+00:00
notes:
  Telepsychiatry platforms face a fragmented reimbursement landscape where originating-site rules, audio-only vs. audio-visual modality distinctions, and state parity-law enforcement vary by payer and jurisdiction. Post-pandemic permanent vs. temporary telehealth waivers created billing-code uncertainty that drove elevated claim-edit rates across commercial contracts.


source_id: ext45_006
source: seed
deal_name: StabilisCenter Psychiatric Urgent Care
buyer: New MainStream Capital
payer_mix: {"commercial": 0.33, "medicare": 0.15, "medicaid": 0.47, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.456216+00:00
notes:
  Crisis stabilization units bill under facility-based revenue codes but often lack the licensed-bed designation needed for inpatient DRG reimbursement, leaving revenue at lower observation or outpatient facility rates. CCBHC Medicaid prospective payment adoption is uneven, creating dual-coding burdens for practices transitioning between fee-for-service and bundled models.


source_id: ext45_007
source: seed
deal_name: RenewPath Eating Disorder PHP/IOP Network
buyer: Behavioral Healthcare Capital
payer_mix: {"commercial": 0.68, "medicare": 0.06, "medicaid": 0.2, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.462694+00:00
notes:
  Eating disorder programs bill across PHP (H0035), IOP (H2036), and residential levels simultaneously as patients step down, requiring level-of-care re-authorization every 7–14 days under most commercial contracts. Mental health parity litigation has pressured insurers but concurrent-review denials and retrospective claim audits remain a primary revenue-cycle risk.


source_id: ext45_008
source: seed
deal_name: NeuroReclaim TBI Rehab Centers
buyer: ABRY Partners
payer_mix: {"commercial": 0.42, "medicare": 0.28, "medicaid": 0.2, "other": 0.1}
ingested_at: 2026-04-25T20:18:35.469805+00:00
notes:
  TBI neurobehavioral rehab billing straddles physical medicine CPT codes and neuropsychological testing codes, with Medicare Part A vs. Part B distinctions determining facility vs. professional billing pathways. Workers' comp and auto-liability payers, which comprise a meaningful share of the 'other' mix, require case-management coordination and lien-resolution workflows that add significant days to cash collection.


source_id: ext45_009
source: seed
deal_name: InclusionPath I/DD Waiver Services
buyer: Sterling Partners
payer_mix: {"commercial": 0.06, "medicare": 0.08, "medicaid": 0.82, "other": 0.04}
ingested_at: 2026-04-25T20:18:35.476900+00:00
notes:
  I/DD waiver services are billed under state-specific Home and Community-Based Services (HCBS) waiver codes with unit-based rather than time-based rates, making accurate time-tracking and EVV electronic visit verification compliance essential to preventing Medicaid recoupment. Annual waiver re-enrollment and person-centered plan updates must be documented within strict state-mandated deadlines to maintain billable eligibility.


source_id: ext45_010
source: seed
deal_name: SparkABA Autism Outpatient Group
buyer: Lee Equity Partners
payer_mix: {"commercial": 0.55, "medicare": 0.03, "medicaid": 0.38, "other": 0.04}
ingested_at: 2026-04-25T20:18:35.483963+00:00
notes:
  ABA outpatient billing relies on HCPCS H-codes (H2019, H2014) and CPT 97151–97158, with commercial payer contracts often capping covered hours annually and requiring behavior analyst supervision ratios to be documented at every session. Medicaid ABA billing adds EPSDT mandates that obligate coverage but require separate prior-authorization pathways across managed-care organizations.


source_id: ext45_011
source: seed
deal_name: ClearChannel Deaf & HoH Communication Services
buyer: Consonance Capital Partners
payer_mix: {"commercial": 0.3, "medicare": 0.35, "medicaid": 0.25, "other": 0.1}
ingested_at: 2026-04-25T20:18:35.490078+00:00
notes:
  Deaf and hard-of-hearing service providers bill audiological rehabilitation CPT codes alongside sign-language interpreter facilitation fees, but payers rarely reimburse interpreter costs directly, requiring creative bundling or grant-funded cost offsets. Medicare coverage for aural rehabilitation (V5362, 92626) is narrow and frequently confused with hearing-aid dispensing exclusions, generating high initial-denial rates requiring robust appeal workflows.


source_id: ext45_012
source: seed
deal_name: BrightSight Vision Rehabilitation Centers
buyer: Thurston Group
payer_mix: {"commercial": 0.35, "medicare": 0.42, "medicaid": 0.15, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.496412+00:00
notes:
  Vision rehabilitation therapy (CPT 97003, 92065) sits at the intersection of ophthalmology and occupational therapy, with Medicare Part B covering low-vision aids under DME benefit rules while therapeutic services are billed under the outpatient rehabilitation benefit. Dual-benefit coordination and modifier usage (GO vs. GN) create frequent claim-edit errors that require specialty billing expertise to resolve.


source_id: ext45_013
source: seed
deal_name: VoiceForward AAC & Assistive Technology
buyer: Serent Capital
payer_mix: {"commercial": 0.4, "medicare": 0.3, "medicaid": 0.24, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.502657+00:00
notes:
  AAC device claims require a detailed written order from a physician plus a speech-language pathology evaluation confirming medical necessity under Medicare's DME speech-generating device rules (HCPCS E2500–E2599). Commercial payers have inconsistent coverage policies for dedicated AAC devices vs. tablet-based apps, and Medicaid requires EPSDT or state plan amendment authority, creating a multi-payer billing matrix with high denial variability.


