Who can share some insights on doing a build-up (buying 2-4 co over 2 yrs)?

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September 12, 2019

by a searcher from The University of Chicago - Booth School of Business in Dallas, TX, USA

I am evaluating several fragmented areas in healthcare. Integration issues are not substantial but the equity upside is, yet investors seem overly cautious.

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Reply by a searcher
from Northwestern University in Los Gatos, CA, USA
We did this in our commercial office plant service business starting in early 2017, with 4 acquisitions total. We were self-funded with no outside equity, which made it easier to move quickly. We used SBA 7a for the initial purchase, but did not and perhaps could not have used SBA for follow-ons on that timescale because the loan was not seasoned enough to go back to the well. Instead, we financed follow-ons with additional sponsor equity + cash flow from operations + seller notes. You can email me at redacted if you want to chat about it. We're placing equity investments into deals like this, so could be an investor. Not a ton of healthcare experience, though I did go to the doctor once about 10 years ago :-P
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Reply by an investor
from University of Colorado at Boulder in Horsham, PA, USA
That sounds way too fast even if you have an excellent platform in place. One has to identify the right targets, do all the due diligence and, most importantly, integrate them. Integration is the hard part. Cultures, systems etc. Not to mention that things won’t go smoothly every time.
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