Industry Insights
Healthcare Services Sector Update
Early Summer 2022

Healthcare Services Sector Update | Early Summer 2022

Highlights
The S&P Healthcare Services Index
decreased by 0.9% over the last month,compared to the S&P 500 Index, which
exhibited no change over the same period.

The Sectors with the Highest Valuation Multiples

Over the past month:

Assisted/Independent Living (2.21x LTM
revenue, 32.1x LTM EBITDA)

The sectors that experienced the largest increase
were Home Medical Equipment (up 38.3%),
Behavioral Health (up 5.7%) and Distribution (up4.3%).

Consumer Directed Health/Wellness (4.41x
LTM revenue, 27.1x LTM EBITDA)

The sectors that experienced the largest decline
were Assisted/Independent Living (down 9.4%),
Care Management/TPA (down 6.5%), and Dialysis
Services (down 5.8%).

HCIT (3.37x LTM revenue, 23.7x LTMEBITDA)

The current average Last Twelve Months (LTM)
revenue and LTM EBITDA multiples for thehealthcare services industry overall are 2.61x and
14.8x, respectively.

Hospital Vendors (1.43x LTM revenue,20.5x LTM EBITDA)

2

Healthcare Services Sector Update | Early Summer 2022

Healthcare Services Sector Update
Market Sector

No. ofCompanies

EquityMkt. Value ($mn)

Average % Change

LTM Multiples

Earnings Ratio

1 mo12 mo

Rev

EBITDALTM

2022E

PEG Ratio
2022E

Providers
Acute Care Hospitals
Assisted/Independent Living
Behavioral HealthDialysis Services
Healthcare Staffing
Home Health/Hospice
Rehabilitation
Skilled Nursing
Providers – Other

4
33
2
2
95
2
8

$79,085
1,281
13,78327,0295,008
26,073
11,821
5,546
23,199

(2.5%)(9.4%)
5.7%(5.8%)(1.5%)(1.1%)
0.0%
1.5%
2.6%

(5.0%)(21.4%)(17.8%)(22.5%)
9.7%(4.6%)(28.3%)(2.7%)(31.4%)

1.28x
2.21x
NM
1.77x
0.76x
1.84x
2.35x
1.53x
4.19x

7.7x
32.1x
15.5x
10.4x
5.7x
19.2x
17.2x
16.3x
17.6x

7.6x
0.3x
26.8x
11.5x
7.7x
27.5x
21.9x
15.9x
11.7x

9.3x
NM
23.6x
12.5x
6.5x
23.1x
20.2x
19.9x
10.0x

0.9x
NM
2.3x
1.2x
0.3x
2.4x
1.1x
1.3x
0.4x

Payors/Managed Care
Commercial Managed Care
Government Managed Care
Specialty Managed Care

53
1$734,409
66,661
9,556(0.1%)(0.8%)(2.9%)

18.3%
9.8%
9.6%

1.83x
0.79x
1.03x

14.6x
11.6x
9.8x

20.8x
28.4x
17.0x

17.7x
15.8x
13.9x

1.3x
1.1x
0.8x

Consumer Directed Health/Wellness

5$8,726

1.9%(23.2%)

4.41x

27.1x

18.6x

33.8x

3.6x

Telemedicine

7$8,2722.3%(70.9%)

1.59x

NM

28.4x

24.4x

NMHCIT30$83,714(2.5%)(2.0%)

3.37x

23.7x

29.2x

39.3x

3.1x

Care Management/Third-Party Administrator

6$7,507(6.5%)(14.5%)

1.20x

11.3x

23.5x

15.6x

NM

Clinical Laboratories

1062,001

2.6%(7.1%)

2.73x

9.5x

16.2x

14.8x

(0.6x)

Contract Research Organizations

478,407(1.3%)(11.6%)

3.32x

18.5x

33.1x

18.7x

1.2x

Hospital Vendors

36,0100.7%(37.6%)