source_id: ext45_014
source: seed
deal_name: ApexLimb Prosthetics & Orthotics Group
buyer: Kinderhook Industries
payer_mix: {"commercial": 0.38, "medicare": 0.45, "medicaid": 0.12, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.509069+00:00
notes:
  O&P billing under Medicare requires functional classification (K-level) documentation for lower-limb prosthetics and must conform to the L-code HCPCS system where components are billed individually or as base-plus-additions, creating significant charge-capture complexity for multi-component devices. Post-2015 competitive bidding exclusion for custom O&P preserved fee-schedule rates but heightened auditor scrutiny around medical-necessity documentation and claims of off-the-shelf vs. custom-fabricated designations.


source_id: ext45_015
source: seed
deal_name: MobilityFirst DME & Complex Rehab Technology
buyer: H.I.G. Capital
payer_mix: {"commercial": 0.28, "medicare": 0.52, "medicaid": 0.15, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.515337+00:00
notes:
  Complex rehab technology billing under Medicare requires CRT-specific HCPCS codes (K0835–K0864 for power wheelchairs) with a face-to-face examination, written order, and detailed product-description letter before delivery, and competitive bidding program exclusions for CRT must be actively maintained through accreditation cycles. Capped rental vs. purchase election rules for standard DME items create ongoing beneficiary-communication requirements and downstream ownership-transfer billing milestones that generate collections risk.


source_id: ext46_001
source: seed
deal_name: BrightSmile Pediatric Dentistry & Orthodontics
buyer: Shore Capital Partners
payer_mix: {"commercial": 0.5, "medicare": 0.02, "medicaid": 0.4, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.522792+00:00
notes:
  Pediatric dental practices must navigate dual billing streams: medical dental codes (CDT) for diagnostic and preventive services under Medicaid CHIP programs alongside orthodontic records codes (D8080) with banding fees spread across contract periods, requiring installment-payment tracking in the RCM system. Medicaid prior-authorization for orthodontic treatment demands Handicapping Labio-lingual Deviation (HLD) index scoring, and denials for incomplete index documentation are the leading source of write-offs in this sector.


source_id: ext46_002
source: seed
deal_name: Summit Oral & Maxillofacial Surgery Partners
buyer: Heartwood Partners
payer_mix: {"commercial": 0.62, "medicare": 0.14, "medicaid": 0.16, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.528894+00:00
notes:
  Oral and maxillofacial surgery occupies a billing gray zone between dental and medical payers: procedures such as impacted wisdom tooth removal (CDT D7240) may be billed under dental benefits or, when performed in a hospital setting under general anesthesia, under medical CPT codes (41899), triggering dual-eligibility coordination challenges. Anesthesia billing requires a separate CRNA or MD anesthesia claim with base units plus time units, and payer inconsistency on whether the surgeon or anesthesiologist's claim is primary drives frequent denial cycles requiring manual adjudication.


source_id: ext46_003
source: seed
deal_name: RootCause Endodontics Network
buyer: Riverside Partners
payer_mix: {"commercial": 0.68, "medicare": 0.03, "medicaid": 0.22, "other": 0.07}
ingested_at: 2026-04-25T20:18:35.536852+00:00
notes:
  Endodontic practices bill root canal therapy under CDT codes D3310–D3330 differentiated by tooth type (anterior, premolar, molar), and incorrect tooth-classification coding is a leading cause of payer downcoding that reduces reimbursement by 15–25% per claim without a denial flag. Many commercial dental plans impose separate annual maximums or frequency limitations on endodontic retreatment (D3346–D3348), requiring real-time benefit verification to avoid balance-billing disputes with patients.


source_id: ext46_004
source: seed
deal_name: PerioCare Implant & Periodontic Centers
buyer: Gauge Capital
payer_mix: {"commercial": 0.58, "medicare": 0.05, "medicaid": 0.18, "other": 0.19}
ingested_at: 2026-04-25T20:18:35.544902+00:00
notes:
  Periodontal practices generate high patient out-of-pocket balances because most dental plans exclude implants (D6010–D6067) entirely or cap annual implant benefits below procedure cost, requiring in-house financing and third-party patient-financing integration in the RCM workflow. Scaling and root planing (D4341/D4342) is frequently subject to frequency edits requiring radiographic and probing-depth documentation to substantiate medical necessity, and insurers routinely downgrade full-mouth treatment to a partial-mouth benefit when quadrant separation is not clearly recorded.


source_id: ext46_005
source: seed
deal_name: DentalFirst DSO General Practice Group
buyer: Ares Management
payer_mix: {"commercial": 0.55, "medicare": 0.04, "medicaid": 0.35, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.551044+00:00
notes:
  DSO general-practice platforms consolidate billing across dozens of dental offices under a single TIN or group NPI, but legacy single-office CDT billing habits and payer-contract fee schedules negotiated at the site level create a fragmented charge-master environment that requires systematic normalization post-acquisition. Medicaid dental carve-outs through managed-care dental organizations (MCDOs) require each acquired office to re-credential under the DSO's group provider agreement, creating a revenue gap of 60–120 days per de novo or acquired location.


source_id: ext46_006
source: seed
deal_name: PrecisionCraft Dental Lab & CAD/CAM Prosthetics
buyer: Sheridan Capital Partners
payer_mix: {"commercial": 0.44, "medicare": 0.08, "medicaid": 0.28, "other": 0.2}
ingested_at: 2026-04-25T20:18:35.558637+00:00
notes:
  Dental laboratory revenue is primarily B2B—billed to dentist practices rather than payers—but outsourced lab cases for federally qualified health centers and Medicaid clinics require CDT lab-fee codes (D9985) and case-tracking documentation to support the referring dentist's claim. The shift to CAD/CAM milling introduces materials-cost variability that must be reconciled against fixed-fee lab invoices when supporting payer audits of prosthetic procedure fees submitted by client offices.


