GLOBAL HEALTHCARE PRIVATE EQUITY AND CORPORATE M based on announcement date; includes announced deals that are completed or pending, with data subject to change; deal value does not account for deals with undisclosed value; totals in healthcare deal by value row in the data table have been rounded to the nearest integer Sources: Dealogic; AVCJ; Bain analysis Deals by valueDeals by countDeals by valueDeals by count HealthcareOther industries 0 100 50 200 250 $700B 150 Figure 2: The years 10 largest healthcare buyouts accounted for nearly 70% of total disclosed deal value *Epic Health/PSA Healthcare deal value does not include rollover of J.H. Whitneys equity Notes: Sum may not equal the total due to rounding; includes announced deals that are completed or pending, with data subject to change Sources: Dealogic; AVCJ; Bain analysis Target MultiPlan North America/ Asia-Pacific North America/ Asia-Pacific TeamHealth Press Ganey ExamWorks ERT BioClinica PCI Pharma Services Netsmart Epic Health/ PSA Healthcare Atos Medical US US US US US US US US US Sweden 7.5 6.1 2.4 2.2 1.8 1.4 1.0 0.95 0.95* 0.95 25.2 Payer and related services (HCIT) Provider and related services Provider and related services (HCIT) Payer and related services Biopharma and related services (HCIT) Biopharma and related services (HCIT) Biopharma and related services Provider and related services (HCIT) Provider and related services Medtech and related services Europe North America Europe Europe Europe North America North America Europe Hellman Leonard Green GIC Blackstone Group; Caisse de dpt et placement du Qubec; PSP Investments; National Pension Service of Korea EQT Partners Leonard Green Novo A/S Cinven Partners Group GI Partners; Allscripts Healthcare Solutions Bain Capital/J.H. Whitney PAI Partners Target country Acquirer(s) Acquirer region(s) Sector Total Deal value ($B) Global Healthcare Private Equity and Corporate M based on announcement date; includes announced deals that are completed or pending, with data subject to change; deal value does not account for deals with undisclosed values Sources: Dealogic; AVCJ; Bain analysis Provider and related servicesPayer and related servicesBiopharma and related servicesMedtech and related services Global Healthcare Private Equity and Corporate M P2P activity was an all-American affair as volatility in the stock market depressed public multiples for US-listed healthcare companies and heated competition for assets bid up multiples in the private market . To understand how these trends affected public and private valuations of US healthcare assets, we analyzed valuations for companies with enterprise values (EV) between $500 million and $10 billion (the size range most actionable by large PE funds) . We then identified assets in segments in which private equity is most active: provider and related services, payer and related services, HCIT and companies that supply services to pharma and medtech firms . We defined the valuation multiple of an asset as EV divided by earnings before interest, tax, depreciation and amortization for the last 12 months (LTM EBITDA), and we aggregated individual company data into composite metrics by weight-averaging the valuation multiples by LTM EBITDA . For public companies, we analyzed companies that were publicly listed at the end of each year over the past decade (2007 to 2016), using their year-end share price to calculate EV . This analysis shows that the weighted average trading multiple for the assets in our universe dipped from a peak in 2014 to approximately 11 times in 2016 (see Figure 4) . For private companies, we analyzed the 16 healthcare companies that PE funds announced they were acquiring in 2016 for which EV and LTM EBITDA were available and that were in the same EV size range of $500 million to $10 billion . We scaled the weighted average valuation multiple for this data set to match the sector composition of our 2016 public data set, and we found that the weighted average valuation multiple was approximately 13 times, two turns higher than the average for our public data set (see Figure 5) . This disparity helps explain the surge in P2P deals in 2016: Even when private investors figured in the sizable premiums that they must typically pay shareholders to acquire public companies, they saw opportunities to win marquee assets at favorable valuations, compared with what they would have had to pay for similar assets on the private market . Another sign of strong private market valuations is the outcome of so-called dual-track exits . The PE owner of an asset who uses this approach will simultaneously file for an IPO while exploring a private sale of the asset, either to another sponsor or to a corporate buyer . When private valuations are high, investors tend to pick the sponsor-to-sponsor option over the IPO . In 2016, Thomas H . Lee Part- ners (THL) pursued a dual-track process for outsourced pharma services company inVentiv Group, ultimately o