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www.harriswilliams.com
Member FINRA/SIPC
Healthcare & Life Sciences Industry Update
July 2014
• On June 30, the Supreme Court ruled, in the case of Burwell vs. Hobby
Lobby, that requiring family-owned corporations to bear the expense of
covering contraception under the Affordable Care Act violated Hobby
Lobby’s right to religious freedom. The ruling has grabbed headlines, with
many outlets speculating that it opens the door to religion-based
challenges to federal laws more broadly, in addition to weakening a well-
publicized measure of the ACA. Justice Ginsberg sounded just such a tone
of alarm in her dissenting opinion following the ruling. The New York Times
published an article discussing the ruling with links to other relevant
information relating to this important and historic legal decision.
• The Atlantic published the results of a study by athenahealth, in partnership
with 535 pediatricians, into the picture of mental health among U.S. youth.
In general, the study found that the prevalence of mental and behavioral
disorders among American children has climbed sharply since 2010. As
many readers may already be aware, mental and behavioral health is an
area that has attracted a growing amount of investment capital recently.
A link to the results of the study can be found here.
• In the wake of the merger of Covidien and Medtronic, through which the
combined company would be domiciled in Ireland with substantially
reduced U.S. tax liabilities, The Wall Street Journal published a highly
informative piece discussing the mechanics of the tax inversion. Given the
recent wave of cross-border healthcare M&A activity, in which tax efficient
structures have take center stage, this piece provides a concise discussion
of the key mechanics. What readers may find surprising is that the primary
value of a tax inversion lies in shielding future earnings, and that the
immediate tax benefits are often not substantial. Regardless, the practice
has drawn the attention of lawmakers and regulators, who are in the
process of examining U.S. tax regulations to potentially restrict future tax
inversions.
What We’ve Been Reading
July 2014
1
HW&Co. HCLS Group Insight
July 2014
2
Health and Wellness Industry Overview
Change in Stock Price
3 mos. 12 mos. Revenue EBITDA Revenue EBITDA
Clinical Laboratories 3 $8,197 4.4% 2.3% 1.7x 9.5x 1.7x 8.7x
Contract Pharma Manufacturing 4 1,840 19.4% 57.4% 2.2x 12.2x 2.1x 11.1x
Contract Research Organizations 7 3,436 0.6% 30.4% 2.1x 13.3x 2.0x 10.8x
Disease Management 2 3,993 7.9% 26.8% 1.8x 20.6x 1.8x 10.8x
Emergency Serv ices 1 2,722 (3.0%) 52.5% 2.9x 11.8x 2.7x 10.0x
Health Care Staffing 4 1,797 (5.9%) 24.0% 1.0x 15.2x 1.0x 12.4x
HMO - Medical 9 25,691 15.8% 30.5% 0.5x 9.2x 0.4x 7.6x
Information Serv ices 10 3,350 (5.5%) 18.0% 3.5x 14.9x 3.2x 12.7x
Specialty Managed Care 2 2,884 (3.0%) 41.6% 1.2x 8.6x 1.1x 5.0x
Specialty Pharmacy Management 4 21,443 (0.4%) 25.9% 0.6x 11.1x 0.6x 10.7x
Dental Products 3 36,909 6.7% 25.2% 3.2x 14.2x 3.1x 13.1x
Durable Medical Equipment 3 3,260 9.3% 23.2% 1.6x 13.4x 1.6x 13.3x
Life Sciences Tools 3 14,402 5.0% 28.0% 2.8x 14.1x 2.7x 12.0x
Medical Devices and Products 14 48,532 5.1% 30.9% 3.2x 12.9x 3.0x 11.7x
Medical / Surgical / Dental Supplies 6 18,458 (0.4%) 27.0% 0.3x 12.6x 0.3x 10.5x
Acute-Care Hospitals 5 22,011 15.2% 27.1% 1.6x 9.6x 1.2x 8.1x
Assisted Liv ing 5 2,897 2.1% (0.3%) 2.7x 15.7x 2.3x 13.8x
Diagnostic Imaging 3 3,270 0.8% 72.6% 1.8x 8.2x 1.9x 10.0x
Dialysis Serv ices 2 22,444 0.9% 4.8% 2.0x 10.0x 1.6x 8.6x
Home Care, Hospice, and Home Infusion 7 852 5.5% 15.7% 0.8x 12.9x 0.7x 9.2x
Long-Term Care 3 1,583 0.7% 17.8% 1.0x 6.9x 0.7x 7.3x
Physician Practice Management 3 2,287 (5.4%) 0.0% 1.3x 11.9x 1.8x 10.7x
Psychiatric Hospitals / Management 3 3,733 20.2% 25.8% 0.4x 7.6x 0.4x 8.3x
Surgicenters / Rehabilitation 5 2,628 1.2% 27.2% 2.1x 10.2x 2.0x 10.6x
Payer, Provider, & Pharmacy Support Serv ices 46 $7,535 3.0% 31.0% 1.8x 12.6x 1.7x 10.0x
Products & Devices 29 $24,312 5.2% 26.9% 2.2x 13.4x 2.1x 12.1x
Provider-Based Serv ices 36 $6,856 4.6% 21.2% 1.5x 10.3x 1.4x 9.6x
HW&Co. HCLS Composite Index 111 $10,776 4.1% 26.4% 1.8x 11.9x 1.7x 10.3x
S&P 500 5.5% 22.0%
Pa
ye
r, P
rov
ide
r, &
Ph
arm
ac
y
Su
pp
ort
Se
rvic
es
Pro
du
cts
&
De
vic
es
Pro
vid
er-
Ba
sed
Se
rvic
es
Median TEV/
Forward MulitplesSectorNumber of
Companies
Average
Enterprise Value
($ mm)
Median TEV/
LTM Multiples
Diagnostic Imaging
Contract Pharma Manufacturing
Emergency Services
Specialty Managed Care
Medical Devices and Products
HMO - Medical
Contract Research Organizations
Life Sciences Tools
Surgicenters / Rehabilitation
Acute-Care Hospitals
Medical / Surgical / Dental Supplies
Disease Management
HW&Co. HCLS Composite Index
Specialty Pharmacy Management
Psychiatric Hospitals / Management
Durable Medical Equipment
Dental Products
Health Care Staffing
S&P 500
Information Services
Long-Term Care
Home Care, Hospice, and Home Infusion
Dialysis Services
Clinical Laboratories
Physician Practice Management
Assisted Living
(10.0%) 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0% 110.0% 120.0%
3
Key Trading Statistics
(detail begins on page 7)
Equity Trading Overview
July 2014
Public Company Sector
Performance (12-month %
change in stock price)
Closing Date Filing Date Issuer Ticker Transaction Type
Gross Proceeds
($mm)
06/05/14 06/05/14 Illumina Inc ILMN Convertible $2,300.0
06/25/14 06/25/14 Envision Healthcare Holdings EVHC Follow-On 1,027.7
06/26/14 06/26/14 AmSurg Corp AMSG Follow-On 439.9
06/11/14 06/11/14 Acadia Healthcare Co Inc ACHC Follow-On 391.0
06/18/14 06/16/14 Acorda Therapeutics Inc ACOR Convertible 300.0
06/19/14 06/19/14 Kindred Healthcare Inc KND Follow-On 213.8
06/11/14 06/11/14 ARIAD Pharmaceuticals Inc ARIA Convertible 200.0
06/18/14 06/18/14 Receptos Inc RCPT Follow-On 178.4
06/04/14 06/04/14 Insulet Corp PODD Convertible 175.0
06/26/14 06/23/14 AmSurg Corp AMSG Convertible 172.5
06/19/14 06/19/14 Kite Pharma Inc KITE IPO 146.6
06/18/14 06/18/14 Revance Therapeutics Inc RVNC Follow-On 140.3
06/26/14 06/26/14 Karyopharm Therapeutics Inc KPTI Follow-On 129.4
06/24/14 06/24/14 Lantheus Holdings Inc LNTH IPO 125.0
06/17/14 06/17/14 ZS Pharma Inc ZSPH IPO 123.1
06/18/14 06/18/14 Zafgen Inc ZFGN IPO 110.4
06/24/14 06/24/14 Adeptus Health Inc ADPT IPO 107.8
06/25/14 06/25/14 Ultragenyx Pharmaceutical Inc RARE Follow-On 100.0
06/24/14 06/24/14 VWR Corp - IPO 100.0
06/30/14 06/30/14 Avalanche Biotechnologies Inc AAVL IPO 86.3
06/20/14 06/20/14 Ocular Therapeutix Inc OCUL IPO 86.3
06/23/14 06/23/14 Intersect ENT Inc XENT IPO 80.0
06/16/14 06/16/14 Trupanion Inc TRUP IPO 75.0
06/25/14 06/25/14 rEVO Biologics Inc RBIO IPO 74.8
06/05/14 06/05/14 Pfenex Inc PFNX IPO 74.8
40
60
80
100
120
140
160
180
200
Jun-11 Sep-11 Dec-11 Mar-12 Jun-12 Sep-12 Dec-12 Mar-13 Jun-13 Sep-13 Dec-13 Mar-14 Jun-14
S&P 500 Dow Jones U.S. Health Care Index HW&Co. HCLS Index
4
Healthcare & Life Sciences
Industry Stock Performance
Top 25 Equity Offerings
(by proceeds)
Equity Markets Overview
July 2014
48.4%
73.9%
45.0%
Announced Target Buyer
6/30/2014 Small Bone Innov ations, Inc. Stryker Corporation
6/26/2014 Hallmark Pathology, P.C. Aurora Diagnostics Holdings, LLC
6/25/2014 MedHelp International, Inc. Physicians Interactiv e, Inc.