source_id: ext46_007
source: seed
deal_name: ClearVision Optical Retail Group
buyer: Apax Partners
payer_mix: {"commercial": 0.52, "medicare": 0.18, "medicaid": 0.2, "other": 0.1}
ingested_at: 2026-04-25T20:18:35.583257+00:00
notes:
  Optical retail chains bill a hybrid of professional exam services (CPT 92004/92014) and vision-benefit product claims (frames and lenses under VSP, EyeMed, or Davis Vision networks), with each payer imposing separate fee schedules, frame allowances, and lens-upgrade co-pay structures that require point-of-sale RCM integration to prevent undercollection. Medicare covers routine exams only when medically necessary (e.g., for diabetic eye disease under CPT 92250), and misrouting routine exams to Medicare generates denials that are the highest-volume coding error in this sector.


source_id: ext46_008
source: seed
deal_name: SpectraLens Contact Lens Specialty Clinics
buyer: Vistria Group
payer_mix: {"commercial": 0.6, "medicare": 0.1, "medicaid": 0.14, "other": 0.16}
ingested_at: 2026-04-25T20:18:35.589548+00:00
notes:
  Contact lens specialty practices separately bill the fitting fee (CPT 92310–92317 based on lens type) and the contact lens materials under vision-benefit plans that impose annual contact lens allowances distinct from spectacle-lens benefits, requiring parallel benefit-verification workflows for each product type. Specialty scleral and rigid gas-permeable lenses billed to medical plans (e.g., for keratoconus) require an ICD-10 medical-necessity diagnosis and prior authorization from commercial payers, substantially increasing administrative cost per unit relative to soft lens dispensing.


source_id: ext46_009
source: seed
deal_name: LuminanceVision Low Vision Rehab Network
buyer: Consonance Capital Partners
payer_mix: {"commercial": 0.28, "medicare": 0.48, "medicaid": 0.18, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.595705+00:00
notes:
  Low vision rehabilitation services are billed under CPT 97003 (OT evaluation) and 92065 (orthoptic/pleoptic training) with Medicare covering therapeutic services under the outpatient rehabilitation benefit subject to therapy-cap thresholds and KX-modifier exceptions, requiring meticulous functional-limitation documentation in each progress note to withstand ADR audits. Low-vision aids and optical devices are billed separately as DME under HCPCS V2600-series codes, creating a split-billing workflow where the same patient encounter generates both a therapy claim and a DME claim through separate billing pathways.


source_id: ext46_010
source: seed
deal_name: ClearSight Refractive Surgery & LASIK Centers
buyer: KKR
payer_mix: {"commercial": 0.15, "medicare": 0.05, "medicaid": 0.02, "other": 0.78}
ingested_at: 2026-04-25T20:18:35.601685+00:00
notes:
  Refractive surgery centers operate largely outside traditional insurance reimbursement because LASIK and PRK are elective procedures excluded from most commercial and government payer contracts, making the 'other' category—primarily self-pay and employer vision-benefit discounts—the dominant revenue stream. The RCM challenge centers on financing-product integration (CareCredit, Alphaeon), package-price versus per-eye billing reconciliation, and post-op enhancement billing, where some contracts include lifetime enhancement coverage that must be tracked to avoid double-billing complications.


source_id: ext46_011
source: seed
deal_name: CornealCare Anterior Segment Specialists
buyer: Frazier Healthcare Partners
payer_mix: {"commercial": 0.46, "medicare": 0.38, "medicaid": 0.1, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.607824+00:00
notes:
  Corneal transplant surgery (PKP, DSAEK, DMEK) generates complex split-billing between the surgeon's professional fee (CPT 65710–65757) and the corneal tissue acquisition fee, which is separately reimbursed by Medicare under a flat add-on amount and by commercial payers at varying invoice-based rates, requiring tissue-registry invoice reconciliation within the RCM workflow to prevent undercollection. Dry eye disease management revenue—increasingly via LipiFlow or intense-pulsed-light devices—is largely non-covered by payers, demanding a self-pay pricing and consent process that must be operationally distinct from the insured visit workflow.


source_id: ext46_012
source: seed
deal_name: NeurOptix Neuro-Ophthalmology Associates
buyer: Nautic Partners
payer_mix: {"commercial": 0.44, "medicare": 0.42, "medicaid": 0.08, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.613834+00:00
notes:
  Neuro-ophthalmology practices bill at the intersection of ophthalmology and neurology fee schedules, where the same visual-field test (CPT 92083) is reimbursed at different rates depending on whether it is submitted under the ophthalmology or neurology specialty taxonomy, creating a deliberate taxonomy-management requirement in provider enrollment. Diagnostic imaging such as orbital MRI (CPT 70553) ordered and interpreted by the same neuro-ophthalmologist requires separate professional and technical component billing with -26 and -TC modifiers, and payer policies on global vs. split billing vary by contract, elevating the risk of systematic under-reimbursement without active contract-edit monitoring.


