US Acute Care Solutions, backed by WCAS, seeks $1bn-plus recap

Physician staffing businesses like USACS face less regulatory overhang after lawmakers reached a compromise to ban surprise medical billing in December.

US Acute Care Solutions, a provider of emergency medical staffing backed by Welsh, Carson, Anderson & Stowe, is seeking a recapitalization, according to sources familiar with the company’s plans. 

Barclays Capital is providing financial advice on the process, which is in its late stages, the people said. 

With $100 million-plus in EBITDA, the process is targeting a refinancing that values Canton, Ohio’s USACS well north of $1 billion, the people said. 

As the physician-owned company looks to bring on a new investor, it’s possible that WCAS retains a residual position, one of the people said. 

The healthcare- and technology-focused private equity firm’s investment dates back more than five years. Known for its partnership strategy, New York-based WCAS in 2015 teamed up with Emergency Medicine Physicians to launch US Acute Care. 

As a result of the transaction, EMP’s practice management operations became the foundation for USACS, a 2015 announcement said. Today USACS provides acute care hospital management as well as emergency medicine, hospitalist and observation medicine jobs for physicians and APPs.

Fueled by both acquisitions and organic efforts, USACS has grown to serve nearly 6 million patients annually at over 220 sites, according to its website – up from 2.7 million annual patients spanning 64 hospitals in 2015. 

The process comes as physician staffing businesses find themselves with better positioned after lawmakers in December agreed to put an end to “surprise medical billing” – thus protecting patients from receiving large unexpected, out-of-network bills following medical procedures. 

The long-awaited legislation will be effective January 2022 as part of The No Surprises Act, which was included within the omnibus spending bill signed into law on December 27. 

The ban on surprise billing is viewed as a win for the broader physician staffing industry. Besides USACS, notable players include Blackstone-backed TeamHealth and EmCare, which KKR acquired through its $9.9 billion mega deal for Envision Healthcare in 2018.

There’s also BBH Capital Partners’ American Physician Partners, whose auction was called off in late 2019 after industry noise around surprise medical billing distracted potential suitors, sources familiar with the matter told PE Hub at the time.

WCAS and Barclays declined to comment. USACS did not return PE Hub’s requests for comment.