6/24/2014 Medical Action Industries Inc. Owens & Minor Inc.
6/23/2014 Capario, Inc. Emdeon Inc.
6/20/2014 OptiNose US Inc. Av ista Capital Holdings, L.P.
6/12/2014 Bay Walk-In Clinic, Inc. ACSH Urgent Care of Florida, LLC
6/10/2014 Phoenix Physicians, LLC EmCare Inc.
6/5/2014 RadCore Lab, LLC Cardiocore Lab, Inc.
6/2/2014 Organ-i, Inc. Immucor, Inc.
HC&LS Industry Number of
Segment Companies
Biotechnology 5
Healthcare Technology 19
Healthcare Distributors 6
Healthcare Equipment 27
Healthcare Facilities 40
Healthcare Serv ices 50
Healthcare Supplies 10
Life Sciences Tools & Serv ices 17
Managed Healthcare 7
Pharmaceuticals 17
Aggregate Number Median Transaction Multiples
Value ($bn) of Deals TEV/Rev TEV/EBITDA
$174.4 1,289 2.19x 10.1x
58
69
94
113
79
42
7165 65
61
3640
60 62
95
49 50
80
120
139144
75
0
20
40
60
80
100
120
140
160
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Tra
nsa
ctio
n V
olu
me
Number of Investments Number of Exits
7.7x
12.8x
11.1x 10.9x 10.0x
18.4x
0.0x
0.5x
1.0x
1.5x
2.0x
2.5x
3.0x
3.5x
4.0x
0x
3x
6x
9x
12x
15x
18x
21x
2009 2010 2011 2012 2013 2014YTD
EV
/ LTM R
eve
nu
e M
ultip
leEV
/ L
TM E
BIT
DA
Mu
ltip
le
TEV / LTM EBITDA TEV / LTM Sales
$174.6
$110.6
$141.4
$101.6 $108.2
$90.0
0
200
400
600
800
1000
1200
$0
$50
$100
$150
$200
$250
$300
$350
$400
$450
$500
2009 2010 2011 2012 2013 2014YTD
Nu
mb
er o
f Tran
sac
tion
s
Ag
gre
ga
te T
ran
sac
tio
n V
alu
e ($ in
billio
ns)
Aggregate Deal Value # of deals
267245 236
219229 221
291
200 209
304
248
304290
16
1318
11
2012
22
1612
18
15
22
14
0
50
100
150
200
250
300
350
2Q11 3Q11 4Q11 1Q12 2Q12 3Q12 4Q12 1Q13 2Q13 3Q13 4Q13 1Q14 2Q14
Nu
mb
er o
f Tra
nsa
ctio
ns
PEG Acquirer Strategic Acquirer
5
Announced Healthcare & Life Sciences
M&A
Announced Healthcare & Life Sciences Transactions Median Healthcare & Life Sciences Transaction Multiples
PEG Investments and ExitsPEG Investments by Segment (Last 3 Years)
Healthcare & Life Sciences
M&A Trends
Announced Private Equity M&A Activity
Middle Market Healthcare Transaction HighlightsQuarterly M&A Activity
LTM Deal Statistics
Note: Transactions based on publicly available information
M&A Overview
July 2014
Date Effective Borrower Name Description Tranche Amount ($mn) Type Rating Spread
06/27/14 Medtronic Inc Electromedical equipment $16,300 Bridge Loan AA- / NR L+ 75
06/24/14 DaVita Inc Kidney dialysis centers 1,000 Revolver/Line >= 1 Yr. B+ / Ba1 L+ 175
06/24/14 DaVita Inc Kidney dialysis centers 1,000 Term Loan A B+ / Ba1 L+ 175
06/24/14 DaVita Inc Kidney dialysis centers 3,500 Term Loan B B+ / Ba1 L+ 275
06/23/14 Bristol Myers Squibb Co Pharmaceutical preparations 3,000 Revolver/Line >= 1 Yr. A+ / A2 L+ 100
06/26/14 Amgen Inc Biological products exc. diagnostic 2,500 Revolver/Line >= 1 Yr. A / Baa1 L+ 100
06/18/14 Kimberly-Clark Corp Surgical appliances and supplies 2,000 Revolver/Line >= 1 Yr. A / A2 L+ 100
06/30/14 Baxter International Inc Surgical and medical instruments 1,500 Revolver/Line >= 1 Yr. A- / NR N/A
06/26/14 Integra LifeSciences Corp Electromedical equipment 750 Revolver/Line >= 1 Yr. NR / NR L+ 150
06/26/14 Integra LifeSciences Corp Electromedical equipment 150 Term Loan A NR / NR L+ 150
06/30/14 Prestige Brands Inc Pharmaceutical preparations 40 Revolver/Line >= 1 Yr. B+ / NR L+ 175
06/30/14 Prestige Brands Inc Pharmaceutical preparations 780 Term Loan B B+ / NR L+ 300
06/19/14 Premier Health Care Management Inc Intermediate care facilit ies 750 Revolver/Line >= 1 Yr. NR / NR L+ 113
06/26/14 Mead Johnson Nutrition Co Pharmaceutical preparations 750 Revolver/Line >= 1 Yr. BBB / NR L+ 113
06/20/14 St Joseph Health System General medical & surgical hospitals 400 Revolver/Line >= 1 Yr. NR / NR L+ 68
06/20/14 St Joseph Health System General medical & surgical hospitals 302 Standby Letter of CreditNR / NR N/A
06/16/14 Phillips Medisize Corp Surgical and medical instruments 365 Term Loan B B / B2 L+ 375
06/16/14 Phillips Medisize Corp Surgical and medical instruments 70 Revolver/Line >= 1 Yr. B / B2 N/A
06/16/14 Phillips Medisize Corp Surgical and medical instruments 170 Term Loan B / Caa2 L+ 725
06/24/14 Acadia Healthcare Psychiatric hospitals 325 Bridge Loan B / NR L+ 525
0.0x
2.0x
4.0x
6.0x
Debt/EBITDA SeniorDebt/EBITDA
EBITDA/CashInterest
EBITDA -Capex/Cash
Interest
EB
ITD
A M
ulti
ple
2008 2009 2010 2011 2012 2013 2014
L + 0
L + 200
L + 400
L + 600
L + 800
L + 1000
Av
era
ge
Sp
rea
d O
ve
r LI
BO
R
L + 0
L + 100
L + 200
L + 300
L + 400
L + 500
2008 2009 2010 2011 2012 2013 2014YTD
Av
era
ge
Sp
rea
d O
ve
r LI
BO
R
Revolving Credit / Term Loan A Weighted-Average Institutional
$0
$3
$6
$9
$12
$15
$18
$21
$24
2Q08 4Q08 2Q09 4Q09 2Q10 4Q10 2Q11 4Q11 2Q12 4Q12 2Q13 4Q13 2Q14
Loa
n V
olu
me
by Q
ua
rte
r ($
in
billio
ns)
Pro Rata Institutional
Key Credit Statistics
Recent Healthcare & Life Sciences
Debt Offerings(by deal amount)
Average Secondary Spread
Average Spread on Healthcare Loans
Credit Statistics
Quarterly Healthcare Loan Volume
Debt Markets Overview
July 2014
6
Healthcare & Life Sciences Trading Statistics
