SCA Pharma is a leading national 503B pharmacy that specializes in providing the highest quality sterile compounded products to hospitals and health systems throughout the U.S. SCA plays a critical role in the pharma supply chain providing its customers with timely and reliable access to the most commonly used medications in ready-to-use formats, while reducing waste and providing a buffer against drug shortages. The SCA team of professionals is committed to leading the 503B industry with the highest levels of medication access, quality and patient safety, while delivering on-time and in-full with exceptional customer service. The company’s state-of-the-art facilities in Windsor, CT and Little Rock, AR exceed USP <797> standards and meet cGMP requirements.
Top Down Investment Thesis
Excellere’s investment in SCA Pharma is a result of the company’s unique value proposition, market leadership and the tailwinds within compounded sterile medication outsourcing. SCA provides significant value to hospitals by lowering overall costs of compounded medications while providing longer shelf-life than in-house production, back filling shortages from generic drug manufacturers, and improving supply chain dynamics and reliability. Rising in-house compounding costs, expanding regulations requiring significant investments for in-house healthcare pharmacies to maintain compliance (e.g. USP <800>) coupled with decreased hospital capex budgets, and a continued focus on patient safety/risk management are driving rising outsourcing rates. 503B providers with larger purchasing volumes, reliable drug access, greater production capabilities and cGMP operations are far better suited to deliver lower cost medications with higher quality assurance. Driven by these factors, demand for outsourced compounded medications significantly outpaces the existing constrained supply. Additionally, the 503B industry acts as a valuable safety net supporting hospitals and ensuring delivery of critical care during drug shortages caused by break downs in the fragile global pharmacy supply chain.
Buy and Build
SCA has differentiated itself by consistently delivering the highest quality products on-time and in-full, and is a unique pharma-grade solution for outsourced compounded sterile medications for hospitals and health systems. To the extent you are interested in learning more about SCA Pharma, please contact Ryan Glaws at , Matt Halverson at , or Ryan Revolinski at .
Advanced Ear, Nose & Throat Specialists (“ADVENT” or the “Company”) is a provider of otolaryngology (“ENT”) services in Illinois and Wisconsin, seeking to improve patient outcomes by identifying, diagnosing, and treating the root causes of breathing and sleeping issues. The Company is a specialty ENT practice, primarily focused on performing in-office balloon sinuplasty, a minimally-invasive procedure that uses a sinus balloon to open blocked passageways. ADVENT employs a unique operating model that improves patient care and outcomes by focusing physician time on procedures and leveraging Advanced Practice Practitioners (“APPs”) for initial patient evaluations and certain post-op visits.
Top Down Investment Thesis
Excellere’s investment in ADVENT capitalizes on increased demand for services in the growing market associated with sleeping conditions such as sleep apnea or habitual snoring, increased emphasis on finding long-term solutions for common nose and throat issues such as sinus infections or nasal congestion, and continued procedural shifts towards outpatient and in-office settings. Additionally, the ENT market remains highly fragmented and is in the beginning stages of consolidation supported by interest from large health systems and institutional capital. Within the U.S., there are approximately ~11,500 otolaryngologists with ~45% of these physicians practicing at one of the estimated ~2,400 private ENT practices, a majority of which are generalists.
Buy and Build
ADVENT’s position in the large and growing market for ENT services associated with sleeping conditions is further supported by its focus on in-office and outpatient procedures which place it on the right side of the cost-curve, lowering overall costs to patients and payers while improving outcomes. ADVENT first focuses on the underlying causes of common breathing and sleeping issues, following a patient-centric care plan that explores non-surgical options before recommending any surgical procedure. For those requiring surgery, almost all procedures are performed in the lower cost in-office setting, which results in favorable treatment from payers and condensed recovery time. To the extent you are interested in learning more about ADVENT, please contact Matt Hicks at , Ross Gundry at , or Ryan Revolinski at .
ParcelShield offers predictive parcel surveillance technology, driven by machine learning algorithms, to protect critical package deliveries primarily for specialty pharmacies, mail order pharmacies, and specialty pharmaceutical distributors in the United States. The Company’s primary service offerings include (i) predicting potential route disruptions and package distress using predictive analytics, (ii) monitoring shipments in real time through a customer-facing surveillance portal, (iii) intercepting distressed shipments and coordinating successful delivery, and (vi) proactively engaging consumers to manage on-time deliveries. The Company’s services are enabled by a proprietary data model and analytics platform based on more than 17 years of shipping data that allows ParcelShield to protect high-cost, temperature-sensitive, and life-sustaining pharmaceuticals on behalf of its clients.
Top Down Investment Thesis
Excellere’s investment in ParcelShield is based upon the convergence of several long-term themes in the pharmaceutical supply chain and broader healthcare industries, including (i) expansion of the overall specialty pharmacy pipeline increasing the supply of high-price, patient-specific medications in the marketplace, (ii) growing demand for home delivery of medications and heightened consumer expectations for timely and reliable delivery, and (iii) new and evolving regulatory requirements, such as URAC 4.0, that demand greater visibility of product in the pharmaceutical supply chain. ParcelShield’s innovative predictive parcel technology platform solves these complex issues and generates a highly compelling financial ROI for its customers of greater than 25x, alongside tangible benefits to patient satisfaction and retention rates.
The parcel shipping market is experiencing substantial growth as the surge in e-commerce is driving increasing consumer expectations for express delivery direct to homes. Global package shipping volume rose 48% from 2014 to 2016 and is expected to continue to rise more than 20% annually through 2021. E-commerce has been the biggest contributor to shipping volume trends with consumers spending $517 billion online in 2018 in the US alone, which was up from 15% in 2017. Healthcare-specific online spending has continued to grow as well with the percentage of online and mail-order drug spend projected to increase from 25% in 2017 to 36% in 2022. A large portion of this growth will be through online and mail-order pharmacies, which are expected to grow at 10% annually through 2022. Rising consumer expectations of convenience coupled with increased pricing pressure will drive a greater percentage of prescription drug spending online in the years to come.
Buy and Build
The market for predictive parcel surveillance and engagement services has substantial tailwinds due to declining profitability margins for specialty and mail order pharmacies driving a need for cost mitigation measures, pharmacies’ need to improve the consumer’s overall experience, and tightening regulations in drug distribution channels. ParcelShield is well positioned to capitalize on these opportunities as a result of its proprietary parcel surveillance technology platform that is unmatched by anything currently in the market. To the extent you are interested in learning more about ParcelShield, please contact Brad Cornell at , Mike Vieth at , or Chris Flight at .
“An exciting opportunity exists for SePRO to create additional value to customers across the markets we serve by expanding the breadth and depth of our products and services. It is clear to us that Excellere supports SePRO’s commitment to solving its customer’s most complex challenges. SePRO anticipates the Excellere partnership will enable the successful next phase of the company’s growth.”
