Patient Square Capital - Insights?

Recently read some interesting things about the new Healthcare PE firm - Patient Square Capital (run by ex KKR head, all-star team, $3-4B first time fund, etc). Curious if anybody has some personal insights into the firm as well as their reputation (even as a new firm) in the healthcare PE space. If healthcare PE/investing is something I want to do long term, would it be best to pursue an opportunity here and try to work my way up, or is getting experience at MFPE HC teams still the way to go?

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Fair point, but many ppl at this firm don’t have any med or PHD background (ex the founder of the firm doesn’t, and associates/VPs are from places like GS, TPG, Silver lake , etc.) Do you think this could mean the ceiling for non med is higher than at OrbiMed?

 

Seems like Jim Momtazee left after the blowup of Envision Healthcare. He still has an overall strong track record, evidenced by the huge first time fund raise, and the firm is making some bold investments even in this market environment . Curious to see how firms like this and Brian Sheth's Haveli Investments will pan out in the next 5-10 years

 

OP here, appreciate the insight. Will be at an EB HC team next summer. Was planning on recruiting FT for HC PE as well - given this, would you suggest aiming for just MFPE HC, or does Patient Square have the profile to be a good place to take some relative career risk (in the sense of getting in early and staying there for a long time)?

Also haven’t heard much about KKR’s Envision. Was this just a bad investment that blew up for them?

 
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The healthcare investing landscape is too complicated to give a simple X or Y answer to your question. It depends largely on 1) strategy - buyouts/minority investments/royalty financing/some combination of the three, and 2) vertical - pharma/medtech/services/some combination of the three. A lot of MF PE firms are trying to get involved at all stages of a company's lifecycle: Blackstone/Blackstone Life Sciences/Clarus, Carlyle/Abingsworth, KKR/KKR Strategic Healthcare. TPG separates buyout and growth teams. There are also the Orbimed, Norwest, WCAS, TA Associates type firms of the world. Find out what interests you because each offers a different experience.

In regards to Patient Square, that also depends on your risk profile because there are pros and cons to each. I'd personally start MF for the name brand because I care about that stuff but starting in an investing role at a place like Patient Square that has a breadth of strategies/verticals of interest would make you just as desirable and prepared for any other HC PE/VC/HF role. Case in point: someone from Patient Square literally just left for Blackstone.

There's a lot of WSJ articles on Envision, but tldr: it was a $5.5b bet that blew up because of covid and KKR destroyed a lot of investor's equity and ruined relationships with lenders.

 

Momtazee left KKR / pushed out a couple years ago when envision started dying. Envision went bk this year. In PE the outside world doesn’t learn what’s going on with a biz until well after the sponsor and the restructuring teams etc have tried their hardest.
He’s still widely considered to be a great investor. Their investment in Syneos is going to be an absolute home run.

Envision died because of the no surprise act. Stroke of the pen risk. Healthcare is complicated and you’ll learn that soon enough but basically this new law made it so that you can’t bill out of network rates when out of network providers perform treatment at in network facilities. I’m guessing this was a big part of their business due to all the utilization machinations large provider businesses like this have to do - basically staffing companies. So basically made it so that the insurance companies wouldn’t pay them what they underwrote as margins, wiped out the business. I think like $4-6b of equity gone but I forget the exact number.

 

Bump, any updates on them? Saw they closed a bunch of deals in late 2022.

 

Any updated views here? Also, anyone interview here following the new blast that went out? 

 

They've just launched their Fund II with scant realizations from the first fund. Jim Momtazee was responsible for the disastrous Envision deal when he was at KKR. The company filed for bankruptcy earlier this year, right after Patient Square closed their 1st fund actually. Would be interesting to see how that impacts their latest fundraise. Other 'buzzy' healthcare funds such as Vistria have struggled to raise as of late so keen to see how Patient Square fares in this tougher environment. I imagine many LPs are just about full up on their healthcare allocations. 

 

It also seems like people that worked at Envision are employed at Patient Square…

 

Firm is experiencing some of the usual growing pains that any Fund I has but on steroids given the target size of Fund II and the KKR personalities on that roster. I'd say 1/3 or more of the "founding partners" have since left the firm. Lots of people coming and going. I'm sure they'll still be able to hit close to their fund target because LPs are still attracted to pedigree and the KKR brand but that track record has since blown up and neither Patient Square nor KKR want to claim ownership. 

 

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