July 2014
As of June 30, 2014
Stock Price
% Change 52 Week
6/30/2014 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Clinical Laboratories
Bio-Reference Laboratories Inc. $30.22 8.2% 5.1% $37.97 $24.13 $838 $66 $24 $879 $760 $93 $70 Apr-14 Oct-13 $808 $109 $86 1.2x 9.5x 1.1x 8.1x
Laboratory Corp. of America Holdings 102.40 4.4% 2.3% 108.00 87.01 8,684 3,008 339 11,372 5,798 1,150 954 Mar-14 Dec-13 5,909 1,155 934 2.0x 9.8x 1.9x 9.8x
Quest Diagnostics Inc. 58.69 1.5% (3.2%) 64.10 50.46 8,480 3,978 144 12,342 7,105 1,402 1,114 Mar-14 Dec-13 7,345 1,421 1,119 1.7x 8.7x 1.7x 8.7x
Number of Companies 3 Median: 4.4% 2.3% Total $18,001 $8,197 $13,663 $14,061 1.7x 9.5x 1.7x 8.7x
Mean: 4.7% 1.4% $8,197 1.6x 9.3x 1.6x 8.9x
Contract Pharma Manufacturing
Akorn, Inc. $33.25 58.3% 145.9% $33.31 $13.34 $3,455 $110 $46 $3,520 $334 $112 $96 Mar-14 Dec-13 $573 $189 $168 10.5x 31.4x 6.1x 18.6x
Cambrex Corporation. 20.70 13.9% 48.2% 22.34 12.56 634 61 22 673 310 59 36 Mar-14 Dec-13 352 71 50 2.2x 11.8x 1.9x 9.5x
Integrated Biopharma Inc. 0.25 25.0% 66.7% 0.32 0.10 5 13 0 19 35 2 2 Mar-14 Jun-13 NA NA NA 0.5x 9.1x NA NA
West Pharmaceutical Serv ices, Inc. 42.18 1.2% 20.1% 51.12 35.25 2,981 410 230 3,149 1,376 246 160 Mar-14 Dec-13 1,468 284 189 2.3x 12.5x 2.1x 11.1x
Number of Companies 4 Median: 19.4% 57.4% Total $7,075 $1,840 $2,055 $2,392 2.2x 12.2x 2.1x 11.1x
Mean: 24.6% 70.2% $1,840 3.9x 16.2x 3.4x 13.1x
Contract Research Organizations
Albany Molecular Research Inc. $20.12 11.6% 69.5% $20.55 $9.71 $651 $125 $167 $610 $246 $42 $27 Mar-14 Dec-13 $289 $60 $44 2.5x 14.4x 2.1x 10.1x
Charles River Laboratories International, Inc. 53.52 (9.9%) 30.4% 62.50 41.05 2,589 641 170 3,073 1,174 256 160 Mar-14 Dec-13 1,278 290 210 2.6x 11.4x 2.4x 10.6x
Covance Inc. 85.58 (15.6%) 12.4% 106.50 76.50 4,914 250 547 4,503 2,442 382 253 Mar-14 Dec-13 2,594 434 299 1.8x 11.8x 1.7x 10.4x
ICON Public Limited Company 47.11 2.4% 33.0% 50.00 35.33 2,922 0 237 2,558 1,369 192 146 Mar-14 Dec-13 1,501 220 175 1.9x 13.3x 1.7x 11.6x
PAREXEL International Corporation 52.84 0.6% 14.9% 57.25 37.53 3,005 297 299 3,004 1,892 262 180 Mar-14 Jun-13 1,937 279 198 1.6x 11.5x 1.6x 10.8x
Quintiles Transnational Holdings Inc. 53.29 6.6% 25.2% 55.00 40.10 6,935 2,069 741 8,263 3,886 587 507 Mar-14 Dec-13 4,147 689 570 2.1x 14.0x 2.0x 12.0x
WuXi PharmaTech (Cayman) Inc. 32.86 (6.3%) 56.5% 40.72 20.09 2,375 89 157 2,037 593 151 106 Mar-14 Dec-13 671 172 127 3.4x 13.5x 3.0x 11.8x
Number of Companies 7 Median: 0.6% 30.4% Total $23,391 $3,436 $11,602 $12,417 2.1x 13.3x 2.0x 10.8x
Mean: (1.5%) 34.6% $3,436 2.3x 12.8x 2.1x 11.0x
Disease Management
Alere Inc. $37.42 9.6% 52.7% $39.90 $24.00 $3,097 $3,832 $433 $7,107 $3,007 $603 $170 Mar-14 Dec-13 $3,043 $661 $530 2.4x 11.4x 2.3x 10.8x
Healthways Inc. 17.54 6.3% 0.9% 22.20 9.59 619 263 2 880 675 30 3 Mar-14 Dec-13 741 82 21 1.3x 29.7x 1.2x 10.8x
Number of Companies 2 Median: 7.9% 26.8% Total $3,716 $3,993 $3,682 $3,784 1.8x 20.6x 1.8x 10.8x
Mean: 7.9% 26.8% $3,993 1.8x 20.6x 1.8x 10.8x
Emergency Services
Air Methods Corp. $51.65 (3.0%) 52.5% $59.07 $32.24 $2,022 $700 $8 $2,722 $926 $230 $150 Mar-14 Dec-13 $1,011 $271 $190 2.9x 11.8x 2.7x 10.0x
Number of Companies 1 Median: (3.0%) 52.5% Total $2,022 $2,722 $926 $1,011 2.9x 11.8x 2.7x 10.0x
Mean: (3.0%) 52.5% $2,722 2.9x 11.8x 2.7x 10.0x
Health Care Staffing
AMN Healthcare Serv ices Inc. $12.30 (10.2%) (14.1%) $16.20 $10.35 $572 $159 $9 $721 $1,001 $79 $65 Mar-14 Dec-13 $999 $80 $65 0.7x 9.1x 0.7x 9.0x
Cross Country Healthcare, Inc. 6.52 (18.6%) 26.4% 11.54 5.14 203 20 7 215 446 5 (1) Mar-14 Dec-13 495 11 5 0.5x 39.6x 0.4x 19.3x
On Assignment Inc. 35.57 (1.6%) 33.1% 39.86 25.24 1,932 394 23 2,303 1,692 159 127 Mar-14 Dec-13 1,895 204 153 1.4x 14.5x 1.2x 11.3x
Team Health Holdings, Inc. 49.94 13.3% 21.6% 52.18 36.41 3,508 498 57 3,950 2,449 248 191 Mar-14 Dec-13 2,675 293 235 1.6x 15.9x 1.5x 13.5x
Number of Companies 4 Median: (5.9%) 24.0% Total $6,215 $1,797 $5,588 $6,064 1.0x 15.2x 1.0x 12.4x
Mean: (4.2%) 16.7% $1,797 1.0x 19.8x 1.0x 13.3x
Company NameLTM
Period
Lastest
FYE Date
TEV/ LTM MultiplesEquity
Mkt.
Value
Total DebtCash and
Equiv.
Total Ent.
Value
(TEV)
Lastest Twelve Months
(LTM)TEV/ Fwd MultiplesForward Estimate
7
Payer, Provider, & Pharmacy Support Services
Healthcare & Life Sciences Trading Statistics
July 2014
As of June 30, 2014
Stock Price
% Change 52 Week
6/30/2014 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
HMO - Medical
Commercial:
Aetna Inc. $81.08 9.4% 27.6% $82.70 $60.32 $28,978 $9,116 $2,074 $36,077 $51,746 $4,634 $4,019 Mar-14 Dec-13 $56,615 $4,547 $4,195 0.7x 7.8x 0.6x 7.9x
Cigna Corp. 91.97 15.8% 26.9% 93.20 71.12 24,708 5,236 2,276 27,777 32,654 2,917 2,564 Mar-14 Dec-13 33,747 3,513 3,075 0.9x 9.5x 0.8x 7.9x
Health Net, Inc. 41.54 24.6% 30.5% 42.34 25.40 3,332 499 737 3,094 11,296 325 287 Mar-14 Dec-13 14,061 473 382 0.3x 9.5x 0.2x 6.5x
Humana Inc. 127.72 12.9% 51.4% 129.36 82.14 19,769 2,865 1,662 20,972 42,539 2,276 2,017 Mar-14 Dec-13 48,028 2,749 2,248 0.5x 9.2x 0.4x 7.6x