Bill Culpepper President & CEO
Active
SePRO Corporation is dedicated to discovering and developing sustainable solutions. Founded in 1994 and based in Carmel, Indiana, SePRO is a research based specialty chemicals company that provides products and services for plant management, plant protection and specialty agriculture. SePRO’s products and services are used in multiple end markets including aquatic invasive weed management, algae and water quality, turf and landscaping management, ornamental and greenhouse markets, as well as specialty agriculture. The company acquires, develops, manufactures, and markets value-added products and is the industry-leading provider of application, lab testing and technical support services. SePRO has partnered with several of the top agriculture chemical companies to develop chemistries for use in SePRO’s key markets. Central to its product innovation and technical support services is a 410-acre SePRO Research & Technology Campus (SRTC) in Whitakers, NC.
Top-Down Investment Thesis
SePRO operates in the aquatic invasive weed management, algae and water quality, turf, ornamental, and specialty agriculture markets. According to a market study, the U.S. aquatic herbicide and algae markets are sized at approximately $155 million and $515 million, respectively, and are expected to grow at 8.0%-9.0% and 4.5%-5.0% annually over the next five years. Market growth is being driven by rising global temperatures, increasing both nutrient runoff in waterways and the severity of drought and flooding. These conditions provide favorable environments for aquatic plants, increasing the prevalence of invasive weeds and algae blooms. Invasive weeds and algae have negative impacts on property values, local economies, recreational activities, fish populations and native ecosystems. Customers, particularly state governments and large waterbody management agencies and companies, place a high level of importance on product performance, technical support and application expertise. SePRO is recognized as the market-leader with these capabilities. Additionally, growing emphasis is being placed on sustainable solutions and reduced-risk profile technologies. SePRO leads the industry in research and product innovation, advancing the aquatics industry with new, proprietary, and eco-friendly chemistries, such as ProcellaCOR, that meet these demands.
The U.S. market for cotton herbicides is approximately $265 million, with an estimated $80 million spent on pre-emergent herbicides. Herbicides are critical to cotton growers’ ability to preserve yield, as invasive weeds such as pigweed can infest growing fields and reduce productivity by approximately 30%. Given growing herbicide resistance issues, cotton agronomists have recommended the complementary use of pre- and post-emergent herbicides. SePRO’s new, pre-emergent herbicide product, Brake, has proven to be highly effective and long-lasting with a different mode of action than existing herbicides driving adoption as a rescue tool for farmers facing resistance issues. In addition, SePRO has several biological products in its development pipeline focused on other the specialty agriculture markets for use in both traditional and organic crops with demonstrated activity against viruses, fungi, mildew, foliar bacteria and/or soil-borne pathogens.
The $860 million U.S. turf and ornamental chemicals market is projected to grow at 1.6% annually, with fungicides and plant growth regulators (“PGRs”) outpacing the market growth at 2.5-3.0% annually. Increased use of PGRs is being driven by golf course superintendents and landscaping companies seeking to reduce manual labor associating with cutting faster growing grass and hedges. Increased use of fungicides is being driven by resistance issues to older chemistries as well as the introduction of new products for specialty solutions. End users of this market typically buy through early order, bundled product programs due to a preference for rebates and desire to simplify purchasing. SePRO has highly efficacious PGRs and has new fungicides in development to add to its portfolio that will create a more robust bundled offering.
Buy and Build Strategy
SePRO’s success over the years has been based on its product innovation, proprietary technology and unique technical expertise and service capabilities. As a result, SePRO benefits from exceptional longstanding partnerships with its customers, distributors and suppliers. SePRO is a highly compelling platform for acquisitions due to its industry-leading capabilities, channel relationships and national reach and reputation. The Company is pursuing strategic acquisition and partnership opportunities in the specialty chemicals and agribusiness industries, including companies and technologies focused on plant protection/management, turf management, water quality, specialty agriculture as well as other environmental and horticulture markets. Opportunities could include both traditional and bio-rational solutions, including but not limited to herbicides, fungicides, algaecides, insecticides/pesticides, molluscicides, virucides, biological enzymes, as well as PGRs, soil surfactants and agents, fertilizers and other specialty chemicals.
To the extent you are interesting in learning more about SePRO, please contact Patrick O’Keefe at or Matt Halverson at .
“Concord has been built on a commitment to provide solutions that help our customers use their data securely and efficiently,” said Chris Moore, founder and CEO of Concord. “We continue to experience tremendous growth and have sought a partner with a proven track record of helping high-growth companies scale into industry leaders. We are thrilled to partner with the Excellere team and believe their unique combination of healthcare expertise and their value creation process will help to position Concord properly for the massive growth that lies ahead.”
Chris Moore CEO
Active
Concord Technologies is a leading SaaS provider of cloud-based document transfer and workflow solutions to more than 1,500 healthcare organizations and companies in other document-intensive industries in which data security and privacy are paramount. Within the healthcare ecosystem, Concord’s solutions promote data interoperability through the efficient and secure exchange of critical, time-sensitive and private documents between independent organizations, including medical records, prior authorizations and explanations of benefits, among many others. In addition, Concord’s AI-powered workflow solutions allow organizations to receive, ingest and direct large amounts of inbound unstructured data, while enabling greater efficiency through tools that allow for document recognition, searchability, extraction, archiving and automation.
Top Down Investment Thesis
Concord’s solutions address the pervasive challenge faced by constituents across the healthcare ecosystem in managing the vast amounts of critical data in paper-based, unstructured formats that cannot be easily transmitted, processed or accessed to support patient care. According to LEK, approximately 64 billion pages of healthcare data was transmitted in 2018, including medical records, patient referrals, diagnostic test results, and prior authorizations, among many others. Of all healthcare document transfers, approximately 80% were transmitted via fax due to fax’s unique ability to connect all healthcare constituents via a common medium in a HIPAA compliant manner. As a result, the U.S. market for cloud fax services is estimated to be $750 million and is expected to grow approximately 13% per year as utilization of healthcare services continues to grow and practices replace legacy paper-based fax architecture with SaaS-based cloud fax solutions.
Despite its advantages and ubiquity in healthcare, fax documents contain only unstructured data which lacks a common format or metadata that would allow for easy automation, data capture, and integration into enterprise technology systems, such as EMR platforms. In fact, Optum estimates that 80% of the health data it receives is in an unstructured format, which must undergo manual review, data abstraction, and management by staff members in order to be converted into a usable, structured data format. This takes clinical staff away from patient care, increases the incidence of human-introduced errors, and increases the overall cost of healthcare through inefficient and expensive manual handling. Concord’s NEXTSTEP solution, through its machine learning and native language processing engines, alleviates many common challenges in its ability to automate the recognition, extraction, structuring and integration of data into external systems or route the information to appropriate recipients based on documents received via fax, scanned paper documents and PDF. Through these automated functions, NEXTSTEP creates significant cost savings, reduces error rates, and makes available vast amounts of previously inaccessible data contained in unstructured form.
