GeBBS Healthcare Solutions, a Los Angeles-based healthcare BPO firm, is being acquired by EQT for $850 million. GeBBS provides technology-enabled revenue cycle management (RCM) services and delivers comprehensive solutions across the entire billing process for healthcare providers, with specific expertise in medical coding.
According to the press release issued by ChrysCapital:
ChrysCapital acquired GeBBS Healthcare in 2018 and has been instrumental in transforming GeBBS into a leading healthcare technology company. After the acquisition, the company expanded its portfolio of offerings through strategic acquisitions, including Aviacode in 2021, CPa in 2023, MRA in 2023, and CCD Health in 2024. The company has grown to over 13,000 employees with delivery centres in India, the Philippines, the USA, and the Dominican Republic. The portfolio of solutions also includes AI-powered tools for coding compliance, autonomous coding, automation of accounts receivable, and streamlined workflows for risk adjustment.
Healthcare Revenue Cycle Deal Volume Trends
Announced RCM deal volume has declined in recent quarters alongside softness across much of the healthcare M&A market. Volume peaked in late 2021 and remained elevated through 2023 before declining in Q1 2024 and remaining low despite modest increases the last two quarters.
Experts expect the market to continue to improve as investors continue to see opportunities for both organic and acquisition-driven growth in the industry. While the market remains highly fragmented, there are a large number of PE-backed and publicly-traded acquirers in the space who have been active over the past few years. The recently acquired R1 RCM has been the largest acquirer both in terms of deal volume and dollars invested since 2019, followed by Med-Matrix, Aspirion, Kovo, Meduit and Waystar.
According to report from IonAnalytics, a number of larger RCM platforms are exploring a potential sale, including Greenway Health, Mudlytix, Accuity, Meduit, Elevate, and GetixHealth.
Billing and RCM EBITDA Multiples
With reported revenue and EBITDA of $200 million and $50 million, respectively, the deal implies multiples of 4.3x revenue and 17x EBITDA, both of which are on the high end of the range for RCM-related businesses. The only two acquisitions with higher implied multiples are R1 RCM's significantly larger acquisition of modular services provider CloudMed in early 2022 and health system -affiliated end-to-end services provider Acclara in late 2023. Acclara was similar in size to GeBBS, but that deal also included contracts to continue to roll out end-to-end RCM services at a number of Providence hospitals post-transaction, resulting in a visible path to substantial growth over the next five years. The implied multiple from the GeBBS deal is slightly higher than the multiples reported in the two most recent Ensemble deals (2019 and 2022).
Implied EBITDA multiples for larger RCM deals have generally increased over the past ten years, with the exception of a few outliers, which include a couple smaller deals and Frazier Healthcare Partners' acquisition of MedData in 2019, which had reported declining revenue and EBITDA in the period immediately proceeding the transaction.
Active Listings
According to our database of precedent deals, smaller billing and RCM companies continue to sell in the 3-6x range (sub $1m EBITDA), while companies with $1 to $10m EBITDA tend to fetch 6-8x. This is corroborated by a number of deals in our active listings database currently being marketed for sale, including:
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Billing/RCM for Labs and Physician Groups: Listed for sale at $4.8m, this company is marketed based on estimated 2024 revenue and adjusted EBITDA of $3.5m and $1.2m, respectively, implying multiples of 1.4x revenue and 4x EBITDA.
Proprietary Tech-Enabled Medical Records Billing in Southeast: Listed for sale at $11.5m, this company is marketed based on EBITDA of $2.8m, implying a multiple of 4.1x.
Absentee-Run Medical Billing in Florida: Listed for sale at $3.9m, this company is marketed based on revenue and adjusted EBITDA of $1.8m and $800,000, respectively, implying multiples of 2.2x revenue and 4.9x EBITDA.
Medical Billing / RCM Business in Southeast: Listed for sale at $2.5m, this company is marketed based on revenue and EBITDA of $1.3m and $500k, respectively, implying multiples of 2x revenue and 5x EBITDA.
Anesthesia Billing in West Virginia: Listed for sale at $2.2m, this company is marketed based on revenue and cash flow of $1.4m and $450,000, respectively, implying multiples of 1.6x revenue and 4.9x cash flow. Anesthesia is a hospital-based specialty that requires unique billing expertise that hospitals often do not have in-house.
consulMED Medical Billing and Consulting Specialists: Listed for sale at $1.5m, this company is marketed based on revenue and cash flow of $1.6m and $375,000, respectively, implying multiples of 0.94x revenue and 4x cash flow.
Other Healthcare Revenue Cycle Deals
Read Scope Research's take on other revenue cycle and billing M&A transactions below:
About Scope Research
The Scope Research Healthcare M&A Valuation Database currently has financial details for 57 revenue cycle management (RCM) and healthcare billing deals going back to 2010, 42 of which include reported EBITDA multiples. The revenue cycle data can be purchased individually, while our affordable annual subscriptions provide access to all of our healthcare M&A databases and segments, updated continuously.
Don't hesitate to reach out to Will Hamilton at will@scoperesearch.co with questions about your specific situation.