UnitedHealth Group Incorporated 81.75 0.2% 24.8% 83.32 64.65 80,104 16,862 7,514 90,720 123,857 10,526 9,538 Mar-14 Dec-13 128,434 11,509 9,901 0.7x 8.6x 0.7x 7.9x
WellPoint Inc. 107.61 8.3% 31.5% 110.03 80.75 30,096 16,365 1,971 44,490 71,307 5,002 4,402 Mar-14 Dec-13 73,314 4,709 4,338 0.6x 8.9x 0.6x 9.4x
Number of Companies 6 Median: 11.2% 29.1% Total $186,986 $37,188 $333,398 $354,200 0.7x 9.1x 0.6x 7.9x
Mean: 11.9% 32.1% $37,188 0.6x 8.9x 0.6x 7.9x
Government:
Centene Corp. $75.61 22.4% 44.1% $77.68 $52.02 $4,361 $817 $1,218 $4,090 $11,475 $399 $327 Mar-14 Dec-13 $15,183 $554 $472 0.4x 10.3x 0.3x 7.4x
Molina Healthcare, Inc. 44.63 19.1% 20.0% 46.17 31.10 2,065 799 1,083 1,781 6,881 173 93 Mar-14 Dec-13 9,803 356 263 0.3x 10.3x 0.2x 5.0x
WellCare Health Plans, Inc. 74.66 17.4% 34.4% 78.37 55.12 3,275 600 1,658 2,217 10,257 353 327 Mar-14 Dec-13 12,339 466 407 0.2x 6.3x 0.2x 4.8x
Number of Companies 3 Median: 19.1% 34.4% Total $9,701 $2,696 $28,613 $37,325 0.3x 10.3x 0.2x 5.0x
Mean: 19.6% 32.9% $2,696 0.3x 8.9x 0.2x 5.7x
Information Services
Data/Analytics:
National Research Corp. $39.11 (8.9%) 11.9% $44.95 $26.61 $427 $10 $26 $411 $94 $30 $26 Mar-14 Dec-13 $99 $32 $29 4.4x 13.8x 4.1x 12.7x
Number of Companies 1 Median: (8.9%) 11.9% Total $427 $411 $94 $99 4.4x 13.8x 4.1x 12.7x
Mean: (8.9%) 11.9% $411 4.4x 13.8x 4.1x 12.7x
eHealth:
WebMD Health Corp. $48.30 16.0% 64.5% $51.41 $26.07 $1,823 $952 $778 $1,997 $536 $87 $70 Mar-14 Dec-13 $576 $156 $96 3.7x 23.0x NA NA
Number of Companies 1 Median: 16.0% 64.5% Total $1,823 $1,997 $536 $576 3.7x 23.0x NA NA
Mean: 16.0% 64.5% $1,997 3.7x 23.0x NA NA
Hospital/Physician:
Allscripts Healthcare Solutions, Inc. $16.05 (10.8%) 24.0% $19.68 $12.91 $2,881 $549 $42 $3,388 $1,366 $13 ($89) Mar-14 Dec-13 $1,418 $222 $118 2.5x NM 2.4x 15.3x
athenahealth, Inc. 125.13 (21.5%) 47.7% 206.70 83.57 4,735 220 51 4,830 632 58 3 Mar-14 Dec-13 741 132 72 7.6x NM 6.5x 36.6x
Cerner Corporation 51.58 (8.1%) 7.4% 63.07 45.81 17,711 160 220 16,840 2,939 774 597 Mar-14 Dec-13 3,338 1,171 847 5.7x 21.8x 5.0x 14.4x
Computer Programs & Systems Inc. 63.60 0.3% 29.4% 71.89 47.23 710 0 19 681 203 56 52 Mar-14 Dec-13 210 60 56 3.3x 12.2x 3.2x 11.4x
HMS Holdings Corp. 20.41 7.9% (12.4%) 26.77 15.10 1,789 198 76 1,911 480 120 70 Mar-14 Dec-13 435 109 56 4.0x 15.9x 4.4x 17.6x
MedAssets, Inc. 22.84 (5.7%) 28.7% 26.58 17.37 1,393 776 0 2,169 678 202 99 Mar-14 Dec-13 706 234 107 3.2x 10.7x 3.1x 9.3x
Merge Healthcare Incorporated 2.27 (5.4%) (36.9%) 4.71 1.97 216 228 20 425 219 25 13 Mar-14 Dec-13 213 41 29 1.9x 16.7x 2.0x 10.3x
Quality Systems Inc. 16.05 (3.6%) (14.2%) 24.15 14.10 967 0 103 853 445 62 49 Mar-14 Mar-14 472 75 53 1.9x 13.8x 1.8x 11.4x
Number of Companies 8 Median: (5.5%) 15.7% Total $1,591 $3,887 $556 $589 3.3x 14.9x 3.2x 12.9x
Mean: (5.9%) 9.2% $2,040 3.8x 15.2x 3.6x 15.8x
Company Name
Equity
Mkt.
Value
Total DebtCash and
Equiv.
Total Ent.
Value
(TEV)
Lastest Twelve Months
(LTM) LTM
Period
Lastest
FYE Date
Forward Estimate TEV/ LTM Multiples TEV/ Fwd Multiples
Payer, Provider, & Pharmacy Support Services
8
Healthcare & Life Sciences Trading Statistics
July 2014
As of June 30, 2014
Stock Price
% Change 52 Week
6/30/2014 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Specialty Managed Care
Assurant Inc. $65.55 2.7% 28.8% $69.71 $50.20 $4,696 $1,267 $1,106 $4,857 $9,345 $1,023 $898 Mar-14 Dec-13 $9,498 $980 $793 0.5x 4.7x 0.5x 5.0x
CorVel Corporation 45.18 (8.7%) 54.4% 53.35 29.17 946 0 35 911 479 73 57 Mar-14 Mar-14 512 NA NA 1.9x 12.5x 1.8x NA
Number of Companies 2 Median: (3.0%) 41.6% Total $5,642 $2,884 $9,824 $10,010 1.2x 8.6x 1.1x 5.0x
Mean: (3.0%) 41.6% $2,884 1.2x 8.6x 1.1x 5.0x
Specialty Pharmacy Management
Express Scripts Holding Company $69.33 (8.2%) 12.3% $79.37 $59.20 $53,638 $13,780 $1,850 $65,579 $101,764 $6,413 $4,218 Mar-14 Dec-13 $97,750 $6,824 $6,188 0.6x 10.2x 0.7x 9.6x
Catamaran Corporation 47.12 (4.0%) (8.0%) 60.93 40.52 9,747 1,453 685 10,597 16,475 725 470 Mar-14 Dec-13 20,734 787 596 0.6x 13.2x 0.5x 13.5x
Omnicare Inc. 66.57 13.3% 39.5% 67.01 47.49 6,592 2,275 347 8,521 6,125 715 580 Mar-14 Dec-13 6,375 717 606 1.4x 11.9x 1.3x 11.9x
PharMerica Corporation 28.59 3.2% 106.3% 30.48 11.84 857 231 13 1,076 1,770 115 80 Mar-14 Dec-13 1,745 120 80 0.6x 9.3x 0.6x 9.0x
Number of Companies 4 Median: (0.4%) 25.9% Total $70,835 $21,443 $126,135 $126,605 0.6x 11.1x 0.6x 10.7x
Mean: 1.1% 37.5% $21,443 0.8x 11.2x 0.8x 11.0x
Company Name
Equity
Mkt.
Value
Total DebtCash and
Equiv.
Total Ent.
Value
(TEV)
Lastest Twelve Months
(LTM) LTM
Period
Lastest
FYE Date
Forward Estimate TEV/ LTM Multiples TEV/ Fwd Multiples
Payer, Provider, & Pharmacy Support Services
9
Healthcare & Life Sciences Trading Statistics
July 2014
As of June 30, 2014
Stock Price
% Change 52 Week
6/30/2014 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Dental Products
3M Company $143.24 6.7% 31.0% $145.53 $108.21 $93,719 $6,577 $1,954 $97,958 $31,068 $8,121 $6,736 Mar-14 Dec-13 $32,101 $8,473 $7,122 3.2x 12.1x 3.1x 11.6x
