Long-term care-related mergers and acquisitions topped all other segments in healthcare for deal volume in 2018, according to a new report from PwC.
“With at least 300 deals per year since at least 2015, long-term care routinely represents at least 30% of deal volume,” the authors stated. “In 2018, the sub-sector eclipsed the 400 threshold.”
Long-term care transactions represented 412 of 1,182 healthcare deals during the year, according to a report by the firm’s deals practice. Those transactions represented 35% of the volume — the largest percentage of any healthcare segment — and 10% of the value of all healthcare deals in 2018, according to PwC. The volume of long-term care deals was up 34.2% year-over-year, and value was down 21.1%.
The behavioral care subsector saw the most year-over-year growth in volume, at 52.6%, and value, at 141.9%, according to PwC.
An especially “notable” transaction called out in the report was Welltower’s acquisition of Quality Care Properties, which together with ProMedica’s acquisition of QCP tenant HCR ManorCare totaled more than $4 billion. PwC ranked it the fourth biggest deal in all of healthcare in 2018 based on value.
Noteworthy long-term care deals in the fourth quarter of the year, according to the report, included Aedifica’s $600 million acquisition of 93 care homes in the United Kingdom — the third largest deal in the quarter, BlueMountain Capital Management’s $400 million purchase of 38 skilled nursing facilities, and Apollo Global Management’s $300 million acquisition of 17 Brookdale Senior Living communities.
The category of “other services” was the largest in healthcare by deal value in 2018, according to the authors, who said that deal values in long-term care and other sub-sectors would have been higher if more prices had been disclosed. Big transactions in the “other services” category included Cigna’s acquisition of Express Scripts, UnitedHealth Group’s purchase of Genoa Healthcare, and Australian Pharmaceutical Industries’ acquisition of Sigma Healthcare, PwC said.
Interest in healthcare deals is likely to continue this year, PwC said.
Data for the report came from Deal Search Online, HealthCareMandA and S&P Capital IQ as well as press releases and other publicly available information, PwC said.