The document summarizes recent mergers and acquisitions (M&A) activity in the healthcare information technology (HCIT) sector in 2011. Key points include: - ExpressScripts' $29 billion acquisition of Medco and Blackstone's $3 billion acquisition of Emdeon were two major deals in 2011, signaling continued consolidation in the sector. - Government incentives promoting electronic health records and regulations requiring healthcare automation will drive further investment and M&A activity over the next few years. - Spending on HCIT in the US is expected to reach $40 billion in 2011 and grow at 24% annually through 2014, with electronic health records and mobile apps seeing strong growth. - Rising healthcare

1. Chase Sanders
Signal Hill Director
csanders@signalhill.com
Sector M&A Update: Healthcare IT 2011
The Healthcare IT (HCIT) M&A market is witnessing Government financial incentives and regulations requiring
significant activity, a sign the sector’s predicted expansion automation in healthcare practices will continue to be
and transformation is taking shape. While most deals in the main drivers in the sector for the next several years.
2011 can be categorized as smaller tuck-ins, two marquee The HCIT market in the U.S. is expected reach $40 billion
transactions were announced this summer: ExpressScripts’ by the end of 2011 and grow at an impressive 24%
$29 billion acquisition of Medco, a pharmacy benefits compound annual growth rate (CAGR) from 2012-2014.1
management provider, and Blackstone’s $3 billion acquisition Spending on healthcare software is expected to rise 20.5%,
of Emdeon, a revenue cycle management and medical data from $6.8 billion in 2010 to $8.2 billion in 2011.2 A large
services provider. As consolidation and HCIT spending portion of the growth will come from spending on
continue to accelerate, we believe the healthcare market is electronic health record (EHR) systems and mobile
poised for increased M&A activity and growth. applications.
Key Factors Driving Continued HCIT medical benefit.3 Growth in medical costs for 2011 has
Investment and M&A been primarily driven by provider cost-shifting from
Medicare to commercial payers due to rate cuts,
increased bargaining power from continued provider
Some of the key factors that we see driving investment and
consolidation (physicians and hospitals) and large
consolidation in the HCIT sector are as follows:
capital investments by hospitals for IT systems and
• Increased government initiatives and healthcare professionals.
reform: Spurred by attractive government incentives
Q/Q Rev • Desire to improve patient safety and health outcomes:
that began in 2011 and greater clarity surrounding
Growth An estimated 80% of serious medical errors involve
meaningful use rules, hospitals will invest billions of
miscommunication between caregivers when a patient
dollars into certified EHR systems. Although many
is transferred or handed off.4 Improvements in the
hospital systems were already planning to invest in
completeness, accuracy and accessibility of patient
EHRs, the government’s new regulations considerably
information can reduce defective hand-offs by an
condensed their timelines. The criteria for meaningful
average of 52%.5
use will be staged in three steps over the next several
years, with Medicare penalties beginning in 2015. Stage 1,
• Innovative technology from niche players: Niche
currently in process through 2012, sets the baseline for
players continue to develop new technologies to
electronic data capture and information sharing.
capture and use data and drive change in the HCIT
• Skyrocketing cost of healthcare delivery to space. These niche markets are large enough to provide
patients, physicians and providers: The largest contributor significant venture capital returns, with readily foreseeable
of increasing medical costs comes from care exit opportunities as large strategics consolidate and
providers, which account for up to 81% of the become “one-stop-shops.”
IN THIS ISSUE: M&A Update - Healthcare IT 2011
2 HCIT M&A By The Numbers 4 Largest HCIT Transactions 7 HCIT Public Company Data
2 Public HCIT Company Multiples 5 Venture Investments in HCIT 8 Precedent HCIT Transactions
3 Noteworthy Recent Transactions 6 Public HCIT Equity Performance 10 References
Sector M&A Update: Healthcare IT 2011 www.signalhill.com

2. Healthcare IT 2011
HCIT M&A By The Numbers
HCIT M&A activity has grown steadily since 2008. The total number of announced deals grew substantially in 2010 and
the expected deal count for 2011 is on pace to exceed it. Median deal size for 2011 grew slightly over 2010, continuing a
positive trend since a low in 2009. The median revenue multiple for 2011 also grew slightly compared to 2010 to 2.5x. The
continued expansion of these metrics signals increased market confidence and the growing value of HCIT to
strategic and financial investors.