1.43x

20.5x

30.0x

43.5x

3.1x

Distribution

7$115,523

4.3%

39.2%

0.63x

11.9x

23.0x

13.8x

1.9x

Home Medical Equipment

4$2,86738.3%(30.3%)

1.59x

10.1x

23.3x

15.5x

NM

14$108,195

3.0%

4.0%

11.84x

19.6x

19.5x

37.8x

NM

Other Outsourced Services

ProductHealthcare REITS

Source: S&P Global Market Intelligence as of May 31, 2022, and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

3Healthcare Services Sector Update | Early Summer 2022

Healthcare Services Sector Update
Value atMarket Indices5/31/2022

S&P 500
NASDAQ Composite Index
Russell 2000 Index
S&P Composite 1500 Health Care Facilities (Sub Ind)
S&P Composite 1500 Health Care Providers & Services (Industry)S&P Composite 1500 Managed Health Care (Sub Ind)S&P Health Care Services Select Industry Index

4,132.1
12,081.4
1,864.0
481.5
1,551.4
2,949.4
13,179.2% Change
1 mo
0.0%(2.1%)(0.0%)(2.0%)
0.1%(1.3%)(0.9%)

Value at5/31/2022

Interest Rates
LIBOR - USD - 6 months
U.S. Treasury - 2 years
U.S. Treasury - 5 years
U.S. Treasury - 10 years
U.S. Treasury - 30 years
U.S. Prime Rate

2.11%
2.53%
2.81%
2.84%
3.06%
4.00%

YTD

12 mo

(13.3%)(22.8%)(17.0%)(14.1%)(0.7%)
0.4%(18.4%)(1.7%)(12.1%)(17.8%)(9.4%)
12.3%
18.3%(23.2%)

1 mo
ago

3 mo
ago

1.91%
2.70%
2.92%
2.89%
2.95%
3.50%

0.76%
1.31%
1.55%
1.71%
2.11%
3.25%

50.1%
62.1%
27.2%
59.9%
84.5%
92.2%
42.4%

12 mo
ago
0.17%
0.16%
0.81%
1.61%
2.30%
3.25%

Capitalization Profile

No. ofCo's

Ag. Equity
Mkt. Value% TotalNo. of Co's% Ag.
Mkt. Value> $5 billion$1 billion - $5 billion$250 million - $1 billion$100 million - $250 million< $100 million

424530911$1,347,157
117,223
17,982
1,707
606

30.7%32.8%
21.9%
6.6%
8.0%

90.7%
7.9%
1.2%
0.1%
0.0%

0.4%
2.9%
(1.3%)(7.1%)(4.7%)(5.3%)(17.8%)(33.0%)(31.9%)(43.3%)(0.8%)(23.4%)(49.5%)(54.5%)(57.1%)

56.6%
98.8%
(8.4%)
10.4%(30.4%)

Total/Average ($mn)

137$1,484,676

100.0%

100.0%(2.0%)(26.3%)(37.0%)

25.4%

1 mo

Average Stock Performance
YTD
12 mo

36 mo

36 mo

Source: S&P Global Market Intelligence as of May 31 2022, and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

4

Healthcare Services Sector Update | Early Summer 2022

Healthcare Services Market Performance
Performance of Market Indices for Latest 36 Months
S&P 500

NASDAQ Composite Index

Russell 2000 Index

S&P Health Care Services Select Industry Index

250

200

150

100

50

0
6/3/199/3/1912/3/19

3/3/206/3/209/3/2012/3/20

3/3/21

6/3/21

9/3/21

12/3/21

3/3/22

Source: S&P Global Market Intelligence.