Buy and Build
The market for secure document transfer, capture, and workflow automation within healthcare has substantial tailwinds due to the continued push to reduce cost, increase interoperability, and improve patient care. Concord’s platform is well positioned to continue its organic growth trajectory due to its market-leading cloud fax platform, further enhanced by its proprietary workflow automation and data capture solutions. To the extent you are interested in learning more about Concord, please contact Ryan Glaws at or Mike Vieth at .
Founded in 1997 and based in Pacheco, CA, Biocare Medical (“Biocare”) is an oncology-focused developer of immunohistochemistry (“IHC”) and molecular reagents, as well as the associated instrumentation. With a product portfolio of patented and licensed products, Biocare offers a comprehensive suite of reagents, equipment, and lab services to clinical laboratories, research organizations, and pharmaceutical manufacturers. Serving nearly 2,000 customers worldwide with a catalogue of over 2,000 unique product SKUs, customers rely on Biocare’s product quality and consistency for their research and clinical needs.
Top Down Investment Thesis
Excellere’s investment in Biocare is a result of the firm’s disciplined top down investment strategy, driven by several factors including i) a compelling value proposition to medical and research professionals who can better identify cancer with enhanced specificity, ii) attractive industry growth driven by increasing cancer incidence rates and expanding testing and research needs, iii) IHC’s position as the most widely used platform in histopathology and standard of care for cancer diagnoses, and iv) the buy-and-build opportunity within a highly fragmented industry sector that Excellere pursued for approximately five years and established a list of over 100 acquisition candidates and industry relationships.
The reagents industry is large, global and fast growing with several drivers providing attractive tailwinds. Biocare’s primary end-market is cancer research and detection, one of the most attractive sub-segments within the broader life sciences tools sector. According to LEK, worldwide cancer incidence is expected to grow 2.4% per annum to nearly 17.1 million new cancer diagnoses in 2020. Increases in the total number of new cancer diagnoses are driving an expanding number of U.S. biopsy procedures and ultimately growing consumption of reagents. The worldwide IHC and molecular diagnostics market is expected to grow to $2.4 billion by 2021, reflective of approximately 5% annual growth driven by cancer incidence rate growth, development of new biomarkers, and pricing increase within the currently primary technology for the cancer diagnostic value chain.
Buy and Build Strategy
Consumable life science and diagnostic tools remains a highly fragmented industry with a multitude of organic and acquisition growth opportunities. Since inception, Biocare has remained focused on providing world class immunohistochemistry and molecular products solely focused on the attractive, growing oncology market with an emphasis on cancer research, diagnostics, and monitoring. Biocare’s significant historical investments in its research and development capabilities, manufacturing footprint, strong executive team and a global sales force provides the scale required to serve a substantial worldwide customer base.
To the extent you are interested in learning more about Biocare, please contact Ryan Glaws at , Justin Unertl at , or Nick Coleman at to discuss the life science tools sector further.
Founded in 1980 and based in Hamilton, NJ, Medlogix is a premier provider of medical claims management solutions to leading auto insurance carriers, administrators for workers’ compensation and group health insurers. Leveraging its proprietary technology platform and deep clinical expertise, Medlogix offers a full suite of medical claims management services including pre-certification, independent medical exams, medical director review, medical bill and code review, and bill negotiation support as well as operates a proprietary PPO network in the northeastern United States.
Top Down Investment Thesis
Excellere’s investment in Medlogix is a result of the firm’s disciplined top down investment strategy, driven by several factors including i) rising medical costs driving an increase in auto and workers’ compensation claim severity, ii) persistence of improper billing and fraudulent claims within the auto and workers’ compensation industries, iii) carrier’s enhanced focus on effective loss prevention and cost containment solutions, and iv) growing utilization of outsourced service providers that improve efficiency and offer a quantifiable ROI.
According to the Insurance Research Council and National Insurance Crime Bureau, annual costs related to improper billing or fraudulent claims in the auto insurance and workers’ compensation industries are estimated to total up to $7.7 and $7.2 billion, respectively. Despite a decline in claim frequency, since 2005 rising medical costs have driven an increase in claim severity (per claim cost) of 35.5% for bodily injury liability claims and 40.7% for workers’ compensation claims. Persistent claim fraud, rising medical costs and growth in claim severity are propelling the need for greater, more robust claims management and cost control measures among insurers and corporations; outsourced providers of medical claims management services offer an essential, highly effective loss containment solution. Medlogix’s medical claims management solutions and proprietary PPO network help carriers i) identify areas for cost savings tied to improper billing and limit leakage due to payment of fraudulent claims, ii) reduce administrative expenses associated with claims adjudication, and iii) lower medical treatment costs. Combined, the Company’s services deliver a more efficient and disciplined claims process, resulting in greater productivity and reduced severity for its customers.
Buy and Build Strategy
Medical claims management is a highly fragmented industry, which combined with continued trends in the outsourcing of non-core service functions by carriers, creates an attractive sector to employ a buy-and-build strategy. It is estimated that there are currently more than 500 outsourced medical claim service providers in the United States, the vast majority of which are regionally focused and family owned. Medlogix is focused on partnering with organizations known for service quality and excellence in complementary business lines and operating in favorable geographies.
To the extent you are interested in learning more about Medlogix, please contact Matt Hicks at , Ross Gundry at , or Nick Coleman at to discuss the medical claims management services sector further.
Founded in 2003 and headquartered in Powell, Ohio, Two Labs Marketing provides innovative solutions for pharmaceutical manufacturers’ most prevalent and complex commercialization challenges. The Company leverages its experience from more than 125 discrete product launches to design and implement proven commercial strategies that are customized to each product’s therapeutic class, distribution channel and patient access needs. Two Labs’ comprehensive portfolio of commercialization services incorporates best-in-class product launch, compendia strategy, trade management, state licensing, e-prescribing, and lifecycle management services. Through strategic partnerships with Two Labs, pharmaceutical clients are able to provide patients with access to critical therapies while optimizing the commercial potential of their brands.
Top Down Investment Thesis
According to the Centers for Medicare & Medicaid Services, pharmaceutical spending in the U.S. is forecasted to nearly double by 2025 to $615 billion annually. Market growth is being driven by a host of favorable demographic trends and the rapid emergence of specialty pharmaceuticals, including biologics and orphan drugs, some of which present promising new clinical options to today’s most significant therapeutic areas. As these revolutionary therapies continue to evolve, so too does the commercial environment and the ways in which pharmaceutical manufacturers must engage with patients, payers, prescribers and regulators to provide access to these treatments. Achieving a product’s full commercial potential requires pharma manufacturers to effectively communicate a product’s clinical value, resolve patient access and support challenges, select appropriate distribution channels and optimize their performance, and cope with ever-evolving regulations. In doing so, manufacturers require strategic partners with substantial expertise in product commercialization, as well as a detailed understanding of the dynamics specific to the product’s therapeutic area and competitive environment. For more than 13 years, Two Labs has been a trusted partner of pharma and biotech companies to manage the most critical details necessary for timely, successful product launches and optimized performance throughout the product lifecycle.
