Healthcare Trends

Cain Brothers, a division of KeyBanc Capital Markets, served as financial advisor to Beacon Health System in its acquisition of Ascension Southwest Michigan, including the Borgess Health System.

On behalf of Beacon, Cain Brothers proactively approached Ascension about divesting Borgess Health. Following numerous discussions, the assets were formally marketed and the persistence of the Cain Brothers team, along with a thoughtful RFP response, positioned Beacon as the best partner. The transaction closed on July 1, 2025.

Founded in 2011, Beacon Health has grown to a nine-hospital not-for-profit system in northern Indiana and southwest Michigan. Beacon is headquartered in South Bend and employs more than 8,000 associates throughout the region at over 74 different locations.

Borgess is a not-for-profit health system consisting of four hospitals, 35 outpatient clinics, and one ambulatory surgery center. The largest facility is a 422-bed acute care hospital in Kalamazoo. Borgess has more than 2,700 associates, including 261 providers.

Ascension is one of the nation’s largest not-for-profit health systems, with approximately 99,000 associates, 23,000 aligned providers, 94 wholly-owned or consolidated hospitals, and ownership interests in 27 additional hospitals. Ascension also operates 30 senior living facilities and a variety of other care sites offering a range of services.

Cain Brothers and KeyBanc Capital Markets served as Joint Lead Arranger and Joint Bookrunner on the transaction due to its industry expertise and long-standing relationship with the Company, as well as leading debt capital markets capabilities.

Radiology Partners is a leading physician-owned and -led radiology practice, offering 24/7/365 on-site and remote diagnostic and interventional services to a diverse base of hospital and outpatient imaging facility customers across all 50 states. The Company focuses on clinical value, technology enablement and outstanding service, offering technology, AI tools, and “around the clock” subspecialty coverage to its customers. Radiology Partners is a partner of choice for leading US health systems, serving all top 10, and 17 of the top 20 largest systems in the country.

NEA is a global venture capital and growth equity firm focused on helping entrepreneurs build transformational businesses across multiple stages, sectors, and geographies. With more than $26 billion in cumulative committed capital since the firm’s founding in 1977, NEA invests in technology and healthcare companies at all stages in a company’s lifecycle, from seed stage through IPO. The firm’s long track record of successful investing includes more than 230 portfolio company IPOs and more than 390 mergers and acquisitions.

Whistler is a Nashville-based private equity firm focused on growth equity and growth buyouts in the healthcare industry and related tech-enabled services verticals. With over $1.8 billion in assets under management, the firm partners with world class leadership teams, supporting them with strategic resources and capital, with a particular focus on deploying or expanding investments in technology-enabled and data-driven opportunities.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive advisor to Allied OMS on its minority recapitalization by 65 Equity Partners, while KeyBanc Capital Markets served as exclusive debt advisor to raise senior debt facilities.

Leveraging a longstanding relationship with management and expertise in the dental sector, Cain Brothers worked with the Company’s leadership to pursue a strategic partnership that aligned with Allied OMS’ strategic vision. The investment by 65 Equity Partners positions the Company for its next phase of growth while preserving its doctor-led model and operational independence.

In parallel, KBCM advised on a new senior credit facility to refinance the Company’s debt facility and provide capital to support continued expansion. The new financing is comprised of a $165 million Term Loan, a $20 million Revolving Credit Facility and a $60 million Delayed Draw Term Loan.

Allied OMS is a doctor-owned, -led and -governed MSO that partners with oral and maxillofacial surgery practices across the U.S. Combining the autonomy of private practice with the scale and sophistication of institutional support, Allied OMS empowers surgeons to lead the future of their specialty. The Company currently supports surgeons in 50+ locations and maintains doctor leadership across all major committees and its Board of Directors.

65 Equity Partners is a global investment firm that supports founders in their growth journey. With $3.3 billion in funds under management and a mandate to invest in entrepreneur-led businesses, 65EP backs companies across healthcare, technology, consumer, industrials, and business services. The firm is backed by Temasek and has offices in Singapore, London, Paris, San Francisco, and New York.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive advisor to Allied OMS on its minority recapitalization by 65 Equity Partners, while KeyBanc Capital Markets served as exclusive debt advisor to raise senior debt facilities.

