Cain Brothers Newsletters: Industry Insights

Cain Brothers, a division of KeyBanc Capital Markets, acted as Exclusive Financial Advisor to Blue Cross and Blue Shield of Kansas City on its affiliation with Highmark, Inc.

Blue KC engaged Cain Brothers to identify a partner to help achieve efficiencies, add new capabilities and drive more affordable health care. Blue KC will maintain its local leadership, brand and commitment to accessible, affordable health care, while gaining access to Highmark’s scale, diversified businesses and leading technology capabilities. Cain Brothers is the leading advisor to Blue Cross and Blue Shield plans and this represents another significant affiliation within the sector.

Serving members since 1938, Blue Cross and Blue Shield of Kansas City is the largest not-for-profit health insurer in Missouri and the only not-for-profit commercial health insurer in Kansas City. Blue KC provides coverage to more than one million residents in the greater Kansas City area, with a mission to provide affordable access to healthcare and to improve the health of its members.

An independent licensee, Highmark, together with its affiliates, is the fifth-largest Blue Cross Blue Shield-affiliated organization in the country, with more than seven million members in Pennsylvania, Delaware, West Virginia and western and northeastern New York. Its diversified businesses serve group customer and individual needs across the U.S.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to DME Express, a portfolio company of WayPoint Capital Partners, in its sale to Palladium Equity Partners.

Cain Brothers was engaged based on its extensive experience and expertise in the hospice and durable medical equipment sectors as well as broader post-acute services. The transaction continues Cain Brothers’ strong track record of representing private equity-backed companies and continued momentum in healthcare services M&A.

DME Express provides durable medical equipment to hospice providers across the U.S. With over 150 years of experience, the founders and management team understand the unique needs of hospices and nursing facilities and DME Express is a leading provider in each of its markets. The company is committed to consistent availability to patients and providers with high-quality medical equipment, proprietary technology and strong customer service.

WayPoint Capital Partners, founded in 2004, is a growth-oriented lower middle market private equity firm making control investments in exceptional founder and family-led companies across healthcare services and industrials. WayPoint brings strategic guidance, operational support, and long-term patient capital to help its businesses scale and thrive.

With over $3 billion in assets under management, Palladium seeks to acquire and grow companies in partnership with founders and experienced management teams by providing capital and strategic guidance. Since its founding in 1997, Palladium has invested in more than 240 companies. Palladium’s partners have experience in consumer, services, industrials, and healthcare sectors, with a focus on companies that will benefit from the growth in the U.S. Hispanic population.

Cain Brothers, a division of KeyBanc Capital Markets, served as advisor to SuperCare Health in its sale to Excellere Partners and KeyBanc Capital Markets served as Joint Lead Arranger, Joint Bookrunner, and Administrative Agent for debt financing associated with the transaction. 

Cain Brothers was engaged based on our long-standing relationship with the Company as well as knowledge of the durable medical and home medical equipment market and connectivity with buyers who would value SuperCare’s capitated and fee-for-service business model. Concurrently, KBCM syndicated Senior Secured Credit Facilities, proceeds of which were used to fund the acquisition, support capital expenditures and for general corporate purposes. 

Founded in 1974 and headquartered in City of Industry, California, SuperCare is a provider of comprehensive complex respiratory care management solutions for adults and children. Its product portfolio consists of ventilators, airway oscillation, CPAP, BiPAP, oxygen concentrators, respiratory medication and home medical equipment. The Company’s business segments are Complex Respiratory Care, Pediatric Respirator Care, and Value-Based Care. SuperCare operates 27 branches across five states and serves 150,000+ patients annually. 

Founded in 2006 and based in Denver, Colorado, Excellere is a private equity investment firm focused on investing in the Healthcare, Business Services, and Industrials industries. The Sponsor has ~$2.2 billion of assets under management and has raised four funds to date, with its latest fund (Excellere Capital Fund IV) raising $875 million of committed capital.

Cain Brothers, a division of KeyBanc Capital Markets, served as advisor to SuperCare Health in its sale to Excellere Partners and KeyBanc Capital Markets served as Joint Lead Arranger, Joint Bookrunner, and Administrative Agent for debt financing associated with the transaction. 

Cain Brothers was engaged based on our long-standing relationship with the Company as well as knowledge of the durable medical and home medical equipment market and connectivity with buyers who would value SuperCare’s capitated and fee-for-service business model. Concurrently, KBCM syndicated Senior Secured Credit Facilities, proceeds of which were used to fund the acquisition, support capital expenditures and for general corporate purposes. 

Founded in 1974 and headquartered in City of Industry, California, SuperCare is a provider of comprehensive complex respiratory care management solutions for adults and children. Its product portfolio consists of ventilators, airway oscillation, CPAP, BiPAP, oxygen concentrators, respiratory medication and home medical equipment. The Company’s business segments are Complex Respiratory Care, Pediatric Respirator Care, and Value-Based Care. SuperCare operates 27 branches across five states and serves 150,000+ patients annually. 