Figure 1: HCIT M&A Deal Metrics, 2008-2011
Source: Signal Hill
As of Q3
2008 2009 2010 2011(E)* 2010 2011*
Number of Deals 48 77 106 118 71 88
% change from prior year - 60.4% 37.7% 11.3% - 23.9%
Total Enterprise Value ($M) $3,607.0 $10,610.1 $8,106.2 $7,848.0 $7,177.0 $5,869.8
% change from prior year - 194.2% -23.6% -3.2% - -18.2%
Median Announced Deal Size ($M) $51.6 $10.5 $59.0 $60.0 $61.3 $60.0
% change from prior year - -79.7% 461.9% 1.7% - -2.1%
Median EV/TTM Revenue Multiple 2.2x 1.1x 2.4x 2.5x 2.7x 2.5x
% change from prior year - -50.0% 118.2% 4.2% - -7.4%
*2011 data excludes the EV $34 billion ExpressScripts/Medco transaction.
Public HCIT Company Multiples
Public HCIT company revenue trading multiples are a key indicator of the health of the market and began expanding at
a healthy clip in 2011, peaking at 3.2x. However, macroeconomic head winds from a slowing U.S. economy and concerns
of a spreading debt crisis in Europe have since depressed HCIT revenue trading multiples to around 2.4x over the last few
months.
Figure 2: Signal Hill HCIT Composite Enterprise Value / LTM Revenue Public Company Trading Multiples
3.4x 3.4x
3.2x 3.2x
3.0x 3.0x
2.8x 2.8x
2.6x 2.6x
2.4x 2.4x
2.2x 2.2x
2.0x 2.0x
1.8x 1.8x
Sep-09 Feb-10 July-10 Dec-10 May-11 Sep-11
Source: Signal Hill
Note: Signal Hill HCIT Composite: ABCO, ACCL, AH, ATHN, CERN, CGM-FR, COP-DE, CPSI, EM, EPOC, ERT, HMSY, HSTM, ICAD, MCK, MDAS,
MDRX, MDSO, MEDW, MRGE, OMCL, OSIS, QSII, SECT.B-SE, SXCI, WBMD and ZIXI.
2

3. Signal Hill
The table below provides a snapshot of public company trading multiples broken down by key subsectors of HCIT.
Figure 3: Current Signal Hill HCIT Subsector Composites Median Enterprise Value / Revenue Trading Multiples
4.5x
4.0x 4.0x
3.5x 3.4x 3.5x
3.3x
3.0x 3.1x
3.0x 2.9x
2.6x
2.5x 2.5x
2.3x
2.2x
2.0x 1.9x
1.5x 1.4x 1.4x
1.2x 1.2x 1.2x 1.2x
1.0x
0.5x
0.0x
Hospital IT Imaging IT Payor IT Pharma IT Physician IT Service IT
LTM 2011E 2012P
Source: Signal Hill
Note: Payor IT: HMSY and SXCI; Pharma IT: ACCL, CGM-FR, EPOC, ERT, MDSO and WBMD; Physician IT: AH, ATHN, COP-DE, MDRX, QSII and ZIXI; Hospital IT:
CERN, CPSI, MCK, MDAS, MEDW and OMCL; Imaging IT: ICAD, MRGE, OSIS and SECT.B-SE; and Services IT: ABCO, EM and HSTM.
Noteworthy Recent HCIT M&A Transactions
• Emdeon / Blackstone (Enterprise Value: $3,061 million; 2.8x revenue): Private equity firm Blackstone agreed to acquire
a controlling interest in Emdeon, a provider of revenue and payment cycle management solutions, connecting payers,
providers and patients in the U.S. healthcare system. Under the terms of the merger agreement, holders of Emdeon
common stock will receive $19.00 per share in cash, representing a 39% premium to its average 30-day trading price.
This transaction marks a complete exit from Emdeon by General Atlantic, the private equity firm that bought a
52% stake in the company in 2006 from HLTH for $1.25 billion. The remaining private equity shareholder, Hellman &
Friedman will retain a minority equity interest in Emdeon.
• Vangent / General Dynamics (EV: $960 million; 1.3x revenue): General Dynamics, a provider of information technology,
systems engineering, professional services and simulation and training support to government customers, agreed to
acquire Vangent, a provider of health informatics and information exchange, electronic health records, data analytics
and business-process outsourcing solutions, also to government customers. The acquisition will add depth and breadth
to GD’s IT operations, which provides HCIT systems and solutions to federal, commercial and military customers. It is
the second time in four years Vangent ownership has changed; Veritas acquired the company from Pearson for
$600 million in 2007.
