The Corner Series

Episode 126: QSBS, Tax Benefit Unlike Any Other, With Shahrooz Shahnavaz

Wed, 25 Mar 2026 03:00:00 -0400

One of the most misunderstood provisions in the entire tax code, the Qualified Small Business Stock (QSBS) has been around for more than 30 years. Yet it remained largely dormant — until now.

The QSBS is “unlike anything in the code,” says Shahrooz Shahnavaz, a tax partner at McGuireWoods.

In this conversation with colleague and host Geoff Cockrell, Shahrooz reviews the history of this unique benefit and puts it into context for today’s M&A deal-makers. Tune in for his insights on the potential 100% exclusion of gain, the structural limits that bar some professions — including healthcare — from qualifying, and the One Big Beautiful Bill Act’s “generous” $15 million per-shareholder, per-company cap.

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☑️ Shahrooz Shahnavaz | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | X

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This podcast was recorded and is being made available by McGuireWoods for informational purposes only. By accessing this podcast, you acknowledge that McGuireWoods makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in the podcast. The views, information, or opinions expressed during this podcast series are solely those of the individuals involved and do not necessarily reflect those of McGuireWoods. This podcast should not be used as a substitute for competent legal advice from a licensed professional attorney in your state and should not be construed as an offer to make or consider any investment or course of action.

Episode 125: Opportunities in Home and Alternate Site Infusion, with Don Hooker

Thu, 12 Mar 2026 03:00:00 -0400

Home and alternate-site infusion therapy is a highly fragmented market. Just two large players command 35% to 40% market share while more than 800 smaller providers making up the remainder. And that fragmentation is exactly what's drawing private equity interest.

Don Hooker, director of research at Bourne Partners, a leading life science investment firm, joins McGuireWoods partner and host Geoff Cockrell to unpack the investment landscape. Don explains that delivering drugs at home or in alternate sites can cost roughly half as much as treatment in an inpatient setting. He also outlines the two main pressures shaping the home infusion space.

Tune in for his insights about reimbursement dynamics, labor intensity, drug pricing and “back-end" strategic buyers such as Option Care Health.

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☑️ Don Hooker | LinkedIn

☑️ Bourne Partners | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 124: The Era of Physician Practice Consolidation, With Ezra Simons

Wed, 18 Feb 2026 03:00:00 -0400

Fifty years ago, the United States had 75 car companies. Today, there are fewer than five. The same consolidation dynamics are reshaping physician practice management, says Ezra Simons, a co-founder and partner at Physician Growth Partners, which has been on the leading edge of consolidation in provider practices nationwide. “I think what we’ll see over the next 10 years of physician practice management is mergers of equals.” Those that separate themselves and grow are those that have unique skills to offer their affiliated practices, he says.

In this conversation with McGuireWoods partner and host Geoff Cockrell, Ezra explores how the provider services M&A landscape has evolved since Physician Growth Partners launched: While dermatology was the huge piece of the market then, the activity today is in urology, orthopedics and cardiology. He looks ahead to the next evolution: philosophical alignment among sponsors and private equity groups. “I think what we’re starting to see are people trying to figure out engagement and provider alignment first and then where to translate that to.”

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☑️ Ezra Simons | LinkedIn

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Episode 123: New Exit Opportunities in Provider Services M&A, With Michael Kroin

Wed, 04 Feb 2026 03:00:00 -0400

From his perspective as CEO and managing partner at Physician Growth Partners, Michael Kroin sees an “interesting time” where different types of buyers are getting into the provider services sector at the same time that payers are aggressively pursuing independent practices.

“You see payers start to have interest in these private equity-backed groups as well or continue to have interest. So, that provides a number of exit opportunities for these private equity-backed groups that they historically haven't evaluated,” he explained to host Geoff Cockrell.

Tune in to hear Michael discuss how strategic and financial buyers now coexist in a specialty-specific landscape, how M&A activity is reopening downstream after years of balance sheet constraints and why geography matters due to state-level restrictions on the corporate practice of medicine.

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☑️ Michael Kroin | LinkedIn

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☑️ Geoff Cockrell | LinkedIn

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Episode 122: When the First Fundraise Is in the Bank, With Henry Yan

Wed, 21 Jan 2026 03:00:00 -0400

“Fund one is tough,” says Henry Yan, principal at Whistler Capital Partners, reflecting on the firm’s successful first fundraise. In this conversation with McGuireWoods partner and host Geoff Cockrell, Henry unpacks the challenges and opportunities of raising capital as an emerging manager in today’s competitive fundraising environment.

Tune in for his thoughts about the use of placement agents for emerging managers, the importance of co-investment opportunities in building LP relationships and the increasing focus by European investors on U.S. lower middle-market buyout opportunities.

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☑️ Henry Yan | LinkedIn

☑️ Whistler Capital | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 121: New and Evolving Investor Theses, With Rebecca Springer

Mon, 12 Jan 2026 03:00:00 -0400

“We’re predicting that 2026 will be a bit stronger than 2025 in terms of overall deal activity,” says Rebecca Springer, director of market development at Bailey & Company, a healthcare-dedicated investment banking group.

In a three-part installment of the “Corner Series Shorts” format, where McGuireWoods partner and host Geoff Cockrell dives into a narrower topic with experts, Rebecca shares her outlook on 2026.

What’s the next big wave in healthcare private equity investing? Healthcare consumerization. “That’s anything cash pay,” Rebecca explains. “Let’s avoid the reimbursement risk altogether and avoid most of the stroke-of-the-pen risk that we see across different healthcare sectors. Think plastics and concierge.” Rebecca offers a forward-looking perspective on other evolving theses, such as medical equipment services.

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☑️ Rebecca Springer | LinkedIn

☑️ Bailey & Company | LinkedIn | X

☑️ Geoff Cockrell | LinkedIn

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This podcast was recorded and is for informational purposes only. By accessing this podcast, you acknowledge that Bailey & Co. makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured. The views, information, or opinions expressed during this podcast series are solely those of the individuals involved and do not necessarily reflect those of Bailey & Co. This podcast should not be used as a substitute for competent investment advice from a licensed professional or attorney in your state and should not be construed as an offer to make or consider any investment or course of action.

Episode 120: PPM Deals in 2026, With Rebecca Springer

Fri, 09 Jan 2026 03:00:00 -0400

In a three-part installment of the “Corner Series Shorts” format, where McGuireWoods partner and host Geoff Cockrell dives into a narrower topic with experts, Rebecca shares her outlook on 2026.

In this episode, Rebecca reviews the outlook for physician practice management (PPM) deals in 2026. She explains why she expects to see a “modest increase” in PPM activity relative to 2025 and shares other insights about the market, including the future of large PPM platforms and the “mixed picture” of dental.

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☑️ Rebecca Springer | LinkedIn

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☑️ Geoff Cockrell | LinkedIn

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Episode 119: The 2026 Forecast for Deal Activity, with Rebecca Springer

Thu, 08 Jan 2026 03:00:00 -0400

“We're predicting that 2026 will be a bit stronger than 2025 in terms of overall deal activity," says Rebecca Springer, director of market development at Bailey & Company, a healthcare-dedicated investment banking group.

In the latest installment of the “Corner Series Shorts” format, where host Geoff Cockrell dives into a narrower topic with experts, Rebecca unpacks where the deal activity is landing, why there are opportunities for small and mid-sized employers to self-insure, and what factors are keeping the landscape of cost-containment vendors fragmented. Stay tuned for two more episodes featuring Rebecca coming soon.

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☑️ Rebecca Springer | LinkedIn

☑️ Bailey & Company | LinkedIn | X

☑️ Geoff Cockrell | LinkedIn

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Episode 118: Opportunities in Lower Middle-Market Healthcare, With Ben Mackay

Tue, 16 Dec 2025 03:00:00 -0400

Lower middle-market private equity in government-reimbursed healthcare requires a different playbook — one that balances controlling ownership with founder retention to build long-term value. Evolve Capital has become a subject matter expert in the Medicare-reimbursed home healthcare space, and principal Ben Mackay shares the playbooks with McGuireWoods partner and host Geoff Cockrell.

Tune in for Ben’s insights about other opportunities in the market — including home healthcare with attached hospice, autism services and specialty pharmacies that cater to pets.

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☑️ Ben Mackay | LinkedIn

☑️ Evolve Capital | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 117: Women's Health as Clinical and Economic Imperatives, with Priya Bathija

Wed, 03 Dec 2025 03:00:00 -0400

As founder and CEO of Nyoo Health, Priya Bathija encourages healthcare leaders to ask questions, starting with, “How does this impact women differently?” Nyoo Health helps leaders align, inspire and execute initiatives that strengthen women’s health services and position their organizations at the forefront of care. In this conversation with McGuireWoods’ Micaela Enger and Gretchen Townshend, Priya reveals where returns on investment in women’s health truly lie — clinically, socially and economically.

She also addresses persistent challenges such as payment disparities, the need for provider education across specialties and the importance of co-creating solutions between startups and health systems. As she explains, “There is an increased acknowledgement in the healthcare sector that women’s health needs to be a priority. After all, we’re 51% of the population.”

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☑️ Priya Bathija | LinkedIn

☑️ Nyoo Health | LinkedIn | YouTube | Instagram

☑️ Micaela Enger | LinkedIn

☑️ Gretchen Townshend | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 116: What’s Next in the Psychedelics Market, With Matt Brockmeier and Rebecca Nicholson

Wed, 19 Nov 2025 03:00:00 -0400

A range of new mental health treatments are available to Western medicine, and practitioners are figuring out how to use them effectively. Matt Brockmeier, co-founder and chief legal officer at Entheogyn and of counsel at Antithesis Law, joins Rebecca Nicholson, foundation director and wellness advisor at Prime Quadrant, to explore this evolving landscape with McGuireWoods partner and host Geoff Cockrell.

Matt discusses the tension between state and federal laws shaping access to psychedelics and controlled substances, while Rebecca contrasts the investment dynamics of cannabis versus psychedelics, emphasizing mental health over recreation. They examine specialized investor appetite, the medical community’s evolving response and the ancillary wellness modalities supporting comprehensive mental health transformation.

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☑️ Rebecca Nicholson | LinkedIn

☑️ Prime Quadrant

☑️ Matt Brockmeier | LinkedIn

☑️ Entheogyn

☑️ Geoff Cockrell | LinkedIn

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Episode 115: Tracking the Fast-Growing Payor Services Market, with Patrick Keavy

Tue, 28 Oct 2025 03:00:00 -0400

Payor services is an “enormous marketplace,” says Patrick Keavy, managing director at Bailey & Co. In this conversation with McGuireWoods partner and host Geoff Cockrell, Patrick, who focuses on payor services within healthcare, shares his insights about the market and its future. Tune in as he reviews the growth of employer-sponsored healthcare, cost-containment strategies that companies can leverage, and the results of his research into the verticals and subverticals that Bailey & Co. covers.

Request a copy of Bailey & Co.’s report “The Rise of Cost Containment in Employer-Funded Healthcare.”

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☑️ Patrick Keavy | LinkedIn

☑️ Bailey & Co | LinkedIn | X

☑️ Geoff Cockrell | LinkedIn

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Episode 114: Private Equity Partnerships and Market Trends, With Geoff Cockrell

Wed, 15 Oct 2025 03:00:00 -0400

The tables turn as McGuireWoods partner and host Geoff Cockrell steps into the guest seat, and Gordon Maner, CEO of the AMB group of companies and co-founder of Frontline Healthcare Partners, takes on hosting duties. Gordon and Geoff explore critical dynamics in healthcare M&A, from preparing first-time sellers for the rigors of a transaction to navigating the delicate partnership between private equity buyers and founder-led businesses. They discuss current market conditions, the resurgence of provider services deal activity and why focusing on market power rather than investor type makes more sense for regulation.

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☑️ Gordon Maner | LinkedIn

☑️ Frontline Healthcare Partners | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 113: From Transactions to True Impact, With Marc Cabrera

Tue, 30 Sep 2025 03:00:00 -0400

From New York to the Rocky Mountains, Marc Cabrera’s journey has spanned high-stakes healthcare deals to hands-on community service. Once a Wall Street investment banker, Cabrera is now the founder of Four Corners Capital, a Colorado-based investment firm focused on healthcare. In this conversation with McGuireWoods partner and host Geoff Cockrell, he shares how his view on making an impact has evolved — from executing milestone transactions to serving as a volunteer firefighter.

“For me, it comes down to this: If I’m going to spend an hour or a day doing something, what kind of impact can I have — for my community, the broader world, my family and myself?”

Tune in to hear Cabrera’s insights on time allocation, strategic networking and the lesser-known challenges of the deal advisory business.

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☑️ Marc Cabrera | LinkedIn

☑️ Four Corners Capital | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 112: Proving Private Equity's Value in Healthcare, With Lauren Makhoul

Tue, 16 Sep 2025 03:00:00 -0400

Returning guest Lauren Makhoul, principal of Avalere Health, explains how private equity allows healthcare providers to focus on what matters most while business professionals handle the administrative burdens.

With McGuireWoods partner and host Geoff Cockrell, she highlights compelling evidence from recent studies showing how private equity-backed physician groups deliver better outcomes with lower costs.

A spinoff of The Corner Series, The Corner Series Shorts delivers quick, high-impact insights from dealmakers and thought leaders at the corner of healthcare and private equity. Each short episode — less than 10 minutes — offers a focused look at key trends, timely topics and expert perspectives

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☑️ Lauren Makhoul | LinkedIn

☑️ Avalare | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | X

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Episode 111: State Regulatory Interventions in Healthcare, With Tim Fry

Tue, 02 Sep 2025 03:00:00 -0400

“For clients in the healthcare space, having a state-based compliance program has grown in importance,” says Tim Fry, partner in the healthcare group at McGuireWoods. With McGuireWoods colleague and host Geoff Cockrell, Tim unpacks how state-specific legal treatment has changed dramatically in the last several years.

He explains how states such as California and Oregon built hostility to private equity into their premerger notice laws while other states diverge on noncompete enforceability even after federal rulemaking failed.

Tune in for his insights about the shifting regulatory landscape.

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☑️ Tim Fry | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 110: Rooting Out Bad Actors in Private Equity, With Lauren Makhoul

Mon, 18 Aug 2025 03:00:00 -0400

Lauren Makhoul of Avalere Health returns for the second installment of The Corner Series Shorts to discuss rooting out bad actors in private equity. In this conversation with McGuireWoods partner and host Geoff Cockrell, Lauren advocates for a “nuanced perspective” that addresses the loopholes allowing bad actors to exist. She explains how mechanisms such as single TIN-billing exploitation affect all healthcare providers, not just private equity-backed platforms, and why site-neutral payment policies could address underlying issues more effectively.

Tune in for her insights about how private equity-backed platforms often face heightened scrutiny while provider-owned businesses may engage in similar practices with less oversight.

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☑️ Lauren Makhoul | LinkedIn

☑️ Avalare | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | X

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Episode 109: Equipping PE Partners With Services for Success, With Tim Schulte

Wed, 13 Aug 2025 03:00:00 -0400

“Our role isn’t to dictate strategy from a distance,” says Tim Schulte, head of the Value Creation team at Council Capital. “We provide the tools and support — but the company is the one driving the vision.” In this conversation with McGuireWoods partner and host Geoff Cockrell, Tim shares how the healthcare-focused private equity firm helps its portfolio companies grow through a robust support system.

This includes in-house experts in talent, finance and technology, as well as the firm’s CEO Council — a network of public- and private-sector leaders offering deep market insight and strategic advice.

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☑️ Tim Schulte | LinkedIn

☑️ Council Capital | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | X

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Episode 108: Site of Care Optimization, With Lauren Makhoul

Mon, 04 Aug 2025 03:00:00 -0400

Site-of-care optimization makes a difference, and that’s made possible by private equity investing in healthcare. Lauren Makhoul, principal at Avalere Health, explains this dynamic in the first installment of The Corner Series Shorts with McGuireWoods partner and host Geoff Cockrell.