Founded in 2006 and based in Denver, Colorado, Excellere is a private equity investment firm focused on investing in the Healthcare, Business Services, and Industrials industries. The Sponsor has ~$2.2 billion of assets under management and has raised four funds to date, with its latest fund (Excellere Capital Fund IV) raising $875 million of committed capital.

Cain Brothers, a division of KeyBanc Capital Markets, served as financial advisor to Healthcare Linen Services Group, a portfolio of York Capital Management, in its sale to The Sterling Group.

Cain Brothers was engaged based on our extensive knowledge of the healthcare and hospital end market and connectivity with buyers who would value HLSG’s infrastructure-oriented service model. This transaction continues Cain Brothers’ strong track record of representing healthcare distribution and logistics solutions. Terms were not disclosed.

Healthcare Linen Services Group is a leading provider of linen services to healthcare facilities, specializing in delivering high-quality linens and unparalleled customer service. With a commitment to excellence and innovation, HLSG serves healthcare organizations across the Midwest and Southcentral market, supporting their critical operations and patient care. 

York Private Equity, the private investing arm of York Capital Management, primarily targets control investments in middle-market businesses. Since inception in 2008, York Private Equity’s middle-market strategy has completed over 50 investments with aggregate transaction value in excess of $4 billion. York Private Equity has 13 dedicated team members. 

Founded in 1982, The Sterling Group is a private equity and private credit investment firm that targets investments in basic manufacturing, distribution, and industrial services companies. Typical enterprise values at initial formation range from $100 million to $1 billion. Sterling has sponsored the buyout of 77 platform companies and numerous add-on acquisitions for a total transaction value of over $27 billion. Sterling currently has approximately $9 billion of assets under management. 

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive sell-side advisor to Central Maine Healthcare in its affiliation Prime Healthcare Foundation. 

Cain Brothers was engaged to assist in the negotiations and affiliation process due to its domain expertise and understanding of the New England healthcare market. The affiliation will help achieve Central Maine and Prime’s joint long-term commitment to deliver the highest quality, most advanced health care to communities across central, western, and mid-coast Maine. The agreement includes continued local governance and management, ongoing community commitment and significant capital investment in the region.

Central Maine Healthcare is an integrated delivery system serving 400,000 people in central, western and mid-coast Maine. With over 600 physicians and advanced practice professionals in more than 40 locations, CMH includes Central Maine Medical Center, a Levell III Trauma Center in Lewiston, as well as critical access facilities, Bridgton and Rumford hospitals, and two long-term care communities. 

Prime Healthcare is a health system operating 44 hospitals and more than 300 outpatient locations in 14 states, providing over 2.6 million patient visits annually. It is one of the nation’s leading health systems with nearly 45,000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity.

KeyBanc Capital Markets and Cain Brothers, a division of KeyBanc Capital Markets, acted as Co-Manager in the $3.8 billion offering of Senior Notes for Thermo Fisher Scientific Inc. (NYSE: TMO).

Cain Brothers and KeyBanc Capital Markets served as Co-Manager due to its industry expertise and long-standing relationship with the Company.  Proceeds will be used to fund the cash consideration related to the acquisition of Clario Holdings as well as general corporate purposes.

Thermo Fisher manufactures scientific instruments, consumables, and chemicals. The Company offers analytical instruments, laboratory equipment, software, and supplies to pharmaceutical and biotech companies, hospitals and clinical diagnostic labs, universities, research institutions, and government agencies.

Cain Brothers, a division of KeyBanc Capital Markets, served as buy-side advisor to MyTown Health Partners in its acquisition of MDB Health Services.

Cain Brothers has a long-standing relationship with management and the sponsor, Webster Equity Partners, as well as expertise and unique insight into the target, given a successful track record of advising primary and post-acute care groups. Cain Brothers was engaged to provide strategic guidance as well as transaction and diligence support. The acquisition expands MyTown’s presence across medically underserved communities and strengthens its commitment to delivering coordinated, high-quality clinical services.

MyTown is a physician-led management organization that works with practices in rural communities to improve access and enhance clinical outcomes. With over 50 clinics across eight states, MyTown’s growing network supports clinicians in the delivery of high-quality, outcome-driven primary care, urgent care, behavioral health, and women’s health services in medically underserved markets.

MDB Health Services is a multi-disciplinary provider serving post-acute care facilities in Mississippi, Louisiana, and Arkansas. Founded in 2013, MDB has grown from its origins in behavioral health services to include primary care, behavioral health, wound care, and foot care. MDB’s clinicians deliver coordinated clinical care that is tailored to the needs of residents in long-term care settings.

Webster Equity Partners is a healthcare-focused private equity firm focusing on high impact growth strategies to deliver optimal outcomes for its investors, portfolio companies and the communities that they serve. Its mission is to deliver superior returns to partners through investment and development of patient-centric healthcare organizations.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to National Radiology Solutions in its sale to Premier Radiology, a portfolio company of Grovecourt Capital Partners.