Buy and Build Strategy
Two Labs’ success has been built over many years based on unique service capabilities, exceptional customer service and deep expertise in product commercialization and support services. As a result, Two Labs benefits from exceptional customer loyalty and longstanding partnerships with its client base. Two Labs is a highly compelling platform for acquisitions due to the breadth and diversity of its customer base, and its proven ability to maintain strong customer relationships through a broad service offering that spans the duration of a product’s lifecycle. The Company is pursuing strategic acquisition opportunities in the pharmaceutical market access services industry, including companies with the following capabilities: (i) managed markets strategy and implementation, (ii) healthcare data aggregation and analytics, (iii) trade management, (iv) patient support services, (v) regulatory pathway and compliance consulting, (vi) government affairs / health economics and outcomes research, or (vii) medical science liaison outsourced agents.
LucidHealth is a leading provider of professional radiology services to hospitals, clinics and outpatient imaging centers, completing over 1.7 million interpretations per year. Powered by the belief that all patients should have access to the highest quality of subspecialized imaging care, regardless of facility size or location, LucidHealth leverages its internally developed, industry-leading workflow technology and clinical processes to provide the highest-quality, subspecialized care for patients and referring physicians. Founded in 1980 and based in Ohio, LucidHealth is a top ten provider of radiology services in the United States.
Top Down Investment Thesis
According to WallStreet Research, United States commercial healthcare spending on the radiology industry is over $200 billion per annum and is expected to grow at a 10% CAGR from 2015-2020, driven by constantly evolving imaging technologies and the overall expansion of healthcare. Imaging and radiology services are one of the largest spend categories at hospitals, representing nearly 10% of total U.S. commercial healthcare spending each year. Hospitals are continuing to outsource highly subspecialized services such as radiology due to operational challenges associated with keeping them in-house. In addition to challenges related to recruiting, retention, and billing, hospitals often are forced to pay for full-time employees regardless of whether there is enough volume to justify an on-staff physician. Outsourced models allow hospitals to benefit from high-quality subspecialty providers, while enjoying the flexibility of only paying for services that are needed.
With the implementation of PQRS and transition to MACRA and other reforms, payers have become increasingly focused on monitoring quality outcomes to justify reimbursement, and LucidHealth is well positioned to benefit from these changes due to its investments in technology and infrastructure. In turn, this is propelling growth in imaging services as a way to increase efficiency and drive elevated clinical outcomes. Radiology is a leading driver of key hospital metrics such as patient safety, emergency department throughput, length of stay, referral patterns and overall patient experience.
Excellere’s investment in LucidHealth is a result of the firm’s disciplined top down investment strategy, driven by several factors including i) expectations for the continued outsourcing of radiology services, ii) an increased aversion to malpractice liability from misdiagnosis, iii) relative stability in radiology reimbursement rates for professional services, and iv) increased focus on quality outcomes within the medical community.
Buy and Build Strategy
Radiology is one of the most fragmented medical subspecialties, which combined with positive outsourcing trends, makes it an attractive subsector to employ a buy-and-build strategy. It is estimated that there are currently more than 3,000 radiology groups in the United States, with only the top 15 in the country having more than 65 radiologists in their practice. LucidHealth is focused on partnering within radiology service providers with a culture of compliance, best-in-class patient outcomes, and a patient-first approach clinically and operationally.
To the extent you are interested in learning more about LucidHealth, please contact Patrick O’Keefe at , Justin Unertl at , or Nick Coleman at to discuss the radiology services sector further.
Mentis, founded in 2006 and headquartered in Houston, Texas, is a leading provider of inpatient and outpatient postacute neuro-rehabilitative care to persons with an acquired brain injury ("ABI"). The Company utilizes an interdisciplinary clinical model with customized modified care plans that focus on each patient’s specific behavioral, clinical and social deficiencies. The Company’s comprehensive services include a combination of neuropsychological services, 24-hour rehabilitative nursing, cognitive rehabilitation, physical therapy, speech and language therapy, occupational / vocational rehabilitation, recreational therapy, group therapy, and physical medicine and rehabilitation management. Mentis allows patients that have suffered an ABI to re-enter their homes, community and/or workforce in a shorter period of time with meaningfully enhanced outcomes and greater independence.
Top Down Investment Thesis
Acquired brain injury includes both traumatic brain injuries ("TBI") (commonly caused by falls, auto accidents, workplace injuries, and assaults) as well as strokes, tumors or other conditions whereby the brain is damaged from a lack of oxygen. An estimated 2.4 million people in the U.S. sustain a TBI and another 795,000 sustain an acquired brain injury from non-traumatic causes each year. Currently more than 6.4 million individuals in the U.S. live with a lifelong disability as a result of TBI or stroke. Patients suffering from an ABI typically undergo a long and exhaustive care process that spans from the highest acuity setting down through lower levels of care and rehabilitation depending on the progress of each individual patient. The ultimate end-point for a patient, depending on their level of rehabilitation and independence, can span from a full recovery and independent living to a very limited recovery that requires life-long custodial care. This broad span of outcomes has very material cost ramifications as long-term custodial care can run millions of dollars depending on the age of the patient when they sustain their injury.
Excellere’s investment in Mentis is a result of the firm’s disciplined top down investment strategy, driven by several factors including i) an increased national awareness of brain injury, ii) the increased survival rate of those who have sustained a TBI due to medical advances, iii) higher incidences of stroke in a growing aging population, iv) cost pressures associated with increased healthcare spending shifting more patients to post-acute, lower cost settings, v) a strong and stable reimbursement outlook for neuro-rehabilitative care, vi) a niche market with a unique and complex patient and referral base making it very difficult for other rehabilitation facilities and new market participants to successfully treat ABI patients, and vii) Mentis' outcomes-driven clinical model offers a clear value proposition to each constituency the Company serves (patients, families, referents and payers) by allowing patients to re-enter their homes, community and/or workforce in a shorter period of time with greater independence.
Buy and Build Strategy
Post-acute neuro-rehabilitation is an underserved and highly fragmented market consisting mainly of smaller local and regional providers. Throughout its growth, Mentis has demonstrated an ability to establish new de novo facilities using a systematic approach to new market evaluation, referral source education, licensing, payer contracting and local recruiting. This proven ability to open new facilities in a fragmented marketplace, combined with the opportunity to expand geographic coverage through new referral and payer relationships, expanded service offerings and enhanced technology, creates an attractive buy-and-build opportunity. Mentis is actively seeking strategic add-on acquisitions of post-acute neuro rehabilitative care providers that will enable the Company to broaden its geographic footprint and deepen its presence in the market.