When private equity-backed platforms invest in ambulatory surgical centers, they capture facility fees while moving procedures to lower-cost settings, benefiting physicians and the healthcare system. This optimization improves patient experience through better scheduling, convenient locations and dedicated facilities while reducing overall healthcare costs.

A spinoff of The Corner Series, The Corner Series Shorts delivers quick, high-impact insights from dealmakers and thought leaders at the intersection of healthcare and private equity. Each short episode — less than 10 minutes — offers a focused look at key trends, timely topics and expert perspectives.

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☑️ Lauren Makhoul | LinkedIn

☑️ Avalare | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | X

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Episode 107: Integration Over Aggregation in Oral Surgery, With Trevor Maurer

Mon, 28 Jul 2025 03:00:00 -0400

“For us to invest in a business and not improve it doesn’t make sense as an investment,” says Trevor Maurer, CEO of OMS360, a Shore Capital-backed dental platform specializing in oral surgery. In this conversation with McGuireWoods partner and host Geoff Cockrell, Trevor explains how OMS360 invests and improves its partners’ practices through its operating system, which optimizes the patient journey through time and motion studies.

Observing that “the days of rack-and-stack are over,” Trevor emphasizes the importance of integration over aggregation. “If you can really integrate and create synergies, driving better patient outcomes and performances,” he says, “investors will want to be a part of your business.”

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☑️ Trevor Maurer | LinkedIn

☑️ OMS360 | LinkedIn | Facebook | Instagram

☑️ Geoff Cockrell | LinkedIn

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Episode 106: Patent Investment Strategies With Amanda Wieker

Mon, 21 Jul 2025 03:00:00 -0400

Think a patent is bulletproof once it's issued? Think again. Amanda Wieker, partner at McGuireWoods and former acting vice chief administrative patent judge at the Patent Trial and Appeal Board, reveals why patent validity can remain in flux for decades.

In this conversation with McGuireWoods colleague and host Geoff Cockrell, Amanda unpacks the complex lifecycle of patents in private equity investments. She explains challenges to patent validity, the Patent Trial and Appeal Board process, and critical diligence considerations for investors acquiring companies where patents are material assets.

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☑️ Amanda Wieker | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 105: Scaling Medical Aesthetics, with Annie Hockey

Mon, 14 Jul 2025 03:00:00 -0400

As the founder of Skytale Group, a boutique healthcare-focused investment banking and management consulting firm, Annie Hockey has a high-level view of what makes medical aesthetics businesses ready for private equity transactions. In this episode, she shares her observations with McGuireWoods healthcare partner Amanda Roenius, taking over hosting duties from Geoff Cockrell.

“I think the best time to transact is fully dependent on the owner and their life goals. It's such a personal decision,” Annie says. Tune in for insights about preparing for transactions, managing regulatory risk and building scalable medical aesthetics practices.

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☑️ Annie Hockey | LinkedIn

☑️ Skytale Group | LinkedIn | Facebook | Instagram

☑️ Amanda Roenius | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | X

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Episode 104: Orthopedic Expansion Through Hub-and-Spoke, With Chris Day

Mon, 07 Jul 2025 03:00:00 -0400

In this episode of The Corner Series, Geoff Cockrell, McGuireWoods partner and host, is joined by Chris Day, CFO of Growth Orthopedics. Chris shares how Growth Orthopedics’ platform is expanding into underserved markets through a hub-and-spoke model, extending clinics up to two hours from surgical centers to increase access to care.

Tune in for his insights about how private equity investment improves healthcare access and why the wave of retiring baby boomer physicians will fuel continued consolidation.

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☑️ Chris Day | LinkedIn

☑️ Growth Orthopedics | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 103: Hot Sectors in Health Tech Today, With Bill Watts

Mon, 30 Jun 2025 03:00:00 -0400

What is a white-hot market in healthcare tech? Governance, risk and compliance (GRC), says Bill Watts, who leads the healthcare tech group at Brown Gibbons Lang & Company. He also lists supply chain for pharma and drug commercialization and employer tech.

In this conversation with McGuireWoods partner and host Geoff Cockrell, Bill unpacks how today's health tech investment landscape has evolved post-pandemic, with investors pursuing different strategies as deal volume normalizes.

Tune in for his insights about mixed business models, deal activity so far this year and the commercial prospects for AI.

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☑️ Bill Watts | LinkedIn

☑️ Brown Gibbons Lang & Company | LinkedIn | X

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | X

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Episode 102: Converting Prospects Faster — The Marketing Funnel Blueprint, With Laurel Mintz

Wed, 25 Jun 2025 03:00:00 -0400

Picture the marketing function of your business like a funnel. At the bottom is the conversion into sales. “But the top of the funnel is really important, and that's where the marketing conversations come in,” explains Laurel Mintz, founder and general partner of Fabric VC and CEO of Elevate My Brand.

Tune in as Laurel shares with host Geoff Cockrell how smart marketing conversations close that gap between the first point of contact and the close of business.

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☑️ Laurel Mintz | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 101: The Physician-First Culture Driving Ophthalmology Success, with Mary Lou Parisi

Mon, 23 Jun 2025 03:00:00 -0400

"Without our doctors being engaged in the business, it won't be successful. Period. The end," states Mary Lou Parisi, co-CEO of Eye Health America, in this conversation with host Geoff Cockrell.

Leading a platform that weathered economic turbulence while maintaining 20-25% year-over-year growth, Mary Lou reveals how Eye Health America’s physician-aligned approach has fueled recruitment success and practice integration across 60 locations and 135 physicians.

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☑️ Mary Lou Parisi | LinkedIn

☑️ Eye Health America | LinkedIn | Facebook | Instagram

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | X

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Episode 100: The Business Development Mindset, With Scott Becker

Mon, 16 Jun 2025 03:00:00 -0400

“The effort it takes to get something new going is gargantuan,” reflects healthcare industry icon Scott Becker in The Corner Series’ milestone 100th episode. Drawing from decades of experience building legal and media businesses, Scott reveals to McGuireWoods colleague and host Geoff Cockrell why most ambitious professionals fail at practice development: They mistake activity for action, analyze too much and give up too early in the desert of “nothing happening.”

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☑️ Scott Becker | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 99: 20 Years of Evolving Healthcare PE, with Amber Walsh

Tue, 10 Jun 2025 03:00:00 -0400

For 20 years, McGuireWoods Executive Committee member Amber Walsh and host Geoff Cockrell have joined forces to run a healthcare private equity conference in Chicago. “Good content has always been, since the very beginning, one of the hallmarks of this conference,” Amber says as she and Geoff reflect on the conference as well as the state of healthcare private equity investing. Tune in for their insights about emerging joint venture opportunities with health systems, the continued importance of inclusion initiatives, and why diversification remains the dominant investment theme in today's healthcare private equity landscape.

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☑️ Amber Walsh | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 98: The Floor vs. Ceiling Shift in Healthcare M&A, With TUSK Practice Sales

Thu, 05 Jun 2025 03:00:00 -0400

Today, sellers of healthcare practices look for a higher floor than ceiling, explains Ryan Mingus, managing director of TUSK Practice Sales, a healthcare M&A advisory firm. Ryan teams up with director Connor Jorgensen for a discussion about how practice owners’ priorities have shifted from maximizing valuation to seeking operational support and sustainability.

Speaking with McGuireWoods partner and host Geoff Cockrell, Ryan and Connor describe how joint venture structures have become increasingly popular across specialties, from dental to GI and dermatology, as sellers prioritize ongoing distributions over potentially risky holding company equity.

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☑️ Ryan Mingus | LinkedIn

☑️ Connor Jorgensen | LinkedIn

☑️ TUSK Practice Sales on LinkedIn | Instagram | Facebook

☑️ Geoff Cockrell | LinkedIn

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Episode 97: How One Orthopedic Platform Defies Today's Market Headwinds, with Grady Wilson

Tue, 03 Jun 2025 03:00:00 -0400

"We're in the best spot from a capital standpoint since I've been with this organization," says Grady Wilson, chief development officer at Varsity-backed Orthopedic Care Partners (OCP). In this conversation with host Geoff Cockrell, Grady discusses how their recent $185 million Brookfield investment positions them for aggressive growth despite challenging market conditions. Drawing from his experience growing OCP to 150 physicians across five states, Grady shares insights about physician recruitment strategies, value-based care opportunities, and the untapped potential in mid-sized markets. He also reveals how OCP’s compensation model creates alignment at local and organization-wide levels to drive success in today's orthopedic landscape.

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☑️ Grady Wilson | LinkedIn

☑️ Orthopedic Care Partners | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Episode 96: The Joint Venture Model Revolutionizing DSOs, with Justin Puckett

Thu, 29 May 2025 03:00:00 -0400

"If you don't have a proper alignment model,” cautions MB2 Dental President Justin Puckett, “it's really hard to win in this game." Speaking with McGuireWoods partner and host Geoff Cockrell, Justin explains why most dental service organizations (DSOs) struggle with provider retention and growth.

He also unveils MB2’s groundbreaking joint venture approach in which dentists maintain local ownership while receiving monthly distributions — a model that has propelled them to nearly 800 practices nationwide. Tune in for insights about the future of large DSOs, acquisition strategies and how MB2's pioneering approach reshapes the dental industry landscape.

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☑️ Justin Puckett | LinkedIn

☑️ MB2 Dental | LinkedIn | Facebook | Instagram | TikTok

☑️ Geoff Cockrell | LinkedIn

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Episode 95: The Real Truth about PE in Healthcare, With Lauren Makhoul

Tue, 27 May 2025 03:00:00 -0400

A principal in the financial services practice at Avalere Health, Lauren Makhoul challenges prevailing narratives about institutional capital. “Private equity investment in healthcare reduces Medicare expenditures by almost $1,000 per beneficiary,” she explains to McGuireWoods partner and host Geoff Cockrell and partner Alyssa Campbell.

Avalere does buy-side, regulatory and reimbursement due diligence for PE sponsors investing across healthcare. Tune in for insights into how capital investment enables struggling practices to survive, provides expansion opportunities without personal guarantees and creates the scale necessary for value-based care participation.

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Episode 94: What Are Healthcare Investment Packs Pursuing? With Matt Searles and Bart Walker

Wed, 21 May 2025 03:00:00 -0400

Investors, as Bart Walker likes to say, “tend to run in packs.” The co-chair of McGuireWoods' healthcare industry team, Bart describes the current “pack” running not so much toward value-based care but rather toward “some risk element, something more interesting than just traditional fee-for-service.”

In this conversation with host Geoff Cockrell, Bart and Matt Searles from Merritt Healthcare explore the slowdown from previous market peaks. But they also highlight opportunities in consumer-focused segments. Tune in for their insights about trends in regulatory scrutiny, artificial intelligence, and joint ventures.

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Episode 93: The Compensation Mistake PPM Investors Regret, With John Tiedmann

Mon, 12 May 2025 03:00:00 -0400

"The key to successful physician practice management is self-control on the sell-side and being reasonable about compensation," observes John Tiedmann, a managing director at Physician Growth Partners, in this conversation with host Geoff Cockrell. With over 70 deals across various medical specialties, John describes how PPM investments have evolved from pure growth to facing challenges in physician alignment and compensation structures.

The discussion highlights emerging pharmaceutical distributors as strategic buyers for large platforms and explores how compensation models are adapting to ensure sustainable practices. Despite recent headwinds, he remains bullish on the sector's future as platforms correct alignment issues and valuation expectations normalize.

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Episode 92: Winning the Insurance Game in Healthcare Transactions, With Hannah Ellithorpe

Thu, 08 May 2025 03:00:00 -0400

“Underwriters are more willing to take creative approaches now than they would have been in the last couple of years,” observes Hannah Ellithorpe, executive director and head of healthcare and life sciences at Atlantic Global Risk. The former M&A attorney shares with McGuireWoods partner and host Geoff Cockrell how the representation and warranty insurance market has evolved toward more flexible coverage terms at lower costs.

Hannah details how softening market conditions have created opportunities to secure previously unattainable regulatory compliance coverage and discusses emerging products specifically designed for healthcare providers serving vulnerable populations.

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Episode 91: Can AI Level the Playing Field in Dental Marketing? With Ryan Torresan

Thu, 01 May 2025 03:00:00 -0400

“The hot topic right now is how AI fits into dental marketing,” says Ryan Torresan, chief marketing officer at Peak Dental Services. With 14 years of experience across multiple dental service organizations (DSOs), Ryan predicts AI will be a market “leveler” that benefits large and small practices while blurring traditional lines between marketing and operations functions.

Tune in for his insights about new markets, creating efficient lead generation systems and measuring marketing success with McGuireWoods partner and host Geoff Cockrell.

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Episode 90: Investment Opportunities in Behavioral Health, With Adam Abramowitz

Fri, 25 Apr 2025 03:00:00 -0400

The behavioral health sector encompasses segments from substance abuse treatment to autism therapy — a breadth of opportunity that Adam Abramowitz, managing director at Intrepid Investment Bankers, explores with McGuireWoods partner and host Geoff Cockrell. Adam details how reduced stigma and increased reimbursements are driving significant market growth, particularly in underserved rural areas.

While discussing industry evolution, he notes a critical shift from out-of-network to in-network insurance strategies driven by institutional investors. Despite considerable private equity activity, he characterizes the market as being in the “middle innings” of consolidation, with substantial unmet demand creating compelling investment cases for mission-driven providers who can deliver care where access is limited.

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Preparing a Compliance Plan, With Garen Marshall

Wed, 23 Apr 2025 03:00:00 -0400

McGuireWoods partner and host Geoff Cockrell welcomes Garen Marshall from the Government Investigations & White Collar Litigation Group to discuss how healthcare companies should prepare for potential government investigations.

Drawing from his experience as a former federal prosecutor, Garen outlines critical steps healthcare organizations should take before law enforcement contact occurs, including establishing document management practices, developing crisis response protocols and engaging experienced outside counsel.

He provides practical guidance on navigating the delicate balance between cooperation and overextending consent during searches and explains how properly handling subpoenas and search warrants can significantly impact investigation outcomes.

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Has the Reset Really Hurt Healthcare M&A? With Diwakar Sinha

Tue, 22 Apr 2025 03:00:00 -0400

Pointing to renewed optimism in healthcare transactions, Diwakar Sinha suggests that “2025 looks very promising and should be a very successful year in the M&A space.” As founder and CEO of Polaris Healthcare Partners, Diwakar shares insights on the current landscape in which regional platforms with $2 to $5 million EBITDA are increasingly coming to market. His conversation with McGuireWoods partner and host Geoff Cockrell covers the effects of changing capital costs on deal structures, the emergence of new buyer expectations and the reconciliation of seller valuations post-pandemic.

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☑️ Diwakar Sinha | LinkedIn

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Despite Complexities, Healthcare PE Opportunities Abound, With Max Reiboldt

Thu, 03 Apr 2025 03:00:00 -0400

Max Reiboldt visits McGuireWoods partner and host Geoff Cockrell about the future of private equity in healthcare, particularly in provider services. Chairman of the Coker Group, a leading sell-side investment bank in healthcare transactions, Max is the lead author of “Private Equity in Healthcare, Leadership Economics and Trends for the Future.”

Tune in for Max’s insights on the impact of private equity on healthcare, the operational challenges faced by private equity-backed provider platforms and evolving market dynamics.

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☑️ Max Reiboldt | LinkedIn

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How Matt Stekier Drives Value Creation in Private Equity Healthcare Investments

Fri, 28 Mar 2025 03:00:00 -0400

McGuireWoods partner and host Geoff Cockrell, invites Matt Stekier, a principal at Plante Moran’s management consulting group, to discuss challenges in the medical devices and product sector. Matt covers supply chain vulnerabilities, inventory management issues, and post-acquisition integration. He explains how Plante Moran helps clients identify and mitigate these challenges, including through due diligence and ongoing operational support. He also outlines industry trends such as the increasing emphasis on risk management and the need for private equity firms to focus more on operational improvements to drive value.