DENTSPLY International Inc. 47.35 4.1% 15.6% 50.99 40.81 6,714 1,532 56 8,190 2,949 574 444 Mar-14 Dec-13 3,028 626 513 2.8x 14.2x 2.7x 13.1x
Sirona Dental Systems Inc. 82.46 11.6% 25.2% 82.84 64.40 4,754 80 255 4,580 1,143 280 212 Mar-14 Sep-13 1,173 322 267 4.0x 16.3x 3.9x 14.2x
Number of Companies 3 Median: 6.7% 25.2% Total $105,186 $36,909 $35,160 $36,301 3.2x 14.2x 3.1x 13.1x
Mean: 7.5% 23.9% $36,909 3.3x 14.2x 3.2x 13.0x
Durable Medical Equipment
Hill-Rom Holdings, Inc. $41.51 9.3% 23.2% $44.64 $32.85 $2,375 $343 $120 $2,598 $1,671 $265 $172 Mar-14 Sep-13 $1,649 $292 $194 1.6x 9.8x 1.6x 8.9x
Invacare Corporation 18.37 (0.5%) 27.9% 25.96 14.25 591 49 21 618 1,330 10 (27) Mar-14 Dec-13 1,319 19 (18) 0.5x 62.4x 0.5x 33.1x
ResMed Inc. 50.63 15.4% 12.2% 57.34 41.52 7,105 396 939 6,562 1,554 491 418 Mar-14 Jun-13 1,574 493 417 4.2x 13.4x 4.2x 13.3x
Number of Companies 3 Median: 9.3% 23.2% Total $10,071 $3,260 $4,555 $4,542 1.6x 13.4x 1.6x 13.3x
Mean: 8.0% 21.1% $3,260 2.1x 28.5x 2.1x 18.4x
Life Sciences Tools
Agilent Technologies Inc. $57.44 5.0% 34.3% $61.22 $42.72 $19,143 $2,693 $2,950 $18,889 $6,780 $1,337 $958 Apr-14 Oct-13 $6,992 $1,573 $1,346 2.8x 14.1x 2.7x 12.0x
Becton, Dickinson and Company 118.30 2.4% 19.7% 120.66 96.73 22,856 3,966 1,731 24,196 8,199 2,140 1,625 Mar-14 Sep-13 8,407 2,268 1,690 3.0x 11.3x 2.9x 10.7x
LifeWatch AG 9.60 8.1% 28.0% 11.35 6.55 128 4 0 122 94 6 2 Mar-14 Dec-13 89 8 5 1.5x 22.4x 1.4x 15.4x
Number of Companies 3 Median: 5.0% 28.0% Total $42,126 $14,402 $15,073 $15,487 2.8x 14.1x 2.7x 12.0x
Mean: 5.2% 27.3% $14,402 2.4x 16.0x 2.3x 12.7x
Medical Devices and Products
Abbott Laboratories $40.90 6.8% 17.3% $41.30 $32.70 $61,429 $7,765 $2,060 $62,246 $21,714 $4,359 $2,663 Mar-14 Dec-13 $22,514 $5,399 $4,212 2.9x 14.3x 2.8x 11.5x
Baxter International Inc. 72.30 (0.8%) 4.4% 75.88 62.80 39,110 8,695 2,049 45,778 15,762 4,087 3,211 Mar-14 Dec-13 16,616 4,546 3,662 2.9x 11.1x 2.8x 10.1x
Boston Scientific Corporation 12.77 (3.3%) 37.8% 14.08 9.05 16,891 4,249 191 20,945 7,156 1,636 937 Mar-14 Dec-13 7,393 1,800 1,083 2.9x 12.8x 2.8x 11.6x
CR Bard Inc. 143.01 (1.7%) 31.6% 150.13 106.72 10,906 1,405 940 11,370 3,080 817 669 Mar-14 Dec-13 3,274 968 804 3.7x 13.9x 3.5x 11.7x
Danaher Corp. 78.73 6.6% 24.4% 81.14 63.16 55,074 3,487 3,347 55,282 19,336 4,236 3,333 Mar-14 Dec-13 20,088 4,533 3,628 2.9x 13.1x 2.8x 12.2x
Hanger, Inc. 31.45 (5.3%) (0.6%) 40.71 28.47 1,082 562 56 1,588 1,053 166 128 Mar-14 Dec-13 1,106 181 138 1.5x 9.5x 1.4x 8.8x
Hologic Inc. 25.35 20.7% 31.3% 26.18 18.46 7,005 4,273 485 10,794 2,470 863 343 Mar-14 Sep-13 2,484 896 773 4.4x 12.5x 4.3x 12.1x
Hospira Inc. 51.37 20.6% 34.1% 52.86 38.06 8,586 1,779 677 9,688 4,170 518 283 Mar-14 Dec-13 4,172 767 553 2.3x 18.2x 2.3x 12.6x
Johnson & Johnson 104.62 7.4% 21.8% 106.00 85.50 295,980 17,292 19,722 283,880 71,922 23,640 19,559 Mar-14 Dec-13 74,940 25,039 20,897 3.9x 12.0x 3.8x 11.3x
Medtronic, Inc. 63.76 5.5% 23.9% 65.50 51.22 63,517 11,939 1,403 61,202 16,893 5,575 4,725 Apr-14 Apr-14 18,416 6,708 5,818 3.6x 11.0x 3.3x 9.1x
Stryker Corporation 84.32 4.7% 30.4% 86.93 63.71 31,965 3,064 1,381 30,982 9,136 1,483 1,155 Mar-14 Dec-13 9,610 2,683 2,303 3.4x 20.9x 3.2x 11.5x
Teleflex Incorporated 105.60 (0.1%) 36.3% 109.73 74.42 4,368 1,289 422 5,239 1,711 369 271 Mar-14 Dec-13 1,822 437 355 3.1x 14.2x 2.9x 12.0x
Thermo Fisher Scientific, Inc. 118.00 (0.4%) 39.4% 127.63 84.41 47,075 17,369 1,497 62,921 13,802 2,985 1,874 Mar-14 Dec-13 16,944 4,030 3,712 4.6x 21.1x 3.7x 15.6x
Zimmer Holdings, Inc. 103.86 10.8% 38.6% 108.33 74.85 17,430 1,683 883 17,527 4,646 1,689 1,320 Mar-14 Dec-13 4,778 1,808 1,449 3.8x 10.4x 3.7x 9.7x
Number of Companies 14 Median: 5.1% 30.9% Total $660,417 $48,532 $192,851 $204,156 3.2x 12.9x 3.0x 11.6x
Mean: 5.1% 26.5% $48,532 3.3x 13.9x 3.1x 11.4x
Medical / Surgical / Dental Supplies
AmerisourceBergen Corporation $72.66 12.1% 30.1% $73.81 $54.40 $16,410 $1,397 $697 $17,110 $104,008 $1,092 $917 Mar-14 Sep-13 $116,760 $1,615 $1,450 0.2x 15.7x 0.1x 10.6x
Cardinal Health, Inc. 68.56 (1.6%) 45.3% 74.40 46.52 23,324 3,920 3,041 24,203 93,610 2,538 2,072 Mar-14 Jun-13 90,027 2,482 2,088 0.3x 9.5x 0.3x 9.8x
Henry Schein, Inc. 118.66 0.8% 23.9% 120.99 95.94 10,129 792 129 11,277 9,697 812 681 Mar-14 Dec-13 10,226 854 715 1.2x 13.7x 1.1x 13.2x
McKesson Corporation 186.21 6.2% 62.6% 192.03 113.26 43,125 10,720 4,193 51,448 137,609 3,176 2,522 Mar-14 Mar-14 166,645 4,730 4,002 0.4x 16.2x 0.3x 10.9x
Owens & Minor Inc. 33.98 (1.6%) 0.4% 38.55 31.71 2,144 215 182 2,177 9,082 243 205 Mar-14 Dec-13 9,233 268 214 0.2x 9.0x 0.2x 8.1x
Patterson Companies, Inc. 39.51 (3.7%) 5.1% 44.39 36.59 4,106 732 265 4,533 4,064 396 346 Apr-14 Apr-14 4,343 432 380 1.1x 11.4x 1.0x 10.5x
Number of Companies 6 Median: (0.4%) 27.0% Total $99,238 $18,458 $358,069 $397,233 0.3x 12.6x 0.3x 10.5x
Mean: 2.0% 27.9% $18,458 0.6x 12.6x 0.5x 10.5x
TEV/ Fwd MultiplesCash and
Equiv.
Total Ent.
Value
(TEV)
Lastest Twelve Months
(LTM) LTM
Period
Lastest
FYE DateCompany Name
Equity
Mkt.
