The Ledger
Every statement that passed quotation and attribution checks. Mix any filter with any other: certainty 1/5, debate potential 5/5, or both at once.
why aren't all 17 resolved? a statement only gets an assessment when the public record can support or contradict it. opinions and what-ifs never can, and 0 checkable ones are still open, waiting for their date. predictions held up or didn't; assertions are supported or contradicted. on every card: ▮▮▮▮▮ certainty · ▮▮▮▮▮ debate potential. speakers are clickable
Michalik: Health systems, not PE, lead provider consolidation
“If you just take providers over the last three or four years, there's been a rapid consolidation of Primary care, as well as specially providers of health care services, and it's been done by private equity, but it wasn't led by private equity. People forget t…”
Michalik: UnitedHealth Agreed to Buy Steward Physician Group for $850M
“United Healthcare ultimately agreed to acquire those assets for eight hundred fifty million dollars, and in May, Stewart filed for bankruptcy.”
Kinderhook Signed $245M Deal in August 2024 for Stewardship Assets
“So we signed a purchase agreement in August of 2024 to acquire the assets of stewardship publicly announced two hundred forty five million dollars.”
Michalik: Over 300 Massachusetts Providers Supported Kinderhook Stewardship Bid
“We've had near universal support from the over 300 employed providers in the state of Massachusetts that they want Rural Health Group slash Kinderhawk to be the acquirer of these assets.”
Michalik: Gavin Newsom vetoed private equity healthcare oversight bill in California
“Gavin Newsom recently vetoed legislation in the state of California to put Further oversight in the acquisition of healthcare investments in the state of California.”
Michalik: Very few CMS patient-provider alignment programs over 15 years succeeded
“There's multiple programs over the last 15 years that the federal government CMS has implemented to create patient provider alignment. Very few of them have succeeded.”
Michalik: Service jobs teach real-world business better than finance internships
“Everybody wants an internship today at a private equity firm or an investment bank, and I would call it the school of the real world. I think there's nothing better, be it working as a waitress or a waiter in a restaurant or working in a service business or wo…”
Michalik: Starting PE careers at smaller firms accelerates learning and networks
“Going into smaller, new firms like my brother and I did when we started in the investment world really made us entrepreneurial. We were not in environments where it was wrote, put together a certain type of model to put together a certain type of presentation …”
Michalik: PE downside is capped at 1x while target upside is 3x-5x
“Ultimately Frank taught us a simple point, which was you can only lose one times your money. And in our business, we're looking to make three to five times your money. So if you're afraid to shoot, you're never going to score.”
Kinderhook: UnitedHealthcare, Molina, and Humana Passed on Acquiring MCS
“Most everyone in the United States in the industry looked at buying this company from private equity firms to UnitedHealthcare to Molina, Humana, and they all passed. And we bought the business in 2021. We actually signed a letter of intent to acquire it in th…”
Kinderhook installs operating partners as CEO in 70-75% of acquisitions
“75, 70% of the time when we buy a company, we're putting in one of our operating partners as the CEO. The other 25, 30%, we're back in the incumbent management team.”
Operating partners invested $100M at full fees in Kinderhook's last two funds
“If you look, the last two funds, operating partners invested a hundred million dollars. They're paying full fees, full carry.”
Michalik: Doctors are the weakest party in US healthcare bargaining
“If you think about the big three forces of healthcare, it's these HMOs negotiating to keep rates down and provide access. Hospitals are negotiating to bring in as many patients as they can and get the highest prices they can to cover their fixed costs in their…”
Michalik: Private Equity Value Creation Requires Having Trusted CEOs-in-Waiting
“If you want to continue to deliver value, you have to have CEOs and waiting, so to speak, people that you trust to step in and lead the businesses you buy.”
Kinderhook: Zero VPs or Above Have Ever Quit in 21 Years
“Everybody that's a managing director today has been with the firm and started as an associate has been promoted internally. We don't bring in lateral hires. Over 21 years that we've been in business, anyone that's made vice president above has never quit the f…”
Michalik: 55% to 60% of US healthcare is government-funded
“As you look at what's happened over the last 30 years, over 55 to 60% of all healthcare in the United States is paid for by federal and state programs.”
Michalik: Ownership aligns incentives with efficiency far better than hourly wages
“There's a lot of ways to make money, but if you're a paperboy as an example, or you own something, you get the job done in 10 minutes and you make 20 bucks to do it in 10 minutes. If you get paid by the hour, like we were in our Teamster jobs, hardworking jobs…”