Industry Insights
Healthcare Services Sector Update
Summer 2022

Healthcare Services Sector Update | Summer 2022

Highlights
The S&P Healthcare Services Index
decreased by 5.9% over the last month,compared to the S&P 500 Index, which
decreased by 8.4% over the same period.
Over the past month:
The sectors that experienced the largest increase
were Healthcare Staffing (up 15.7%), Care
Platform (Affiliate-Based) (up 11.6%) and HCIT
(up 1.0%).
The sectors that experienced the largest decrease
were Providers – Other (down 29.6%) Acute Care
Hospitals (down 21.7%) andAssisted/Independent Living (down 20.8%).
The current average Last Twelve Months (LTM)
revenue and LTM EBITDA multiples for thehealthcare services industry overall are 2.44x and14.3x, respectively.

The Sectors with the Highest Valuation Multiples

Consumer Directed Health/Wellness (3.10xLTM revenue, 32.8x LTM EBITDA)

Assisted/Independent Living (2.11x LTM
revenue, 30.9x LTM EBITDA)

HCIT (3.29x LTM revenue, 25.0x LTM
EBITDA)

Healthcare REITs (11.49x LTM revenue,19.0x LTM EBITDA)

2

Healthcare Services Sector Update | Summer 2022

Healthcare Services Sector Update
Market Sector

No. ofCompanies

EquityMkt. Value ($mn)

Average % Change
1 mo

12 mo

LTM Multiples

Earnings Ratio

PEG Ratio

RevEBITDA

LTM

2022E

2022E

Providers
Acute Care Hospitals
Assisted/Independent Living
Behavioral HealthDialysis Services
Healthcare Staffing
Home Health/Hospice
Rehabilitation
Skilled Nursing
Care Platform (Affiliate-Based)
Care Platform (Facility-Based)
Providers – Other

43222
952
4
4
5

$63,296
1,025
8,204
22,154
5,702
24,144
10,611
5,117
13,9386,700
7,798(21.7%)(20.8%)(12.0%)(18.1%)
15.7%(8.6%)(10.3%)(8.6%)
17.0%(15.6%)(29.6%)(20.9%)(45.9%)(14.5%)(37.7%)
14.9%(14.4%)(32.5%)(12.0%)(65.9%)(71.8%)(34.0%)

1.17x
2.11x
NM
1.61x
0.85x
1.71x
2.22x
1.45x
3.17x
1.47x
2.62x

7.1x
30.9x
14.9x
9.4x
6.4x
18.0x
16.3x
15.6x
14.0x
NM
12.1x

6.1x
0.2x
25.5x
9.4x
8.8x
33.3x
20.6x
14.7x
23.6x
NM
11.5x

7.5x
NM
22.5x
10.2x
7.5x
20.4x
19.0x
18.0x
32.2x
NM
10.9x

0.8xNM
2.2x
1.2x
0.3x
2.7x
1.0x
1.2x
3.0x
NM0.4x

Payors/Managed Care
Commercial Managed Care
Government Managed Care
Specialty Managed Care53
1$743,702
68,0309,349(0.6%)(1.7%)(4.7%)

24.0%
12.6%
10.7%

1.75x
0.82x
1.01x

14.6x
11.5x
9.6x

20.8x
28.6x
16.6x

17.8x
15.7x
13.6x

1.3x
1.1x
0.8x

Consumer Directed Health/Wellness

4$6,192(8.4%)(31.8%)

3.10x

32.8x

NM

48.2x

3.1x

Telemedicine

7$8,202(3.5%)(72.6%)

1.65x

NM

27.5x

23.4x

NMHCIT

28$55,6441.0%(20.0%)

3.29x

25.0x

25.2x

40.1x

3.2x

Care Management/Third-Party Administrator

5$7,051(4.7%)(16.2%)

1.27x

11.0x

22.9x

14.9x

NM

Clinical Laboratories

1057,160(10.1%)(15.2%)

2.49x

9.1x

15.0x

13.9x

(0.6x)

Contract Research Organizations

476,911(4.1%)(12.3%)

3.22x

18.0x

32.1x

18.1x

1.2x

Hospital Vendors

35,384(9.2%)(40.5%)

1.22x

17.5x

27.0x

34.2x

3.2x

Distribution

6$106,631(6.6%)