Cain Brothers developed a relationship with the founder, Robb Kolb, and discussed potential transaction alternatives. Collectively, the team decided to run a targeted process due to preemptive interest, with the option to expand into a broad sale if needed.

Premier Radiology is a leading provider of teleradiology solutions in outpatient settings across the United States, delivering fast, accurate, and secure medical image interpretations. Founded in 2006 and headquartered in Deerfield Beach, Florida, the company interprets over three million medical images annually through a network of more than 165 board-certified, fellowship-trained radiologists.

Grovecourt is a private equity firm based in West Palm Beach, Florida, specializing in investments in founder-led and family-owned businesses in the lower middle market business services and healthcare services sectors.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to Tenor Health Foundation in its acquisition of Commonwealth Health, an affiliate of Community Health Systems, Inc. (NYSE: CYH). Cain Brothers also arranged debt financing associated with the transaction.

Tenor Health acquired Commonwealth Health, a subsidiary of Community Health Systems. Commonwealth is a three-hospital health system in northeast Pennsylvania that includes Regional Hospital of Scranton (186 beds), Moses Taylor Hospital (122 beds) and Wilkes-Barre General Hospital (369 beds). Rosemawr Management provided acquisition financing.

With a mission rooted in advancing equitable and innovative care, Tenor Health Foundation was formed to identify, own, manage, and turn around financially challenged hospitals. Tenor Health is committed to the needs of its communities, providing compassionate care and delivering quality patient outcomes.

Community Health Systems operates 70 affiliated hospitals in 14 states, as well as more than 1,000 sites of care, including physician practices, urgent care, freestanding emergency and occupational medicine clinics, and imaging, cancer and ambulatory surgery centers. CHS reported consolidated annual revenues of over $12 billion.

Cain Brothers, a division of KeyBanc Capital Markets, served as financial advisor to FHN in its affiliation with Mercyhealth. 

After years of discussion, FHN elected to pursue a change-of-control transaction with the goals of improving the organization’s cost structure and injecting outside capital. Cain Brothers led a competitive process, resulting in two fully negotiated letters of intent. The Board selected Mercyhealth, out of Rockford, Illinois, who committed to contribute a minimum of $100 million over five years. The transaction was signed on September 30, 2025, and closed on December 31, 2025.

FHN is a regional healthcare system serving northwest Illinois and southwest Wisconsin. FHN is headquartered in Freeport, Illinois and consists of a 100-bed full-service hospital known as FHN Memorial Hospital, 16 outpatient sites that treat over 45 specialties, a comprehensive Cardiovascular Center and a leading Cancer Center. Over 1,500 people visit FHN each day, and FHN is one of the leading employers in northwest Illinois.

Mercyhealth is an Illinois not-for-profit system serving northern Illinois and southern Wisconsin. Mercyhealth operates five acute-care hospitals with over 500 beds, a large multi-specialty physician group, over 85 primary and specialty care clinics, a rehabilitation hospital, and a significant home health and hospice business. Mercyhealth was created after the merger of Mercy Health in Janesville, Wisconsin and Rockford Health System in Rockford, Illinois. Mercyhealth produced $1.3 billion in revenue in 2025.

KeyBanc Capital Markets and Cain Brothers successfully closed the syndication of $1.07 billion Senior Secured Credit Facilities for US Fertility Enterprises, LLC, a portfolio company of Amulet Capital Partners and L Catterton Partners. 

Proceeds from the transaction supported the recapitalization of US Fertility, which included a new equity investment led by L Catterton and the Company’s acquisition of Genetics & IVF Institute.  The financing was comprised of a $120 million Revolving Credit Facility, an $825 million Term Loan B, and a $125 million Delayed Draw Term Loan. 

KBCM was selected to serve as Joint Lead Arranger and Administrative Agent based on Cain Brothers’ expertise in the women’s health space, our long-standing relationship with Amulet Capital Partners, and our best-in-class leveraged finance platform.

US Fertility is the largest fertility group in the U.S., offering a broad range of assistive reproductive technology services and ancillary life sciences offerings. Since 2021, the Company has grown from ~85 physicians across 59 locations to the leading IVF platform in the nation with over 200 physicians across 118 treatment locations and 32 embryology labs.

Founded in 2015, Amulet Capital Partners is a middle-market private equity firm focused exclusively on making investments in the broader healthcare industry. They have $2.7 billion in AUM and are currently investing out of their third fund. Amulet partners with strong businesses across high-conviction, high-growth subsectors within the broader life sciences outsourcing, healthcare provider, and payor and payor services ecosystems.

Founded in 1989, L Catterton is the largest consumer-focused private equity firm in the world, with over $38 billion of equity capital across nine fund strategies in 18 offices globally. They have $38 billion in AUM and have extensive experience in consumer healthcare and multi-site service platforms. L Catterton has an operationally focused value creation approach, augmented by a deep operating team with highly differentiated capabilities.