• Sage Software Healthcare / Vista Equity Partners (EV: $320 million; 2.8x revenue): Vista Equity Partners, a private
equity firm focused on enterprise software and technology businesses, agreed to acquire Sage Software Healthcare, a
provider of practice management and EHR offerings. The transaction will allow Sage to focus on other U.S opportunities
within its core customer base. Sage will make a loss of up to 70 million pounds ($108.4 million) through the sale and
redistribute cash proceeds of $320 million to shareholders by buying back shares.
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4. Healthcare IT 2011
• Gateway EDI / TriZetto (EV: $230 million; revenue multiple unavailable): TriZetto, a healthcare payment software and
services provider, agreed to acquire Gateway EDI, a St. Louis-based provider of healthcare revenue cycle management
solutions. The acquisition will enable TriZetto to offer an integrated end-to-end payment information product.
Gateway EDI’s leadership will remain in place and will operate the company as an independent subsidiary.
• Vitalize Consulting / SAIC (EV: $190 million; 2.5x revenue): SAIC, a scientific, engineering, and technology
applications company, agreed to acquire Vitalize Consulting, a provider of clinical, business and IT services for healthcare
enterprises. The acquisition enables SAIC to expand in the commercial health provider market and leverage its
information integration and data analytics expertise with Vitalize Consulting’s HCIT and clinical workflow optimization
capabilities to further grow as commercial and Federal health markets converge.
• Medical Present Value / Experian (EV: $185 million; 4.1x revenue): Experian, a global information services company,
agreed to acquire Medical Present Value, a provider of data, analytics and software in the RCM market. Medical
Present Value’s revenue CAGR over the past three years has exceeded 30%, driven primarily by new business wins.
The acquisition will provide Experian a more comprehensive set of products and services across the healthcare
payments life cycle and help clients manage multiple vendors through a single point of contact.
• M*Modal / MedQuist (EV: $130 million; 5.4x revenue): MedQuist, a provider of integrated clinical documentation
solutions for healthcare, agreed to acquire M*Modal, a provider of speech recognition and natural language processing
software enabling structured data to be pulled from dictation and placed in an EHR. The deal will allow MedQuist to
provide advanced speech understanding technologies and services that seamlessly capture the physician narrative.
MedQuist intends to enhance further the integration of M*Modal’s front-end speech recognition technology with
MedQuist’s clinical documentation platform.
Figure 4: Largest HCIT Transactions by Enterprise Value, 2010-2011
Source: Signal Hill
EV/ TTM
Date Enterprise Revenue
Announced Seller Buyer Value ($M) Multiple Target Description
21-Jul-11 Express Scripts, Medco Health $34,000.0 0.5x Pharmacy benefit management provider.
Inc. Solutions
09-Jul-10 MultiPlan, Inc. BC Partners & $3,100.0 NA Provider of healthcare cost management solutions that deliver transaction
Silver Lake based services to insurers, health plan administrators, and other payers
Partners of healthcare services.
04-Aug-11 Emdeon, Inc. The Blackstone $3,061.0 2.8x Provider of revenue and payment cycle management and clinical
Group information exchange solutions.
09-Jun-10 Eclipsys Allscripts $1,205.0 2.3x Provider of advanced integrated clinical, revenue cycle and performance
management software, clinical content and professional services.
16-Aug-11 Vangent, Inc. General $960.0 1.3x Provider of health informatics and information exchange, electronic
Dynamics health records and data analytics, as well as state-of-the-art business
process outsourcing solutions to federal clients.
14-Sep-10 The Broadlane MedAssets, Inc. $850.0 5.1x Provider of supply chain management, strategic sourcing of supplies
Group and services, capital equipment lifecycle management, medical device
or PPI cost management, centralized procurement, clinical and lean
process consulting, and clinical workforce optimization.
16-Apr-10 Phase Forward Oracle Corp. $575.9 2.7x Provider of integrated data management solutions for clinical trials and
drug safety.
07-Dec-10 Medicity Inc. Aetna Inc. $500.0 NA Offers a broad range of products and services that enable health systems,
hospitals, physician practices and health information exchanges to
securely access and exchange health care information.
22-Sep-11 Sage Group / Vista Equity $320.0 2.8x Provides electronic healthcare records (EHR) and medical practice
Sage Software Partners management software for the medical sector with features for business
Healthcare LLC intelligence analytics, patient online self-service, reporting and
transaction processing.
14-Sep-10 Chamberlin Emdeon, Inc. $260.0 NA Provides comprehensive eligibility services through technology-enabled
Edmonds & patient access solutions nationwide for hospitals, government agencies
Associates, Inc. and managed care organizations.
