HCA

“In, in health systems like HCA, it's a very similar story. We've been able to add a couple hours to every physician's day.”

“We've now grown to over 1500 hospitals. We work with a lot of hospitals in the U S and the largest, you know, we work with the largest health systems, including Ascension and Trinity and HCA.”

“Nobody would have really believed, and frankly, we weren't even sure in that 2005, six timeframe, could you really do a deal as big as HCA, which was a thirty-three billion dollar enterprise value transaction.”

“Those were in the early days of LBO investing when you could Make those investments with very small equity accounts, and if you get good growth on a very small equity account, you can have a very successful investment, and so that turned out to be a very succe…”

“If we can build the right capacity to be really important hospital systems in any given city, then that is going to put us in a position to be able to make the investments we need to make, to have the right capital base, to be able to attract the right physici…”

“And actually, Tommy called us. It was the original genesis of this for us back in, it was probably late, 2005, maybe early 2006, with what almost started off as, hey, I've got a crazy idea, because the transaction was so large that no one ever really would hav…”

“It was Bain Capital, KKR, Merrill Lynch, and the Frist family speaking for the equity, but then we also needed to figure out how do we fill out north of twenty billion dollars worth of debt that was going to need to be underwritten for this transaction.”

“Merrill Lynch first managed to get their own internal approvals, not just for the equity, but for the debt. Speaking for about a quarter of the debt deals, we decided we needed three more banks to be able to fill out the whole thing. And so then we went to the…”

“We don't engage in any misinformation or anything like that, so generally the best thing you can do is just sit quietly and let it go away on its own, because the more you're making awkwardly worded, non-denial denials, the more you're probably just be contrib…”

“Shortly after HCA, as the debt markets heading right into the GFC got really hot, there was a period of time where lots of different public to privates could happen and frankly did happen, but HCA was really on the very, very front Edge of that, and maybe you …”

“It was the largest transaction ever at the time, and by far the largest that had happened since the late eighties during that first wave of big LBOs.”

“This might be the only time that I've ever bought a company without ever having actually visited the company's headquarters or real estate. All of this diligence Happened with the HCA management team. They were very much engaged in it, but in conference rooms …”

“When we finally came back with our final proposal, it was literally our last dollar, probably even a little bit beyond what we thought our last dollar was going to be.”

“This actually wasn't a case where we had a lot of very transformative initiatives in mind. HCA was a well-run company, and so this was much more a story about just Really focusing on a longer list of tactical optimizations with the idea that driving that kind …”

“Hospital businesses are not recession immune, but they are fairly recession insensitive because you're delivering healthcare and people, well, maybe some larger portion of the population might lose their insurance coverage during a recession. There is good saf…”

“And then the next step, which I thought was brilliant, they started advertising ER wait times on electronic billboards.”

“Unfortunately for them, they pushed to sell their HCA stake once we were a public company, certainly with the benefit of hindsight, earlier than was optimal, and so we went public sometime in 2011. They sold their whole stake shortly thereafter, and HCA went o…”

“They went public at around 30 dollars a share, And I think the stock is currently somewhere in the mid to high 200.”

“The IPO is actually mainly Secondary capital, because we had done a good job of growing into our capital structure and already going down the path of spreading it over time.”

“We went public at 30 dollars a share, which felt like a good valuation to us. And, but look, I don't think the Frist's have sold many of their shares over the years. And we ended up, I think, selling our last shares around 75 dollars a share or so.”

“We ended up making about a five times multiple of money on that investment.”

“Until 2005, the way deals worked is that the private equity sponsor would say, I'd love to buy your business for a hundred dollars, but I'm borrowing 50 dollars, and if I can't get my mortgage, I've got a mortgage contingency in my contract, and there was a de…”