To the extent you are interested in learning more about Mentis, please contact Ryan Glaws at or Matt Halverson at to discuss the neurorehabilitation services sector further.
Founded in 2001, TrialCard Incorporated (“TrialCard” or the “Company”) provides specialized services that solve the market access challenges faced by the pharmaceutical industry. The Company offers customized solutions for clients that assist with prescription adherence and abandonment, sales force support, patient case management, reimbursement and clinical support, market share lift, product rescue, and loss of exclusivity challenges. TrialCard’s pharmaceutical manufacturer clients optimize revenue through a brand’s life cycle, while patients and providers benefit from better clinical outcomes and lower overall cost of care. TrialCard’s broad suite of services is enabled by the Company’s database of pharmacy-level transactions, data analytics capabilities, award-winning customer experience center, and proprietary program management processes; all of which enhance program efficacy and return on investment for its customers.
Top Down Investment Thesis
According to the New England Healthcare Institute, medication non-adherence is estimated to drive $290 billion in avoidable spending to the U.S. healthcare industry annually through unnecessary hospitalizations and additional medical risks. Seven percent of prescriptions are abandoned at the point of sale and between 33% and 50% of patients do not take their medications as prescribed. TrialCard’s portfolio of services helps drive patient access and adherence for pharmaceutical manufacturers, while simultaneously adding value across the healthcare delivery chain (i.e., pharmacies, patients and healthcare providers). One significant factor in non-adherence is the out-of-pocket cost burden on patients, thus co-pay programs and product vouchers have proven to be powerful tools in driving adherence. Patients are 2.3x more likely to refill physician prescribed medication when using TrialCard programs. Additionally, these programs generate actionable consumer insights while driving superior patient outcomes, which benefit physicians, patients and payers. Another significant cause of non-adherence is the complexities of specialty drugs relating to payer support, clinical coordination and drug administration. To address this issue, TrialCard’s specialty therapy hub provides assistance for patients in navigating the complex reimbursement challenges associated with specialty drug therapies such as prior authorization, benefits investigation and appeals processes. Through improving patient outcomes and lowering overall cost of care, increasing adherence generates benefits for all constituents in the healthcare system.
Buy and Build Strategy
The patient access and pharmaceutical adherence services industry is highly fragmented with a limited number of competitors providing a complete customer solution. TrialCard is well positioned to continue the expansion of its capabilities, customer relationships and technologies across the entire patient journey. The Company is pursuing strategic acquisition opportunities in the outsourced pharmaceutical support services industry, including the following existing and complementary capabilities: (i) specialty therapy hub services, (ii) tele-detailing, (iii) patient support / education, (iv) disease management, and (v) consulting and enhanced analytics.
To the extent you are interested in learning more about TrialCard, please contact Brad Cornell at or Mike Vieth at .
G2 Integrated Solutions is a provider of asset integrity solutions to midstream and downstream energy companies, offering a suite of services designed to help clients manage risk within their existing transmission and distribution networks, demonstrate regulatory compliance, and extend the useful lives of their infrastructure assets. The Company leverages customers' internal data and records, its proprietary tools and methodologies, and a deep pool of highly trained professionals to solve complex operating problems for an extensive client base that includes a number of high profile North American pipeline operators and natural gas utilities.
Top Down Investment Thesis
Given the dramatic increase in activity in the domestic energy market, aging midstream and downstream infrastructure, and an increasingly stringent regulatory environment surrounding these assets, Excellere believes that there is an opportunity to establish a vertically integrated integrity management services provider that operates through a national footprint and broad suite of capabilities. Excellere’s investment into G2 Integrated Solutions is driven by a number of dynamics, including (i) the opportunity to deliver G2’s broad suite of advanced technical solutions to a diverse set of clients that are focused upon risk management solutions and regulatory compliance support, and (ii) attractive end market fundamentals, whereby new project build-out is resulting in an expanded installed base for service and an aging infrastructure is positioning high-quality integrity management services providers for future growth.
Increasing global demand, advancements in horizontal drilling and hydraulic fracturing technologies and new discoveries of economically viable basins have contributed to the continued emphasis on unconventional oil and gas production. In order to support this increased activity, energy companies are required to build infrastructure to integrate new producing regions into existing midstream and downstream networks, maintain and support aging infrastructure given increased throughput, and engineer complex solutions such as converting gas pipelines to liquids in order to respond to market conditions. Furthermore, given the increase in energy activity and the number of high profile catastrophic incidents, an increasingly stringent regulatory environment has evolved, which is driving higher compliance standards. As a result, the North American natural gas industry is currently projected to spend an estimated $20.0 billion annually through 2035 to build new infrastructure and maintain existing assets, resulting in substantial future opportunities for integrity management service providers with advanced technical capabilities and broad service offerings.
Buy and Build Strategy
The North American asset integrity market is highly fragmented with numerous independent product and service providers. As such, G2 Integrated Solutions is well-positioned to add complementary capabilities and extend its geographic reach via acquisitions. The fragmentation in this market, coupled with the increased importance of domestically produced oil and natural gas to the North American energy supply, has created an opportunity to build a full-scale integrity management solutions provider to midstream and downstream energy companies. Specific areas of interest within the systems integrity management industry include: (i) complementary high-end infrastructure engineering services, (ii) GIS products and services, (iii) data analytics and management, and (iv) safety services.
To the extent you are interested in learning more about G2 Integrated Solutions or the integrity management industry, please contact Brad Cornell at .
“When it came to selecting a partner to help grow our business, there were two critical factors that we considered. First, it was culture. We wanted a partner that mirrored our unwavering commitment to doing things the right way... be it for our patients, referral sources or for our employees. Second, we desired to join forces with a firm that would help us grow and enhance our company in a manner that included additional resources beyond capital. With Excellere Partners we have found both of these elements and we couldn’t be more excited about our future together.”
Chuck Bell Founder
Active
Advanced Infusion Solutions (“AIS”) is a compliance focused provider of patient-specific medications for chronic pain patients with intrathecal pumps, as well as for patients requiring other chronic therapies such as immune globulin. Intrathecal drug delivery is a method of providing customized medications directly to a patient’s spinal cord through an implanted pain pump that is surgically placed under the skin of a patient’s abdomen. The pump is programmable to allow for the slow release of patient-specific medication over a period of time through a catheter to a targeted area around the spinal cord and is refilled periodically. Founded in 1998, AIS operates is headquartered in Dallas, Tx and provides services in all 50 states with additional operations in Ridgeland, MS, Clinton, MS, Valdosta, GA and Birmingham, AL.