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☑️ Plante Moran on LinkedIn | Facebook | Instagram

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What Optometry Needs to Know to Remain Competitive, with Ben Chudner

Tue, 18 Mar 2025 03:00:00 -0400

The optometry market suffers from a staffing shortage but benefits from an aging population — a balance of headwinds and tailwinds that Dr. Ben Chudner discusses with McGuireWoods partner and host Geoff Cockrell.

The chief medical officer at AEG Vision, a private equity consolidator of optometric practices, Ben explains that while the number of optometry schools has increased, the number of applicants has not. He remains optimistic about the market’s growth potential due to an aging population and the increase of eye-related diseases such as cataracts and macular degeneration.

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Investment Outlook for Three Healthcare Sectors, with Jeremy Johnson

Wed, 12 Mar 2025 03:00:00 -0400

McGuireWoods partner and host Geoff Cockrell invites Jeremy Johnson, senior managing director at Bourne Partners investment bank, for a discussion about business and investment prospects in three healthcare sectors: pharma services, provider services and payor services.

The pharma services sector faces challenges from reduced biopharma funding while the provider services sector sees improving conditions despite past pressures. The payor services sector, particularly around pharmacy benefit managers, is likely to undergo disruption and reform. The outlook for healthcare M&A activity is positive in 2025, though the shifting regulatory environment introduces uncertainty.

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☑️ Jeremy Johnson | LinkedIn

☑️ Bourne Partners | LinkedIn

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Five Things to Watch in Healthcare This Year, with Gyasi Chisley

Tue, 25 Feb 2025 03:00:00 -0400

As a $4.6 trillion industry in the United States, “pretty much everything is connected or interconnected to healthcare,” says Gyasi Chisley, head of corporate healthcare at PNC Bank. “So, that positions us for another interesting and pivotal year in 2025.”

In a conversation with McGuireWoods partner and host Geoff Cockrell, Gyasi highlights five areas to watch: the pivot of private equity from services to digitation, the evolving landscape of healthcare delivery, the “war on talent,” the impact of inflation on consumers, and the disrupters: publicly traded healthcare companies or companies within healthcare.

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Healthcare Compliance Tools: What Investors Need to Know, with Rebecca Springer

Tue, 18 Feb 2025 03:00:00 -0400

Healthcare data pioneer Rebecca Springer visits The Corner Series as a newly minted director at healthcare investment banking boutique Bailey & Co. With McGuireWoods partner and host Geoff Cockrell, Rebecca details the growing governance, risk and compliance (GRC) market in healthcare.

She describes the four “buckets” of GRC — provider data; workforce; safety, quality and risk; and contract/vendor management — and explains how consolidating these traditionally siloed functions can drive efficiencies and offer data-driven insights for providers and payers. She also teases findings of Bailey & Co.’s upcoming research on other trends, including individual contribution health reimbursement arrangements, skilled nursing staffing models and value-based care.

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☑️ Rebecca Springer | LinkedIn

☑️ Bailey & Co | LinkedIn | X

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Seizing the Future in Ophthalmology Surgery Centers, With Randall Shaw

Tue, 11 Feb 2025 03:00:00 -0400

Declining interest rates and a new administration foretell a warmer M&A market in ophthalmology, says Randall Shaw, co-founder and chief strategy officer of Vision Integrated Partners. With 25 practices and 13 surgery centers in six states, Vision Integrated Partners has annual revenues above $200 million.

Joining McGuireWoods partner and host Geoff Cockrell, Randall sees significant activity for 2025 in purchases and joint ventures of surgery centers. Vision Integrated Partners plans to be at the center of this market.

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☑️ Randall Shaw | LinkedIn

☑️ Vision Integrated Partners | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Start With Fundamentals to Help Healthcare Investors Succeed, With Mike Murphy

Thu, 30 Jan 2025 03:00:00 -0400

The days when healthcare investors could financially engineer their way to an outcome are gone. In today’s economy, they must focus on improving valuation and performance. In this podcast, McGuireWoods partner and host Geoff Cockrell and Mike Murphy, founder and managing partner of Sunstone Management Advisors, discuss how to succeed in this harsh reality.

At Sunstone, Mike leverages his four decades of experience in the healthcare insurance space to help small to mid-sized businesses improve their enterprise value. For Mike, it starts with uncovering the fundamentals of a client’s business: Are the messaging and targeting right? Then there’s the execution around selling into the payers, which is not for the faint of heart, Mike says. The CEO should be the thought leader, not the salesperson.

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☑️ Mike Murphy | LinkedIn

☑️ Sunstone Management Advisors | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Advocating for Healthcare Providers, With Eleanor Kasper

Thu, 23 Jan 2025 03:00:00 -0400

Out of the blue, D.C. healthcare regulators informed Hero Practice Services that its two dental practices needed a “certificate of need.” The lengthy, stringent process to secure one would have hamstrung the practices, which served 50% Medicaid patients. Hero’s general counsel Eleanor Kasper and her team worked with the D.C. council to update the antiquated law so dental practices would no longer be called out on certificates of need.

The story reflects the mission of Hero, a healthcare practice management company whose providers in dental, vision and orthodontics are located in many underserved communities and see 97% Medicaid recipients. In this conversation with McGuireWoods partner and host Geoff Cockrell, Eleanor discusses navigating regulatory requirements across different states, retaining providers and challenging the notion that private equity-backed healthcare is “bad.”

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☑️ Eleanor Kasper | LinkedIn

☑️ Hero Practice Services | LinkedIn | Facebook

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Shedding Light on Healthcare Compliance, With Mindy Sauter and Mike Elliott

Mon, 13 Jan 2025 03:00:00 -0400

McGuireWoods partner and host Geoff Cockrell invites Government Investigations & White Collar Litigation partners Mindy Sauter and Mike Elliott to discuss compliance and regulatory challenges within private equity healthcare investments. As Mindy explains, private equity groups are sensitive to compliance issues because they bring in individual entities that tend to function in a siloed manner.

The ideal member of the private equity group’s board is someone with healthcare experience who will look at the appropriate type of oversight of compliance functions, says Mike. In the new administration, Mike anticipates an increased push toward investigating antitrust violations, while Mindy suggests that investigations into healthcare fraud, waste and abuse will remain consistent with the current landscape.

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☑️ Mindy Sauter | LinkedIn

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Life Sciences Investors: Keep These Developments Top of Mind, with Kevin Madagan

Mon, 06 Jan 2025 03:00:00 -0400

McGuireWoods partner Kevin Madagan offers private equity investors a window into the future of the life sciences industry in this wide-ranging conversation with partner and host Geoff Cockrell.

From the FDA’s new Advisory Committee for Digital Health to the controversial Biosecure Act, which could open avenues for investors in the life sciences sector, Kevin suggests news for investors to monitor. He highlights the growth of radiopharmaceuticals, driven by increased partnerships between contract development and manufacturing organizations and Big Pharma.

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☑️ Kevin Madagan | LinkedIn

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Optimizing Med Spa for Private Equity Growth, With Amanda Roenius and Jessica Nunn

Tue, 17 Dec 2024 03:00:00 -0400

McGuireWoods partner and host Geoff Cockrell and associate Amanda Roenius welcome Jessica Nunn, CEO of Maven Financial Partners, for a discussion about the convergence of med spas and private equity.

Jessica describes key characteristics of the med spa arena, different membership models and drivers of profitability and explains why she expects the space to be more competitive in 2025.

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☑️ Jessica Nunn | LinkedIn

☑️ Maven Financial Partners | LinkedIn

☑️ Amanda Roenius | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Growing a Pure-Play Med Spa, with Alyssa Rapp and Logan Pitts

Tue, 03 Dec 2024 03:00:00 -0400

Med spas are rapidly becoming the front door to healthcare, and Empower Aesthetics has put out the welcome mat.

Partnering with financial sponsor Shore Capital, Empower’s platform of medical spas are located in Texas and Tennessee and building in the Midwest and upstate New York. With host Geoff Cockrell, Empower’s CEO Alyssa Rapp and Shore’s Logan Pitts share their insights on growing a med spa platform. She attributes Empower’s success to a relentless focus on “pure-play med spa” that offers injectables, lasers, and body contouring. “We’re sticking to our knitting and very clear on what we’re doing,” she says.

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☑️ Alyssa Rapp | LinkedIn

☑️ Empower Aesthetics | LinkedIn | Instagram

☑️ Logan Pitts | LinkedIn

☑️ Shore Capital Partners | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | X

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What Pharma Services Investors Should Know about Government Regulations, with Clint Narver

Mon, 25 Nov 2024 03:00:00 -0400

As the pharma services sector grows, regulators at the Department of Justice and Food and Drug Administration are placing everything from clinical trials to site management under the microscope. McGuireWoods partner Clint Narver speaks from experience: He joined the firm after serving in leadership roles at both agencies.

With host Geoff Cockrell, Clint helps industry stakeholders understand regulators’ enforcement priorities. He covers the responsibilities of clinical research organizations (CROs), the impact of decentralized clinical trials on regulatory oversight, and the importance of corporate compliance in avoiding enforcement actions. To investors looking at acquiring a company, Clint notes that DOJ’s recent Mergers and Acquisitions Safe Harbor policy is designed to incentivize the disclosure of corporate crime that is uncovered through the due diligence process.

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☑️ Clint Narver I LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Capitalizing on the GI M&A Market, With Sap Sinha

Tue, 19 Nov 2024 03:00:00 -0400

At fast-growing Allied Digestive Health, with 194 GI physicians, 75 nurse practitioners, and locations in New Jersey and New York, COO Sap Sinha is excited about the future.

“Private equity in general is looking at GI very specifically, and there are multiple reasons for it,” Sap says in this conversation with host Geoff Cockrell. One reason lies in the fact that colon cancer is the second-largest cancer or cause of death in the United States. Sap describes the current landscape, where Allied is investing in clinical quality and partnering with large institutions, as well as frontiers, such as genetics to detect colon cancer and helping obese patients reduce weight to manage non-alcoholic fatty and liver disease.

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☑️ Sap Sinha | LinkedIn

☑️ Allied Digestive Health

☑️ Geoff Cockrell | LinkedIn

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Adjusting as the Dental DSO Market Adjusts, with Steve DeLong

Tue, 12 Nov 2024 03:00:00 -0400

Host Geoff Cockrell invites Steve DeLong, founder and co-CEO of Bluetree Dental, to discuss growing a DSO in a competitive healthcare landscape. Bluetree, which has expanded to more than 40 offices across six states since its inception in 2012, represents a successful model of combining de novo growth with acquisitions. Steve emphasizes the importance of maintaining a balance between central guidance and local practice autonomy, ensuring that dental professionals retain a degree of control over their operations. Geoff and Steve also cover the strategic alignment of interests between a DSO and its dental providers, detailing Bluetree's approach to equity ownership and partnership models. Finally, Steve shares insights about Bluetree's decision to partner with Clairvest Group for a minority private equity investment, highlighting the desire for a cautious, long-term growth strategy over rapid expansion.

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☑️ Steve DeLong | LinkedIn

☑️ Bluetree Dental I LinkedIn I Instagram I Facebook

☑️ Geoff Cockrell | LinkedIn

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Mergers Slow Right Now with Reed Van Gorden of Deerpath Capital

Tue, 29 Oct 2024 03:00:00 -0400

Host Geoff Cockrell observes that seller anxiety about the potential for broken deals seems to be high right now. A surprising number of deals, he says, are reluctant to “go out into a wider market process.” Guest Reed Van Gorden of Deerpath Capital sees the same trend: mergers and business sales are slow. He’s waiting to see if the two additional interest rate cuts that are expected this year will set more deals in motion.

Reed finds that companies are performing well and have stabilized since the effects of the COVID pandemic. And the local businesses that Deerpath focuses on, such as medical offices, are not terribly affected by world events like supply chain problems or fluctuating oil prices.

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☑️ Reed Van Gorden | LinkedIn

☑️ Deerpath Capital | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Enforcement Risks for Private Equity Investors in Healthcare, with Michael Podberesky, a Former DOJ Prosecutor

Tue, 22 Oct 2024 03:00:00 -0400

The US Department of Justice has annunciated several enforcement priorities relevant to the healthcare sector: senior care, opioids, cyber security and privacy, and – of particular interest to listeners of “The Corner Series” – private equity investors in the healthcare space.

Michael Podberesky, a former DOJ prosecutor who is now co-chair of McGuireWoods’ False Claims Act Investigations, Litigation and Enforcement team, outlines these priorities in this installment of “The Professor’s Corner,” a special episode where “The Corner Series” host Geoff Cockrell invites experienced practitioners to share insight about nuanced topics. Michael offers an insider’s view of the agency, including how it balances political pressure with its evidentiary burden and how its attorneys triage the large number of complaints they receive. He also observes that his former DOJ colleagues typically have one overriding calculus: “Am I dealing with a bad actor?” For the most part, they are fair and reasonable, he says, adding: “That doesn't mean we’re going to agree, and it doesn’t mean our listeners are going to agree.”

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☑️ Michael J. Podberesky | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Improving Oral and Maxillofacial Surgery Practice through Private Equity with Daniel Hosler and David Kostohryz

Tue, 01 Oct 2024 03:00:00 -0400

The business-side of running an oral and maxillofacial surgery practice can present unique challenges, such as purchasing the latest equipment, staffing offices and dealing with technology and cyber security. That’s where private equity and a group run by doctors tries to help.

Listen as Daniel Hosler, who brings experience in equity, and Dr. David Kostohryz, Jr., an oral surgeon, discuss Allied OMS, an oral and maxillofacial surgery platform they founded that helps with the “business of the business” of oral surgery offices.

Their platform helps offices purchase equipment, staff their offices, keep up with rules and regulations, communicate with other doctors who are part of Allied OMS through a Slack channel, receive some mentoring, and help with IT. And the group helps open satellite offices to expand the services of respected practices.

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☑️ Daniel Hosler | LinkedIn

☑️ David Kostohryz, Jr. | LinkedIn

☑️ Allied OMS | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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The Med Spa Difference: Experiential, Clinical, Recession-Resistant, with Nicole Chiaramonte

Tue, 24 Sep 2024 03:00:00 -0400

Everyone wants to dip their toe in the medical aesthetics space, and why not? It’s beautiful. But among platforms in this space, such as day spas, it’s the pure med spa that has longevity “because it mixes the experiential with the service and the clinical outcomes,” says Nicole Chiaramonte

In October 2022, Nicole founded Advanced MedAesthetic Partners, which now has 62 locations operated by “young, motivated entrepreneurs” who are hungry to grow their one or two locations into more. The partners are integrated under one umbrella, with standardized back office functions but individualized local patient experiences. With host Geoff Cockrell, Nicole explains AMP’s strategies for expansion and discusses one of the biggest trends in med spa: weight loss drugs. She also shares insights about risks in the industry, including competition, drying up of credit, and state legislation. As AMP approaches its two-year mark, she’s optimistic about what 2025 will bring.

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☑️ Nicole Chiaramonte | LinkedIn

☑️ Advanced MedAesthetic Partners | LinkedIn | Instagram

☑️ Geoff Cockrell | LinkedIn

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FTC’s Non-Compete Ban Overturned + Evolution of Non-Competes in M&A Deals

Thu, 12 Sep 2024 03:00:00 -0400

On this cross-over episode of Deal by Deal and The Corner Series, McGuireWoods’ partners Greg Hawver and Geoff Cockrell welcome labor and employment partner Meghaan Madriz to discuss recent headlines regarding the FTC’s proposed ban and the broader legal landscape for non-competes.