05-Mar-10 AMICAS, Inc. Merge $240.1 3.3x Offers a suite of image and information management solutions
Healthcare including radiology PACS, cardiology PACS, radiology information
Incorporated systems, cardiovascular information systems, revenue cycle management
solutions and enterprise content management tools designed to power
the imaging component of the electronic medical record (EMR).
4

5. Signal Hill
HCIT Venture Capital Investments
Venture Capital investments in the HCIT sector witnessed significant growth during 2010 and 2011. As of September 30,
the number of investments was up more than 10% compared to 2010, while total dollars invested already exceeds the
total amount for all of 2009.
Figure 5: HCIT Venture Capital Investments, 2005-2011*
Source: VentureXpert/ThomsonOne
As of 9/30 TOTAL as of
2005 2006 2007 2008 2009 2010 2011(E) 2011* Q3 2011
Total Number of Investments 42 54 53 55 45 69 67 49 367
Percent change over previous period - 28.6% -1.9% 3.8% -18.2% 53.3% -2.9% 11.4% -
Total Dollars Invested ($M) $195.7 $257.7 $257.4 $349.1 $184.6 $282.7 $259.2 $194.0 $1,721.2
Percent change over previous period - 31.6% -0.1% 35.6% -47.1% 53.2% -8.3% -10.2% -
*2011 as of 9/30/10. Percentage change compared to same period in 2010.
Business process management technology for healthcare continued to bring in the majority of venture capital investments
during the first three quarters of 2011. Revenue cycle management witnessed a large increase in investments, while the
other subsectors witnessed declines, mostly due to general market weaknesses.
Figure 6: HCIT Venture Capital Investments by Subsector, 2005-2011*
Source: VentureXpert/ThomsonOne
As of 9/30
Sub-sector 2005 2006 2007 2008 2009 2010 2011(E) 2011 TOTAL
Electronic Medical Records
(EMR) $27.4 $30.3 $11.5 $29.1 $9.5 $16.4 $12.8 $9.6 $133.8
Health Information Exchange
(HIE) $13.2 $25.0 $4.0 $0.4 $0.5 $41.1 $20.1 $15.0 $99.2
Revenue Cycle Management $44.5 $79.6 $91.9 $121.8 $52.9 $18.8 $49.3 $36.9 $446.4
Healthcare Business Process
Management $96.0 $91.2 $98.6 $101.0 $101.2 $92.2 $127.4 $95.3 $675.6
Storage of Medical Information NA $9.1 $14.8 $9.1 $4.0 $53.1 $19.3 $14.4 $104.5
Mobile / Internet Technology
$14.6 $22.6 $36.5 $87.7 $16.6 $16.6 $3.3 $2.5 $197.0
for Healthcare
*2011 data as of 9/30/10.
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6. Healthcare IT 2011
Public HCIT Equity Performance
The Signal Hill HCIT Composite performed in line with the NASDAQ Composite over the last quarter of 2010 and
outperformed the NASDAQ through Q3 2011, up 22.7% over the last year.
Figure 7: One Year Signal Hill HCIT Composite vs NASDAQ Composite
40% 40%
30% 30%
20% 20%
10% 10%
0% 0%
-10% -10%
Sep-10 Dec-10 Feb-11 May-11 Jul-11 Sep-11
Signal Hill HCIT Composite NASDAQ Composite
Source: Signal Hill
Note: Signal Hill HCIT Composite: ABCO, ACCL, AH, ATHN, CERN, CGM-FR, COP-DE, CPSI, EM, EPOC, ERT, HMSY,
HSTM, ICAD, MCK, MDAS, MDRX, MDSO, MEDW, MRGE, OMCL, OSIS, QSII, SECT.B-SE, SXCI, WBMD and ZIXI.
The HCIT equity subsectors for Services, Payor, Physician, Hospital and Imaging outperformed the NASDAQ Composite
over the last year, up 56.6%, 40.6%, 31.9%, 28.1% and 20.0% respectively. Only the Pharma HCIT equity subsector under-
performed the NASDAQ Composite over last year, down 38.7%.
Figure 8: One Year Signal Hill HCIT Sub-sector Composites vs NASDAQ Composite
70% 70%
60% 60%
50% 50%
40% 40%
30% 30%
20% 20%
10% 10%
0% 0%
-10% -10%
-20% -20%
-30% -30%
-40% -40%
-50% -50%
Sep-10 Dec-10 Feb-11 May-11 Jul-11 Sep-11
Payor IT NASDAQ Composite Pharma IT Physician IT Hospital IT Imaging IT
Services IT
Source: Signal Hill
Note: Payor IT: HMSY and SXCI; Pharma IT: ACCL, CGM-FR, EPOC, ERT, MDSO and WBMD; Physician IT: AH, ATHN, COP-DE,
MDRX, QSII and ZIXI; Hospital IT: CERN, CPSI, MCK, MDAS, MEDW and OMCL; Imaging IT: ICAD, MRGE, OSIS and SECT.B-SE;
and Services IT: ABCO, EM and HSTM.