Top Down Investment Thesis
Excellere’s investment in AIS is based upon (i) the non-discretionary need for intrathecal drug delivery for patients with chronic pain conditions that cannot be improved from further surgeries or oral pain medications, (ii) the highly recurring revenue model of intrathecal pain management, as the estimated 250,000 patients using this treatment receive 4 to 6 pain pump refills annually, and (iii) the highly-fragmented nature of the industry.
The U.S. chronic pain industry, at over $100 billion in annual spending, is characterized by numerous constituents trying to serve the 100+ million Americans suffering from chronic pain linked to diseases and syndromes such as obesity, cancer, diabetes, arthritis, HIV-AIDS, failed surgeries, cerebral palsy, multiple sclerosis and countless other conditions. The industry is expected to continue growing due to (i) a rapidly growing geriatric population – “baby boomers” currently account for 30%+ of the U.S. population, (ii) continued and growing U.S. obesity, which contributes to chronic pain as body structures support heavier weights over time and wear down, (iii) increasing recognition of the therapeutic benefits of effective pain management (specifically, versusoral pain medications) and (iv) expected growth in surgical procedures (29% from 2010 to 2020).
Buy and Build Strategy
The intrathecal pain pump market is composed of approximately 250,000 patients, and is expanding due to the increase in chronic pain patients as well as the recognition of intrathecal pumps as a safe and cost effective treatment methodology for patients that have exhausted other forms of therapy (e.g. continual oral medications and multiple surgeries). AIS’s platform is well positioned to grow both organically and through selective acquisitions due to its (i) compliance-centric model (including USP 797), (ii) growing and recurring patient base, (iii) diversified referral network and (iv) proven growth profile.
To the extent you are interested in learning more about AIS, please contact Ryan Glaws at or Matt Halverson at .
“At PhyMED, we saw an opportunity to parlay the success of our proven model – focused on the provision of quality anesthesia care, service and patient safety – by expanding the breadth and depth of our services. The Board and senior management decided the time was right to find a partner that shared our vision for growth and passion for delivering unparalleled quality care to a broader market. We believe we found all that and more in Excellere as evidenced by their commitment to help the company achieve its goals and take it to the next level”
David Whitten Chief Executive Officer
Realized
PhyMED is a leading provider of outsourced anesthesia, interventional pain management and other complementary services to hospitals, medical facilities and ambulatory surgery centers. Formed in 1994 and based in Tennessee, PhyMED is a top ten provider of anesthesia services in the United States.
Top Down Investment Thesis
Excellere’s investment in PhyMED is a result of a four year search for an anesthesia platform based on the firm’s disciplined top down investment strategy, driven by several factors including i) the non-discretionary nature of anesthesia services that carry a high degree of medical necessity as sedation is required for most surgical procedures, ii) a clear and deep value proposition to patients, surgeons, medical facilities and payers, and iii) the highly-fragmented nature of the industry.
The key customers for an outsourced provider of anesthesia services are the healthcare facilities, and more specifically the surgeons that anesthesiologists work with. For the medical facilities, a contracted or outsourced anesthesiology partner provides dedicated anesthesiologists and Certified Registered Nurse Anesthetists (CRNAs), while reducing the need for internal resources dedicated to recruiting, credentialing, scheduling, billing, collections and compliance. For the surgeon and facility, there is significant value gained through access to a consistent staff of anesthesia professionals available in order to maximize the efficiency and throughput of the operating room, which is one of the most profitable areas of a hospital.
The U.S. anesthesia services industry is estimated at over $23.0 billion and growing at 4% per year, in line with growth in total surgical procedures and case reimbursement rate trends. The number of U.S. surgical procedures is projected to grow 29% from 2010 to 2020.
Buy and Build Strategy
The anesthesia services sector is highly fragmented and comprised of over 1,000 providers nationally. This fragmentation, combined with the opportunity to significantly enhance the value provided to its customers’ experiences and outcomes through the use of technology-driven solutions, suggests an immense opportunity to execute a customer-centric, buy-and-build strategy. Specific areas of focus within the outsourced anesthesia services sector include other compliance-focused anesthesia providers and complementary service lines such as interventional pain management and critical care coverage.
To the extent you are interested in learning more about PhyMED, please contact Matt Hicks at or Justin Unertl at to discuss the anesthesia services industry further.
“We elected to partner with Excellere given its proprietary value creation tools and processes that we will leverage to help accelerate our growth and solidify our position as the premier provider of outsourced oil and natural gas engineering services. Excellere’s successful track record and experience supporting entrepreneurs with aggressive growth strategies focusing on the customer will prove invaluable as we seek to further enhance our service offerings, expand our capabilities and enter new markets.”
Todd Poulson President
Realized
IPT is an oil and natural gas engineering services firm specializing in the integration of modern well completion, hydraulic fracture stimulation and reservoir engineering technologies. The Company is comprised of practicing petroleum engineers with extensive operator and service company experience throughout the United States and in select international markets. IPT is considered one of the foremost thought leaders in the hydraulic fracturing industry with over 20 years of experience working in most basins and major shale plays. IPT not only provides highly technical consulting services that significantly influence the economics of a well, but also represent an independent third-party expert at the well site that helps to ensure that all parties are performing their respective duties in a safe and efficient manner.
Top Down Investment Thesis
Recent discoveries of oil and natural gas reserves, increasing global demand and the evolution of horizontal drilling and well completion technologies have spawned a substantial increase in exploration and production activity in the United States. According to the Annual Energy Outlook 2012 as published by the U.S. Energy Information Administration (“AEO12”), U.S. dependence on imported petroleum liquids is projected to decline by more than one million barrels per day by 2020 driven primarily by growth in domestic oil production. In addition, net petroleum imports as a share of total U.S. liquid fuels consumed is projected to drop from 49 percent in 2010 to 36 percent in 2035 as the United States continues to harvest its natural resources in pursuit of energy independence. Technological advances and the increasing commercial consumption of natural gas will also drive increased exploration and production activity. Since 2000, U.S. shale gas production has increased 17-fold, currently comprising approximately 30 percent of the total U.S. production, and is projected to comprise 49% of total U.S. production by 2035 (according to AEO12).
In order to unlock the potential of the oil and natural gas resources trapped in tight formations and shale plays, exploration and production companies have enlisted the services of hydraulic fracturing experts that employ advanced completion and stimulation techniques to optimize the output of their wells. The pressure pumping market, which includes hydraulic fracturing and other stimulation services provided to oil and gas exploration and production companies, is expected to grow from $16.7 billion in 2009 to $51.0 billion in 2012, driven in part by the effectiveness of these services to enhance well production.
Buy and Build Strategy
The oil and natural gas engineering services market is highly fragmented with a limited number of institutional service providers capable of managing national programs for customers. Furthermore, the majority of service providers offer only one solution to customers, rather than providing a fully integrated suite of capabilities that spans the lifecycle of an active well. This fragmentation, coupled with the limited service offerings of most industry participants, has created an opportunity to build an integrated solutions provider with a broad set of complementary capabilities to better serve customers. Specific areas of interest within the oil and natural gas engineering services industry include: (i) complementary high-end capabilities such as seismic processing or well design (ii) technology enabled solutions and software (iii) data collection, management and analytics, and (iv) regulatory compliance.