36.2%

0.42x

11.5x

21.2x

12.6x

2.1xHome Medical Equipment

4$2,849(0.2%)(32.4%)

1.53x

9.7x

22.7x

15.3x

NM

14

$99,514(8.2%)(8.4%)

11.49x

19.0x

25.5x

36.1x

NM

Other Outsourced Services

ProductProducts

Healthcare REITS

Source: S&P Global Market Intelligence as of June 30, 2022, and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

3

Healthcare Services Sector Update | Summer 2022

Healthcare Services Sector Update
Value atMarket Indices6/30/2022

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

3,785.4
11,028.7
1,708.0
398.9
1,527.1
2,998.6
12,525.1% Change
1 mo

YTD

12 mo

(8.4%)(10.6%)(8.4%)(18.8%)(1.5%)
0.4%(5.9%)(20.6%)(29.5%)(23.9%)(28.8%)(2.3%)
2.1%(22.5%)(11.9%)(24.0%)(26.1%)(22.6%)
13.6%
23.3%(28.2%)

1 moago3 moago

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

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

Value at6/30/2022

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

2.94%
2.92%
3.00%
2.97%
3.12%
4.75%

36 mo
28.7%
37.8%
9.0%
20.2%
74.6%
93.1%
25.9%

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

Capitalization Profile

No. ofCo's

Ag. Equity
Mkt. Value% Total
No. of Co's% Ag.
Mkt. Value> $5 billion$1 billion - $5 billion$250 million - $1 billion$100 million - $250 million< $100 million

40
45
30
10
12

$1,284,135
113,883
17,223
1,866
622

29.2%
32.8%
21.9%
7.3%
8.8%

90.6%
8.0%
1.2%
0.1%
0.0%

(7.6%)(4.7%)(7.8%)(25.4%)(11.3%)(12.7%)(20.8%)(38.1%)(44.4%)(49.5%)(8.4%)(30.6%)(51.5%)(60.5%)(60.7%)

37.3%
83.7%
(13.7%)
0.1%(42.8%)

Total/Average ($mn)

137$1,417,729

100.0%

100.0%(11.4%)(33.1%)(42.4%)

12.9%

1 mo

Average Stock Performance
YTD
12 mo36 mo

Source: S&P Global Market Intelligence as of June 30, 2022, and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

4

Healthcare Services Sector Update | 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

250200

150

100

50

0
7/1/19

10/1/19

1/1/204/1/207/1/2010/1/20

1/1/214/1/21

7/1/21

10/1/21

1/1/22

4/1/22

Source: S&P Global Market Intelligence.

5Healthcare Services Sector Update | Summer 2022

Healthcare Services Sector Change
Average % - 1 Month Change
Healthcare Staffing
Care Platform (Affiliate-Based)
HCIT
Home Medical Equipment
Commercial Managed Care
Government Managed Care
Telemedicine
Contract Research Organizations
Care Management/TPA
Specialty Managed Care
Distribution
Healthcare REITS
Consumer Directed Health/Wellness
S&P 500
Home Health/Hospice
Skilled Nursing
Hospital Vendors
Clinical Laboratories
Rehabilitation
Behavioral HealthCare Platform (Facility-Based)
Dialysis Services
Assisted/Independent Living
Acute Care Hospitals
Providers – Other(50.0%)(40.0%)(30.0%)(20.0%)(10.0%)

0.0%

10.0%

20.0%

30.0%

Source: S&P Global Market Intelligence as of June 30, 2022, and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

6

Healthcare Services Sector Update | Summer 2022

Healthcare Services Sector Change
Average % - 12 Month Change
Distribution
Commercial Managed Care
Healthcare Staffing
Government Managed Care
Specialty Managed Care
Healthcare REITS
S&P 500
Skilled Nursing
Contract Research Organizations
Home Health/Hospice
Behavioral Health
Clinical Laboratories
Care Management/TPAHCIT
Acute Care Hospitals
Consumer Directed Health/Wellness
Home Medical Equipment
Rehabilitation
Providers – OtherDialysis Services
Hospital Vendors
Assisted/Independent Living
Care Platform (Affiliate-Based)
Care Platform (Facility-Based)
Telemedicine(120.0%)(100.0%)(80.0%)(60.0%)(40.0%)(20.0%)

