Americans are already furious that Blackstone and its private equity rivals are buying up all the good homes, helping to drive the surge in residential real-estate prices that is helping to make buying a home even more unobtainable, especially for first time buyers who don't have wealthy parents to help with the down payment.
As Apollo struggles to rehabilitate its reputation following those unseemly Epstein ties, Bloomberg reported Thursday that one of the firm's flagship funds booked a $1.6 billion profit by selling a once-struggling hospital chain to...another Apollo flagship fund?
Specifically, Apollo's eighth flagship fund completed the sale of hospital chain LifePoint to its ninth fund last month for $2.6 billion after investing a total of $975MM in the Brentwood, Tennessee-based chain. In the year or so before the deal was struck in April, LifePoint received $1.6 billion lifeline from the government during the pandemic, including more than $600MM in grants, and nearly $1 billion in loans. Management stresses that the firm paid back the loans already. Still, that's a half-a-billion dollar government hand out that's padding the returns for wealthy PE investors (a group which also includes pension funds).
The move isn't that surprising when one considers that costly "alternative" strategies like private equity are under immense pressure to maintain sky-high returns in an environment where good deal targets are few and far between, thanks in part to the SPAC boom (and the Fed's stimulus).
The Apollo fund that bought LifePoint finished raising its capital in 2017. Given the time table for these types of funds, the timing of the sale makes sense: the original investors in the 2013 fund that initially bought the hospital chain are looking to cash out. Fortunately for them, there's plenty of new money coming in.
For what it's worth, LifePoint says that $500MM+ in pandemic grants it received didn't benefit shareholders, but instead were "applied to LifePoint's communities". Whether you believe that, or not, there are plenty of critics who say private equity doesn't belong in America's hospital system.
"All grant aid we received has been applied to LifePoint's communities and only partially offset the $1.1 billion in extraordinary expenses and lost revenue that we incurred" because of the pandemic, she said.
One fact that probably helped Apollo pitch the investment to backers of its 9th flagship fund is the massive cash pile that LifePoint is sitting on. The firm has already grown substantially via acquisitions since Apollo bought it back in 2013.
The firm built LifePoint through the acquisition of three regional hospital chains in 2015, 2016 and 2018, and the company now operates 87 hospitals in small towns across the U.S. Apollo has said it can operate hospitals more efficiently by merging them. Technology and infrastructure upgrades are among a number of improvements LifePoint has made on Apollo’s watch, according to the private-equity giant, which is marketing the health-care firm as a socially responsible investment in its pitch to raise an inaugural impact fund.
LifePoint has emerged from the pandemic in a position of strength even as many rural hospitals have struggled to survive. Its cash stockpile grew significantly during the crisis as the company tapped debt markets.
Apollo told Fund IX investors that they stood to gain from their investment in LifePoint, as the hospital chain was sitting on more than $2 billion of cash that could be used to expand the business through acquisitions.
And Apollo isn't the only major PE firm engaged in the practice of flipping hospital chains.
Apollo wasn’t the only private-equity firm to orchestrate an uncommon exit from a for-profit hospital chain this year. Cerberus Capital Management and Leonard Green & Partners sold their remaining interests to insiders at the health-care companies they had backed, rather than selling to an industry competitor or pursuing an initial public offering.
Cerberus made roughly $800 million on its investment in Boston-based Steward Health Care, after paying $246 million in 2010 for what started as a chain of struggling Catholic hospitals.
With this in mind, it's perhaps not surprising that some progressive Dems are pounding the alarm about the risks of private equity firms taking over practically every hospital chain in the country.
"Private equity’s growing reach into our health-care system is concerning precisely because private equity’s mission to reap enormous profits often stands in direct conflict with the Hippocratic Oath," U.S. Representative Bill Pascrell, a New Jersey Democrat, said in an emailed statement. "We need greater transparency and more cutting oversight of these private-equity firms."
But setting aside the question of medical ethics for a moment, deals like these are certainly telling. Perhaps this is a sign that after 18 months of unprecedented deal flow buoyed by Jerome Powell's money printer, the biggest PE firms might be running out of ideas.