To the extent you are interested in learning more about IPT, please contact David Kessenich at or Brad Cornell at to further discuss the oil and natural gas services industry.
“We were very fortunate to have found a capital provider like Excellere whose team is totally committed to the over-achievement of our business goals. The Excellere team understands what it takes to build a best-in-class industry leader in the insurance sector and have already helped us immensely in pursuing our strategic objectives.”
Kieran Sweeney Chairman
Realized
Personable Insurance (“Personable” or the “Company”) is an independent agent-driven, specialist non-standard auto insurance provider. Personable has partnerships with multiple insurance carriers and relationships with over 3,000 independent agents in California, Florida, Georgia and Texas. The Company plans to expand its capabilities further via the organic extension of its service offerings and acquisitions of additional non-standard auto assets and businesses in a number of key strategic states.
Top Down Investment Thesis
Excellere’s investment in Personable is a result of the firm’s disciplined top down investment strategy, and is driven by several factors including (i) the non-discretionary, critical nature of insurance products and services, ii) the highly-fragmented nature of the industry and iii) the opportunity to create a highly-compelling value proposition to carriers, distributors, service providers and insured companies and individuals (“insureds”).
The insurance products and services industry can be segmented into carriers, distributors (agencies and brokerages) and service providers. Carriers receive premiums for providing insurance coverage and typically assume the risks covered by the policy. Depending on a primary carrier’s risk preference, the actual risk may be offloaded to reinsurers who assume all or part of the risk associated with a particular policy. Agencies and brokerages serve as the distribution channel for carriers by selling policies to individuals and businesses, and in some instances rendering services such as underwriting, claims management and customer relations on behalf of their carrier partners. Finally, service providers supply both carriers and distributors with outsourced services and expertise in select areas in which a carrier or distributor may not maintain a core competency.
Gross premiums in the U.S. are expected to exceed $1.5 trillion in 2010/11, and with continued economic recovery, each segment of the insurance sector is poised for expansion at varying growth rates.
Buy and Build Strategy
The insurance sector is highly fragmented and comprised of over 3,000 U.S. carriers, 35,000 distributors and 5,000 service providers. This fragmentation, combined with the opportunity to significantly enhance its customers’ experiences and outcomes through the use of technology-driven automated systems, has created an opportunity to execute a customer-centric, buy-and-build strategy. Specific areas of focus within the insurance sector include: Managing general agents (“MGAs”) in non-standard auto or other niche segments, rural and independent agencies, and service providers (specifically TPAs, loss control / underwriting support, subrogation, data providers and software providers).
To learn more about Personable or the insurance products and services industry, please contact Brad Cornell at or Justin Unertl at .
“Excellere was chosen as our partner of choice due to their knowledge of our industry, partnership approach, and demonstrated ability to assist our company in our quest to become an industry leader.”
Allan Bly CEO
Realized
U.S. Water Services (“USWS” or the “Company”) is one of the largest independent, fully-integrated, industrial / commercial water treatment companies in the U.S., serving a wide range of industrial, commercial and institutional accounts. The Company's chemicals division offers a comprehensive line of approximately 350 proprietary, branded and blended chemical products and support services. These chemicals improve production efficiency, reduce utility and maintenance costs, protect against contamination/corrosion, enhance compliance regulation and are non-discretionary purchases for customers providing highly predictable and recurring revenue for USWS. The Company's equipment division offers a complete line of engineered water treatment capital equipment (filtration, softeners, delivery systems, etc.), parts and consumable supplies (filters, membranes, etc.).
Top Down Investment Thesis
The increasing cost of water due to scarcity, quality challenges and environmental policies has driven manufacturers and other water users to employ increasingly sophisticated techniques to treat their water supply for industrial processes and/or discharge. Small and mid-sized businesses often do not have the in-house knowledge to apply more advanced technologies or properly adhere to the evolving regulatory environment. Leading water treatment providers offer customers this expertise on an outsourced basis and can provide the diagnostic support to continuously evaluate the clients' needs and offer proprietary chemical blends and engineered equipment to meet each customer's unique requirements.
Buy and Build Strategy
Having completed the recapitalization with Excellere in January of 2011, USWS is actively seeking to acquire and/or partner with other water treatment companies in the United States. Companies serving the food and beverage, utility, microelectronic and other commercial industries would complement USWS current customer base.
To the extent you are interested in learning more about U.S. Water Services, please contact David Kessenich at or Patrick O’Keefe at .
“We are grateful for the partnership created with Excellere. From our first introduction, it was clear to our senior management that AxelaCare and Excellere shared similar values and a passion to be a best in class provider. We looked at Excellere as more than just a capital partner. With their experience in multiple healthcare segments, they helped us refine our current core strengths and add others to expand our value proposition with the goal of having an even greater impact on the patients we serve.”
Ted Kramm Co-Founder and CEO
Realized
AxelaCare, headquartered in Lenexa, Kansas, is a leading provider of home infusion therapy services, including Intravenous Immune Globulin (“IVIg”), Hemophilia and other traditional home infusion services, such as Intravenous Antibiotics and Total Parenteral Nutrition (“TPN”). The company, which was founded by a team of proven industry veterans, is experiencing rapid growth and currently operates three pharmacies serving patients in 25 states. AxelaCare’s full service approach includes hands-on clinical management of the patient intake process to ensure that patients are able to begin therapies in a timely and efficient manner. This combination of outstanding clinical and pharmacy services, along with AxelaCare’s culture of patient advocacy and support, significantly differentiates the company from other industry participants.
Top Down Investment Thesis
Excellere’s investment in AxelaCare is a result of the firm’s disciplined top down investment strategy. In 2008, Excellere targeted the specialty pharmacy sector (including home infusion) as an attractive buy-and-build opportunity and spent the subsequent two years carefully seeking a partnership with an industry leading management team who shared a vision to build a truly differentiated company.
AxelaCare competes within the specialty infusion sector of the specialty pharmacy industry. Specialty infusion services primarily involve the intravenous (i.e., directly into veins or muscles, or under the skin) administration of medications to treat a wide range of acute and chronic health conditions. Physicians, hospital discharge planners and case managers generally refer patients to specialty infusion providers to continue their therapies at home or in other non-acute settings.
The market for specialty infusion is approximately $10 billion and growing at approximately 8% to 12% annually. This significant organic growth is driven by numerous factors including: (i) favorable demographic trends, (ii) a growing pipeline of new pharmaceuticals and therapies that are appropriate for infusion, (iii) patient preference for home care (especially in cases of chronic diseases), (iv) lower costs as compared to treating chronic illnesses in a hospital setting, and (v) technological advancements that have made delivering complex therapies in the home safer and more prevalent. Approximately 70% of the drugs now under development in the biotech pipeline will require some degree of specialized, hands-on administration via injection or infusion.