Value
Total Debt
TEV/ LTM MultiplesForward Estimate
Products & Devices
10
Healthcare & Life Sciences Trading Statistics
July 2014
As of June 30, 2014
Stock Price
% Change 52 Week
6/30/2014 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Acute-Care Hospitals
Community Health Systems, Inc. $45.37 17.4% (3.2%) $49.87 $34.55 $5,229 $17,071 $613 $22,460 $13,919 $1,709 $1,010 Mar-14 Dec-13 $19,134 $2,805 $1,564 1.6x 12.9x 1.2x 8.0x
HCA Holdings, Inc. 56.38 10.2% 56.4% 58.55 35.20 24,223 29,197 850 53,859 34,574 6,607 4,831 Mar-14 Dec-13 38,548 6,787 5,013 1.6x 8.1x 1.4x 7.9x
Lifepoint Hospitals Inc. 62.10 15.2% 27.1% 66.02 43.97 2,762 2,382 532 4,708 3,754 490 240 Mar-14 Dec-13 4,820 585 330 1.3x 9.6x 1.0x 8.1x
Tenet Healthcare Corp. 46.94 12.1% 1.8% 50.25 36.87 4,584 11,234 141 16,070 12,641 1,455 831 Mar-14 Dec-13 17,306 1,847 1,034 1.3x 11.0x 0.9x 8.7x
Universal Health Serv ices Inc. 95.76 20.2% 43.0% 98.89 63.51 9,460 3,233 16 12,956 7,372 1,393 1,043 Mar-14 Dec-13 8,830 1,384 1,013 1.8x 9.3x 1.5x 9.4x
Number of Companies 5 Median: 15.2% 27.1% Total $46,258 $22,011 $72,260 $88,639 1.6x 9.6x 1.2x 8.1x
Mean: 15.0% 25.0% $22,011 1.5x 10.2x 1.2x 8.4x
Assisted Living
Brookdale Senior Liv ing Inc. $33.34 0.8% 26.1% $34.80 $24.42 $4,287 $2,634 $46 $6,876 $2,572 $436 $162 Mar-14 Dec-13 $2,966 $498 $175 2.7x 15.7x 2.3x 13.8x
Capital Senior Liv ing Corp. 23.84 (6.4%) (0.3%) 26.89 19.87 692 528 12 1,208 349 53 11 Mar-14 Dec-13 384 70 20 3.5x 22.5x 3.1x 17.2x
Emeritus Corp. 31.65 2.1% 36.5% 32.57 18.15 1,552 3,994 59 5,481 1,981 347 160 Mar-14 Dec-13 2,102 376 173 2.8x 15.8x 2.6x 14.6x
Five Star Quality Care Inc. 5.01 6.1% (10.7%) 6.20 4.41 244 48 20 258 1,087 42 16 Sep-13 Dec-12 1,362 45 16 0.2x 6.1x 0.2x 5.8x
Skilled Healthcare Group, Inc. 6.29 25.3% (5.8%) 7.15 4.08 249 419 4 664 835 64 40 Mar-14 Dec-13 839 73 47 0.8x 10.0x 0.8x 9.1x
Number of Companies 5 Median: 2.1% (0.3%) Total $7,023 $2,897 $6,823 $7,652 2.7x 15.7x 2.3x 13.8x
Mean: 5.6% 9.2% $2,897 2.0x 14.0x 1.8x 12.1x
Diagnostic Imaging
Alliance Healthcare Serv ices, Inc. $27.00 (19.9%) 72.6% $35.40 $15.57 $284 $515 $29 $813 $444 $136 $61 Mar-14 Dec-13 NA NA NA 1.8x 5.8x NA NA
RadNet, Inc. 6.63 142.0% 150.2% 7.67 1.50 277 625 0 904 699 105 45 Mar-14 Dec-13 714 109 44 1.3x 8.2x 1.3x 8.3x
Varian Medical Systems, Inc. 83.14 0.8% 23.3% 86.60 65.70 8,643 469 939 8,093 2,986 671 610 Mar-14 Sep-13 3,131 688 628 2.7x 12.1x 2.6x 11.8x
Number of Companies 3 Median: 0.8% 72.6% Total $9,204 $3,270 $4,129 $3,845 1.8x 8.2x 1.9x 10.0x
Mean: 41.0% 82.0% $3,270 1.9x 8.7x 1.9x 10.0x
Dialysis Services
DaVita HealthCare Partners Inc. $72.32 5.7% 19.7% $73.61 $52.75 $15,491 $8,364 $1,108 $23,609 $11,971 $2,377 $1,832 Mar-14 Dec-13 $12,537 $2,402 $1,832 2.0x 9.8x 1.9x 9.8x
Fresenius Medical Care AG & Co. KGAA 49.02 (3.8%) (10.0%) 55.00 46.58 14,799 8,614 574 21,278 14,994 2,825 2,166 Mar-14 Dec-13 15,287 2,902 2,213 2.0x 10.3x 1.4x 7.3x
Number of Companies 2 Median: 0.9% 4.8% Total $30,290 $22,444 $26,964 $27,824 2.0x 10.0x 1.6x 8.6x
Mean: 0.9% 4.8% $22,444 2.0x 10.0x 1.6x 8.6x
Home Care, Hospice, and Home Infusion
Home Care / Hospice:
Addus HomeCare Corporation $22.48 0.6% 13.9% $32.40 $17.62 $245 $0 $17 $228 $275 $18 $15 Mar-14 Dec-13 $305 $22 $19 0.8x 12.9x 0.7x 10.5x
Almost Family Inc. 22.08 (5.9%) 15.7% 33.97 18.37 209 53 8 257 392 15 12 Mar-14 Dec-13 487 28 22 0.7x 17.2x 0.5x 9.0x
Amedisys Inc. 16.74 13.6% 44.3% 18.70 10.49 549 43 3 590 1,203 31 (4) Mar-14 Dec-13 1,193 37 2 0.5x 17.9x 0.5x 16.0x
Gentiva Health Serv ices Inc. 15.06 66.4% 51.2% 16.13 7.35 555 1,165 63 1,662 1,799 129 107 Mar-14 Dec-13 1,979 181 152 0.9x 12.9x 0.8x 9.2x
LHC Group, Inc. 21.37 (2.6%) 9.1% 26.90 19.12 380 71 3 461 647 52 43 Mar-14 Dec-13 709 53 44 0.7x 8.9x 0.7x 8.8x
Chemed Corp. 93.72 5.5% 29.4% 94.03 64.16 1,644 186 39 1,790 1,405 183 157 Mar-14 Dec-13 1,452 209 170 1.3x 9.8x 1.2x 8.6x
Number of Companies 6 Median: 3.1% 22.5% Total $3,581 $831 $5,720 $6,126 0.8x 12.9x 0.7x 9.1x
Mean: 13.0% 27.3% $831 0.8x 13.3x 0.7x 10.3x
Home Infusion:
BioScrip Inc. $8.34 23.6% (49.5%) $17.62 $5.61 $571 $419 $9 $980 $901 $24 $5 Mar-14 Dec-13 $965 $52 $18 1.1x 40.3x 1.0x 18.9x
Number of Companies 1 Median: 23.6% (49.5%) Total $571 $980 $901 $965 1.1x 40.3x 1.0x 18.9x
Mean: 23.6% (49.5%) $980 1.1x 40.3x 1.0x 18.9x
Long-Term Care
The Ensign Group, Inc. $31.08 (28.3%) (11.8%) $47.78 $26.02 $691 $259 $57 $888 $926 $130 $95 Mar-14 Dec-13 $998 $132 $108 1.0x 6.9x 0.9x 6.7x
Kindred Healthcare Inc. 23.10 0.7% 75.9% 26.81 12.50 1,474 1,671 49 3,040 4,924 296 140 Mar-14 Dec-13 5,140 388 224 0.6x 10.3x 0.6x 7.8x
National Healthcare Corp. 56.29 3.7% 17.8% 58.15 45.30 800 49 84 821 807 111 81 Mar-14 Dec-13 NA NA NA 1.0x 6.7x NA NA
Number of Companies 3 Median: 0.7% 17.8% Total $2,964 $1,583 $6,658 $6,139 1.0x 6.9x 0.7x 7.3x
Mean: (8.0%) 27.3% $1,583 0.9x 7.9x 0.7x 7.3x
TEV/ LTM Multiples TEV/ Fwd Multiples
Company Name
Equity
Mkt.
Value
Total DebtCash and
Equiv.
Total Ent.
Value
(TEV)
Lastest Twelve Months
(LTM) LTM
Period
Lastest
FYE Date
Forward Estimate
Provider-Based Services
11
Healthcare & Life Sciences Trading Statistics
July 2014
As of June 30, 2014
Stock Price
% Change 52 Week
6/30/2014 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Physician Practice Management
Multispecialty / Primary Care:
IPC The Hospitalist Company, Inc. $44.22 (9.6%) (13.9%) $63.70 $38.13 $758 $85 $23 $819 $629 $67 $62 Mar-14 Dec-13 $716 $77 $70 1.3x 12.2x 1.1x 10.7x
Number of Companies 1 Median: (9.6%) (13.9%) Total $758 $819 $629 $716 1.3x 12.2x 1.1x 10.7x
Mean: (9.6%) (13.9%) $819 1.3x 12.2x 1.1x 10.7x
Specialty:
MEDNAX, Inc. $58.15 (5.4%) 27.0% $64.51 $45.29 $5,779 $248 $20 $6,000 $2,218 $506 $465 Mar-14 Dec-13 $2,422 $560 $514 2.7x 11.9x 2.5x 10.7x
Number of Companies 1 Median: (5.4%) 27.0% Total $5,779 $6,000 $2,218 $2,422 2.7x 11.9x 2.5x 10.7x
Mean: (5.4%) 27.0% $6,000 2.7x 11.9x 2.5x 10.7x
Dental:
Birner Dental Management Serv ices Inc. $16.36 0.5% 0.0% $22.40 $16.75 $33 $9 $0 $42 $64 $4 ($0) Mar-14 Dec-13 NA NA NA 0.7x 11.7x NA NA
Number of Companies 1 Median: 0.5% 0.0% Total $33 $42 $64 $0 0.7x 11.7x NA NA
Mean: 0.5% 0.0% $42 0.7x 11.7x NA NA
Psychiatric Hospitals / Management
Magellan Health, Inc. $62.24 6.6% 11.0% $63.36 $53.51 $1,674 $26 $261 $1,417 $3,691 $240 $198 Mar-14 Dec-13 $3,709 $239 $136 0.4x 5.9x 0.4x 5.9x
Providence Serv ice Corp. 36.59 31.2% 25.8% 43.35 23.91 533 124 106 558 1,131 55 40 Mar-14 Dec-13 1,257 67 52 0.5x 10.1x 0.4x 8.3x
Universal Health Serv ices Inc. 95.76 20.2% 43.0% 98.89 63.51 9,460 3,233 16 12,956 7,372 1,393 1,043 Mar-14 Dec-13 8,830 1,384 1,013 1.8x 9.3x 1.5x 9.4x
Number of Companies 3 Median: 20.2% 25.8% Total $11,667 $3,733 $12,194 $13,797 0.4x 7.6x 0.4x 8.3x
Mean: 19.3% 26.6% $3,733 0.7x 6.3x 0.8x 7.9x
Surgicenters / Rehabilitation
Surgery Centers1:
AmSurg Corp. $45.57 (2.0%) 29.8% $52.81 $35.11 $1,872 $585 $47 $2,410 $1,084 $180 $147 Mar-14 Dec-13 $1,136 $193 NA 2.7x 13.4x 2.1x 12.5x
Surgical Care Affiliates, Inc. 29.08 (4.4%) NA 37.69 25.50 1,169 653 121 1,701 791 168 103 Mar-14 Dec-13 839 NA NA 2.4x 10.1x 2.0x NA
Number of Companies 2 Median: (3.2%) 29.8% Total $3,040 $2,055 $1,875 $1,975 2.6x 11.8x 2.1x 12.5x
Mean: (3.2%) 29.8% $2,055 2.6x 11.8x 2.1x 12.5x
Rehabilitation / Long Term Acute Care:
HEALTHSOUTH Corp. $35.87 2.3% 24.5% $37.68 $28.70 $3,160 $1,503 $53 $4,843 $2,266 $557 $458 Mar-14 Dec-13 $2,374 $571 $465 2.1x 8.5x 2.0x 8.5x
Select Medical Holdings Corporation 15.60 30.8% 90.2% 15.86 7.77 2,041 1,631 5 3,711 2,949 362 297 Mar-14 Dec-13 3,051 376 306 1.3x 10.2x 1.2x 9.9x
US Physical Therapy Inc. 34.19 1.2% 23.7% 37.25 26.91 418 47 17 474 267 46 40 Mar-14 Dec-13 292 42 NA 1.8x 10.4x 1.6x 11.4x
Number of Companies 3 Median: 2.3% 24.5% Total $5,619 $3,009 $5,482 $5,718 1.8x 10.2x 1.6x 9.9x
Mean: 11.4% 46.2% $3,009 1.7x 9.7x 1.6x 9.9x
Company Name
Equity
Mkt.
