The Buyout Show with Fexingo: Private Equity, Roll-Ups, and Business Acquisitions

Private equity has quietly consolidated a huge chunk of the pharmacy benefit management industry. In this episode, Lucas and Luna unpack the economics of PBMs, the vertical integration wave, and a specific case: how firms like Madison Dearborn and Hellman & Friedman have rolled up multiple PBMs into a single giant. They walk through the 80-20 rule in drug pricing, the spread between what PBMs charge and what they pay pharmacies, and why regulators are starting to ask questions. If you've ever wondered why your prescription costs what it does, this episode explains the middleman you've never heard of.

#PharmacyBenefitManagers #PBMs #PrivateEquity #HealthcareConsolidation #MadisonDearborn #HellmanAndFriedman #DrugPricing #VerticalIntegration #ExpressScripts #CVSHealth #OptumRx #BusinessPodcast #Finance #Healthcare #FexingoBusiness #MergersAndAcquisitions #RollUps #PrescriptionDrugs

Keep every episode free: buymeacoffee.com/fexingo

Episode 101 of The Buyout Show explores the quiet but massive private equity land grab in the data center market. Lucas and Luna break down how firms like Blackstone and KKR are pouring hundreds of billions into hyperscale facilities, the math behind a 20% compound annual growth rate, and why cloud giants like Amazon and Microsoft are both customers and competitors. They examine the rise of a new breed of 'digital infrastructure' funds, the tension between PE's hold period and the tech cycle, and what happens when AI training clusters need 100 megawatts apiece. Expect specific numbers, real lease economics, and a clear look at why data centers have become the hottest hard asset in private equity.

#PrivateEquity #DataCenters #DigitalInfrastructure #Blackstone #KKR #Hyperscale #CloudComputing #AI #RealAssets #InfrastructureInvesting #MergersAndAcquisitions #RollUps #TheBuyoutShow #FexingoBusiness #BusinessPodcast #Business #Finance #Investing

Keep every episode free: buymeacoffee.com/fexingo

Episode 100 of The Buyout Show explores the wave of private equity acquisitions sweeping the home care industry. Lucas and Luna break down why PE firms are targeting agencies that provide in-home health aides, personal care, and dementia support. Using the example of a mid-sized regional agency acquired by a search fund backed by a family office, they discuss the operational playbook: centralizing scheduling software, standardizing caregiver training, and layering on private-pay services like companion care. They also examine the tensions—higher caregiver turnover under cost pressure, regulatory risk from state Medicaid reimbursement changes, and the cultural friction between PE efficiency and caregiving relationships. Specific numbers include the 7.5% annual industry growth rate, average EBITDA multiples of 8 to 10 times, and how a roll-up of 15 agencies can cut back-office costs by 30 percent. The episode closes with the question of whether the model can deliver quality outcomes at scale.

#PrivateEquity #HomeCare #RollUps #AgingPopulation #Medicaid #EBITDA #CaregiverTurnover #SearchFund #FamilyOffice #InHomeCare #HealthcareInvesting #BusinessAcquisition #DealRoom #FexingoBusiness #BusinessPodcast #Episode100 #OperationalPlaybook #HealthAides

Keep every episode free: buymeacoffee.com/fexingo

Episode 99 of The Buyout Show. Lucas and Luna drill into one of private equity's quietest roll-up plays: the consolidation of commercial fire protection and security monitoring companies. They walk through the numbers behind a single acquisition platform — Ficarino Holdings, which has aggregated over 50 regional fire alarm and sprinkler contractors since 2017 — and unpack the economics that make this sector irresistible to P-E firms: recurring service contracts, state-mandated inspection schedules, and sticky B2B relationships. They also discuss the risk that consolidation creates fewer supplier options for building owners and whether quality of service can survive multiple roll-ups. Specific case: how Ficarino went from a small Philadelphia outfit to a national player worth an estimated $2 billion by 2025. Concrete, skeptical, and well-sourced.

#PrivateEquity #RollUp #FireProtection #SecuritySystems #FicarinoHoldings #CommercialRealEstate #BusinessAcquisition #ServiceContracts #Consolidation #InspectionRevenue #LucasAndLuna #TheBuyoutShow #FexingoBusiness #BusinessPodcast #Finance #Investing #SprinklerSystems #AlarmMonitoring

Keep every episode free: buymeacoffee.com/fexingo

Episode 98 of The Buyout Show explores a consolidating corner of the death care industry: cremation services. Lucas and Luna break down how private equity firms have been rolling up funeral homes and crematoriums, with a focus on the largest player in the space, Service Corporation International (SCI), which owns over 1,500 funeral homes and 450 cemeteries. They discuss the economics of pre-need contracts, the shift from burial to cremation (now over 60% in the US), and how PE firms like Aterian Investment Partners and the publicly traded Carriage Services are capitalizing on the trend. The episode also touches on the ethical debates around for-profit death care and the long tail of family-owned operators. Specific numbers include SCI's market cap of roughly $12 billion and the average cost of a cremation ($2,500) versus a burial ($8,000). A light donation segment at the 75% mark invites listeners to support the ad-free show.