source_id: ext46_013
source: seed
deal_name: VisionKids Pediatric Ophthalmology & Strabismus Group
buyer: Lee Equity Partners
payer_mix: {"commercial": 0.5, "medicare": 0.03, "medicaid": 0.42, "other": 0.05}
ingested_at: 2026-04-25T20:18:35.619735+00:00
notes:
  Pediatric ophthalmology practices rely heavily on Medicaid for strabismus surgery (CPT 67311–67340) and amblyopia management, where EPSDT mandates coverage but Medicaid managed-care plans impose prior-authorization requirements and surgery-facility credentialing that extend scheduling timelines and create revenue-cycle lag. Vision therapy billed for amblyopia (CPT 92065) is excluded by many commercial plans or subjected to strict visit-number caps, requiring proactive benefit verification and patient financial counseling to prevent surprise balances that drive bad-debt write-offs.


source_id: ext46_014
source: seed
deal_name: OcuOnco Ophthalmic Oncology Centers
buyer: New Enterprise Associates
payer_mix: {"commercial": 0.48, "medicare": 0.36, "medicaid": 0.1, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.679627+00:00
notes:
  Ocular oncology centers bill radiation-based treatments such as episcleral plaque brachytherapy (CPT 77778) under both ophthalmic and radiation oncology fee schedules, requiring co-management billing coordination between the ophthalmologist and radiation physicist that must be explicitly documented in a co-management agreement to avoid Medicare split-billing denials. Proton beam therapy for uveal melanoma at academic centers requires pre-authorization under most commercial contracts and Medicare Advantage plans, and the documentation packet—including ocular pathology, tumor measurement, and treatment planning records—must be assembled within tight authorization windows to prevent revenue delay.


source_id: ext46_015
source: seed
deal_name: OculoPlastics & Orbital Reconstructive Surgery Group
buyer: Warburg Pincus
payer_mix: {"commercial": 0.55, "medicare": 0.28, "medicaid": 0.08, "other": 0.09}
ingested_at: 2026-04-25T20:18:35.686498+00:00
notes:
  Oculoplastic practices must rigorously distinguish functional from cosmetic procedures in their coding: upper-lid blepharoplasty (CPT 15822/15823) is reimbursable when visual-field testing documents superior-field obstruction exceeding 30%, but payers routinely request the Humphrey visual-field printout as a claim attachment, and missing attachments are the single largest denial driver. Botulinum toxin injections for blepharospasm (J0585/J0587) are billed under the medical benefit at drug-acquisition cost plus an administration fee, requiring buy-and-bill drug-inventory reconciliation and J-code unit accuracy to avoid payer-initiated drug audits and recoupment demands.


source_id: ext47_001
source: seed
deal_name: ClearDerm Practice Partners
buyer: Varsity Healthcare Partners
payer_mix: {"commercial": 0.52, "medicare": 0.18, "medicaid": 0.08, "other": 0.22}
ingested_at: 2026-04-25T20:18:35.693023+00:00
notes:
  Medical derm blends insurance-covered procedures (biopsies, excisions) with elective cosmetic services, creating complex split-billing workflows that require rigorous modifier usage and prior-authorization tracking across multiple payers.


source_id: ext47_002
source: seed
deal_name: Apex Aesthetics Surgery Group
buyer: Gryphon Investors
payer_mix: {"commercial": 0.12, "medicare": 0.02, "medicaid": 0.01, "other": 0.85}
ingested_at: 2026-04-25T20:18:35.699169+00:00
notes:
  Cosmetic surgery centers are predominantly cash-pay, so RCM complexity centers on consumer financing integration, package pricing reconciliation, and the minority of reconstructive cases that do require insurance adjudication.


source_id: ext47_003
source: seed
deal_name: Renovo Reconstructive Partners
buyer: Shore Capital Partners
payer_mix: {"commercial": 0.48, "medicare": 0.22, "medicaid": 0.1, "other": 0.2}
ingested_at: 2026-04-25T20:18:35.705232+00:00
notes:
  Reconstructive plastic surgery carries high payer complexity due to medical-necessity documentation requirements and frequent cross-coding between cosmetic and reconstructive CPT codes, elevating denial rates and requiring robust appeals infrastructure.


source_id: ext47_004
source: seed
deal_name: Strands Hair Restoration Clinics
buyer: Kingswood Capital Management
payer_mix: {"commercial": 0.08, "medicare": 0.01, "medicaid": 0.0, "other": 0.91}
ingested_at: 2026-04-25T20:18:35.711338+00:00
notes:
  Hair restoration is nearly entirely elective and cash-pay, making RCM simpler on the payer side but operationally complex given multi-session procedure packages, financing plans, and the occasional PRP billing that straddles cosmetic and medical coding.


source_id: ext47_005
source: seed
deal_name: Luminary MedSpa Holdings
buyer: L Catterton
payer_mix: {"commercial": 0.07, "medicare": 0.01, "medicaid": 0.0, "other": 0.92}
ingested_at: 2026-04-25T20:18:35.717890+00:00
notes:
  MedSpa chains operate almost entirely outside traditional insurance reimbursement, so RCM focus shifts to gift-card liability tracking, membership-model revenue recognition, and ensuring any supervised medical procedures are properly documented under physician oversight to avoid regulatory risk.


source_id: ext47_006
source: seed
deal_name: DermScience Cosmeceuticals
buyer: Highlander Partners
payer_mix: {"commercial": 0.05, "medicare": 0.0, "medicaid": 0.0, "other": 0.95}
ingested_at: 2026-04-25T20:18:35.724150+00:00
notes:
  Cosmeceutical manufacturers and clinic-affiliated skincare brands have minimal traditional RCM exposure, though physician dispensing programs require accurate NDC-level tracking and compliance with state pharmacy regulations when bundled with clinical services.