5

Healthcare Services Sector Update | Early Summer 2022

Healthcare Services Sector Change
Average % - 1 Month ChangeHome Medical Equipment
Behavioral HealthDistribution
Healthcare REITSClinical Laboratories
Providers – Other
Telemedicine
Consumer Directed Health/Wellness
Skilled Nursing
Hospital Vendors
Rehabilitation
S&P 500
Commercial Managed Care
Government Managed Care
Home Health/Hospice
Contract Research Organizations
Healthcare Staffing
HCIT
Acute Care Hospitals
Specialty Managed Care
Dialysis Services
Care Management/TPA
Assisted/Independent Living(30.0%)(20.0%)(10.0%)

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

Source: S&P Global Market Intelligence as of May 31, 2022, and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

6Healthcare Services Sector Update | Early Summer 2022

Healthcare Services Sector Change
Average % - 12 Month Change
Distribution
Commercial Managed Care
Government Managed Care
Healthcare Staffing
Specialty Managed Care
Healthcare REITS
S&P 500
HCIT
Skilled Nursing
Home Health/Hospice
Acute Care Hospitals
Clinical Laboratories
Contract Research Organizations

Care Management/TPA
Behavioral Health
Assisted/Independent Living
Dialysis Services
Consumer Directed Health/Wellness
Rehabilitation

Home Medical Equipment
Providers – Other
Hospital Vendors
Telemedicine(100.0%)0.0%

Source: S&P Global Market Intelligence as of May 31 2022, and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

7

Healthcare Services Sector Update | Early Summer 2022

Healthcare Services Multiples
Overview of Subsector EV/LTM EBITDA
35.0x

32.1x

30.0x

27.1x
23.7x

25.0x

20.5x 19.6x

20.0x

19.2x 18.5x

17.6x 17.2x

15.0x

16.3x 15.5x

14.6x

11.9x 11.6x 11.3x

10.0x

10.4x 10.1x 9.8x

9.5x

7.7x

5.7x5.0x

Healthcare Staffing

Acute Care Hospitals

Clinical Laboratories

Specialty Managed Care

Home Medical Equipment

Dialysis Services

Care Management/TPA

Government Managed CareDistribution

Commercial Managed Care

Behavioral Health

Skilled Nursing

Rehabilitation

Providers – Other

Contract Research Organizations

Home Health/Hospice

Healthcare REITS

Hospital Vendors

HCIT

Consumer Directed Health/Wellness

Assisted/Independent Living

Telemedicine-0.0x

Source: S&P Global Market Intelligence as of May 31 2022, and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