#PrivateEquity #CremationServices #DeathCare #ServiceCorporationInternational #SCI #CarriageServices #FuneralHomes #RollUps #BusinessAcquisitions #Consolidation #PreNeedContracts #AterianInvestmentPartners #DeathIndustry #CremationRate #Business #Finance #FexingoBusiness #BusinessPodcast

Keep every episode free: buymeacoffee.com/fexingo

Private equity is quietly consolidating the junk removal industry, buying up local haulers like 1-800-GOT-JUNK and Junk King to build regional platforms. In this episode, Lucas and Luna break down the economics: how a business that charges by the truckload can generate predictable cash flow, why software is making route optimization a competitive advantage, and what the roll-up strategy means for customers and franchisees. They also discuss the role of recycling revenue and how PE firms are betting on a 'trash as a service' model. If you've ever wondered who profits when you clear out your basement, this episode is for you.

#PrivateEquity #JunkRemoval #RollUps #BusinessAcquisitions #1-800-GOT-JUNK #JunkKing #Franchise #WasteManagement #Recycling #RouteOptimization #CashFlow #SmallBusiness #Consolidation #FexingoBusiness #BusinessPodcast #PE #Infrastructure #Services

Keep every episode free: buymeacoffee.com/fexingo

Episode 96 of The Buyout Show dives into the quiet consolidation of medical billing companies by private equity. Lucas and Luna explore why firms like R1 RCM and Athenahealth have become acquisition targets, and how PE is betting on the backend of healthcare. They discuss the business model: billing companies take a percentage of reimbursements, and by rolling up smaller players, PE can gain pricing power with hospitals and insurers. The hosts zero in on a specific deal: the 2023 take-private of R1 RCM by New Mountain Capital and TowerBrook Capital, valued at roughly $8.2 billion. They unpack the logic — medical billing is fragmented, cash-flow heavy, and resistant to tech disruption. But they also raise the question: when PE owns the billing infrastructure, who gets squeezed — hospitals, insurers, or patients? A sharp, concrete look at a slice of healthcare most people never think about.

#PrivateEquity #MedicalBilling #R1RCM #Athenahealth #HealthcareM&A #RevenueCycleManagement #NewMountainCapital #TowerBrookCapital #TakePrivate #HealthcareFinance #BusinessPodcast #BuyoutShow #FexingoBusiness #Consolidation #BackendHealthcare #MergersAndAcquisitions #VentureCapital #HealthTech

Keep every episode free: buymeacoffee.com/fexingo

Episode 95 of The Buyout Show examines the quiet consolidation of traffic ticket law firms. Lucas explains how private equity firms are rolling up high-volume, cash-flow-positive practices that handle minor moving violations. He breaks down the unit economics: a single ticket case costs about $50 to process and generates $250–$400 in revenue, with almost zero marketing spend once the firm ranks on Google for 'speeding ticket lawyer near me.' Luna pushes back on whether this is a sustainable play, given regulatory risks and the rise of ticket-dismissal apps. The episode closes with a comparison to the urgent care roll-up model and a question about whether PE can professionalize a cottage industry without losing the local court relationships that make it work.

#TrafficLawyers #PrivateEquity #LegalConsolidation #Business #FexingoBusiness #BusinessPodcast #TheBuyoutShow #LegalIndustry #RollUpStrategy #PEInvesting #TrafficTickets #LawFirmMergers #LegalTech #GoogleAds #LocalSEO #RegulatoryRisk #CashFlowBusiness #UnitEconomics

Keep every episode free: buymeacoffee.com/fexingo

Lucas and Luna dive into a surprising roll-up target: hearing aid dispensaries. With the OTC hearing aid rule from 2022 finally reshaping the market, private equity sees a fragmented $8 billion industry ripe for consolidation. They break down how firms like Audibel and HearingLife are being acquired by larger platforms, the demographics driving demand, and why the average cost of a pair of hearing aids—$4,600—creates both opportunity and scrutiny. A focused look at what happens when PE meets audiology.

#PrivateEquity #HearingAids #HealthcareInvesting #RollUp #Audibel #HearingLife #OTCHeaingAids #Demographics #Consolidation #BusinessAcquisition #HealthcareRollUp #FexingoBusiness #BusinessPodcast #TheBuyoutShow #Audiology #SilverEconomy #HealthcarePE #MergerAndAcquisition

Keep every episode free: buymeacoffee.com/fexingo

In this episode of The Buyout Show, Lucas and Luna dive into the wave of private equity acquisitions rolling through the veterinary industry. With an estimated 20 to 25 percent of US veterinary practices now owned by non-clinician investors, the hosts examine the economics driving the consolidation and what it means for pet owners, veterinarians, and the quality of care. Lucas explains the roll-up playbook—how firms like PetVet and Mars Inc. are aggregating independent clinics into regional networks to capture scale advantages in purchasing, staffing, and specialty referrals. Luna raises the friction: rising prices for routine procedures, the tension between clinical autonomy and corporate protocols, and the emergence of a two-tier veterinary market. The conversation looks back at a case study from the UK, where similar consolidation has already played out, to ask whether American pet owners should brace for higher costs even as access to advanced care improves.

#PrivateEquity #VeterinaryMedicine #PetCare #RollUps #BusinessAcquisitions #VetClinics #MarsInc #PetVet #Consolidation #PetOwners #Veterinarians #AnimalHealth #Business #Investing #FexingoBusiness #BusinessPodcast #TheBuyoutShow #MergersAndAcquisitions

Keep every episode free: buymeacoffee.com/fexingo