source_id: ext47_007
source: seed
deal_name: Photon Laser Aesthetics Network
buyer: Revelstoke Capital Partners
payer_mix: {"commercial": 0.1, "medicare": 0.02, "medicaid": 0.01, "other": 0.87}
ingested_at: 2026-04-25T20:18:35.730287+00:00
notes:
  Laser and energy-based device clinics face RCM challenges at the boundary between cosmetic and medically necessary treatments — laser hair removal is excluded, but laser treatment of vascular lesions or acne scarring may qualify, requiring procedure-level documentation to support any insurance submissions.


source_id: ext47_008
source: seed
deal_name: Fade Studios Tattoo Removal
buyer: Carousel Capital
payer_mix: {"commercial": 0.05, "medicare": 0.0, "medicaid": 0.0, "other": 0.95}
ingested_at: 2026-04-25T20:18:35.736244+00:00
notes:
  Tattoo removal is almost exclusively cash-pay elective; the narrow insurance-eligible segment involves gang-related removal programs contracted through county or state agencies, adding unique government-contract billing requirements distinct from standard healthcare RCM.


source_id: ext47_009
source: seed
deal_name: DryShield Hyperhidrosis Centers
buyer: Kinderhook Industries
payer_mix: {"commercial": 0.38, "medicare": 0.04, "medicaid": 0.02, "other": 0.56}
ingested_at: 2026-04-25T20:18:35.742455+00:00
notes:
  Hyperhidrosis treatment sits at the cosmetic-medical boundary; miraDry and botulinum toxin injections for axillary hyperhidrosis can be covered by commercial plans with step-edit requirements, demanding thorough prior-authorization workflows and conservative use of topicals documentation before approval.


source_id: ext47_010
source: seed
deal_name: ScarFree Revision Specialists
buyer: New MainStream Capital
payer_mix: {"commercial": 0.35, "medicare": 0.05, "medicaid": 0.02, "other": 0.58}
ingested_at: 2026-04-25T20:18:35.748532+00:00
notes:
  Scar revision and keloid management require differentiation between functional and cosmetic intent in clinical documentation; reconstructive intent (e.g., post-burn contracture, post-surgical deformity) can unlock commercial and Medicare coverage, while purely cosmetic improvement does not, necessitating dual-path billing logic.


source_id: ext47_011
source: seed
deal_name: ClearFlow Vein & Vascular Clinics
buyer: Bain Capital Double Impact
payer_mix: {"commercial": 0.5, "medicare": 0.28, "medicaid": 0.06, "other": 0.16}
ingested_at: 2026-04-25T20:18:35.754922+00:00
notes:
  Vein clinics carry high RCM complexity because varicose vein procedures require duplex ultrasound documentation and conservative treatment failure evidence before commercial and Medicare approval; spider vein sclerotherapy remains cosmetic and cash-pay, requiring careful charge segregation at the procedure level.


source_id: ext47_012
source: seed
deal_name: PRP Renew Aesthetics Group
buyer: Trive Capital
payer_mix: {"commercial": 0.06, "medicare": 0.01, "medicaid": 0.0, "other": 0.93}
ingested_at: 2026-04-25T20:18:35.761690+00:00
notes:
  Microneedling and PRP-based facial rejuvenation are almost universally excluded from insurance coverage, keeping RCM operationally straightforward; however, PRP when used as an adjunct to orthopedic or hair-loss protocols may generate a small billable insurance claim requiring separate coding and documentation.


source_id: ext47_013
source: seed
deal_name: ContourMed Body Studios
buyer: Thurston Group
payer_mix: {"commercial": 0.05, "medicare": 0.0, "medicaid": 0.0, "other": 0.95}
ingested_at: 2026-04-25T20:18:35.768087+00:00
notes:
  Non-surgical body contouring (cryolipolysis, radiofrequency, HIFU) is entirely elective and cash-pay; RCM infrastructure focuses on financing-platform reconciliation, multi-area package pricing compliance, and accurate session-count tracking for subscription and series-based service models.


source_id: ext47_014
source: seed
deal_name: LiftLine Thread Aesthetics
buyer: Edgewater Growth Capital
payer_mix: {"commercial": 0.05, "medicare": 0.01, "medicaid": 0.0, "other": 0.94}
ingested_at: 2026-04-25T20:18:35.777104+00:00
notes:
  Thread lift procedures are elective and insurance-excluded in virtually all cases; clinics must ensure that any patient with a co-occurring reconstructive indication (e.g., post-oncologic facial reconstruction) is billed through a separate clinical encounter to avoid inadvertent cosmetic bundling that forfeits reimbursement.


source_id: ext47_015
source: seed
deal_name: Revive Injectable Aesthetics Co.
buyer: General Atlantic
payer_mix: {"commercial": 0.09, "medicare": 0.02, "medicaid": 0.01, "other": 0.88}
ingested_at: 2026-04-25T20:18:35.783506+00:00
notes:
  Botox and filler clinic chains are predominantly cash-pay, but the therapeutic botulinum toxin segment (migraines, hyperhidrosis, spasticity) creates a parallel insurance billing track that demands distinct CPT and J-code workflows, separate medical-necessity documentation, and strict dose-unit reconciliation to prevent payer audits.