Leveraging a longstanding relationship with management and expertise in the dental sector, Cain Brothers worked with the Company’s leadership to pursue a strategic partnership that aligned with Allied OMS’ strategic vision. The investment by 65 Equity Partners positions the Company for its next phase of growth while preserving its doctor-led model and operational independence.

In parallel, KBCM advised on a new senior credit facility to refinance the Company’s debt facility and provide capital to support continued expansion. The new financing is comprised of a $165 million Term Loan, a $20 million Revolving Credit Facility and a $60 million Delayed Draw Term Loan.

Allied OMS is a doctor-owned, -led and -governed MSO that partners with oral and maxillofacial surgery practices across the U.S. Combining the autonomy of private practice with the scale and sophistication of institutional support, Allied OMS empowers surgeons to lead the future of their specialty. The Company currently supports surgeons in 50+ locations and maintains doctor leadership across all major committees and its Board of Directors.

65 Equity Partners is a global investment firm that supports founders in their growth journey. With $3.3 billion in funds under management and a mandate to invest in entrepreneur-led businesses, 65EP backs companies across healthcare, technology, consumer, industrials, and business services. The firm is backed by Temasek and has offices in Singapore, London, Paris, San Francisco, and New York.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to Western Washington Medical Group in the formation and capitalization of a management services organization with IKS Health.

Cain Brothers was engaged based on its expertise and experience in advising multi-specialty physician groups and its success in structuring innovative, value-aligned partnerships. The joint venture supports WWMG’s long-term goals of clinical independence, operational efficiency and sustainable growth.

WWMG represents over 100 providers in 20+ specialty areas serving patients and their families in the north Puget Sound region of Washington. The providers are owners of WWMG, and live and work in the communities they serve. For over 30 years, WWMG’s mission provides clinicians the freedom to practice medicine with compassion and in the best interest of patients and their communities.

IKS Health takes on the chores of healthcare — spanning administrative, clinical, and operational burdens — so that clinicians can focus on their core purpose: delivering great care. Combining technology and dedicated experts, IKS enables stronger, financially sustainable enterprises. IKS’s Care Enablement Platform delivers data-driven value and expertise across the care journey, and IKS is a partner for clinician enterprises looking to effectively scale, improve quality, and achieve cost savings through forward-thinking solutions. Founded in 2006, IKS’s global workforce supports large health systems across the United States. 

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to ChristianaCare in its acquisition of Crozer Health’s outpatient centers in southeastern Pennsylvania.

On May 27th, 2025, ChristianaCare was the successful bidder in a highly competitive bankruptcy auction to acquire five ambulatory surgery and outpatient centers in Delaware County, Pennsylvania that were part of the Crozer Health regional health system. Crozer is subsidiary of Prospect Medical Holdings, who filed for bankruptcy protection earlier this year. The transaction complements ChristianaCare’s plans for expansion in the service area. 

ChristianaCare is a non-profit regional healthcare system that provides healthcare services to all of Delaware and portions of the bordering counties in Pennsylvania, Maryland and New Jersey. The system includes an extensive network of primary care and outpatient services, hospitals and specialized centers of excellence. ChristianaCare reported consolidated revenues of $3.1 billion for the last twelve months ending June 30, 2024.

Crozer Health was one of the largest private hospital systems in Pennsylvania, operating multiple hospitals, primary care clinics and outpatient centers across the state. Crozer Health was a subsidiary of Prospect Medical Holdings, a California-based national network of hospitals and affiliated medical groups, who filed for Chapter 11 Bankruptcy in January 2025.

Due to its deep experience with strategic and tactical M&A advisory, Cain Brothers was engaged to serve as financial advisor to assist with financial due diligence, valuation, and bankruptcy auction strategy and tactics. A Purchase Agreement was signed on May 27th, with closing subject to court approval and regulatory review in mid-2025.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to Welsh, Carson, Anderson & Stowe in its strategic growth investment in Constitution Surgery Alliance.