Tune in as Meghaan breaks down the evolving enforceability of restrictive covenants, including non-competes tied to employment agreements, sales of businesses, and equity ownership. She also highlights trends in state-specific legislation and shares insights from her experience litigating these issues. The conversation covers how businesses can use alternative tools, such as deferred compensation or retention bonuses, to retain employees amidst increasing scrutiny of non-competes.

Tapping the Pediatric and Orthodontic Dentistry Market with Ananya Shah and Will MacInnis

Mon, 02 Sep 2024 03:00:00 -0400

There are already big players in the pediatric and orthodontic space, so what inspired Ananya Shah and Will MacInnis to launch their own dental service organization in the same arena? The answer lies in untapped markets and “a ton of opportunity.”

With host Geoff Cockrell, Ananya and Will outline their journey from a tech-focused healthcare start-up in Silicon Valley to co-founding Cliff Ridge Specialty Partners about a year ago. They explain what differentiates Cliff Ridge. One is their strategy of giving full clinical autonomy to providers. The other is their operational and technological playbook to make the lives of the doctors and office managers easier. Tune in to hear their insights about how they manage labor pressures, the factors that are more important to doctor retention than non-competes, and why their greatest opportunity in the next year may be acquiring more pediatric practices.

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☑️ Ananya Shah | LinkedIn

☑️ Will MacInnis | LinkedIn

☑️ Cliff Ridge Specialist Partners | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | X

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“Phenomenal Opportunity” in the Dental Consolidation Arena with Naimish Patel

Mon, 26 Aug 2024 03:00:00 -0400

At six months old, Seva Dental Team – Naimish Patel’s second venture in the dental consolidation arena – is already as successful as his first operation was at three years. What’s driving Seva’s fast-track?

“We believe in picking a swim lane and swimming really fast in it,” explains Naimish, Seva’s chairman and co-founder. “So we are exclusively GP-focused, and we’re acquisition based.” With host Geoff Cockrell, Naimish breaks down his strategies. A critical one is acquiring practices where the doctor plans to transition in 12 to 24 months. Seva then brings in its doctors “to take over that practice very quickly and, frankly, grow it.”

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☑️ Naimish Patel | LinkedIn | Email

☑️ Seva Dental Team on Facebook

☑️ Geoff Cockrell | LinkedIn

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Trends in Middle Market Healthcare M&A with James Heidbreder of Fifth Third Bank

Thu, 15 Aug 2024 03:00:00 -0400

M&A activity in the healthcare space has slowed since 2022, but with stable interest rates and creative deal structuring, M&A activity should increase going forward.

Host Geoff Cockrell is joined by James Heidbreder, managing director in Fifth Third’s Healthcare Investment Banking group, to discuss challenges faced in healthcare M&A since 2022, the factors leading to an uptick in healthcare M&A activity, and how balancing scrapes, income repair, and other factors can lead to more M&A deals being made. Tune to learn how healthcare M&A, especially in middle markets, should be on the rise for the rest of 2024 and into 2025 and beyond!

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☑️ James Heidbreder | LinkedIn

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☑️ Geoff Cockrell | LinkedIn

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Investing in Dermatology with Michael Pennington of Platinum Dermatology Partners

Thu, 01 Aug 2024 03:00:00 -0400

Michael Pennington used his background in middle-market investment banking to establish Platinum Dermatology Partners eight years ago. Now with 400 providers across five states, the physician-owned practice is thriving in a marketplace beset by challenges such as wage inflation and declining reimbursement models.

In this episode of The Corner Series, Michael describes the foundation of success to host Geoff Cockrell. He acknowledges that navigating healthcare markets is more difficult than ten years ago, but he also promotes the unique advantages in the dermatology space. Here’s one: “I worry about a lot of things at night,” Michael says, “but patient demand is not one of them.”

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☑️ Michael Pennington | Email | LinkedIn

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HR, Accounting, Finance, and AI in Medical Practices with Erik Miller of MedHQ

Tue, 25 Jun 2024 03:00:00 -0400

The back office of a medical practice is like the offensive line on a football team: they do the job no one else wants to do.

On this episode of The Corner Series, host Geoff Cockrell is joined by MedHQ president Erik Miller to discuss how outside back office support for areas such as HR, accounting, and credentialing can improve and streamline a medical practice of any size. Tune in as Erik discusses how both smaller practices and full health systems can benefit from outside back office support, the “frenemy” relationship between ASCs and large health systems, and how artificial intelligence can benefit the medical community at large!.

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☑️ Erik Miller | LinkedIn

☑️ MedHQ on LinkedIn, Facebook, Twitter/X, & YouTube

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Using Tax Insurance and RWI in Middle Market M&A Deals with Jordan Tamchin of CAC Specialty

Fri, 14 Jun 2024 03:00:00 -0400

Tax insurance and representation and warranty insurance have become common in M&A deals over the past two decades, but the use of those products continues to evolve as transactions become more complex.

In this episode of The Corner Series, Jordan Tamchin of CAC Specialty joins host Geoff Cockrell to discuss tax insurance and RWI in today’s middle market M&A environment. Jordan discusses the most common uses of tax insurance in M&A deals, trends in how tax insurance and RWI claims have been processed and paid, and how these insurance products will evolve to cover more aspects of M&A deals.

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☑️ Jordan Tamchin | LinkedIn

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Private Equity in Pediatric Practices with Tucker Moore and Chris O’Dekirk of Concierge Capital

Thu, 30 May 2024 03:00:00 -0400

Private equity investment in the medical environment is nothing new. But what investment considerations and challenges are specific to pediatric practices?

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell is joined by Tucker Moore and Chris O’Dekirk of Concierge Capital Advisory to discuss trends and issues related to private equity involvement in pediatric practices. Specifically, Tucker and Chris discuss how the retail-heavy aspects of pediatrics can be attractive to investors, how consolidation can increase the quality of care provided, and how incentive programs can mean pediatric offices have higher revenue.

Tune in as Geoff, Tucker, and Chris discuss all that and more related to pediatric practices!

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☑️ Tucker Moore | LinkedIn

☑️ Chris O’Dekirk | LinkedIn

☑️ Concierge Capital Advisory | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Opportunities and Challenges in the Dental Practice Market with Kevin Cumbus of TUSK Practice Sales

Wed, 22 May 2024 03:00:00 -0400

While the dental practice market is one of the most mature healthcare markets, it is also highly fragmented. That fragmentation means that opportunities vary widely at every valuation level.

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell is joined by Kevin Cumbus, Founding Partner and President at TUSK Practice Sales.

Tune in as Geoff and Kevin delve into the current dental market from an investment and practice sale perspective, including where strategic buyers are focused, where the buyer market opens up, as well as some of the pressures faced by dental practices. They also address the impact of the FTC’s recent non-compete rule on the healthcare market, and tools to maximize equity alignment at every level.

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☑️ Kevin Cumbus | LinkedIn

☑️ TUSK Practice Sales | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Challenges Facing Family Offices with R. Adam Smith of Salomon Brothers

Wed, 15 May 2024 03:00:00 -0400

Family offices have been growing since the end of the Great Recession. Now, family offices face new challenges such as determining diversification strategy and succession planning.

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell welcomes guest R. Adam Smith, the Managing Director of Salomon Brothers, who advises many family office clients.

Tune in to hear Adam share his thoughts on family offices engaging in direct investing, the need to hire experienced staff and advisors, and how diversification can provide more financial security.

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☑️ R. Adam Smith | LinkedIn

☑️ Salomon Brothers | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Capital Trends in Medical Technology with Brian Scullion of William Blair

Wed, 08 May 2024 03:00:00 -0400

Medical technology is evolving every day. What trends are investment banks seeing, and what are some of the capital trends in the medical technology space?

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell chats with Brian Scullion, Senior Director, Medical Technology at William Blair, a boutique multinational investment bank and financial services company, to discuss how investment banks view emerging healthcare technologies.

Listen as Brian talks about private equity considerations in the healthcare industry, how AI and other emerging technology are impacting capital investments in healthcare, and when value-based healthcare might grow in the commercial healthcare arena.

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☑️ Brian Scullion | LinkedIn

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☑️ Geoff Cockrell | LinkedIn

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Prepping for a Sale: Strategies for Provider Groups with Marc Anderson

Tue, 30 Apr 2024 03:00:00 -0400

From a seller’s perspective, how does a provider group get ready for a sale process?

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell interviews Marc Anderson, Managing Partner of The Belay Group, on the nuances of preparing companies, particularly in healthcare services, for a sale process. The discussion highlights the importance of professionalizing back-office operations and financial reporting, and the potential pitfalls around ownership structure and economics. Marc and Geoff also discuss the variables in strategic decisions, such as consolidating smaller entities to gain scale and the role of tax planning. The conversation provides valuable insights, essential for any healthcare provider group considering a sale.

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☑️ Marc Anderson | LinkedIn

☑️ The Belay Group

☑️ Geoff Cockrell | LinkedIn

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Investment Considerations for Dermatology and Aesthetics Practices with Clint Bundy and Stewart Carlin

Tue, 23 Apr 2024 03:00:00 -0400

Dermatology and aesthetics practices took off after the Great Recession, thrived during Covid, and now show no signs of slowing down. What makes dermatology and aesthetics such desirable investments?

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell chats with Clint Bundy and Stewart Carlin, managing directors of the Bundy Group, a boutique investment bank specializing in the healthcare industry, to discuss specific considerations for investing in dermatology and aesthetics practices.

Listen as Clint and Stewart explain why those practices are high-value investment targets, including the increasing influence of healthcare technology, the difference between being an investment cornerstone versus an add-on acquisition, and how aggressive investors will keep the market for dermatology and aesthetics providers robust.

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☑️ Clint Bundy | LinkedIn

☑️ Stewart Carlin | LinkedIn

☑️ Bundy Group | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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Choosing the Right CEO to Meet the Moment with Leon Brujis

Wed, 10 Apr 2024 03:00:00 -0400

One common myth about leadership is the idea of the “born leader,” whereby certain individuals are born with inherent leadership traits. However, leadership is not exclusively determined by genetics or innate abilities. Rather, leadership traits can be learned.

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell welcomes guest Leon Brujis, an experienced investor who serves as Partner and Head of the East Coast Division of 65 Equity Partners, a global investment firm.

Tune in to hear Leon share his thoughts on the necessary components of leadership in a private equity-backed platform, including the significance of the CEO and the characteristics and traits that make a good CEO. Leon also discusses tools such as psychometric evaluations, that can be useful in making assessments.

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☑️ Leon Brujis | LinkedIn | Email

☑️ 65 Equity Partners | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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☑️ Resource mentioned: The CEO Next Door

Physician Compensation in the PPM Context with Justin Chamblee and Holly Buckley

Wed, 03 Apr 2024 03:00:00 -0400

PPM deals are one of the hottest trends in the current transaction environment with healthcare professionals.

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell is joined by fellow partner and chair of the firm’s Healthcare Group, Holly Buckley, along with Justin Chamblee. Justin is the President of the Coker Group, a healthcare consulting firm that advises leading healthcare organizations on a wide range of financial, transactional, and operational solutions.

Tune in to hear Geoff, Holly, and Justin discuss physician compensation in the PPM context, including provider compensation in structuring PPM transactions, provider compensation models, regulatory constraints, such as the Stark Law and the Anti-Kickback Statute, and retention and recruitment in the market.

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☑️ Justin Chamblee | LinkedIn

☑️ Holly Buckley | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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The Power of Digital Marketing for P.E. Firms with Laurel Mintz

Wed, 27 Mar 2024 03:00:00 -0400

Historically, private equity and venture capital have not been great at marketing, due to the conservative and highly regulated nature of the industry. However, “really good marketing shortens the first-point-of-contact-to-close-of-business, whether that's on the funding or founder side,” says Laurel Mintz.

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell welcomes guest Laurel Mintz, the CEO of Elevate My Brand, a digital and experiential marketing agency, and general partner at Fabric VC, a venture capital and private equity firm.

Tune in to hear Geoff and Laurel discuss the importance of branding and marketing in the world of private equity and venture capital, including how to target the right audience, the need for consistent communication and messaging, and finding the right mix of omnichannel platforms.

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☑️ Laurel Mintz | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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Macroeconomic Market Trends Affecting the Healthcare Industry with Tim Fry and Alex Chausovsky

Mon, 11 Mar 2024 03:00:00 -0400

Unemployment trends have significant ramifications not only for labor market dynamics but the macroeconomy as a whole. Understanding these types of wide-ranging implications of the macroeconomy can help business leaders make more informed investment decisions.

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell welcomes two guests, Tim Fry, Healthcare Partner at McGuirewoods, and Alex Chausovsky, Director of Analytics and Consulting at Bundy Group, a boutique industry-focused investment bank.

Tune in to hear Geoff, Tim, and Alex cover the macroeconomic aspects impacting private equity investing in healthcare. Their discussion touches on unemployment trends, including the low unemployment rate in healthcare, inflation and interest rates affecting borrowing costs and investment decisions, and labor market dynamics.

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☑️ Tim Fry | LinkedIn

☑️ Alex Chausovsky | LinkedIn

☑️ Bundy Group | LinkedIn | Twitter/X | Vimeo

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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The Partnership Approach to Private Equity Investing in Healthcare with Gordon Maner

Mon, 04 Mar 2024 03:00:00 -0400

“We believe in partnering with people that have that passion, that really want to put the business and the patient over themselves. That's really the secret sauce of microcap investing.”

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell welcomes healthcare investor Gordon Maner. Gordon is the CEO of AMB Wealth, a financial services firm that specializes in asset management and healthcare investment banking. He is also the founding partner of Frontline Healthcare Partners, a private investment firm focused exclusively on investing in lower middle market, distributed healthcare businesses.

Tune in to hear Geoff and Gordon’s discussion about investing in healthcare, including the microcap side of healthcare, growing areas, such as behavioral health, overlooked sectors that provide good investment opportunities, and creating a world-class board.

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☑️ Gordon Maner | LinkedIn

☑️ AMB Wealth | LinkedIn

☑️ Frontline Healthcare Partners | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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Healthcare Investing: What to Expect in 2024 with Bart Walker and Matt Searles

Mon, 26 Feb 2024 03:00:00 -0400

As the market recovers, multiple trends are taking shape in the healthcare provider services industry that will affect investors in 2024.

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell welcomes two guests, Bart Walker and Matt Searles. Bart is a fellow McGuireWoods partner and co-chair of the Healthcare & Life Sciences Industry Team. Matt is the managing partner at Merritt Healthcare Advisors, a healthcare services-focused investment bank.

Tune in to hear Bart and Matt share their perspectives on private equity investing in the healthcare services space and their forecast for 2024. Their discussion includes things such as impediments to closing and active areas in healthcare investing.

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☑️ Bart Walker | LinkedIn

☑️ Matt Searles | LinkedIn

☑️ Merritt Healthcare Advisors | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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Navigating Investment Trends in the Plastic Surgery and Med Spa Sectors with Mitch Stern of Dresner Partners

Mon, 05 Feb 2024 03:00:00 -0400

People have invested a lot in derm and dental and other areas and are now looking for the next sector.

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell is joined by Mitch Stern, Managing Director, Head of Healthcare at Dresner Partners to discuss plastic surgery and medical spa investing.

The discussion delves into the growing private equity interest in the plastic surgery and med spa sectors and compares various operating models. Stern addresses considerations for potential sellers in plastic surgery, emphasizing the need to avoid key man risk and highlighting the attractiveness of practices that have boosted the percentage of their business from med spa. The conversation covers both the opportunities and risks inherent in these sectors, with Stern expressing optimism for the market in 2024.