source_id: ext48_001
source: seed
deal_name: TravelNurse Alliance Group
buyer: Warburg Pincus
payer_mix: {"commercial": 0.55, "medicare": 0.2, "medicaid": 0.15, "other": 0.1}
ingested_at: 2026-04-25T20:18:35.789945+00:00
notes:
  Travel nurse agencies face complex multi-state payroll and credentialing workflows that complicate W-2 vs. 1099 classification billing. Shift-based timekeeping must reconcile against facility invoicing to prevent revenue leakage.


source_id: ext48_002
source: seed
deal_name: AlliedTherapy Staffing Partners
buyer: Blackstone Growth
payer_mix: {"commercial": 0.48, "medicare": 0.28, "medicaid": 0.18, "other": 0.06}
ingested_at: 2026-04-25T20:18:35.796863+00:00
notes:
  Therapy staffing contracts span PT, OT, and SLP disciplines each carrying distinct CPT code sets and payer-specific documentation requirements. Per-visit contract reconciliation against facility census data is a persistent RCM challenge.


source_id: ext48_003
source: seed
deal_name: LocumLink Physician Staffing
buyer: KKR
payer_mix: {"commercial": 0.6, "medicare": 0.22, "medicaid": 0.1, "other": 0.08}
ingested_at: 2026-04-25T20:18:35.802916+00:00
notes:
  Locum tenens placements require temporary credentialing at each facility, creating payer enrollment lags that delay billing authorization by 30–90 days. Accurate tracking of NPI-to-facility linkages is essential to avoid claim denials.


source_id: ext48_004
source: seed
deal_name: PinnacleEd CME Solutions
buyer: Francisco Partners
payer_mix: {"commercial": 0.2, "medicare": 0.05, "medicaid": 0.02, "other": 0.73}
ingested_at: 2026-04-25T20:18:38.342770+00:00
notes:
  CME providers bill pharmaceutical sponsors, health systems, and individual physicians under diverse fee structures that do not align with standard insurance billing workflows. Revenue recognition must differentiate grant-funded content from direct-pay registration fees.


source_id: ext48_005
source: seed
deal_name: ClearScript Patient Education Platform
buyer: Vista Equity Partners
payer_mix: {"commercial": 0.15, "medicare": 0.08, "medicaid": 0.05, "other": 0.72}
ingested_at: 2026-04-25T20:18:38.348773+00:00
notes:
  SaaS patient education platforms typically bill health systems and payers via enterprise subscription contracts, requiring multi-site license reconciliation. Usage-based tiers tied to patient volume create variable revenue that complicates ARR forecasting and billing automation.


source_id: ext48_006
source: seed
deal_name: SimHealth Clinical Training Centers
buyer: Bain Capital
payer_mix: {"commercial": 0.1, "medicare": 0.04, "medicaid": 0.02, "other": 0.84}
ingested_at: 2026-04-25T20:18:38.354855+00:00
notes:
  Simulation centers derive revenue from hospital contracts, nursing school affiliations, and government grants, each with distinct invoicing cadences. Accurate cost-center allocation between simulation lab equipment depreciation and instructional labor is critical for margin visibility.


source_id: ext48_007
source: seed
deal_name: CodeMaster RCM Education
buyer: General Atlantic
payer_mix: {"commercial": 0.08, "medicare": 0.03, "medicaid": 0.02, "other": 0.87}
ingested_at: 2026-04-25T20:18:38.361046+00:00
notes:
  Coding certification bodies collect exam fees, annual renewal dues, and online courseware subscriptions under different revenue streams that require separate deferred revenue schedules. ICD-10 and CPT update cycles create periodic spikes in exam volume that must be reflected in billing projections.


source_id: ext48_008
source: seed
deal_name: DocuIntegrity CDI Advisors
buyer: Carlyle Group
payer_mix: {"commercial": 0.3, "medicare": 0.38, "medicaid": 0.18, "other": 0.14}
ingested_at: 2026-04-25T20:18:38.367088+00:00
notes:
  CDI consulting engagements are billed on retainer plus performance-based fees tied to documented case-mix index improvement, creating contingency revenue recognition complexity. DRG query response rates must be tracked at the physician level to substantiate performance billing.


source_id: ext48_009
source: seed
deal_name: RegGuard Healthcare Compliance Group
buyer: TPG Capital
payer_mix: {"commercial": 0.18, "medicare": 0.12, "medicaid": 0.08, "other": 0.62}
ingested_at: 2026-04-25T20:18:38.373823+00:00
notes:
  Compliance consulting firms bill hospital and payer clients under time-and-materials and fixed-fee project structures that require separate revenue recognition treatment. OIG work plan updates and CMS final rules drive episodic demand, creating lumpy backlog that complicates cash flow forecasting.


source_id: ext48_010
source: seed
deal_name: CredVerify Medical Staff Solutions
buyer: GTCR
payer_mix: {"commercial": 0.22, "medicare": 0.15, "medicaid": 0.08, "other": 0.55}
ingested_at: 2026-04-25T20:18:38.379985+00:00
notes:
  Credentialing outsourcing firms invoice hospitals on a per-provider or PEPM basis and must track privilege expiration dates to avoid billing for lapsed practitioners. Payer enrollment delays tied to credentialing create revenue holds that directly impact client cash collections.


source_id: ext48_011
source: seed
deal_name: QualityReview Physician Partners
buyer: Hellman & Friedman
payer_mix: {"commercial": 0.25, "medicare": 0.3, "medicaid": 0.15, "other": 0.3}
ingested_at: 2026-04-25T20:18:38.386158+00:00
notes:
  Peer review organizations bill hospitals and payers per case review with additional fees for expedited turnaround, requiring SLA-based invoice tiering. Retrospective audits by payers of previously paid cases add receivables complexity when clawbacks are issued.