Cain Brothers was engaged as buy-side advisor to assist with transaction and process dynamics, M&A landscaping, and related industry research based on our strong knowledge of CSA as well as deep experience in the ambulatory surgery and health system sectors.

CSA is a leading independent developer and operator of outpatient surgery centers in partnership with health systems and surgeons. Its surgery centers complete more than 100,000 cases each year and have won the prestigious LeapFrog “Top ASC” award nine times. For more information about Constitution Surgery Alliance or its award-winning ASCs, please visit www.CSAsurgery.com.

WCAS is a leading U.S. private equity firm focused on two target industries: technology and healthcare. Since its founding in 1979, the firm’s strategy has been to partner with outstanding management teams and build value for its investors through a combination of operational improvements, growth initiatives, and strategic acquisitions. The firm has raised and managed funds totaling over $33 billion of committed capital. For more information, please visit www.wcas.com. 

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to the County of Santa Clara in the acquisition of Regional Medical Center from HCA Healthcare (NYSE: HCA).

On April 1, 2025, Santa Clara County completed the acquisition of Regional Medical Center from HCA Healthcare, integrating RMC into the County of Santa Clara Health System. The acquisition strengthens its commitment to the health and well-being of all communities in Santa Clara County.

Regional Medical Center is a premier healthcare facility known for providing comprehensive medical services, including emergency care, specialized treatments, and advanced surgical procedures. With this acquisition, RMC will expand important clinical programs and services, including trauma, stroke, obstetrics, and advanced cardiac services to patients living in East San Jose.

Santa Clara operates one of California’s most robust public healthcare systems, dedicated to serving the diverse needs of its communities. With a longstanding commitment to accessible healthcare for all residents, the county oversees the Santa Clara Health System, which includes hospitals, clinics, and specialty care services.

HCA Healthcare, a Fortune 500 company, is one of the nation’s leading healthcare providers, operating a vast network of hospitals and medical facilities across the United States.

Together with the KeyBank Beach Point Direct Lending Program, KeyBanc Capital Markets and Cain Brothers, a division of KeyBanc Capital Markets, successfully closed on Senior Secured Credit Facilities supporting SK Capital’s acquisition of Spectrum Vascular.

SK Capital’s investment in Spectrum, a provider of vascular access and medication management products, will enable the Company to accelerate growth initiatives and expand its presence. Through its relationship with the Company and deep understanding of the end market, Cain Brothers was able to provide value-added support to SK Capital in their evaluation and execution of the transaction. The Credit Facilities consisted of a Revolving Credit Facility, a Unitranche Term Loan, and a Delayed Draw Term Loan.  

Spectrum Vascular is an innovative medical device company focused on vascular access and medication management. The Company’s mission is to improve the lives of patients worldwide by providing caregivers with high quality, innovative products with exceptional customer service. Innovation has been a core strategic pillar throughout Spectrum Vascular's history and many of its products have been designed to deliver antimicrobial protection and thrombus reduction. Spectrum Vascular was formed through the acquisition of the vascular access businesses of Cook Medical and AngioDynamics. For more information, please visit www.spectrumvascular.com.

SK Capital is a private investment firm with a disciplined focus on the specialty materials, ingredients, and life sciences sectors. The Firm seeks to build resilient, sustainable, and growing businesses that create substantial long-term value. SK Capital aims to utilize its industry, operating, and investment experience to identify opportunities to transform businesses into higher performing organizations with improved strategic positioning, growth, and profitability, as well as lower operating risk.

KeyBanc Capital Markets and Cain Brothers, a division of KeyBanc Capital Markets, successfully priced $1.0 billion of Convertible Senior Notes Due 2030 for Integer Holdings Corporation. 

The offering was upsized from $750 million to $875 million, prior to the exercise of the overallotment option. The Notes will mature in 2030 and bear interest at a rate of 1.875% per annum, with a conversion premium of 27.50%. Both the coupon and the conversion premium priced at the midpoint of the initial talk ranges. Proceeds from the offering will be used to refinance a portion of the company’s outstanding 2028 Convertible Senior Notes, repay borrowings under its revolving credit facility, fund the cost of capped call transactions, and for general corporate purposes.