8Healthcare Services Sector Update | Early Summer 2022

Appendix | Selected Companies
Acute Care Hospitals (4)Community Health Systems, Inc. (NYSE:CYH), HCA Healthcare, Inc. (NYSE:HCA), Tenet Healthcare Corporation (NYSE:THC), Universal Health Services, Inc. (NYSE:UHS)
Assisted/Independent Living (3)AlerisLife Inc. (NasdaqCM:ALR), Brookdale Senior Living Inc. (NYSE:BKD), Sonida Senior Living, Inc. (NYSE:SNDA)
Behavioral Health (3)Acadia Healthcare Company, Inc. (NasdaqGS:ACHC), LifeStance Health Group, Inc. (NasdaqGS:LFST), Oak Street Health, Inc. (NYSE:OSH)
Dialysis Services (2)DaVita Inc. (NYSE:DVA), Fresenius Medical Care AG & Co. KGaA (DB:FME)
Healthcare Staffing (2)AMN Healthcare Services, Inc. (NYSE:AMN), Cross Country Healthcare, Inc. (NasdaqGS:CCRN)
Home Health/Hospice (9)Addus HomeCare Corporation (NasdaqGS:ADUS), Amedisys, Inc. (NasdaqGS:AMED), Aveanna Healthcare Holdings Inc. (NasdaqGS:AVAH), Chemed Corporation (NYSE:CHE), InnovAge Holding
Corp. (NasdaqGS:INNV), LHC Group, Inc. (NasdaqGS:LHCG), ModivCare Inc. (NasdaqGS:MODV), Option Care Health, Inc. (NasdaqGS:OPCH), Pennant Group, Inc. (NasdaqGS:PNTG)
Rehabilitation (5)ATI Physical Therapy, Inc. (NYSE:ATIP), Encompass Health Corporation (NYSE:EHC), Select Medical Holdings Corporation (NYSE:SEM), The Joint Corp. (NasdaqCM:JYNT), U.S. Physical Therapy,Inc. (NYSE:USPH)
Skilled Nursing (2)National HealthCare Corporation (NYSEAM:NHC), The Ensign Group, Inc. (NasdaqGS:ENSG)
Providers – Other (8)1Life Healthcare, Inc. (NasdaqGS:ONEM), agilon health, inc. (NYSE:AGL), CareMax, Inc. (Nasdaq:CMAX), MEDNAX, Inc. (NYSE:MD), Nutex Health, Inc. (NasdaqCM:NUTX), The Oncology Institute,Inc. (Nasdaq:TOI), RadNet, Inc. (NasdaqGM:RDNT), Surgery Partners, Inc. (NasdaqGS:SGRY)
Commercial Managed Care (5)Anthem, Inc. (NYSE:ANTM), Cigna Corporation (NYSE:CI), Humana Inc. (NYSE:HUM), Progyny, Inc. (NasdaqGS:PGNY), UnitedHealth Group Incorporated (NYSE:UNH)
Government Managed Care (3)Alignment Healthcare, Inc. (NasdaqGS:ALHC), Centene Corporation (NYSE:CNC), Molina Healthcare, Inc. (NYSE:MOH)
Specialty Managed Care (1)Assurant, Inc. (NYSE:AIZ)
Consumer Directed Health and Wellness (5)Benefitfocus, Inc. (NasdaqGM:BNFT), HealthEquity, Inc. (NasdaqGS:HQY), Owlet, Inc. (NYSE:OWLT), Sharecare, Inc. (Nasdaq:SHCR), Tivity Health, Inc. (NasdaqGS:TVTY)
Source: S&P Global Market Intelligence as of May 31, 2022 and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