source_id: ext48_012
source: seed
deal_name: CaseAxis UM Outsourcing
buyer: New Mountain Capital
payer_mix: {"commercial": 0.4, "medicare": 0.3, "medicaid": 0.22, "other": 0.08}
ingested_at: 2026-04-25T20:18:38.392180+00:00
notes:
  Case management outsourcers contract with health plans on PMPM and per-authorization fee schedules, creating dual revenue streams that must be separately tracked against member eligibility rosters. Length-of-stay reductions tied to UM decisions affect both provider billing and payer fee calculations simultaneously.


source_id: ext48_013
source: seed
deal_name: NecessityIQ Review Platform
buyer: Insight Partners
payer_mix: {"commercial": 0.45, "medicare": 0.28, "medicaid": 0.2, "other": 0.07}
ingested_at: 2026-04-25T20:18:38.398211+00:00
notes:
  SaaS medical necessity platforms bill health plans per clinical decision supported and face regulatory scrutiny over InterQual/MCG criteria licensing that can affect contractual revenue caps. Denial rate reductions create performance-based revenue tiers that complicate GAAP revenue recognition under ASC 606.


source_id: ext48_014
source: seed
deal_name: AuthBridge PA Automation
buyer: Thoma Bravo
payer_mix: {"commercial": 0.5, "medicare": 0.25, "medicaid": 0.18, "other": 0.07}
ingested_at: 2026-04-25T20:18:38.404362+00:00
notes:
  PA automation platforms invoice providers and health systems on transaction volume tiers, where per-authorization fees vary by specialty and urgency, requiring granular usage metering. CMS e-PA mandates under the Interoperability Rule are expanding addressable volume but also compressing per-transaction pricing.


source_id: ext48_015
source: seed
deal_name: ScrubShield Claim Intelligence
buyer: Veritas Capital
payer_mix: {"commercial": 0.52, "medicare": 0.26, "medicaid": 0.16, "other": 0.06}
ingested_at: 2026-04-25T20:18:38.410594+00:00
notes:
  Claim scrubbing platforms price on a per-claim or percentage-of-collections basis, creating revenue volatility tied directly to client billing volumes and payer mix shifts. Edits targeting Medicare LCD/NCD compliance must be updated with each quarterly CMS release or clients face denial spikes that trigger SLA penalties.


source_id: ext49_001
source: seed
deal_name: Meridian Population Health Partners
buyer: Welsh Carson Anderson & Stowe
payer_mix: {"commercial": 0.3, "medicare": 0.4, "medicaid": 0.2, "other": 0.1}
ingested_at: 2026-04-25T20:18:38.416648+00:00
notes:
  Value-based contract oversight introduces multi-payer attribution logic and risk-adjustment reconciliation that generate complex claims adjudication workflows. Shared-savings settlements require specialized billing infrastructure to track performance metrics across heterogeneous payer contracts.


source_id: ext49_002
source: seed
deal_name: Aligned Care ACO Solutions
buyer: New Mountain Capital
payer_mix: {"commercial": 0.15, "medicare": 0.65, "medicaid": 0.1, "other": 0.1}
ingested_at: 2026-04-25T20:18:38.422509+00:00
notes:
  ACO management platforms must reconcile CMS benchmark updates, quality-measure attestations, and attribution rosters on a rolling basis, creating layered RCM complexity. Revenue recognition depends heavily on annual settlement timing from the Shared Savings Program, requiring careful accrual management.


source_id: ext49_003
source: seed
deal_name: ChronicLink Care Technologies
buyer: Silversmith Capital Partners
payer_mix: {"commercial": 0.25, "medicare": 0.55, "medicaid": 0.12, "other": 0.08}
ingested_at: 2026-04-25T20:18:38.428568+00:00
notes:
  CPT 99490 and related CCM codes require time-based monthly documentation and care-plan attestation before claims can be submitted, adding significant billing overhead per patient. Payer-specific coverage policies for CCM create variable reimbursement rates that complicate revenue forecasting in SaaS billing models.


source_id: ext49_004
source: seed
deal_name: VitalSense Remote Monitoring
buyer: General Atlantic
payer_mix: {"commercial": 0.35, "medicare": 0.45, "medicaid": 0.1, "other": 0.1}
ingested_at: 2026-04-25T20:18:38.434580+00:00
notes:
  RPM billing under CPT 99453-99458 demands device-days thresholds and provider supervision attestation, creating multi-step claims workflows prone to denials. Evolving CMS guidance on RPM reimbursement requires frequent coding updates and ongoing payer contract negotiations to protect revenue integrity.


source_id: ext49_005
source: seed
deal_name: OutreachIQ Health Engagement
buyer: Summit Partners
payer_mix: {"commercial": 0.28, "medicare": 0.38, "medicaid": 0.24, "other": 0.1}
ingested_at: 2026-04-25T20:18:38.442966+00:00
notes:
  Care gap closure programs bill across multiple HEDIS measure categories, requiring coordination between clinical documentation and claims submission to substantiate quality-incentive payments. Attribution of outreach-driven encounters to the correct payer episode is a persistent RCM challenge in multi-payer environments.


source_id: ext49_006
source: seed
deal_name: Equity Health SDOH Analytics
buyer: Andreessen Horowitz Bio Fund
payer_mix: {"commercial": 0.18, "medicare": 0.3, "medicaid": 0.42, "other": 0.1}
ingested_at: 2026-04-25T20:18:38.451732+00:00
notes:
  SDOH screening services frequently rely on Z-code billing under ICD-10, which many commercial payers still do not reimburse consistently, creating revenue leakage risk. Medicaid-heavy payer mix adds managed-care contract variability and prior authorization complexity for community health worker services.


