Strategic Buy-Side Search in Healthcare Services

Industry: Healthcare Services

Service Area: Commercial Due Diligence

Client Type: Lower-Middle Market Firm

Service Provider Type: Buy-Side Advisory Firm

The Need
Multi-Site Roll-Up Strategy in Healthcare Services

A lower-middle market private equity firm, with a successful history in executing multi-site roll-up strategies, sought to delve into the healthcare services sector. Their vision was clear: identify a healthcare practice that resonates with their investment thesis, marking the inception of a broader roll-up strategy. The ideal acquisition would be a multi-doctor practice in the Midwest, South or Southeast, boasting more than $5 million in annual net collections and an entry EBITDA above $2 million.

The Challenge
Precise Buy-Side Search

The challenge was twofold: identifying a healthcare practice that not only met the stringent financial criteria but also aligned with the firm’s strategic vision for a multi-site roll-up. The firm sought a partner who would reinvest back into the business, ensuring a synergy that would fuel the envisioned growth and expansion. The search required a nuanced understanding of the healthcare services sector, coupled with a strategic approach to identify practices that resonated with the firm’s investment thesis.

How BluWave Helped
Facilitating a Connection Tailored to Strategic Success

BluWave utilized its extensive network to connect the firm with a specialized buy-side advisory firm. This partnership was instrumental in navigating the complexities of the search, leveraging deep industry experience and a nuanced understanding of the private equity landscape. The advisory firm’s strategic approach and geographical insights were pivotal in identifying healthcare practices that aligned with the firm’s vision and investment thesis.

The Result
Poised for Transformative Growth

Through the connection facilitated by BluWave, the firm was empowered to execute a strategic buy-side search that resonated with their investment thesis. This partnership has set the stage for the identification of promising healthcare practices, ready to be woven into a transformative multi-site roll-up strategy that echoes the firm’s vision of growth and success in the healthcare services sector.

What Makes a Commercial Due Diligence Firm ‘Specialized’?

Private equity firms face fierce competition for new deals. Even when the economy is strong, there could be dozens of groups vying for the same target.

When the deal market is stagnant, though, it can seem impossible to find a viable acquisition, let alone have the winning bid.

BluWave founder and CEO Sean Mooney encountered this challenge in his nearly 20 years in private equity.

“As the competitive tension of supply and demand intersected in private equity with more and more capital under management, chasing the same supply of deals was causing pressure for me to say, ‘I can’t just be a market taker anymore,’” Mooney recently shared. “’The surplus is being skimmed. I have to see something that no one else can see.’”

Mooney since started the Business Builders’ Network to help other leaders solve this very problem. He recently spoke with Andrew Joy, partner at Hidden Harbor, about how PE firms use specialized commercial due diligence providers to cut through the noise and rise above competitors.

So how do the world’s top private equity firms distinguish themselves in this cutthroat environment? One way is through commercial due diligence.

Bald, white business man working hard on his notebook and tablet early in the morning in the board room, concentrating and deep in thought while being productive.

What is Specialized Commercial Due Diligence?

Specialized commercial due diligence can only be performed by firms that have deep experience in the target’s specific industry and are ready to go well below the surface to provide exclusive insights.

At a high level, a commercial due diligence project usually involves looking at a company’s market size, its total addressable market, conducting a competitive analysis and performing a voice of customer study.

READ MORE: What is Commercial Due Diligence?

“The goal of commercial due diligence is to validate the story that the target’s telling or to identify the reality of the marketplace out there so they can make an informed decision,” according to Don Jenkins*, the founding partner at one of the specialized diligence firms in the BluWave network.

While the details of the process are much more nuanced, a world-class CDD firm will be able to get up to speed faster, give private equity firms a deeper understanding of the business and equip them with a significant competitive advantage over other PE firms that conduct more general due diligence.

Looking Beyond the Acquisition

When PE firms consider buying a business, they aren’t just thinking about its present-day value. They’re also evaluating what an exit will look like and how much value they can create long-term once the company is no longer in their hands.

That’s why it’s so important for them to thoroughly investigate every potential target. Mooney said that PE firms have moved beyond a “trust but verify” mindset and are looking even longer term than they may have been a decade ago.

“You’re not building for the next five [years] because if nothing else, if you’re going to sell to the next person, there’s got to be some cream left to build it,” Mooney said. “If you’re only thinking three to five years ahead, you’re playing a chess versus checkers game.”

Differentiated Data

“As information and data have become more commoditized and more accessible, it’s becoming harder and harder to really find areas where you have a competitive advantage,” Joy said. “We like to say, ‘What’s our angle on this target or deal?’”