9Healthcare Services Sector Update | Early Summer 2022

Appendix | Selected Companies
Telemedicine (7)American Well Corporation (NYSE:AMWL), Babylon Holdings Limited (NYSE:BBLN), DocGo Inc. (Nasdaq:DCGO), Medica Group Plc (LSE:MGP), Talkspace, Inc. (Nasdaq:TALK), Teladoc Health,Inc. (NYSE:TDOC), UpHealth, Inc. (NYSE:UPH)
HCIT (30)
Accolade, Inc. (NasdaqGS:ACCD), Allscripts Healthcare Solutions, Inc. (NasdaqGS:MDRX), CareCloud, Inc. (NasdaqGM:MTBC), Cerner Corporation (NasdaqGS:CERN), Certara, Inc.
(NasdaqGS:CERT), Change Healthcare Inc. (NasdaqGS:CHNG), Computer Programs and Systems, Inc. (NasdaqGS:CPSI), Convey Health Solutions Holdings, Inc. (NYSE:CNVY), Craneware plc(AIM:CRW), Definitive Healthcare Corp. (NasdaqGS:DH), Doximity, Inc. (NYSE:DOCS), Evolent Health, Inc. (NYSE:EVH), GoodRx Holdings, Inc. (NasdaqGS:GDRX), Health Catalyst, Inc.
(NasdaqGS:HCAT), Healthcare Triangle, Inc. (NasdaqCM:HCTI), HealthStream, Inc. (NasdaqGS:HSTM), NantHealth, Inc. (NasdaqGS:NH), National Research Corporation (NasdaqGS:NRC), NextGenHealthcare, Inc. (NASDAQ:NXGN), Omnicell, Inc. (NasdaqGS:OMCL), OptimizeRx Corporation (NASDAQ: OPRX), Pear Therapeutics, Inc. (Nasdaq:PEAR), Phreesia, Inc. (NYSE:PHR), Premier, Inc.
(NasdaqGS:PINC), Privia Health Group, Inc. (NasdaqGS:PRVA), R1 RCM Inc. (NasdaqGS:RCM), Science 37 Holdings, Inc. (NasdaqGM:SNCE), Signify Health, Inc. (NYSE:SGFY), Streamline HealthSolutions, Inc. (NasdaqCM:STRM), Tabula Rasa HealthCare, Inc. (NasdaqGM:TRHC)
Care Management/TPA (6)CorVel Corporation (NasdaqGS:CRVL), Crawford & Company (NYSE:CRD.B), eHealth, Inc. (NasdaqGS:EHTH), Marpai, Inc. (NasdaqCM:MRAI), Maximus, Inc. (NYSE:MMS), P3 Health Partners Inc.
(Nasdaq:PIII)
Clinical Laboratories (10)23andMe Holding Co. (Nasdaq:ME), Biodesix, Inc. (NasdaqGM:BDSX), Fulgent Genetics, Inc. (NasdaqGM:FLGT), Invitae Corporation (NYSE:NVTA), Laboratory Corporation of America Holdings(NYSE:LH), Biora Therapeutics, Inc. (NasdaqGM:BIOR), Psychemedics Corporation (NasdaqCM:PMD), Quest Diagnostics Incorporated (NYSE:DGX), Sonic Healthcare Limited (ASX:SHL), Sotera
Health Company (NasdaqGS:SHC)
Contract Research Organizations (4)Charles River Laboratories International, Inc. (NYSE:CRL), ICON Public Limited Company (NasdaqGS:ICLR), Syneos Health, Inc. (NasdaqGS:SYNH), IQVIA Holdings Inc. (NYSE:IQV)
Hospital Vendors (3)Healthcare Services Group, Inc. (NasdaqGS:HCSG), Sharps Compliance Corp. (NasdaqCM:SMED), Stericycle, Inc. (NasdaqGS:SRCL)
Distribution (7)AdaptHealth Corp. (NasdaqCM:AHCO), AmerisourceBergen Corporation (NYSE:ABC), Cardinal Health, Inc. (NYSE:CAH), Henry Schein, Inc. (NasdaqGS:HSIC), McKesson Corporation (NYSE:MCK),
Owens & Minor, Inc. (NYSE:OMI), Patterson Companies, Inc. (NasdaqGS:PDCO)
Home Medical Equipment (4)AdaptHealth Corp. (NasdaqCM:AHCO), Great Elm Group, Inc. (NasdaqGS:GEG), Quipt Home Medical Corp. (TSXV:QIPT), Viemed Healthcare, Inc. (TSX:VMD)
Healthcare
REITsInc.
(14)
CareTrust REIT,(NYSE:CTRE), Community Healthcare Trust Incorporated (NYSE:CHCT), Healthcare Realty Trust Incorporated (NYSE:HR), Healthcare Trust of America, Inc. (NYSE:HTA), LTC
Properties, Inc. (NYSE:LTC), Medical Properties Trust, Inc. (NYSE:MPW), National Health Investors, Inc. (NYSE:NHI), Omega Healthcare Investors, Inc. (NYSE:OHI), Physicians Realty Trust(NYSE:DOC), Sabra Health Care REIT, Inc. (NasdaqGS:SBRA), Diversified Healthcare Trust (NasdaqGS:DHC), Universal Health Realty Income Trust (NYSE:UHT), Ventas, Inc. (NYSE:VTR),
Welltower Inc. (NYSE:WELL)
Source: S&P Global Market Intelligence as of May 31, 2022 and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

10

For the detailed May trading multiples for individual healthcare services companies,
please contact one of our professionals below.
Brooks Dexter

Eric Coburn

Managing Director
Head of Healthcare M&ALos Angeles

Managing Director
New York+1 310 850 8714
brooks.dexter@kroll.com

Priyanka Sharma
Managing Director
New York+1 917 692 6283

+1 917 455 8308
priyanka.sharma@kroll.com

eric.coburn@kroll.com

Peter Machmeier

Cray Yoo

DirectorMinneapolis

Vice President
Los Angeles+1 612 849 3792

+1 310 498 2500

peter.machmeier@kroll.com

cray.yoo@kroll.com

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