Buy and Build Strategy
The specialty infusion sector is highly fragmented, with an estimated 700 to 1,000 home infusion providers in the United States. This fragmentation, combined with the industry’s strong organic growth, creates an attractive buy-and-build opportunity. AxelaCare is actively seeking strategic add-on acquisitions of home infusion providers that will enable the Company to broaden its geographic footprint and deepen its presence in the attractive home infusion market.
To the extent you are interested in learning more about AxelaCare, please contact Ryan Glaws and or Justin Unertl at .
MTS Medication Technologies (“MTS”) is a leading international provider of pharmaceutical adherence packaging solutions focused on the long term care, retail and nutraceutical markets. MTS designs, develops and manufactures proprietary pharmaceutical adherence packaging along with a complete line of highly specialized automated equipment to assist institutional pharmacies and long term care facilities with pharmaceutical dispensing, inventory management, and storage. MTS serves more than 8,000 customers in the United States, Canada, Europe, Australia, and the Middle East.
Top Down Investment Thesis
Pharmaceutical adherence packaging (i) increases patient compliance for their drug regimens; (ii) enables pharmacies to dispense drugs more efficiently/reliably and store/handle drugs properly; (iii) makes compliance easier for patients, who often must consume multiple drugs, multiple times per day to comply with their doctor’s prescribed regimen; (iv) provides physicians, through greater patient adherence, with the comfort that their prescriptions are being followed properly; and (v) reduces healthcare costs through fewer emergency room visits/deaths/hospital admissions related to non-adherence. Estimates indicate 28% of emergency room visits are related to the misuse of drugs; 70% of which are preventable and 24% of which result in hospital admissions. In addition, U.S. healthcare costs related to treating patients due to medication non-adherence is estimated to be $60-$100 billion annually (Healthcare Compliance Packaging Council).
Buy and Build Strategy
Partnering with Excellere to pursue a buy-and-build strategy, MTS is currently looking for acquisition opportunities that would enable the company to add more products and services to its existing customers, as well as increase its reach through new customers and distribution channels both domestically and internationally.
For more information regarding MTS please contact Matt Hicks at or Ryan Glaws at .
“We had two primary objectives for our transaction with Excellere. We wanted to diversify our net worth and find a partner to help us take our business to the next level. Excellere became instrumental in developing our growth strategy, improving our core processes and aligning our organization to become more scalable. Excellere was an invaluable extension of my team and I could not be more pleased with our partnership – we accomplished great things together.”
Vishal Lal CEO
Realized
Advanced Pain Management (“APM”) is a Milwaukee-based, leading provider of interventional pain management services throughout Wisconsin. APM has the expertise to diagnose and treat a broad range of pain conditions, including pelvic, spine, neck, hip, cancer, diabetes, and obesity-related pain.
Top Down Investment Thesis
Chronic pain is estimated to cost the U.S. economy $90 to $100 billion per year. Costs continue growing due to increasing obesity, the aging population, and overall poor lifestyles. Interventional pain management (“IPM”) is a multidisciplinary approach for managing and eliminating pain and became more visible when it was granted a medical sub-specialty from the Centers for Medicare and Medicaid Services in 2003.
Interventional pain management develops customized plans, and uses minimally invasive outpatient procedures, such as nerve blocks, epidurals, and implants to help patients manage or eliminate pain. IPM is an attractive alternative to higher-risk heavy drug regimens that simply mask the pain or costly surgeries that require lengthy recovery and questionable long term outcomes. As a result, IPM offers an excellent value proposition to the patients, referring physicians, and payors
To learn more about Advanced Pain Management, please call Matt Hicks at .
“I learned three powerful lessons as an owner of a rapidly growing business. First, you must invest, and continue to invest, to grow. Second, the manner of that investment may change over time and you need to be disciplined but flexible. And, third, always choose your partners well, based on a foundation of integrity, excellence, and shared vision and commitment. We embarked on a nationwide search and chose Excellere Partners above all others; together, we are turning yesterday’s dreams into today’s realities. In short, Excellere delivers even more than they promise.”
Ann Costello Co-Founder
Realized
ASI is a trusted advisor to the Federal Government, providing consulting services, productivity tools and training to over 56 clients within the Department of Defense, Homeland Security and Civilian agencies.
Top Down Investment Thesis
The dollar volume of Federal government purchases has grown by 63% over the past six years to approximately $425 billion (~8.5% growth). Meanwhile, the aging demographics of the federal workforce, high turnover among government employees and budgetary pressures have created greater demand for a trusted advisor to assist the Government in improving acquisition, program management and broader IT processes and outcomes.
Buy and Build Strategy
ASI is pursuing acquisition opportunities that will allow it to accelerate its geographic expansion into key markets (Huntsville, AL; San Diego, CA; etc.) as well as add additional differentiated service offerings for its clients within two general categories:Smaller,
Niche Service Providers – Government consulting and training companies that enhance and broaden ASI's current service offering.
Divestitures – There is an excellent opportunity to acquire the divisions of larger, diversified companies that are compelled to divest their acquisition support business units to eliminate conflicts of interest.
To learn more about ASI, please contact Patrick O’Keefe at .
“When we considered our liquidity options, we wanted to find a financial partner with a track record and the ‘know how’ to help us realize our dream of expanding nationwide and becoming an industry leader. During our partnership with Excellere, we invested heavily in our infrastructure and grew the company ten-fold in size. Excellere’s passion for our vision has inspired our entire team.”
Frank Alderman Co-Founder and CEO
Realized
MedExpress Urgent Care (“MedExpress”) is a leading provider of outpatient urgent care services. It currently operates urgent care centers in Pennsylvania, West Virginia, Colorado, and Florida. MedExpress delivers high-quality urgent care, including digital X-ray, laboratory work, EKGs, IV therapy, and minor surgery, and provides patients a greater level of convenience and flexibility than emergency rooms or primary care physicians. The clinics always have physicians onsite and are open daily to deliver flexible, efficient, and fast care.
Top Down Investment Thesis
Urgent care is an emerging model within the U.S. health care system. It is based on improved access to care delivered in a timely and cost effective manner. Many emergency departments have long wait times, and an antiquated primary care system leaves patients waiting days and sometimes weeks for an appointment. Urgent care provides a convenient and affordable health care solution for patients who need timely, high quality care. A typical urgent care center visit costs approximately 25 percent of a similar visit to a hospital emergency room. Because most visits to emergency departments are not for life threatening reasons, urgent care centers reduce healthcare costs significantly.
To learn more about MedExpress, please call Ryan Glaws at .
Healthcare
Business Services
Industrial Growth