Mooney noted that investment banks do a great job exposing as much value creation as possible within a company. But PE firms that don’t dig deeper are going to be working from the same perspective as everyone else.

READ MORE: Data Consolidation: Benefits, Challenges, Processes

“The undifferentiated commercial diligence firm is calling the expert networks to get the insights about the markets that they’re sharing,” Mooney said. “Odds are if one over the other is not using a specialized group that sees something that the expert networks don’t, everyone’s getting beta. They’re spending hundreds of thousands of dollars on the sell-side study, which is calling two or three market network expert networks.”

Joy said that when PE firms use the same tools as everyone else, “that’s just the ante to get into the game.”

He added: “You really have to then figure out how this target or this opportunity fits within an angle that you can play. Whether that’s operationally, whether that’s commercially, so that you can justify to your committee why we think this asset is more valuable and we’re going to be the winning bid.”

Closing with Confidence

When commercial due diligence is done right, private equity firms can make acquisitions with confidence.

“By the time we close on a transaction, we have a really strong hypothesis around what are the value-creation levers that we are going to pull over our whole period to create outsized market returns,” Joy said. “And that’s informed by the commercial due diligence.”

When Hidden Harbor is deciding on a target, Joy said they like to ask where the company’s right to win is, and how they can get there.

“It’s amazing to see sometimes and that when you do a full cycle of investment from closing to selling and you look back and you say, ‘What were the three biggest value-creation drivers of our return?’ And you’re able to say, those were the three that we identified in diligence. That’s pretty powerful to have that amount of conviction and be right about that and being validated.”


BluWave has a close relationship with a deep bench of world-class, specialized commercial due diligence providers.

Each one has been vetted before joining the invite-only network and is re-vetted before they’re matched with private equity firms.

When you contact our research and operations team, they’ll connect you with a shortlist of service providers – with industry-relevant experience – in less than 24 hours.

Start your project today to get the differentiated insights that a specialized commercial due diligence provider can uncover.

*Privacy is important to us. While the source and company name have been changed, these are real quotations from a real service provider in the BluWave Business Builders’ Network.

A Wave of Deals is Coming: Commercial Due Diligence Webinar

The private equity deal market has been slow in 2023. There are signs, however, that that could change soon.

In fact, BluWave founder and CEO Sean Mooney believes PE is ready to “call a bottom” based on proprietary internal data. That means that firms must have their due diligence resources lined up ahead of the anticipated wave of deals this fall and beyond.

Mooney was recently joined by BluWave Head of Technology Houston Slatton and Hidden Harbor CP Partner Andrew Joy to discuss the intricacies of commercial due diligence on a live webinar.

A woman at a desk with a computer. You can't see the top half of her face. She's wearing a white shirt while writing something in a notebook to the right of the computer. Her cell phone is also on her desk. It appears to be sunrise or sunset in the background.

Here are some of the top takeaways from their conversation:

Understanding Target Markets

The panel touched on how commercial due diligence is pivotal in assessing market conditions.

“The definition of commercial due diligence in my mind is a synthesis of all factors, both historically and in the future that affect the growth and the competitiveness of the target in that particular model,” Joy said.

This “synthesis” involves myriad factors, from end-market demand drivers to regulatory inputs and global competition. The goal is to understand not just the immediate future but to project growth and trends 10-20 years ahead.

“Commercial due diligence is a term of art for a market study,” Mooney added. “It’s standard operating procedure by the best private equity investors in the world.”

READ MORE: What is Commercial Due Diligence?

The Role of Due Diligence in Bid Strategy

The competitive landscape of private equity demands a unique approach to bid strategies.

Mooney said private equity firms aim to see something unique in their investment targets that others don’t.

“One of the big trends is investment bankers are starting to put sell-side commercial due diligence studies in the data rooms,” Mooney said. “The incentive may be for private equity firms, ‘Oh, this is great, I can rely on the money that they’ve spent and I’ll just take their word for it.’ “But a newsflash is, if you’re buying the market study, you get to pick what it says so you can frame it.”

He added that that’s one of the reasons the private equity industry still uses its “own source of truth.”

Joy elaborated on other challenges PE firms are facing.

“I think as information and data has become more commoditized and more accessible, it’s becoming harder and harder to really find areas where you have a competitive advantage,” he said.

Finding that unique angle in a saturated market can make all the difference for a firm.

READ MORE: Buy-Side Commercial Due Diligence Strategies

Choosing the Right Commercial Due Diligence Provider

The choice of a due diligence provider can make or break a deal.