source_id: ext49_007
source: seed
deal_name: TransitionBridge Care Continuum
buyer: Warburg Pincus
payer_mix: {"commercial": 0.22, "medicare": 0.52, "medicaid": 0.18, "other": 0.08}
ingested_at: 2026-04-25T20:18:38.457743+00:00
notes:
  Transitional care management codes (TCM) require a qualifying discharge event, specific follow-up timelines, and provider attestation before claims are payable, making workflow adherence critical to revenue capture. Hospital readmission penalty linkage adds a secondary RCM dimension tied to quality reporting submissions.


source_id: ext49_008
source: seed
deal_name: ClearBenefits Plan Administration
buyer: Leonard Green & Partners
payer_mix: {"commercial": 0.55, "medicare": 0.2, "medicaid": 0.15, "other": 0.1}
ingested_at: 2026-04-25T20:18:38.463746+00:00
notes:
  Health plan administration requires managing COB rules, subrogation recovery, and claims repricing across multiple benefit designs, each with distinct RCM configuration requirements. Regulatory mandates around MLR reporting and ACA risk-adjustment data validation audits add compliance-driven billing complexity.


source_id: ext49_009
source: seed
deal_name: Apex Medicare Advantage Services
buyer: TPG Capital
payer_mix: {"commercial": 0.05, "medicare": 0.85, "medicaid": 0.05, "other": 0.05}
ingested_at: 2026-04-25T20:18:38.470156+00:00
notes:
  Medicare Advantage revenue is driven by CMS risk-adjustment score submissions, where HCC coding accuracy and retrospective chart review directly impact capitation payments, creating high-stakes RCM workflows. RADV audit exposure requires ongoing documentation improvement programs that are deeply integrated with billing operations.


source_id: ext49_010
source: seed
deal_name: ClearRx PBM Technology Group
buyer: Francisco Partners
payer_mix: {"commercial": 0.48, "medicare": 0.32, "medicaid": 0.12, "other": 0.08}
ingested_at: 2026-04-25T20:18:38.476587+00:00
notes:
  PBM technology platforms must reconcile real-time claims adjudication with post-adjudication rebate accounting, creating dual revenue streams with distinct recognition timing and audit trails. DIR fee reconciliation under Part D adds retroactive adjustments that complicate revenue forecasting and cash flow management.


source_id: ext49_011
source: seed
deal_name: RxGuard Drug Utilization Review
buyer: Parthenon Capital
payer_mix: {"commercial": 0.4, "medicare": 0.35, "medicaid": 0.18, "other": 0.07}
ingested_at: 2026-04-25T20:18:38.482762+00:00
notes:
  DUR platforms generate revenue through PMPM fees and per-intervention billing tied to clinical decision alerts, requiring documentation of pharmacist review outcomes to support claims. Medicaid DUR mandates under OBRA '90 add mandatory retrospective review programs with state-specific billing requirements.


source_id: ext49_012
source: seed
deal_name: SpectraPharm Formulary Analytics
buyer: Insight Partners
payer_mix: {"commercial": 0.5, "medicare": 0.3, "medicaid": 0.1, "other": 0.1}
ingested_at: 2026-04-25T20:18:38.489530+00:00
notes:
  Specialty pharmacy analytics require integrating buy-and-bill reimbursement models with specialty distribution fee arrangements, creating multi-channel revenue recognition complexity. Formulary tier change cycles generate batch prior authorization waves that stress billing operations and increase denial rates temporarily.


source_id: ext49_013
source: seed
deal_name: NexusHIE Data Exchange Network
buyer: Vista Equity Partners
payer_mix: {"commercial": 0.35, "medicare": 0.28, "medicaid": 0.27, "other": 0.1}
ingested_at: 2026-04-25T20:18:38.496495+00:00
notes:
  HIE platforms monetize through transaction-based query fees and subscription licensing, requiring revenue recognition policies that distinguish usage-based from term-license arrangements under ASC 606. Data quality gaps in admission, discharge, and transfer (ADT) feeds can delay claims trigger events, indirectly impacting downstream RCM performance for connected provider clients.


source_id: ext49_014
source: seed
deal_name: OpenPath Interoperability Solutions
buyer: Bessemer Venture Partners Growth
payer_mix: {"commercial": 0.42, "medicare": 0.25, "medicaid": 0.23, "other": 0.1}
ingested_at: 2026-04-25T20:18:38.509433+00:00
notes:
  FHIR-based interoperability platforms must navigate CMS information-blocking rules and ONC certification requirements that directly affect product roadmap and revenue model timing. API-driven data access services create usage-based billing models with variable revenue that require sophisticated metering and invoicing infrastructure.


source_id: ext49_015
source: seed
deal_name: Prism Clinical Analytics RWE
buyer: Carlyle Group
payer_mix: {"commercial": 0.38, "medicare": 0.3, "medicaid": 0.17, "other": 0.15}
ingested_at: 2026-04-25T20:18:38.516610+00:00
notes:
  RWE platforms sell research licenses and payer analytics subscriptions where deliverable milestones drive revenue recognition, creating project-accounting complexity alongside recurring SaaS streams. Linking RWE outcomes to value-based payment contracts introduces contingent revenue components that require careful ASC 606 variable consideration treatment.