Value
Total DebtCash and
Equiv.
Total Ent.
Value
(TEV)
Lastest Twelve Months
(LTM) LTM
Period
Lastest
FYE Date
Forward Estimate TEV/ LTM Multiples TEV/ Fwd Multiples
12
Provider-Based Services
(1) EBITDA, EBIT, and Enterprise Value figures are adjusted for minority interest.
Enterprise Enterprise Value / LTM Private Equity
Announced Target Seller Buyer Value ($mm) Sales EBITDA EBIT Involvement
hoh18.75
6/30/2014 Transcept Pharmaceuticals, Inc. (NasdaqGM:TSPT) InterWest Partners LLC; Hamilton
BioVentures; SC Fundamental LLC; BVF
Inc.; Roumell Asset Management, LLC;
Valence Life Sciences
Paratek Pharmaceuticals, Inc. - - - - Yes
6/30/2014 Three Senior Liv ing Communities Located in Ohio - Capital Senior Liv ing Corp. (NYSE:CSU) 92.9 - - - No
6/30/2014 Catholic Health Care Serv ices of Archdiocese of
Philadelphia
Archdiocese of Philadelphia,
Endowment Arm
Center Management Group, LLC 145.0 - - - No
6/30/2014 Small Bone Innovations, Inc. HarbourVest Partners, LLC; Viscogliosi
Brothers LLC; NGN Capital; Trev i Health
Ventures LP; DFJ Esprit Secondaries
LLP; New Health Capital Partners LLC
Stryker Corporation (NYSE:SYK) 375.0 - - - Yes
6/30/2014 Precision Genome Engineering, Inc. - bluebird bio, Inc. (NasdaqGS:BLUE) 154.9 - - - No
6/30/2014 6 Senior Housing Communities - Newcastle Investment Corp. (NYSE:NCT) 186.0 - - - No
6/30/2014 Memphis Gastroenterology Group, P.C. - Gastro One Inc. - - - - No
6/30/2014 Presence Our Lady of the Resurrection Medical
Center
Presence Health - - - - - No
6/30/2014 St. Andrew's Life Center And Presence Ballard
Rehabilitation
Presence Health Glen Health & Home Management Inc. - - - - No
6/27/2014 CRG Operating Company, LLC - Fresenius Medical Care AG & Co. KGAA
(DB:FME)
- - - - No
6/27/2014 Advanced Health Care Partners, LLC - Regenerative Medicine Solutions, LLC - - - - No
6/26/2014 Hallmark Pathology, P.C. - Aurora Diagnostics Holdings, LLC - - - - No
6/26/2014 Ulthera, Inc. New Enterprise Associates; Apposite
Capital LLP
Merz North America, Inc. 600.0 6.6x 45.3x 50.2x Yes
6/26/2014 The University of Arizona Health Network, Inc. - Banner Health - - - - No
6/26/2014 Seven Area Hospitals from Erie to Pittsburgh - Highmark Inc. - - - - No
6/25/2014 South Shore Hospital, Inc. South Shore Health And Educational
Corporation
Partners HealthCare System, Inc. - - - - No
6/25/2014 MedHelp International, Inc. - Physicians Interactive, Inc. - - - - No
6/25/2014 HealthTech Serv ices and Consulting, Inc. - HealthPort Incorporated - - - - No
6/24/2014 Medical Action Industries Inc. (NasdaqGS:MDCI) - Owens & Minor Inc. (NYSE:OMI) 286.7 1.0x 18.9x 45.7x No
6/24/2014 Sound Inpatient Physicians, Inc. TowerBrook Capital Partners L.P. Fresenius Medical Care AG & Co. KGAA
(DB:FME)
- - - - Yes
6/24/2014 DAVA Pharmaceuticals, Inc. Guggenheim Capital, LLC Generics International (US), Inc. 600.0 4.6x 6.1x 9.5x Yes
6/24/2014 Medical Lasers Manufacturer Inc. - Medifirst Solutions, Inc (OTCPK:MFST) 0.0 - - - No
6/24/2014 Three Nursing Centers in Missouri - Av iv REIT, Inc. (NYSE:AVIV) 16.2 - - - No
6/24/2014 Prosthetic Laboratories of Rochester, Inc. - Hanger, Inc. (NYSE:HGR) - - - - No
6/23/2014 Clyde Bennett & Associates - Aldridge Minerals Inc. (TSXV:AGM) - - - - No
6/23/2014 Capario, Inc. Marlin Equity Partners, LLC Emdeon Inc. 115.0 - - - Yes
6/23/2014 Gentris Corporation - Cancer Genetics, Inc.
(NasdaqCM:CGIX)
6.3 - - - No
6/21/2014 Health Serv ices Connection Inc. - Nursing Resources by Black Stone - - - - No
6/20/2014 Virtus Pharmaceuticals, LLC - Linden LLC - - - - Yes
6/20/2014 OptiNose US Inc. - Avista Capital Holdings, L.P. - - - - Yes
6/20/2014 E. Claiborne Robins Company, Inc. Hi-Tech Pharmacal Co., Inc. Valeant Pharmaceuticals International,
Inc. (TSX:VRX)
41.0 - - - No
6/19/2014 Honored Citizens Choice Health Plan, Inc. - Alignment Healthcare LLC - - - - No
6/19/2014 Glenridge Healthcare Solutions, Inc. - WhiteGlove Health, Inc. - - - - No
6/19/2014 Adam Nutrition, Inc. - IVC Industries, Inc. - - - - No
6/18/2014 Portfolio of Four Properties Located in Alabama,
Michigan, Oklahoma and Tennessee
Chartwell Retirement Residences
(TSX:CSH.UN)
Focus Healthcare Partners; Garrison
Street Partners, Inc.