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☑️ Mitchell Stern | LinkedIn

☑️ Dresner Partners, Investment Banking | LinkedIn | Twitter/X

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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Prognosis on the PPM Environment and Areas of Opportunity with Andy Colbert of Ziegler

Mon, 22 Jan 2024 03:00:00 -0400

The physician practice management (PPM) arena is a mixture of tailwinds, including the ability to expand ancillary services, and headwinds, including more expensive labor costs and antitrust pressures.

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell speaks with Andrew Colbert, Senior Managing Director at Ziegler, a privately held investment bank, capital markets, and proprietary investments firm. Andy joined Ziegler in 2006 as a founding member of Ziegler’s Healthcare Investment Banking practice. He specializes in advising healthcare services and healthcare information technology companies on a spectrum of strategic and financing alternatives.

Tune in to hear Geoff and Andy talk about the physician practice management (PPM) environment and areas of opportunity, including the future of value-based contracting, the impact of a rising senior population, avoiding patient-acquisition expenses, potential around women’s healthcare, and what 2024 is going to look like in the PPM space.

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☑️ Andy Colbert | LinkedIn

☑️ Zeigler | LinkedIn | Facebook | Twitter/X | YouTube

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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Government Investigations of Private Equity Funds: Insights From Former Prosecutors

Thu, 18 Jan 2024 03:00:00 -0400

Government investigations by the DOJ, FTC, and others, into private equity funds–both in the civil and the criminal space–are a recent trend that doesn’t show any signs of slowing down.

In this episode of The Corner Series, McGuireWoods’ Geoff Cockrell speaks with fellow McGuireWoods partners, Jason Cowley and Ben O'Neil, both of whom are former federal prosecutors and current members of the firm’s Government Investigations and White Collar Litigation practice.

Tune in to hear Jason and Ben talk about the government’s attempts to reach beyond the portfolio company to get at the investor and the private equity company itself, as well as the list of factors that the government will look at when deciding whether to extend liability up the chain. They also discuss what changes private equity funds should make, if any, in how they manage their investments.

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☑️ Jason Cowley | LinkedIn

☑️ Ben O'Neil | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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Private Equity Interest in Cardiology: Insights From Tim Attebery of Cardiovascular Associates of America

Mon, 15 Jan 2024 03:00:00 -0400

The consolidation wave of private equity-backed platforms has moved through different sectors at different times. One of the most recent sectors to see increased interest from private equity is cardiology.

This episode of The Corner Series introduces the “Executive Corner”, where McGuireWoods’ Geoff Cockrell is joined by Tim Attebery, CEO of Cardiovascular Associates of America, to discuss private equity interest in cardiology.

Tune in to hear Geoff and Tim explore the current drivers of private equity interest in cardiology, antitrust scrutiny of private equity-backed provider services platforms, the opportunities present in entering into value-based contracting in cardiology, and what is coming down the pike to transform the sector.

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☑️ Timothy Attebery | LinkedIn

☑️ Cardiovascular Associates of America | LinkedIn | Facebook | Twitter | Instagram

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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Private Equity and Healthcare Consolidation: The Revolution in Antitrust Enforcement

Mon, 08 Jan 2024 03:00:00 -0400

The healthcare sector is witnessing a trend towards consolidation, but it's not just big hospital mergers making headlines. Private equity is playing a pivotal role in driving smaller consolidations within healthcare provider services.

In this episode of The Corner Series, McGuireWoods’ partner, Geoff Cockrell is joined by his colleague Holden Brooks, a partner in the antitrust department at McGuireWoods, to discuss the the role of private equity in the evolving landscape of antitrust enforcement.

Tune in as Geoff and Holden discuss the intensifying scrutiny of PE-backed healthcare transactions by antitrust regulators, the challenges for investors in this evolving landscape, and the expected changes in antitrust enforcement in 2024, including new regulations and guidelines.

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☑️ Holden Brooks | LinkedIn

☑️ Geoff Cockrell | LinkedIn

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Drivers and Forecast for Private Equity Investing in the Dental Arena with Karan Garg of Solomon Partners

Mon, 18 Dec 2023 03:00:00 -0400

All sectors of the healthcare market are experiencing investments and growth. Dental and specialty dental practices are part of this growing trend.

In this episode of The Corner Series, McGuireWoods’ partner, Geoff Cockrell speaks with Karan Garg, who is a Partner and serves as Head of Healthcare Services at Solomon Partners, a leading financial advisory firm and one of the oldest independent investment banks. Geoff and Karan discuss the provider services industry, with a specific focus on the dental market and related specialty niches.

Tune in to hear Karan share his experience and insights in the dental arena, including growth strategies, risks and headwinds for dental platforms, market trends, and his 2024 prognosis for provider services and dental services in particular.

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☑️ Karan Garg | LinkedIn

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The Growth of Private Equity Investment in Orthopedics with Scott Davis of Provident Healthcare Partners

Mon, 11 Dec 2023 03:00:00 -0400

Although investment in the orthopedic sector is not new, private equity investment interest in this specialty area continues to grow. In fact, orthopedics has become one of the leading sectors for private equity investing, just behind cardiology.

In this episode of The Corner Series, McGuireWoods’ partner, Geoff Cockrell speaks with Scott Davis, Managing Director at Provident Healthcare Partners, one of the leading investment banks providing M&A advisory services, strategic planning, and capital formation to owners and operators of healthcare services businesses. Geoff and Scott focus their discussion on the highly active and evolving orthopedics sector.

Tune in to hear Scott share his insights into the state of the orthopedic industry and the leading drivers that make it so appealing to investors.

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☑️ Scott Davis | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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Growing Businesses: A Commitment to Mission and Margin with Edward Crawford of Coltala

Tue, 28 Nov 2023 03:00:00 -0400

Some private equity groups buy assets just to pull them apart and sell them for the pieces. However, that is the exception rather than the norm. In fact, private equity has done a lot to build businesses and make them better, especially in the small and medium-sized business segment.

In this episode of The Corner Series, McGuireWoods’ partner, Geoff Cockrell speaks with Edward Crawford, the Co-founder and Co-CEO of Coltala, a Dallas-Fort Worth-based venture capital and private equity firm that employs a “mission” investment style. Geoff and Edward discuss Coltala’s unique investment style, the ethos that drives the firm’s investment strategy, and the misconception about private equity.

Tune in to learn more about Coltala’s partnership culture, the mission and margin investment strategy that serves as a filter to screen out certain companies, the test used to evaluate potential deals, and hear why Edward has walked away from opportunities that otherwise looked great financially.

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☑️ Edward Crawford | LinkedIn

☑️ Coltala | LinkedIn | Twitter/X

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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Value-Based Care: Investment Opportunities, Evolution, and Disruptors with Andrew Clark of Leavitt Equity Partners

Mon, 20 Nov 2023 03:00:00 -0400

The fee-for-service model in U.S. healthcare is going to become more and more unattractive. However, shifting to a value-based care paradigm can move the healthcare system towards better outcomes, lower costs, better patient access and experiences–and also, provides investment opportunities.

In this episode of The Capital Corner, McGuireWoods’ Geoff Cockrell is joined by Andrew Clark, managing partner at Leavitt Equity Partners, to discuss investment opportunities in value-based care.

Tune in to hear Geoff and Andrew explore the evolution of value-based care and how it will continue to shape the healthcare industry. They discuss the different sectors that lend themselves to value-based care investment, including primary care, chronic care, episodic care, and women's care. They also address the disruptive potential of non-healthcare participants like Amazon, payer and provider convergence, and the role of artificial intelligence in driving efficiency and improving patient care.

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☑️ Andrew Clark | LinkedIn

☑️ Leavitt Equity Partners | LinkedIn

☑️ Geoff Cockrell | LinkedIn

☑️ McGuireWoods | LinkedIn | Facebook | Instagram | Twitter/X

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Navigating Healthcare Consolidation in a Post-COVID World With Robert Aprill of Physician Growth Partners

Mon, 13 Nov 2023 03:00:00 -0400

After an active 2022, this year has seen a shift in the PPM space. There are now challenges around the cost of capital, pricing, and labor. Some who raised a lot of capital in 2022 will still be looking for deals, while others are more cautious, putting more emphasis on valuation and financial performance.

On this episode of The Banker's Corner, McGuireWoods' Geoff Cockrell sits down with Robert Aprill, Managing Director at Physician Growth Partners, to share insights on how the market might evolve in 2023 and beyond. Robert’s focus on helping physicians and physician-led businesses navigate private equity within their medical specialty gives him a front row seat to the headwinds this sector is facing currently.

The aftermath of COVID has led many business owners to reevaluate the importance of size and scale in their operations; they are now more open to considering partnering with larger entities to navigate uncertain futures.

The role of advisors in private equity is to educate clients about various compensation and alignment options when considering partnerships with healthcare platforms. The focus is on an equity perspective and a comp perspective to ensure that physicians are partners and are compensated based on their performance and the practice's performance, promoting alignment through incentives rather than punitive measures like production thresholds.

“We spend a lot of time with our clients. I think oftentimes with us, we're presenting something versus having buyers present something to us,” explains Robert.

The two also discuss areas of consolidation, interest in niche specialties, and aligning equity with compensation.

Featured Guest

Name: Robert Aprill

What he does: Robert is a Managing Director at Physician Growth Partners. With prior experience as a healthcare investment banker, he now advises founder- and provider-owned businesses in the healthcare services industry as they prepare for and ultimately pursue a transaction.

Organization: Physician Growth Partners

Connect: LinkedIn

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Driving Growth and Profitability: Private Equity's Role in Modern Medical Practices With Alessio Baraldi, Albaron Partners

Tue, 07 Nov 2023 03:00:00 -0400

When introducing the idea of private equity entering a business, it’s important to make the potential value-add clear from the initial conversation. Doctors are often skeptical about private equity ownership, but providing references and having a clear focus on growing revenue over cutting costs can help facilitate these early conversations.

On this episode of The Capital Corner, McGuireWoods' Geoff Cockrell invites Alessio Baraldi, Managing Director at Albaron Partners, to discuss value creation in healthcare provider services. This topic is timely as the market has shifted from an environment where all investors were finding wins in the sector, to today’s environment, which has more challenges to overcome.

Alessio provides insight into the equity structures that have worked the best for his portfolios and how he prefers to approach compensation to keep everyone aligned. “What we found is that in an environment where there is quite a bit of wage inflation, having a unified system where the management team is able to manage expenses at the center level without relying on the doctors making those calls, has been quite helpful,” he says.

Value creation from a growth strategy can be quite effective, and different firms use various approaches like de novo or acquisitions. Alessio and Albaron Partners prefer a mixture of both to add the most value to their partners.

Integrations and centralization are two other ways to provide value to a portfolio company. Being well-integrated and centralizing support functions like billing and call centers can help a company adapt to unique challenges such as wage inflation while increasing operational efficiency.

Featured Guest

Name: Alessio Baraldi

What he does: Alessio founded Albaron Partners in 2017. He plays a key role in directing the firm’s strategy and investment decisions. Alessio is responsible for sourcing and executing new investments, monitoring portfolio companies as an active board member, and overseeing exit processes.

Organization: Albaron Partners

Connect: LinkedIn

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Assessing the Headwinds in the Healthcare Provider Consolidation Process With Mark Francis of Houlihan Lokey

Wed, 01 Nov 2023 03:00:00 -0400

The difficulties faced by healthcare provider consolidations could be temporary or they could indicate a long-term decline in the attractiveness of consolidation. Some challenges, like high debt and labor market imbalances, are temporary and don't reflect the fundamental quality of the businesses involved.

On this episode of The Banker’s Corner, McGuireWoods' Geoff Cockrell is joined by Mark Francis, Managing Director and Global Head of Healthcare Investment Banking at Houlihan Lokey. The two discuss the future of healthcare provider consolidations through the lens of those working in the industry right now.

Over the past six to eight months, some larger platforms that had been acquiring smaller companies have paused their acquisition activities due to a disconnect between seller expectations and current valuations. They were also waiting for more favorable credit conditions and pricing adjustments. Now, these platforms are beginning to look to the market again and see what is available.

Geoff and Mark discuss the healthcare sector’s resilience during economic slowdowns. Healthcare is often less volatile than other sectors, making it an attractive option for investors looking to allocate funds during economic uncertainties.

Healthcare is a mature market, but new interest in private equity has led to a reshuffling of focus within sectors. Some sectors like healthcare technology, veterinary care, and behavioral health remain highly attractive despite varying trends in their valuations.

Later on in the episode, Mark and Geoff discuss valuations and the importance of running and operating integrated businesses. “Great companies get great valuations, and we can debate what great is, but if people don't feel good about the valuations, largely they're not trading,” says Mark.

Featured Guest

Name: Mark Francis

What he does: Mark is a Managing Director and Global Head of Houlihan Lokey’s Healthcare Group. He has nearly 25 years of experience in M&A and financial operations in the healthcare industry and has managed a wide variety of projects, including divestitures, financial restructurings, joint ventures, and strategic alliance formation.

Organization: Houlihan Lokey

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Prospering in the Healthcare Market: Investment Outlook, With Diwakar Sinha

Mon, 23 Oct 2023 03:00:00 -0400

The healthcare market may be tumultuous these days, but deals are still happening.

On this episode of The Professor’s Corner, Diwakar Sinha of Polaris Healthcare Partners joins McGuireWoods’ Geoff Cockrell to discuss how practices can prepare to sell, what specialties are especially attractive, and how the search for investors varies from practice to practice.

According to Diwakar, the same volume of deals are occurring, but the number of A-grade deals may be fewer. Currently, most A-grade deals exist in certain specialties.

Diwakar recommends that group practices run a quality of earnings (QOE) analysis to firm up their EBITDA projections. This eliminates some of the doubt for investors and makes a deal more appealing.

Diwakar also predicts that the cost of capital will come down mid-2024, which is a good reason to start planning from the sell-side now.

On the consulting side of Polaris Healthcare Partners, Diwakar shares that for a practice to engage Polaris Healthcare Partners, it typically needs seven to 10 locations with aspirations to grow. At that point, the leadership team needs to expand to include a CFO and a more robust accounting team.

Tune in for more on current trends in healthcare group practice investing.

Featured Guest

Name: Diwakar Sinha

What he does: With about 22 years of experience in healthcare lending and transaction services, Diwakar is a Co-Founder and Partner at Polaris Healthcare Partners. Polaris provides consulting services to healthcare group practices across all specialties, as well as capital and sell-side advisory.

Organization: Polaris Healthcare Partners

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Capitalizing on Primary Care: Trends and Opportunities, With Craig Sager

Mon, 16 Oct 2023 03:00:00 -0400

While primary care tends to be overlooked by investors, the industry is shifting to give it the interest it deserves. Regulatory changes, a focus on value-based care, and the potential to achieve both scale and savings, simultaneously, all have investors looking closer at primary care opportunities.

On this episode of The Banker's Corner, McGuireWoods' Geoff Cockrell discusses investing in primary care with Craig Sager, Director at Provident Healthcare Partners. In his current role, Craig leads sell-side M&A in primary care and behavioral health.

Investors in primary care are typically private equity firms that have shorter timelines on when they expect to see a return on their investment. Alternatively, sometimes payer-owned entities invest. They have the ability to make long-term plays that might take decades to show a return.

“These consolidations in primary care, in particular, have an easier to envision backend scenario. You have these massive companies like CVS or UnitedHealthcare, that can be those backend purchasers. It changes some of the dynamics for the private equity investors as well,” says Geoff.

Craig also shares his insights on investors working with fee-for-service healthcare groups. Some investors may find it too risky and prefer to wait for the transition to value-based care before investing. Others see an opportunity to enter at a lower price and facilitate the conversion to value-based care.

Looking at the end of 2023 and into 2024, investors can be confident that there is always going to be interest in this sector and there is capital available to be deployed.

Featured Guest

Name: Craig Sager

What he does: Craig Sager is a Director at Provident Healthcare Partners. He has over nine years of healthcare M&A experience via principal investing, corporate development, and sell-side advisory. He has executed over 30 transactions on both the buy-side and sell-side.

