A national Urgent Care provider with 170+ locations throughout 12 states faced a series of financial challenges following epidemiology changes with flu and Covid visits dropping significantly and unexpectedly in late December ’22 and January ‘23. Other underperformance due to rising labor costs and underperforming acquisitions + de novo clinics led its lenders to engage SCALE to better understand why the company wasn’t doing well, how it could improve, and if the plan to improve would work.
A multi-specialty DSO with approximately 250 clinics across 6 states was experiencing meaningful growth up until H2’22, when hurricane-related site closures, expense management challenges, new provider hire-ramp up, and challenging labor markets led to a high leverage ratio, resulting in a limited availability of capital.
BACKGROUND – SCALE Healthcare was engaged with a midsize orthopedic group in Pennsylvania. The practice decided it needed a new vision and business plan to improve its performance within their clinical research division. SCALE provided a 4-week timeline and commissioned a Subject Matter Expert (SME) with over 10 years of experience in Clinical Research.
BACKGROUND – SCALE was engaged to assess a plastic surgery client’s (had 16 providers with 5 sites across 2 states) holistic provider oversight and compensation program in the context of high provider turnover and provider dissatisfaction despite running a profitable business. Approximately 10 providers left over the past couple of years and provider compensation as a percentage of revenue was very low (22%). Optimizing provider retention and developing a scalable and sustainable compensation model (to both the providers and the MSO) was critical to achieving the Company’s mid- and longer-term value creation potential.
Overview – A multi-national, $800 billion in assets, institutional lender engaged SCALE to advise in the restructuring of a specialty pharmacy and infusion borrower owned by a private equity firm.
The underlying company included multiple business lines serving both disparate and partially overlapping markets. Each business line had a unique strategic and financial profile, as well as varying levels of reliance on shared corporate infrastructure.
SCALE was engaged by a lender to assess a DSO business that is failing, and provide a recommended course of action to management to support closure, or stabilization & future success.
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