136.1 - - - No
6/18/2014 Global Distribution, Inc. - - - - - - No
6/18/2014 Blackmaple Prov ider Recovery Group, LLC The Blackmaple Group Medical Reimbursements of America,
LLC
- - - - No
6/17/2014 Health & Comfort Home Care Agency, Inc. - C & M Health Serv ices, LLC - - - - No
6/17/2014 Spectrum Health Systems, Inc. - RepuCare Onsite LLC - - - - No
6/17/2014 Park Avenue Nursing & Rehabilitation Center Inc. - Synergy Health Centers LLC - - - - No
6/16/2014 ProteinSimple Domain Associates, L.L.C.; Essex
Woodlands Health Ventures; The
Vertical Group; Wellcome Trust; Novo
A/S; Latterell Venture Partners
Techne Corp. (NasdaqGS:TECH) 300.0 5.6x 43.6x 84.8x Yes
6/16/2014 Blueprint Clinical, Inc. - BioClinica, Inc. - - - - No
6/16/2014 California Occupational Clinic, Inc. - U.S. Healthworks, Inc. - - - - No
6/16/2014 Evolution1, Inc. Genstar Capital, LLC WEX Inc. (NYSE:WEX) 532.5 6.0x 20.0x - Yes
6/16/2014 Michigan Veterinary Supply Co., Inc. - ANIMART Inc. - - - - No
6/15/2014 Cipe Consulting Group, LLC - Cumberland Consulting Group, LLC - - - - No
6/13/2014 Actavis Plc. Lincoln County operations Actavis plc (NYSE:ACT) G & W Laboratories, Inc. - - - - No
6/13/2014 Health Technology Solutions, Inc. - VertitechIT, Inc. - - - - No
6/13/2014 Lane Blood Center - Puget Sound Blood Center and Program - - - - No
6/12/2014 Bay Walk-In Clinic, Inc. - ACSH Urgent Care of Florida, LLC 2.2 - - - No
6/12/2014 Centra Panoramic Wellness - Centra Health, Inc. 0.4 - - - No
6/12/2014 Amirsys, Inc. - Elsev ier B.V. - - - - No
6/12/2014 Rancho Injury Care Center - Matt Smith Physical Therapy - - - - No
6/11/2014 Collaborative Research LLC, Health Access
Div ision
Collaborative Research LLC Germain & Co., Inc. - - - - No
6/11/2014 Manzo Pharmaceuticals, Inc. - Fortune Oil & Gas, Inc. (OTCPK:FOGC) - - - - No
6/10/2014 National Database of Nursing Quality Indicators American Nurses Association,
Endowment Arm
Press Ganey Associates, Inc. - - - - No
6/10/2014 Phoenix Physicians, LLC - EmCare Inc. 170.0 - - - No
6/10/2014 T-System, Inc., Medical Billing Business T-System, Inc. Intermedix Corp. - - - - No
6/10/2014 Jacksonville Pediatric Associates, M.D., P.A. - Pediatric Associates, Inc. - - - - No
6/9/2014 The van Halem Group, LLC - VGM Group, Inc. - - - - No
6/9/2014 Fortitude Group, Inc., Medical Assets Fortitude Group, Inc. (OTCPK:FRTD) Cascade Technologies Corp.
(OTCPK:CSDT)
2.0 - - - No
6/8/2014 Idenix Pharmaceuticals Inc. (NasdaqGS:IDIX) MPM Capital; Novartis Venture Funds;
Nomura International plc; The Baupost
Group, LLC; Novartis Pharma AG; T.
Rowe Price Associates, Inc.
Merck & Co. Inc. (NYSE:MRK) 3,644.0 - - - Yes
6/6/2014 Expression Genetics, Inc. - Celsion Corp. (NasdaqCM:CLSN) 44.2 - - - No
6/5/2014 TBLO - Interactive Health Network
(OTCPK:IGRW)
- - - - No
M&A Detail
July 2014
Announced U.S. Healthcare & Life Sciences
M&A
13
Enterprise Enterprise Value / LTM Private Equity
Announced Target Seller Buyer Value ($mm) Sales EBITDA EBIT Involvement
6/5/2014 Mastix Medica LLC - GelStat Corp. (OTCPK:GSAC) - - - - No
6/5/2014 RadCore Lab, LLC - Cardiocore Lab, Inc. - - - - No
6/5/2014 Globalone Information Technologies LLC - Medytox Solutions, Inc. (OTCBB:MMMS) - - - - No
6/4/2014 Medical Advantage Group Michigan State Medical Society The Doctors Company - - - - No
6/4/2014 Care Medical Partners, LLC - Patient Home Monitoring Corp.
(TSXV:PHM)
1.4 0.1x 0.8x - No
6/4/2014 LABREPCO, Inc. - VWR International LLC - - - - No
6/4/2014 Cardiac Data Solutions, Inc. - Healthtrust Purchasing Group, LP - - - - No
6/3/2014 Cappella Peel Away, Inc. Cappella Inc. STENTYS Société anonyme (ENXTPA:STNT) 1.2 - - - No
6/3/2014 Zefon International, Inc., GRIP-LOK Zefon International, Inc. TIDI Products, LLC - - - - No
6/3/2014 Pine Manor Healthcare, Greentree Health &
Rehab, Englewood Post-Acute & Rehab and
Rainier Rehab
- The Ensign Group, Inc.
(NasdaqGS:ENSG)
- - - - No
6/3/2014 Labrys Biologics, Inc. Canaan Partners; InterWest Partners
LLC; Sofinnova Ventures, Inc.; venBio
LLC
Teva Pharmaceutical Industries Limited
(NYSE:TEVA)
825.0 - - - Yes
6/3/2014 AKM Medical Group, Inc. - Apollo Medical Holdings, Inc.
(OTCPK:AMEH)
- - - - No
6/3/2014 Texas Regional Medical Center Ltd. - Tenet Healthcare Corp. (NYSE:THC) - - - - No
6/3/2014 PediaVision Holdings, LLC - Welch Allyn, Inc. - - - - No
6/2/2014 La Conner Retirement Inn and South Pointe
Assisted Liv ing
- CNL Lifestyle Properties, Inc.
(OTCPK:CLLY)
12.5 - - - No
6/2/2014 Sunnyside Operations LLC - Avamere Family of Companies Inc. - - - - No
6/2/2014 RJ Health Systems International, LLC - Fitzroy Health, LLC - - - - No
6/2/2014 Refine Technology, LLC - Repligen Corporation
(NasdaqGS:RGEN)
33.4 - - - No
6/2/2014 Rehab Documentation, Inc. Council & Enhanced Tennessee Fund,
LLC
Net Health Systems, Inc. - - - - No
6/2/2014 Access Dental Plan, Inc. - The Guardian Life Insurance Company
of America
- - - - No
6/2/2014 Endo Pharmaceuticals Inc., Early Stage Drug
Discovery Portfolio
Endo Pharmaceuticals Inc. Asana BioSciences, LLC - - - - No
6/2/2014 REGENX Biosciences, LLC, Worldwide License to
Proprietary NAV® Vectors
REGENX Biosciences, LLC Voyager Therapeutics, Inc. - - - - No
6/2/2014 Brevard HMA Nursing Home, LLC Health Management Associates Inc. Greystone Healthcare Management
Corp.
- - - - No
6/2/2014 Industricare, LLC - U.S. Healthworks, Inc. - - - - No
6/2/2014 56 Unit Assisted Liv ing Community in Sacramento - National Health Investors Inc. (NYSE:NHI) 11.5 - - - No
6/2/2014 Aid & Assist At Home LLC - Addus HomeCare Corporation
(NasdaqGS:ADUS)
- - - - No
6/2/2014 Post-Acute And Long-Term Care Skilled Nursing
Facility In Kentucky
- Aviv REIT, Inc. (NYSE:AVIV) 6.0 - - - No
6/2/2014 Medical Staffing Network Healthcare, LLC - Cross Country Healthcare, Inc.
(NasdaqGS:CCRN)
48.3 0.2x - - No
6/2/2014 First Aid Only, Inc. - Acme United Corp. (AMEX:ACU) 13.8 0.8x - - No
6/2/2014 RevPoint Healthcare Technologies, Inc. - Availity, LLC - - - - No
6/2/2014 Bettencourt Skin Center LLC - Advanced Dermatology & Cosmetic
Surgery Inc.
- - - - No
6/2/2014 Mid-Atlantic Pathology Serv ices, Inc. - Aurora Diagnostics Holdings, LLC - - - - No
6/2/2014 Organ-i, Inc. - Immucor, Inc. - - - - No
6/1/2014 Physician Serv ices of Cleveland, LLC - Team Health Holdings, Inc. (NYSE:TMH) - - - - No
6/1/2014 Kindred Healthcare, Inc., Seven Nursing Centers
Located in Wisconsin
Kindred Healthcare Inc. (NYSE:KND) Midwest Geriatric Management, LLC - - - - No
6/1/2014 OSO BioPharmaceuticals Manufacturing, LLC Altaris Capital Partners, LLC Albany Molecular Research Inc.
(NasdaqGS:AMRI)
110.0 - - - Yes
M&A Detail
July 2014
Announced U.S. Healthcare & Life Sciences
M&A(Continued)
14
Bill KayserVice President
+1 (804) 915-0180
15
Contacts
July 2014
Contacts Turner BredrupManaging Director
+1 (804) 915-0110
Cheairs PorterManaging Director
+1 (804) 915-0130
James ClarkManaging Director
+1 (804) 915-0119
Todd MorrisManaging Director
+1 (415) 217-3412
Andy DixonDirector
+1 (415) 217-3419
Geoff SmithDirector
+1 (804) 915-0195
Whit KnierVice President
+1 (804) 932-1321
Paul HepperVice President
+1 (804) 932-1326
Andy HewlettVice President
+1 (415) 217-3427
16
Sources: Capital IQ.
Thomson Financial.
S&P.
Reuters.
Bloomberg.
Irving Levin Associates.
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