Organization: Provident Healthcare Partners

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Headwinds and Tailwinds: The Current Challenges and Upward Trends in Healthcare

Thu, 05 Oct 2023 03:00:00 -0400

From orthopedics and cardiology to urology and even med spas, the future of specialized healthcare clinics is here — and growing rapidly each quarter.

“The med spa industry is growing double-digit right now. The patient total addressable market continues to expand with the younger generation utilizing those products and services, and male patients and consumers using those products and services,” Rich Blann says of this current trend in healthcare private equity.

On this episode of The Capital Corner, McGuireWoods' Geoff Cockrell sits down with Hector Torres and Rich Blann, both of whom are Managing Directors at DC Advisory on their global healthcare team. They discuss market trends and some current areas of interest from both investors’ and sellers’ perspectives.

Hector and Rich share the challenges they’ve seen to the market this year, as well as where they see the upward trends heading. From the bid-ask spread to physician practice consolidations, they share plenty of advice and hope for the remainder of the year.

And while general M&A volume is down, Hector and Rich find there’s a silver lining: the decreased volume is actually better for the industry as a whole. In 2021 and 2022, there was an overabundance of M&A. Now, this general decrease gives these groups the opportunity to digest all of the M&A deals and integrate those businesses the right way. This will better set the stage for the market in the coming years.

Tune in to hear more about the current market and why the dismal year so far is no reason to fear the months to come.

Featured Guest

Name: Hector Torres

What he does: Hector is a Managing Director of DC Advisory’s global healthcare team. With nearly 20 years of investment banking experience, Hector specializes in M&A and strategic advisory transactions.

Organization: DC Advisory

Connect: LinkedIn | DC Advisory

Name: Rich Blann

What he does: Rich is a Managing Director of DC Advisory’s global healthcare team. Rich brings more than 23 years of global investment banking experience to the table, with a focus on M&A and capital raising.

Organization: DC Advisory

Connect: LinkedIn | DC Advisory

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Hospital M&A and Private Equity with Rex Burgdorfer

Mon, 07 Aug 2023 08:00:00 -0400

The healthcare system is one of the most fragmented industries in the United States. But as strategic players begin consolidating through mergers and acquisitions, private equity investors are seeing growth opportunities in the industry.

On this episode of The Banker's Corner, McGuireWoods' Geoff Cockrell invites Rex Burgdorfer, Partner at Juniper Advisory, to discuss M&A trends, consolidation, and activity in the healthcare sector.

The hospital industry presents challenges for private equity in terms of regulation. This limits investors’ ability to exert control and influence over management compared to other sectors. A successful model that has emerged is the partnership between private equity firms and high-quality academic medical centers.

But how is this changing business model impacting investors’ interest? According to Rex, fewer well-capitalized investor-owned companies are available today. What he has seen is nonprofits holding an advantage in making acquisitions due to tax exemptions, participation in programs like 340B drug pricing, and lower cost of capital from the tax-exempt bond market.

This trend may change in the near future as nonprofits struggle with access to capital and rising interest rates.

Geoff and Rex also discuss trends for private equity and health systems, regulatory scrutiny in the industry, creative competitors, and how a looming recession could affect the industry.

Featured Guest

Name: Rex Burgdorfer

What he does: Rex has over two decades of investment banking and strategic financial advisory services experience. He has advised all forms of nonprofit hospital systems on M&A transactions, including academic, community 501(c)3, faith-based, and local government entities. Rex was previously with Morgan Stanley and holds an MBA from the Kellogg School of Management at Northwestern University.

Organization: Juniper Advisory

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SBIC Fund Trends, Deal Structures, and Challenges with Parkway Capital’s Andy Silverman

Wed, 26 Jul 2023 00:00:00 -0400

Closing a deal requires a lot of give and take, and in times of uncertainty, the right sponsors will have your back.

On this episode of The Capital Corner, McGuireWoods' Geoff Cockrell joins Andy Silverman, Managing Director at Parkway Capital, to discuss the trends, deal structures and challenges that an SBIC may see in the market right now.

Geoff and Andy explore topics related to investment and underwriting, including the significance of independent sponsors in Parkway Capital’s deal flow. Andy notes that being a long-tenured capital partner of independent sponsors allows his firm to make informed decisions on which deals to pursue, with eight of their current nine portfolio company deals being independent sponsor-led deals.

The evolving market has affected how EBITDA multiples are considered for mezzanine debt. Compared to previous years, there have been lower prices and a decrease in total funded debt requested by sponsors due to a decline in values and rising interest rates.

The current underwriting environment has also presented new challenges, with companies experiencing pandemic-related benefits performing better than they would have otherwise. This can make it difficult to determine the baseline performance for the company, particularly with younger companies that were founded around 2020.

The senior cash flow lending market has also tightened up, with credit officers declining deals they would have previously approved.

Despite these challenges, it’s important to keep the deals coming. “We continue to try and fill the pipeline because it really is a numbers game. You need to have X number of deals in order to put out Y LOIs to close Z deals,” Andy says.

Featured Guest

Name: Andy Silverman

What he does: Andy is the Managing Director at Parkway Capital, the mezzanine credit affiliate of Calvert Street Capital Partners. He helps manage the mezzanine investment business. Prior to Calvert Street / Parkway Capital, Andy was a partner at Capital Resource Partners (CRP), a long-standing private investment firm.

Organization: Parkway Capital

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Why the Investor Community Should be Watching Medspas

Wed, 19 Jul 2023 03:00:00 -0400

The healthcare sector attracts interest from the investment community because it’s seen as being more resilient compared to other parts of the economy. But how does the medspa sector compare? During COVID, cosmetic procedures actually rebounded faster than the medical dermatology side.

On this episode of The Banker's Corner, McGuireWoods' Geoff Cockrell discusses all things medspas with Mike Pisani, Managing Director and Co-Head of Healthcare Services at Houlihan Lokey. They discuss the trends, growth opportunities, and challenges that are present for today's medspas and how that affects investors' views of the space.

The market has massive opportunity, and looking at the variety of services available, its value could be upwards of $25 billion. Combined with a strong margin profile, the opportunity for recurring revenue, and a cash-pay service line, this makes it attractive to investors.

The medspa sector currently has a high level of fragmentation both in terms of the number of single clinic businesses that are operating and in how many businesses have been opened within just the past few years. This provides a high level of opportunity for investors looking for attractive deals in the sector.

Recently there has been a mix of consumer and healthcare teams doing deals in the space. This has also been the approach at Mike’s firm, as they prefer to co-team a medspa deal with expertise from both sides.

But where is the industry headed? Given the growth in the category and the opportunity still left on the table, true consolidation can be projected to be 5-10 years away still.

“As we think out 10 years, which is oftentimes irresponsible to do, I think what you'll find is there's going to be some consolidation that exists to create national brand opportunities, but there's also going to be some convergence, where I think we'll see medical derm groups realize perhaps they need new and innovative models outside of their existing clinics,” Mike says.

Featured Guest

Name: Mike Pisani

What he does: Mike is the Managing Director and Co-Head of Healthcare Services at Houlihan Lokey. He has approximately two decades of healthcare and investment banking experience, including more than 15 years at Houlihan Lokey. During his career, Mike has closed more than 100 healthcare transactions, including sellside and buyside M&A transactions, and private financing and equity raise transactions for public and private companies.

Organization: Houlihan Lokey

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Navigating the Credit Crunch: Insight on Private Equity Trends in 2023 with Bob Bartell

Thu, 06 Jul 2023 03:00:00 -0400

Proceed with caution — and a little creativity.

That’s the tip-off for 2023. In this episode, Geoff Cockrell, host of The Banker's Corner, sits down with Bob Bartell, Managing Director and President of Kroll Corporate Finance and CEO of Kroll Securities, LLC.

Together, Bob and Geoff delve into a topic that has been at the forefront of private equity for a few months now: tightening credit. Given his position at Kroll and experience in a broad array of corporate finance advisory engagements, Bob provides an apt commentary on the current climate, including the impact on healthcare business.

The two also discuss market trends and pauses they’ve seen in 2023 so far, and the creative ways lenders and private equity professionals have been able to think outside the box.

“Until the owners of these businesses — many of them are private-equity-backed mid-market, private equity sponsors — see an opening in the credit markets, there's a pause,” says Bob, who goes on to explain why and how this pause affects different levels of the market.

Tune in to hear about the outlook for the rest of 2023 and the creative ways professionals are dealing with workarounds and earnouts in this strange market climate.

Featured Guest

Name: Bob Bartell

What he does: Bob Bartell, CFA, is the Managing Director and President of Kroll Corporate Finance and CEO of Kroll Securities, LLC. He’s also a FINRA registered broker/dealer. He specializes in a variety of corporate finance advisory engagements, including fairness opinions, solvency opinions, M&A advisory, financial restructurings, shareholder disputes, and more.

Organization: Kroll

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Redefining Healthcare: Transitioning from Fee-For-Service to Value-Based Models

Tue, 27 Jun 2023 00:00:00 -0400

In most professions, pay-for-performance is the norm. A certain level of performance is expected for an individual to get paid. So why has the fee-for-service model in healthcare persisted for so long? And what’s causing the shift towards value-based care?

On this episode of The Professor’s Corner, Larry Elisco, Partner at Wipfli LLP, discusses trends in value-based medicine with McGuireWoods’ Geoff Cockrell. The two acknowledge that the compensation structure has had a slow start despite its promising future.

“My view is that value-based care changes the landscape. It's pay-for-performance. It creates risk at the provider level where providers are in fact either going to be paid for performing well or not being paid if they don't perform well. And that's really what I see as a mega trend,” says Larry.

Some of the subspecialties that have been embracing value-based care are those that have commercial payers and can offer bundled payments, including orthopedics, cardiology, and OBGYN. Areas where a specialty is contained within itself are more likely to engage in value-based contracting.

Finally, Larry also shares insights into how buyers are approaching deals while incorporating value-based care and the importance of having strong data analytics and infrastructure in place.

Featured Guest

Name: Larry Elisco

What he does: Larry Elisco is a partner in Wipfli LLP’s healthcare practice and works closely with physician practices to provide accounting, audit, and valuation services. He has extensive experience serving the needs of physicians and their practices.

Organization: Wipfli LLP

Words of wisdom: “I think in every level of healthcare, that pay-for-performance component really has to be in place at some point.”

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Deciphering the Pharma Services Market: Challenges and Opportunities with Daniel Brinkenhoff

Thu, 08 Jun 2023 03:00:00 -0400

Did you know that pharma services are one of the most active areas of healthcare investing?

On this episode of The Capital Corner, McGuireWoods' Geoff Cockrell sits down with Daniel Brinkenhoff, Managing Director at Centre Partners, to discuss the segmenting of the pharma services sector and some of the headwinds and tailwinds that investors are seeing.

To kick things off, Dan explains how the pharma services sector has seen an uptick in outsourcing due to rapidly evolving science and technology. These advancements have opened the door for players like biotech and biologics by bringing down the cost of targeted therapeutics, but have driven up the costs of bringing new drugs to market by increasing the complexity of production. The market is further segmented by the complexity of the science itself, requiring more specialized skill sets that are difficult for one company to employ.

Despite the new challenges with more complex science and technology, innovation is driving a strong growth outlook for the sector. Dan anticipates that the new therapeutics coming to market will continue to result in high single to low double-digit growth.

This sector is also sheltered from the broader economy, with massive capital going into developing new drugs, whatever market conditions may be. Dan also shares insights into the niche subspecialties that he finds particularly compelling, including clinical trial site management, patient recruitment, and anything consulting-oriented.

“The knock on some of these segments is that sometimes they’re project-based work, but there are some interesting consulting firms that really help the smaller-end biotech firms navigate the FDA approval process, their regulatory submissions, paperwork with the FDA, market mapping, and some interesting specialty firms out there that we think are quite attractive as well,” he says.

Featured Guest

Name: Daniel Brinkenhoff

What he does: Daniel is the Managing Director at Centre Partners. Before joining the firm in 2008, he gained experience at ClearLight Partners, LLC and UBS Investment Banking.

Organization: Centre Partners

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Healthcare Investment Models with Dan Hosler of DuneGlass Capital

Tue, 23 May 2023 03:00:00 -0400

On this episode of The Capital Corner, McGuireWoods' Geoff Cockrell sits down with Dan Hosler, Managing Partner and Founder at DuneGlass Capital, to discuss the trends for healthcare services companies that are interested in using the private equity playbook to surcharge their growth.

Dan discusses how the doctor equity model works to provide alignment among all stakeholders, including patients, staff, doctors, and investors. The model starts with knowledge sharing so doctors have a strong base understanding of private equity, before moving on to strategizing on how to keep incentives aligned over time. Aligning incentives is crucial when creating a true alternative to traditional private equity investments.

“To us, doctor equity starts with knowledge-sharing with all our partners.” Dan says.

Dan and Geoff also review which subsectors and specialties could be interesting investment areas. Two areas Dan and his team are researching are the biotech and pharmaceutical spaces. Both are areas where there’s an opportunity to reduce costs in the healthcare system while improving patient care. They also talk through investment opportunities in value-based care, an area that has also seen an uptick in interest in recent years, and the complexity and risk-taking that can come along with those investments.

Featured Guest

Name: Dan Hosler

What he does: As Managing Partner and Founder at DuneGlass Capital, Dan has both operational experiences, having started three companies before business school, as well as deep deal experience, having spent 15+ years in private equity. Most recently he led M&A for an eye care rollup where he closed 10 deals in under two years.

Organization: DuneGlass Capital

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Navigating the Cardiology Boom: Insights from Industry Experts on Market Trends and Opportunities

Wed, 03 May 2023 03:00:00 -0400

On this episode of The Banker's Corner, Provident Healthcare Partners’ Senior Managing Director Rebecca Leiba and Managing Director Eric Major sit down with McGuireWoods' Geoff Cockrell to discuss investing in cardiology, a sector that has seen a sizable uptick in activity over the last two years.

“What we're seeing in the specialty is that consolidation and investment seems to be moving at a pace that's far exceeding what we've seen in other physician specialties areas,” Eric explains.

Rebecca, Eric, and Geoff discuss what makes cardiology attractive for investors, the various avenues for acquisitions, as well as ancillary opportunities for cardiology practices, such as cardiac urgent cares and rehabilitation centers, which are becoming more attractive to independent groups and investors. From potential headwinds to growth opportunities, they cover all the trends they predict to see in the cardiology sector.

“I do think we are still in the early innings of this consolidation,” Geoff says. “Even if it's not a huge market, there's going to be quite a bit more activity and interesting future maneuvers…It’ll certainly be interesting to see.”

Featured Guests

Name: Rebecca Leiba

What she does: Rebecca is a Senior Managing Director at Provident Healthcare Partners. During her career, she has completed over 200 healthcare M&A transactions and has organized interactions between buyers, clients, attorneys, CPAs, and consultants through the entire transaction processes.

Organization: Provident Healthcare Partners

Connect: LinkedIn

Name: Eric Major

What he does: Eric is a Managing Director at Provident Healthcare Partners. For the last decade, Eric has supported the planning and execution for deals pertaining to multisite provider-based businesses focused on surgical care and rehabilitation.

Organization: Provident Healthcare Partners

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Compliance in Healthcare Is King — Even for Investors

Mon, 17 Apr 2023 03:00:00 -0400

In this era of private equity involvement with healthcare, investors can no longer avoid liability with the claim that they are just an investor. The liability of investors in companies is now in the spotlight. Professionals in the industry predict that the government will increase the frequency of commercial audits and CMS audits.

On this episode of The Professor’s Corner, host Geoff Cockrell is joined by Wiks Moffat for a discussion of the importance of compliance programs. Bringing over 25 years of professional experience to the role, Wiks is Principal at the HealthCare Compliance Network, where he assesses, builds, implements, and maintains compliance programs.