Integer is one of the largest medical device contract development and manufacturing organizations in the world, serving the cardiac rhythm management, neuromodulation, and cardio and vascular markets. As a strategic partner of choice to medical device companies and OEMs, Integer is committed to enhancing the lives of patients worldwide by providing innovative, high-quality products and solutions. Integer’s brands include Greatbatch Medical^® and Lake Region Medical^®.

KeyBanc Capital Markets and Cain Brothers, a division of KeyBanc Capital Markets, successfully closed the syndication of $625 million of Senior Secured Credit Facilities in support of ImageFirst Holdings, a portfolio company of Calera Capital.

The Credit Facilities consist of a $125 million Revolving Credit Facility, and a $500 million Term Loan B. Proceeds from the Credit Facilities will be used to refinance existing indebtedness and fund a distribution to shareholders.

ImageFirst is a leading provider of outsourced laundry and textile rental services with a focus on outpatient and specialty healthcare in the U.S. With 70+ locations across 33 states serving over 28,000 customer locations, the Company provides mission critical services to their customers who cannot care for patients without clean linens and other laundry products.

Founded in 1991, Calera Capital is a private investment firm based in San Francisco and Boston that has invested over $4 billion of equity into leading middle market companies. Calera has significant experience and a successful track record of investment in commercial services, healthcare services, and other businesses similar with ImageFirst.

KeyBanc Capital Markets and Cain Brothers successfully closed the syndication of $1.058 billion of Senior Secured Credit Facilities in support of Eversana, a portfolio company of JLL Partners and Water Street Healthcare Partners. 

The Credit Facilities consist of a $108 million Revolving Credit Facility and a $950 million First Lien Term Loan. Proceeds from the Credit Facilities will be used to refinance existing indebtedness and pay transaction-related expenses. 

Eversana is a Chicago-based provider of drug commercialization services for pharmaceutical and biotechnology customers with over 6,000 employees and 30 locations across the globe. Services include strategic advisory, market access, global pricing, HEOR, and agency with expertise in over 100 therapeutic areas. The Company serves a diverse customer base of over 650 organizations, including the top 25 pharmaceutical companies and top 10 biotechs in the world.

JLL Partners is a New York–based middle-market private equity firm specializing in healthcare, industrials, and business services. Since being founded in 1988, JLL Partners has raised $5.8 billion across eight funds, working to accelerate growth and elevate their portfolio companies through organic growth initiatives, operational enhancements, and strategic M&A. 

Founded in 2005, Water Street Healthcare Partners is a private equity firm focused exclusively on the healthcare industry. The Sponsor has ~$7.5 billion in AUM and is investing out of its fifth fund. Water Street is currently an investor in 21 healthcare companies across numerous healthcare subsectors.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to EmblemHealth. 

EmblemHealth has sold its wholly owned subsidiary, ConnectiCare, to Molina Healthcare (NYSE: MOH). The transaction enables Molina to add an established government business with a recognized brand, a statewide provider network and a new state, while EmblemHealth will use proceeds to focus on existing business lines. Cain Brothers was engaged as exclusive financial advisor because of its long-standing relationship with EmblemHealth as well as deep domain expertise in managed care. 

ConnectiCare is a leading health plan in Connecticut and has been dedicated to making the state a healthier place to live and work since its founding in 1981. ConnectiCare has a range of products and services for businesses, municipalities, and individuals, as well as those who are Medicare-eligible, and is the leading provider of individual health insurance in the state.

EmblemHealth is one of the nation’s largest nonprofit health insurers, with more than 3 million members and an 80-year legacy of serving New York’s communities. The company offers a full range of commercial and government-sponsored health plans to employers, individuals, and families, as well as convenient community resources. As a market leader in value-based care, EmblemHealth partners with top providers and hospitals to deliver quality, affordable care.

Molina Healthcare, a FORTUNE 500 company, provides managed healthcare services under the Medicaid and Medicare programs and through the state insurance marketplaces.