0.0%

20.0%

40.0%

60.0%

Source: S&P Global Market Intelligence as of June 30 2022, and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

70.0x-Telemedicine
Care Platform (Facility-Based)

7.1x

Healthcare Staffing

9.4x

Acute Care Hospitals

9.6x

Clinical Laboratories

9.7x

Dialysis Services

10.0x

Specialty Managed Care

11.0x

Home Medical Equipment

12.1x 11.5x 11.5x

Care Management/TPA

Government Managed Care

Distribution

14.6x 14.0x

Providers – Other

Care Platform (Affiliate-Based)

15.6x 14.9x

Commercial Managed Care

15.0x

Behavioral Health

16.3x

Skilled Nursing

18.0x 18.0x 17.5x

Rehabilitation

Hospital Vendors

19.0x

Home Health/Hospice

20.0x

Contract Research Organizations

25.0x

Healthcare REITS

32.8x

HCIT

35.0x

Assisted/Independent Living

Consumer Directed Health/Wellness

Healthcare Services Sector Update | Summer 2022

Healthcare Services Multiples
Overview of Subsector EV/LTM EBITDA
30.9x

30.0x

25.0x

9.1x
6.4x

5.0x

Source: S&P Global Market Intelligence as of June 30 2022, and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

8

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99Healthcare Services Sector Update | Summer 2022

Appendix | Selected CompaniesAcute 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 (2)Acadia Healthcare Company, Inc. (NasdaqGS:ACHC), LifeStance Health Group, Inc. (NasdaqGS:LFST)
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)
Care Platform (Affiliate-Based) (4)Privia Health Group, Inc. (NasdaqGS:PRVA), agilon health, inc. (NYSE:AGL), Apollo Medical Holdings, Inc. (Nasdaq:AMEH), P3 Health Partners Inc. (Nasdaq:PIII)
Care Platform (Facility-Based) (4)1Life Healthcare, Inc. (NasdaqGS:ONEM), Cano Health, Inc. (NYSE:CANO), CareMax, Inc. (Nasdaq:CMAX), Oak Street Health, Inc. (NYSE:OSH)
Providers – Other (5)Pediatrix Medical Group, 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)Elevance Health Inc. (NYSE:ELV), 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)

Source: S&P Global Market Intelligence as of June 30, 2022 and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

10

Healthcare Services Sector Update | Summer 2022

Appendix | Selected Companies
Specialty Managed Care (1)Assurant, Inc. (NYSE:AIZ)
Consumer Directed Health and Wellness (4)Benefitfocus, Inc. (NasdaqGM:BNFT), HealthEquity, Inc. (NasdaqGS:HQY), Owlet, Inc. (NYSE:OWLT), Sharecare, Inc. (Nasdaq:SHCR)
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 (28)
Accolade, Inc. (NasdaqGS:ACCD), Allscripts Healthcare Solutions, Inc. (NasdaqGS:MDRX), CareCloud, Inc. (NasdaqGM:MTBC), 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), NextGen Healthcare, Inc. (NASDAQ:NXGN), Omnicell, Inc. (NasdaqGS:OMCL), OptimizeRx Corporation(NASDAQ: OPRX), Pear Therapeutics, Inc. (Nasdaq:PEAR), Phreesia, Inc. (NYSE:PHR), Premier, Inc. (NasdaqGS:PINC), R1 RCM Inc. (NasdaqGS:RCM), Science 37 Holdings, Inc. (NasdaqGM:SNCE), Signify Health,Inc. (NYSE:SGFY), Streamline Health Solutions, Inc. (NasdaqCM:STRM), Tabula Rasa HealthCare, Inc. (NasdaqGM:TRHC)
Care Management/TPA (5)CorVel Corporation (NasdaqGS:CRVL), Crawford & Company (NYSE:CRD.B), eHealth, Inc. (NasdaqGS:EHTH), Marpai, Inc. (NasdaqCM:MRAI), Maximus, Inc. (NYSE:MMS)
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 (6)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 REITs (14)CareTrust REIT, Inc. (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 June 30, 2022 and includes the most actively traded healthcare companies for respective covered sectors, excluding most microcap companies.

11

For the detailed June trading multiples for individual healthcare services companies,
please contact one of our professionals below.
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Managing Director
Head of Healthcare M&A
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New York+1 917 692 6283

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