Wiks shares insights on what to look for during due diligence, in particular, whether a company has a culture of compliance. He advises companies to consider compliance at all times, and recommends putting a compliance committee in place to ensure they company have the necessary reporting structures in place.

“You would much rather, because of your culture of compliance, find a problem, than have the feds or the commercial payers come in and start poking around and find these things because then you're in a much less defensible position. For lack of better words, you want to be policing yourself throughout all of this,” explains Wiks.

Featured Guest

Name: Wiks Moffat

Organization: HealthCare Compliance Network

Connect: LinkedIn

Key Takeaways

Compliance programs are not optional.
Healthcare compliance companies and legal support complement each other.
Compliance is a continual process.

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The Broad Impact of The FTC Noncompete Proposed Rule

Wed, 01 Mar 2023 03:00:00 -0400

In January 2023, the Federal Trade Commission released a proposed rule that is making waves in the business and legal communities. The proposed rule would make it illegal for employers to enter into noncompete agreements with workers in most circumstances and would also require employers to rescind existing noncompete provisions.

The FTC is currently accepting public comments about the proposed rule and conducting listening sessions and the FTC has asked for feedback on ways in which the final rule may be narrowed or expanded.

Holden Brooks, Partner at McGuireWoods Antitrust Group, sits down with McGuireWoods’ Geoff Cockrell to explore the potential ramifications of a noncompete ban, potential legal challenges to the rule and the scope of the FTC’s rulemaking authority, what to watch in the ongoing debate surrounding the scope of the rule, and what alternative tools to consider in order to protect your business interests in the event that the rule goes into effect.

Featured Guest

Name: Holden Brooks

What she does: As a Partner in McGuireWoods Antitrust Group, Holden focuses on mergers, complex litigation, civil and criminal enforcement, and counseling across several industries with a focus on Healthcare.

Organization: McGuireWoods

Words of wisdom: “[The FTC] are charged with this and they have a real responsibility to pursue this. So I think this is sort of the best part of democracy, in a way. We have an opportunity to speak up, to deliver thoughtful comments to this body, and to also have our courts consider whether this is the way that things should play out, whether this is the right way to make policy.”

Connect: LinkedIn

Notes From the Professor’s Corner

Top takeaways from this episode

Most workers would be affected by the potential rule. This includes sophisticated, high-earning employees with a great deal of leverage in employment negotiations as well as lower-wage workers with no leverage. Watch for some narrowing in the final rule in this area.
There will be substantial legal challenges. Many groups have promised to bring legal challenges to the rule if it is adopted, which could delay the need to comply with the rule for a substantial period of time. Watch for these to go right up to the U.S. Supreme Court.
What constitutes a noncompete? One area to watch as the rule is finalized is what the FTC will consider to be a noncompete covered by the rule. Will it only be traditional restrictive covenants that are affected, or “de facto” noncompetes as well?

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How Sponsors Can Avoid Liability with Mark Freedlander

Mon, 21 Nov 2022 03:00:00 -0400

In this episode of The Professor’s Corner, Mark Freedlander is back to continue the discussion on the ways a sponsor company can find themselves liable if their portfolio companies enter financial distress.

Having debt recharacterized as equity is the next level of exposure that sponsors need to understand.

Simply calling something debt doesn’t cut it. Being unclear in the management of debt versus equity can open sponsors up to companion fraudulent conveyance claims if the courts recharacterize a company’s debt.

The last piece of the liability puzzle focuses on breach of duty claims. If a sponsor is sitting on the board of one of their portfolio companies, they need to stay informed of the company, its financials, and potential liquidity issues. This awareness can be the difference between creating or avoiding liability issues.

“When a portfolio company runs into trouble [...] it may very well make sense for an independent director to be brought into a company,” explains Mark. “Having an independent director that is truly independent can provide a significant level of protection to the financial sponsor or the equity sponsor.”

For sponsors concerned about potential liability exposures, Mark offers insight into different situations that a sponsor may encounter, discussing the protection that is available to a sponsor who recognizes problems early and takes a cautious approach.

This is the second episode in a two-part series. If you haven’t listened to the first half yet, check out the previous episode for an overview of statutes and claims that sponsors need to keep on their radar.

Featured Guest

Name: Mark E. Freedlander

What he does: As a Partner at McGuireWoods, Mark has been advising clients about creative, business-oriented solutions to matters involving financial distress for the past 25 years. Mark is a goal-driven problem solver whose clients benefit from the creative, pragmatic, and strategic perspective he brings to each engagement.

Organization: McGuireWoods

Words of wisdom: “The more attention to detail you do pay, the better that your records are, the greater the level of deliberation about things that are close calls — the better off a sponsor will be.”

Connect: LinkedIn

Notes From the Professor’s Corner

Top takeaways from this episode

Calling something debt doesn’t mean it’s debt in the eyes of the law. According to Mark, recharacterization of debt will occur under common law, and the courts may consider debt instruments to be equity, which can add additional exposure to the sponsor.
Sponsors can be liable when you can’t differentiate the sponsor and the portfolio company. Liability is often created when the sponsor has significant control over its troubled portfolio company. The most common instances arise under ERISA for anything from COBRA claims, warrant claims, or pension plans.
Sponsors who sit on the board of portfolio companies need to be informed. Board members have a duty of care and a duty of liability that needs to be fulfilled. Awareness of what’s happening with the company, its financials, and any potential liquidity issues can be the difference between creating or avoiding a liability situation.

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The Liability Implications of Financial Challenges in Portfolio Companies with Mark Freedlander

Fri, 28 Oct 2022 03:00:00 -0400

Many investors take on an operating thesis that, by law, the obligations of investment companies are not the obligations of the investor. They apply this whether their fund has invested in the securities of a limited partnership, a limited liability company, or a corporation.

In this episode of The Professor’s Corner, McGuireWoods’ Mark Freedlander joins host Geoff Cockrell to explore the limits of this idea.

As chair of the bankruptcy group, Mark has seen a host of real-world examples where sponsors of private equity funds get themselves in trouble when their portfolio companies are experiencing financial challenges.

“If you're a sponsor that owns a distressed company, you need to be careful with money and things leaving that company — both in terms of the timing of when that's happening, the nature in which it's happening, and the value,” Geoff explains. “Recognize that all of those transfers will be looked at after the fact with different eyes.”

It’s within normal course of business for sponsors to be overseeing aspects of the day-to-day management of their portfolio companies. However, if you’re a sponsor that owns a distressed company, you need to be careful about monetary decisions and money leaving that company.

On this first of two episodes on this topic, both Mark and Geoff review examples of potential issues drawn from real-life situations they have lived through and experienced, along with their experience on the litigation side of these issues. The next episode will continue the discussion where they left off, looking deeper into the nature of these claims and reviewing proper board management.

Featured Guest

Name: Mark E. Freedlander

Organization: McGuireWoods

Connect: LinkedIn

Notes From the Professor’s Corner

Top takeaways from this episode

Patterns emerge in troubled portfolios. According to Mark, it’s common for sponsors to see potential claims asserted against them.
It’s important to understand preference statutes when it comes to payments. A preference statute exists to ensure creditors are treated fairly. Often this will come into play when reviewing payments and antecedent debt with a transferee.
Fraudulent conveyance is designed to protect creditors from fraud. Compared to preference statutes, fraudulent conveyance exposure doesn’t have the same defenses as a preference action.

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When Claims Arise: Tackling the Internal and External Elements with Tony Tatum

Wed, 24 Aug 2022 03:00:00 -0400

It’s nine to 12 — maybe even 18 — months after the deal closed. There’s an R&W policy in place; the purchase agreement covers an array of representations and warranties. But you become aware of something that might be a breach.

Tony Tatum, a partner at McGuireWoods and head of the Insurance Recovery Practice, certainly knows the ins and outs of claims, and how to properly see them through to fulfillment.

In this episode of The Professor’s Corner, Tony walks listeners through the process of filing a claim, citing the internal and external issues that might arise, as well as errors to look out for from the beginning. He discusses the importance of gathering evidence, being thorough, advocating for your company, and mitigating losses.

“In some ways, you don't want to go overboard, but you certainly want to start gathering [evidence] — two or three key buckets of emails or other communications. Of course, right off the bat are things that are critical to whatever that issue is,” says Tony. “And be looking at the knowledge provision and the insurance policy.”

Featured Guest

Name: Tony Tatum

What he does: As a Partner at McGuireWoods, Tony is co-lead of the Insurance Recovery Practice. With more than 23 years of litigation practice, Tony represents both prominent public and private companies on insurance coverage and complex commercial disputes.

Organization: McGuireWoods

Words of wisdom: “You want someone who's got that expertise to be thinking about the issues and making sure that you're crossing the Ts and dotting the Is as needed.”

Connect: LinkedIn

Notes From the Professor’s Corner

Top takeaways from this episode

There are two sides to every claim: internal and external. When a claim is filed, Tony breaks it down into two buckets. Doing so helps prevent missteps while also preparing for every possible outcome.
Be thorough with information gathering. From the moment of a potential breach, information and evidence gathering should begin. This is crucial to proving a breach and reaping the benefits of the filed claim.
Advocate for answers. When it seems like the insurer might be dragging their feet with little intention to pay the claim, do not hesitate to advocate for your company. Call, ask questions, and be a little reminder that the claim is still there and you have proof to back it up.

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How Increased Demand Is Driving Interest in Women’s Health Investing

Thu, 21 Jul 2022 03:00:00 -0400

The women’s health sector is an incredibly diverse subset of businesses covering multiple specialties, including women’s health, fertility, and ancillary services.

Kayla McCann Marty, an Associate at McGuireWoods, shares her expertise on women’s health investing, broadening how people think of the many different sub-sectors attracting regulatory and investor interest in the space.

Ancillary services and connections from practices to the local health system are two of the ways Kayla sees businesses in this sector growing. For example, building surrogacy matching programs internally or utilizing referrals are both successful growth strategies that businesses can use to expand their footprint.

Increased demand through market conditions, attractive ancillary services, and new opportunities for reimbursement are playing into the fertility market, which Kayla describes as “white hot.” These combined factors are contributing to the attention being paid to businesses catered towards women’s health.

On this episode of The Professor’s Corner, Kayla and McGuireWoods’ Geoff Cockrell talk through all aspects of women’s health investing from growth models, regulatory concerns, and what to expect in the future from this very active sector of the market.

Featured Guest

Name: Kayla McCann Marty

What she does: As an Associate at McGuireWoods, Kayla focuses her practice on healthcare transactional law, representing healthcare providers, including hospitals, ambulatory surgical centers, dialysis centers, physician practices, private equity funds, and lenders, in healthcare transactions and compliance matters.

Organization: McGuireWoods

Words of wisdom: “I think the next frontier of value-based care in the women's health sector is trying to bring in the cost of the total continuum of care by preventative care for a woman — from day one when they become pregnant, all the way through excellent care when they deliver their baby and maybe even on into pediatrics.”

Connect: LinkedIn

Notes From the Professor’s Corner

Top takeaways from this episode

★ There are many growth models worth exploring in women’s health. Some firms opt for de novo growth, while others will focus more on acquisition.

★ The fertility sub-sector is “white hot.” Increased interest in the fertility sector is due to a combination of factors. Demand is growing with more women utilizing fertility services combined with the shortage of physicians specializing in the field.

★ Do your research to avoid regulatory compliance issues. The number one area that can trip up investors in the space is not thoroughly reviewing state law restrictions on ownership, investment, and profitability of ancillary investments.

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Indemnity or Self-Disclosure? Here Are The Best Ways to Deal With Policy Compliance Issues

Mon, 16 May 2022 03:00:00 -0400

In the healthcare industry, some of the biggest policy compliance issues and violations can go unnoticed for too long — until it’s too late.

Just ask Timothy J. Fry, today’s guest on The Professor’s Corner. As someone who worked in the healthcare policy world for five years, including nearly two years as a staffer at the Centers for Medicare & Medicaid Services, Timothy has seen just about every mistake in the business.

As a current Partner at McGuireWoods, that experience gives him a unique perspective on healthcare regulatory compliance.

So when it comes to some of the most common mistakes like Stark Law violations or billing and coding issues, is the smartest strategy to self-disclose to the government, or to settle with indemnity? The answer isn’t as simple as you might think.

Tim joins us on this episode of The Professor’s Corner to talk about the most common mistakes he sees in healthcare policy compliance, the potential consequences, and the smartest ways to resolve these issues.

Featured Guest

Name: Timothy J. Fry

What he does: As a Partner at McGuireWoods, Tim helps clients navigate compliance and regulatory issues in the healthcare industry. As a former staffer at the Centers for Medicare & Medicaid Services, he has unique insight into healthcare policy from the perspective of policymakers.

Organization: McGuireWoods

Words of wisdom: “Today, it is very much a market position of many of these transactions, as they trade for self-disclosure to take place. And so as a buyer, if you don't cut it off at the time you do your transaction, it is very likely you're going to get pushed into it. And you have to bear that expense during that recap opportunity.”

Connect: LinkedIn

Notes From The Professor’s Corner

Top takeaways from this episode

★ Stark Law violations often go unnoticed. Also known as the physician self-referral law, it’s common for healthcare groups to make mistakes on revenue splits for referrals. Unfortunately, these mistakes are often not caught until a client begins working with counsel.

★ Indemnity is not always an option. That’s because the Stark Law has the potential to trigger the False Claims Act, which comes with exorbitant fines. To avoid triggering the False Claims Act and a potential whistleblower situation, the best thing healthcare companies can do is self-disclose to the government.

★ For billing and coding violations, go with indemnity. Unlike Stark Law violations, common billing and coding mistakes should be settled with indemnity or smaller repayments rather than full self-disclosure. These settlements often offer some flexibility based on the scale of the issue.

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Understanding Antitrust Law in the Healthcare Space

Mon, 02 May 2022 03:00:00 -0400

In healthcare transactions, people often think that antitrust is a big corporation’s problem. However, smaller companies need to think about these issues, too.

There have been recent developments on both state and federal levels, calling for greater regulation in the healthcare space. More statutes have been put in place to catch smaller transactions statewide, and in 2021, the Federal Trade Commission and Department of Justice were ordered to take a close look at antitrust in the healthcare industry.

In the last couple of years, multiple criminal cases have been brought against individual healthcare providers and corporate entities alike. Oftentimes, these people don’t even realize that certain actions can subject them to criminal liability.

Luckily, there are specific measures you can take to mitigate risk and ensure that you maintain antitrust compliance. From your pipeline strategy and business goals to team training and education, analyzing through an antitrust lens can help you avoid issues and efficiently secure a deal.

In this episode of The Professor’s Corner, host Geoff Cockrell interviews Holden Brooks, Partner of McGuireWoods’ Antitrust, Trade, and Commercial Litigation Department, to discuss the best practices to manage antitrust risk in the healthcare space.

As an expert in antitrust law, Holden details new developments and regulations to help prepare you for deals and avoid antitrust risk — no matter the size of your business.

Featured Guest

Name: Holden Brooks

What she does: Holden is a Partner of McGuireWoods’ Antitrust, Trade, and Commercial Litigation Department. Her practice focuses on mergers, complex litigation, civil and criminal enforcement, and counseling across industries with significant experience in the area of healthcare.

Organization: McGuireWoods

Words of wisdom: “I think there are a lot of ways that providers can get in trouble in that market allocation area, because I think there's always a sense that they're professionals, that making decisions about who's going to do what is part of practicing medicine in a collaborative way. But the antitrust division really is looking at that in the same way they would in any other industry where there's an effort to reach agreement about how you're going to compete or not compete.”