Mooney emphasized the importance of team experience and relevance.

“When you’re vetting your group, I’ll show exactly how we do it. It’s ‘What is your experience in the defined industry you’re exposing? Which projects have you worked on in this industry?’ When did they work on it? Who is the team that worked on it?”

In the end, he said, it comes down to ensuring that the diligence team has relevant experience with the target, the market and the industry.

“I think it’s really finding the right team that has the most relevant experience and just knows the market cold,” Joy added.

Mooney also warned against trying to pull an up-market firm down to your budget. Because of scarcity of resources, this could mean they don’t put their best team members on your project.


As the PE world braces for influx of new deals, having your diligence sources lined up ahead of time is key. To learn more about how to prepare, you can watch the webinar on demand.

If you would like to hear about the commercial due diligence resources in the Business Builders’ Network, contact our research and operations team to scope your need.


Panelist Bios:

Transforming Big Data into Actionable Insights for Legal Services

Industry: Professional Services

Service Area: Technology

Client Type: Portfolio Company – B2B Legal Services

Service Provider Type: Business Intelligence, Analytics and AI Firm

The Need
Efficient Analytics for Transaction Lode

A portfolio company in the B2B legal services sector reached out with a specific challenge. They had an Excel dataset with three tabs, each containing 1 million rows of transaction data. Their objective was to create cohort analyses and slice and dice this vast amount of information. Given Excel’s limitations, they needed a more robust solution.

The Challenge
Large Datasets and Tight Deadlines

The company, which offers online legal services to SMB customers, had recently accessed a large transaction database that was cumbersome to manage in Excel. They needed to make use of the new data trove for an upcoming project on a short timeframe. Their previous go-to firm, which used Tableau for data visualization, was unavailable for immediate assistance.

How BluWave Helped
The Right Big Data Connections, Fast

Understanding the urgency and the scale of the data challenge, BluWave tapped into its network to identify a boutique business intelligence, analytics and AI firm with the expertise to handle large datasets efficiently. The selected firm was lauded for its ability to work at “deal speed,” ensuring that projects were completed promptly without compromising on quality.

The Result
Seamless Integration, Insightful Analysis

With the expertise of the selected service provider, the portfolio company successfully integrated their vast transaction data into a more manageable and analyzable format. The firm not only set up the database for easy manipulation but also provided rigorous analysis, offering valuable insights that were highly appreciated by the company’s management team during diligence. The entire process, from initial setup to detailed analysis, was completed within the tight deadlines, ensuring the company was equipped for its key upcoming project deadline.

Their analysis was rigorous, and a company’s management team found their work to be insightful during diligence. They operate at deal speed and frequently work late at night and over weekends to ensure clients receive quality work product on time. I’d highly recommend their services.

-Vice President at PE Firm

Revamping Market Positioning, Expanding with M&A

Service Area: Commercial Due Diligence

Client Type: Portfolio Company

Service Provider Type: Merger & Acquisition Strategy Firm

Industry: Generalist

The Need
Reinvigorating Market Strategy and Exploring M&A Opportunities

A portfolio company sought help improving its market positioning and evaluating strategic M&A prospects within the HR SaaS sector. With a strong tech-focused approach, the firm aimed to identify adjacent markets and solidify its foothold through targeted acquisitions.

The Challenge
Navigating Complex Market Dynamics

The challenge lay in revitalizing the company’s market strategy. The client required a comprehensive analysis of their current positioning and an exploration of potential adjacent markets. Additionally, the portco sought guidance on devising a strategic M&A roadmap that aligned with their growth objectives and unlocked synergies.

How BluWave Helped
Strategic Insight and M&A Roadmap

BluWave connected the client with an M&A strategy firm well-versed in the HR SaaS industry. This partnership offered the portfolio company strategic expertise to analyze their current positioning and identify gaps. The specialized firm crafted a tailored plan for expansion into adjacent segments, including evaluating potential M&A targets. Weekly interactions with the investment team ensured alignment and effective execution of the strategy.

The Result
Empowering Informed Decision-Making

Through this collaboration, the client gained in-depth insights into their current market standing and potential growth opportunities. The M&A strategy firm’s expertise assisted the client in devising a strategic roadmap for M&A, considering tuck-in acquisitions and larger-scale ventures. This collaborative approach enabled the firm to make informed decisions, enhance its market presence and strategically leverage its investment for maximum impact.

The service provider was knowledgeable about the sector. They provided concrete action items and feedback. They also responded to feedback on the initial draft report to provide a final project in-line with expectations.

-VP at Private Equity Firm