Connect: LinkedIn

Notes From The Professor’s Corner

Top takeaways from this episode

★ There are common antitrust myths regarding smaller companies. The biggest risk for healthcare businesses — even smaller ones — entering into transactions is that they don’t know what they don’t know. There are specific state requirements and federal enforcements that have recently developed. For example, in Nevada, Washington, and Connecticut, there are state statutes and sophisticated Attorney General offices that can catch smaller transactions. Ultimately, a greater amount of smaller deals in the healthcare space are being scrutinized.

★ Managing antitrust risk requires time in the pipeline stage. You can get great ROI if you’re smart about your pipeline, and this is the first step to help you manage risk. If you can create an acquisition strategy that doesn’t involve consolidation in anything within an antitrust-relevant market, then you can still harness the scale without incurring antitrust risk.

★ Certain behaviors can tie into criminal aspects of antitrust. Within the last couple of years, there have been multiple criminal cases brought against individual healthcare providers and corporate entities. These criminal behaviors include price fixing, dividing the market by geography, or dividing the market by drugs. Sometimes, people have no idea they’re executing criminal behaviors. So, it’s important to get educated and train your team to understand the guardrails.

Episode Insights

[01:19] The myth around antitrust issues: Holden explains why everyone needs to think about antitrust issues — not just big companies.

[02:06] State and federal statutes: Holden discusses the recent changes in specific state and federal statutes and how they could affect small roll-up deals.

[05:39] Managing antitrust risk: Spend more time in the pipeline stage and highlight the positive motivations behind a transaction.

[08:42] Criminal aspects of antitrust: The different ways that individual healthcare providers and corporate entities can get in trouble.

[12:27] Educating your people on antitrust topics: Holden details what investors and businesses should do to get educated, train their people, save time and money, and ultimately avoid liability.

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Mitigating Risk With Healthcare Investing

Wed, 20 Apr 2022 08:15:00 -0400

The last quarter of 2021 was a rough one for the health care sector, and naturally, carriers felt the effects: they had written beyond their budgets, and resources were stretched to their limits.

“I don't think the market has ever seen rates go that high,” says Sumit Agarwal, who works in mergers and acquisitions at Marsh, one of the world’s leading insurance brokerage firms. Demand was high and deals were closing at a record pace, which made placing deals that much more difficult.

The strain on the system led to the reintroduction of exclusions of important factors like representations and warranties insurance which, if not included in the deal, “it’s not worth it,” Sumit says.

Prospects are looking a bit brighter for 2022: those exclusions have mostly fallen away, but the market is still recovering as prices go down and carriers try to settle rate prices and averages.

In this episode of The Professor’s Corner, we’re joined by Marsh’s Sumit Agarwal and Sam Bell who tell us more about the current climate for healthcare acquisitions, what we can expect for the year ahead, and mistakes to avoid when making deals.

Featured Guests

Name: Sumit Agarwal

What he does: Sumit is the Senior Vice President of Mergers and Acquisitions at Marsh, where he deals with transactional risk.

Organization: Marsh

Words of wisdom: “Being involved in the conversation from the start helps us overcome some challenges that may arise later in the process. And when you're looking at the eleventh hour to secure a policy, we could have gotten well ahead of it if we were brought in a lot earlier.”

Connect: LinkedIn

Name: Sam Bell

What he does: Sam is Vice President of Marsh, where he is responsible for attracting new clients and servicing all of their commercial insurance brokerage and risk management consultation needs.

Organization: Marsh

Connect: LinkedIn

Notes From The Professor’s Corner

Top takeaways from this episode

★ The end of 2021 strained the health industry. That’s because there was record demand for healthcare deals with many being underwritten by managing general agents who had reached their maximums a lot earlier in the year than in years past. Because of those challenges, negotiations saw constraints that are no longer a problem in 2022. “There is no healthcare regulatory-related exclusion. Everyone is willing to underwrite it; it's just finding the right market to do it,” Sumit says.

★ Make sure your legal team is involved in acquisitions early on. One of the biggest mistakes Sumit and Sam see at Marsh is buyers involving their brokerage team too late in the game or hiring a third-party to speed up the due diligence process. At the very least, a full report detailing the diligence that has been done is necessary to smoothly carry out a deal. “That way, we can mark it to deal appropriately and accurately with the best carrier suited for the risk,” Sumit says.

★ Small transactions might not be worth it. For example, having a $20 or $30 million deal would allow as little as $1 million to $5 million in limits. With the added acquisition costs and risks, the costs might not outweigh the benefits.

Episode Insights

[00:32] Meet our guests: Sam and Sumit both work with Marsh, one of the world’s leading insurance brokers and advisors.

[1:23] Looking forward: The last quarter of 2021 was a difficult one for private healthcare carriers, but things are feeling a little different this year. Sam and Sumit talk about what went wrong last year and what to expect in 2022.

[07:34] What to avoid: Sumit tells all about the biggest mistakes they’ve seen in both corporate and private equity health care acquisitions.

[11:09] Too small to succeed?: Can a deal be too small to make sense? Sumit explains which transaction sizes are worth your time.

[15:06] Special products: ‘Special product’ transactions, like underwriting the risk of PPP loan reimbursement, for example, carry specific risks, Sumit explains.

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Representation and Warranty Policies for Private Equity-Backed Healthcare Deals

Thu, 24 Mar 2022 11:30:00 -0400

When preparing a private equity-backed investment, it’s likely that something called a “representation and warranty” insurance policy, or “reps and warranty,” will be discussed. These policies help to minimize exposure in corporate transactions.

In healthcare deals, two types of exclusions can be requested by the reps and warranty insurer: general exclusions and specific exclusions. General exclusions arise before the due diligence process, while specific exclusions are a result of things uncovered in the due diligence process.

The end of 2021 showed a significant increase in general exclusions for coding and billing, which left companies exposed to risk from the False Claims Act. This trend started shifting around in early 2022, but is still something that should be examined by counsel.

When specific exclusions are proposed by an insurer, it’s important for counsel to narrow the scope of the exclusion so that the deal can have the most comprehensive reps and warranty coverage possible.

In this episode of The Professor’s Corner, host Geoff Cockrell brings on a fellow McGuireWoods partner, Trey Andrews, to discuss how to navigate both general and specific exclusions when purchasing a reps and warranty policy.

With experienced attorneys like Geoff and Trey, it’s much easier to have the leverage needed with reps and warranty insurers, establishing rapport and developing trust in their extensive private equity experience.

Featured Guest

Name: Trey Andrews

What he does: As a Partner at McGuireWoods, Trey is a member of the healthcare transactions team. He focuses on private equity-backed healthcare acquisitions.

Organization: McGuireWoods

Words of wisdom: “At McGuireWoods, we do a substantial amount of these healthcare private equity-backed transactions, where quite a few [of those deals] have reps and warranty policies put in place. I think that gives us the benefit of having colleagues to go to who really understand how this issue has been dealt with by others.”

Connect: LinkedIn

Notes From the Professor’s Corner

Top takeaways from this episode

★ General exclusions for billing and coding can have a far reach. Billing and coding are how healthcare organizations generate income. When that function is excluded in a reps and warranty policy, it can be very risky. For example, exposing the client to litigation from a False Claims Act. It’s more common to see these exclusions in home health and hospice providers who generate a large volume of claims.

★ Specific exclusions are born out of the due diligence process. An insurer might discover something too risky for them to cover while reviewing a company’s due diligence. Healthcare organizations often operate in gray-area decision-making, so it’s important for counsel to explain how something that seems risky on the surface is part of the nature of the industry.

★ There are 3 steps to negotiate exclusions in a reps and warranty policy. Trey recommends communicating openly with the carrier regarding gray areas, working to minimize the scope of exclusions by demonstrating an understanding of the industry, and giving the carrier a sense of how other players in the market have viewed the same risk.

Episode Insights

[00:47] General vs. specific exclusions: Geoff runs down the basics of general and specific exclusions in reps and warranty policies.

[02:00] Billing and coding exclusions: Trey explains how the False Claims Act potentially exposes companies with billing and coding exclusions in their policies.

[04:44] Q4 2021 to Q1 2022: Geoff and Trey go over some of the trends that have been quickly changing in the reps and warranty market.

[07:26] Know your stuff on billing and coding: Be thorough in examining the client’s billing and coding through chart audits.

[11:10] What to disclose to the insurance carrier: There are times when a company is operating in a gray area within healthcare law and while it’s not necessarily a deal-breaker, it’s important to disclose that in the diligence memorandum and discuss it with the carrier.

[14:36] 3 steps for fewer exclusions: Trey breaks down exactly how he negotiates with insurance carriers to minimize exclusions.

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The Legal Implications of Board-Driven Decision Making (Pt. 2)

Tue, 28 Dec 2021 03:00:00 -0400

In the premiere episode of The Professor’s Corner, David Pivnick, Partner at McGuireWoods, shared best board practices to mitigate risk when making challenging decisions. In this follow-up episode, David expands on a larger trend in healthcare litigation: private equity funds are finding themselves legally responsible for the activity of the companies in their portfolio.

David believes these claims are driven primarily from the whistleblower bar and not the Department of Justice. By leaning on Qui Tam laws, litigators can cast a wide net in who they name in their court filings.

Despite these cases being relatively easy to defend, they still require significant investments in time and money.

To minimize a private equity fund’s risk spectrum, investors should think proactively about board practices, ensuring that relationships are appropriately vetted, and that specific concerns are addressed and corrected. In addition, especially when making decisions that involve substantial gray areas, owners need to seek counsel to ensure the legality of their choices.

Featured Experts

Name: Geoffrey Cockrell

What he does: Geoff is the Chair of McGuireWood's private equity group and serves on the firm's Board of Partners; he has extensive experience in mergers and acquisitions, especially in the healthcare space.

Organization: McGuireWoods

Connect: LinkedIn

Name: David Pivnick

What he does: As a partner at McGuireWoods, David co-chairs the Healthcare and Life Sciences Industry Team. David primarily practices complex commercial litigation in healthcare.

Organization: McGuireWoods

Words of wisdom: “The darker the shade of the gray, the more likely that conduct ends up coming under scrutiny generally, which means it's more likely that as an owner, you could get swept up in an investigation.”

Connect: LinkedIn

Notes From the Professor’s Corner

Top takeaways from this episode

★ Qui tam rules make it easier for litigators to include private equity funds in their claims. The growing trend of litigating against PE funds is driven primarily from the whistleblower bar, not the Department of Justice. While these claims rarely carry much legal weight, they can lead to significant financial strain for investors who must hire a legal defense team.

★ The darker the gray, the greater the risk. Most claims against PE funds from the Department of Justice include clear misconduct by investors who serve on their portfolio company’s board. David warns that making decisions that involve a lot of gray area opens everyone involved up to a greater risk spectrum. Seeking counsel in these situations is recommended.

★ Investors have a responsibility to ensure proper conduct. Because most boards in private equity-funded healthcare companies are decision-making boards, investors would be wise to ensure that companies in their portfolio are following regulatory compliance standards.

Episode Insights

[01:33] A growing trend: David sees increasing instances of the government pursuing claims and investigating the potential for claims against private equity funds.

[02:06] Improper conduct: David outlines past examples of how PE funds have gone to court for allegedly engaging in improper activity for financial gain.

[03:39] Identify problematic areas: David presents a spectrum of activity for private equity funds to pursue to bolster best practices and mitigate risk.

[06:21] In pursuit of deeper pockets: The Department of Justice and the whistleblower bar have differing mindsets about when and why to pursue private equity funds in litigation.

[07:24] Qui tam’s wide net: David and Geoff discuss how whistleblowers can leverage qui tam rules to target a broad range of defendants.

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The Legal Implications of Board-Driven Decision Making

Thu, 02 Dec 2021 16:00:00 -0400

A recent whistleblower case in Massachusetts has rocked the widely accepted notion that private equity investors are insulated from risk beyond the scope of their financial investment.

In the case, the Massachusetts Attorney General pursued claims for purportedly improper and fraudulent billing against the underlying healthcare provider but also pursued the private equity fund that invested in the entity and had board members involved at the management level.

While the case ended in a settlement for the private equity fund, it’s important to remember that the fund neither accepted nor denied guilt in the situation.

However, regardless of guilt, the fund was viewed as a potential area of pursuit in litigation. This fact alone is noteworthy and warrants further discussion.

David Pivnick, Partner at McGuireWoods and expert in complex corporate healthcare litigation, weighs in on the scenario and draws an important distinction between the role of investor as owner and the role of investor as decision-maker.

On the premiere episode of The Professor’s Corner, David tells McGuireWoods’ Geoff Cockrell how funds can limit risk and lead with a compliance-driven mindset. Seeking counsel, documenting deliberations, and providing regular compliance training sessions for board members are worthwhile investments.

Featured Experts

Name: Geoffrey Cockrell

Organization: McGuireWoods

Connect: LinkedIn

Name: David Pivnick

What he does: As a Partner at McGuireWoods, David co-chairs the Healthcare and Life Sciences Industry Team. David primarily practices complex commercial litigation in healthcare.

Organization: McGuireWoods

Words of wisdom: “If you’re not comfortable putting in writing how you landed at a decision and how factors were ultimately weighed, to me, the bigger sign is not, Don’t put this in writing at the board level. It’s: Don’t make that decision, and go on a different pathway.”

Connect: LinkedIn

Notes From the Professor’s Corner

Top takeaways from this episode

★ Having the best intentions makes a difference. According to David, there’s an important distinction to be made between a board that seeks counsel and makes an educated (but ultimately bad) decision and a board that is directly informed of misconduct and looks the other way or proceeds despite the warnings.

★ In difficult situations, document deliberations to clarify the rationale. Boards should not be afraid of documentation. Often, legal issues arise months to years after a decision is made. When a minimal paper trail exists, it is hard to demonstrate the debate and reasoning behind past choices.

★ Ensuring best practices in compliance should extend to the board level. For example, forming a compliance committee or identifying a compliance officer who can speak candidly with private equity investors allows the board to minimize risk.

Episode Insights

[00:38] A jarring settlement: Geoff and David discuss a recent court case that has potential implications for private equity funds — risk extends beyond financial investment.

[02:51] Ownership vs. board involvement: David differentiates between a private equity investor’s role as owner and as decision-maker.

[04:52] The gray area: David discusses how board leadership can make nuanced decisions when there isn’t a clear black and white answer.

[06:48] Documenting deliberation: David explains the importance of record-keeping and compliance for board-level leadership.

[12:41] ‘Don’t put it in writing’: David raises a red flag in scenarios where individuals or groups are hesitant to document conversations.

[16:15] The ‘one purpose’ rule: Geoff and David talk about the Anti-Kickback Statute and the importance for private equity funds to operate with a compliance-focused mindset.

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Welcome to The Professor's Corner

Fri, 26 Nov 2021 03:00:00 -0400

The Professor’s Corner is a McGuireWoods series exploring business and legal issues prevalent in today’s private equity industry. Tune in with McGuireWoods partner, Geoff Cockrell as he and specialists share real-world insight to help enhance your knowledge.

McGuireWoods is a full-service firm providing legal and public affairs solutions to corporate, individual, and nonprofit clients worldwide for more than 200 years collectively. Our commitment to excellence in everything we do gives our clients a competitive edge in everything they do. Our law firm, over its 186-year history, has earned the loyalty of our many long-standing clients with a deep understanding of their businesses, and broad skills in corporate transactions, high-stakes disputes, and complex regulatory and compliance matters.

To learn more about our discussions, please email host Geoff Cockrell at gcockrell@mcguirewoods.com or visit our website at mcguirewoods.com.

This series was recorded and is being made available by McGuireWoods for informational purposes only. By accessing this series, you acknowledge that McGuireWoods makes no warranty, guarantee or representation as to the accuracy or sufficiency of the information featured in this installment. The views, information or opinions expressed are solely those of the individuals involved and do not necessarily reflect those of McGuireWoods. This series should not be used as a substitute for competent legal advice from a licensed professional attorney in your state and should not be construed as an offer to make or consider any investment or course of action.