6

7. Signal Hill
Figure 8: HCIT Public Company Data
($ in Millions, except per share data)
Source: Signal Hill Market Data Financial Data Valuation Data
Stock
Pricing Date 09/30/11 Price Q/Q Rev LTM Margins EV/Revenues EV/EBITDA1
Price % of 52 Market Enterprise LTM Growth CY CY CY CY
Median Metrics 9/30/11 Week High Cap Value Revenue YoY Seq. Gross EBITDA LTM 2011(E) 2012(P) LTM 2011(E) 2012(P)
Hospital IT
McKesson Corp $72.70 83.3% $18,466 $19,339 $114,614 9.2% 3.9% 5.3% 2.2% 0.2x 0.2x 0.2x 7.6x 6.6x 6.1x
Cerner Corp. 68.52 92.1% 11,894 11,327 1,979 15.0% 6.6% 77.8% 30.5% 5.7x 5.3x 4.7x 18.8x 16.9x 14.3x
MedAssets Inc. 9.61 42.7% 566 1,465 481 54.9% 12.9% 58.7% 28.4% 3.0x 2.5x 2.3x 10.7x 8.0x 7.2x
Computer Programs
& Systems Inc 66.15 83.7% 732 707 173 29.5% 20.9% 46.3% 23.7% 4.1x 3.9x 3.5x 17.2x 15.5x 13.5x
Omnicell Inc. 13.78 75.9% 468 287 232 11.5% 6.7% 54.8% 8.7% 1.2x 1.2x 1.0x 14.3x 8.4x 6.7x
Mediware Information
11.90 86.8% 100 70 56 20.6% 16.0% 58.5% 27.8% 1.3x 1.2x NA 4.5x NA NA
Systems Inc.
Median 83.5% 17.8% 9.8% 56.7% 25.8% 2.2x 1.9x 2.3x 12.5x 8.4x 7.2x
Imaging IT
OSI Systems Inc. $33.52 74.0% $662 $609 $656 10.9% 4.9% 36.5% 10.6% 0.9x 0.9x 0.8x 8.7x 7.8x 6.5x
Merge Healthcare Inc. 5.75 93.2% 515 719 200 91.7% 5.5% 55.1% 22.5% 3.6x 3.1x 2.7x 16.0x 11.5x 10.0x
Sectra AB 6.12 87.7% 230 202 131 -0.8% -25.8% 2.1% 8.5% 1.5x 1.6x 1.6x 18.3x 14.5x 9.7x
icad Inc. 0.47 26.6% 26 18 26 9.0% -9.5% 71.0% -43.0% 0.7x 0.6x 0.4x NM NA NA
Median 80.9% 10.0% -2.3% 45.8% 9.5% 1.2x 1.2x 1.2x 16.0x 11.5x 9.7x
Payor IT
SXC Health Solutions $55.70 83.9% $3,552 $3,217 $3,326 152.8% 10.4% 7.0% 3.9% 1.0x 0.7x 0.5x 24.8x 19.2x 14.2x
HMS Holdings Corp. 24.39 86.3% 2,115 1,997 339 26.3% 8.4% 34.3% 27.7% 5.9x 5.4x 4.4x 21.3x 17.9x 14.6x
Median 85.1% 89.6% 9.4% 20.7% 15.8% 3.4x 3.0x 2.5x 23.1x 18.6x 14.4x
Pharma IT
WebMD Health Corp. $30.15 51.5% $1,769 $1,424 $577 15.2% 7.4% 60.7% 27.6% 2.5x 2.4x 2.2x 8.9x 7.2x 6.3x
Cegedim S.A. 30.72 43.0% 430 1,133 1,316 15.2% 22.8% 12.5% 5.9% 0.9x 0.9x 0.9x 14.5x 5.0x 4.6x
Medidata Solutions Inc. 16.44 60.0% 408 314 179 24.5% 23.2% 68.7% 21.8% 1.7x 1.7x 1.5x 8.0x 7.2x 5.9x
Epocrates Inc. 9.01 29.8% 233 152 111 10.2% -4.5% 67.8% 6.7% 1.4x 1.3x 1.1x 20.4x 10.4x 5.8x
Accelrys Inc. 6.06 67.7% 336 220 NA NA NA NM NM NA 1.5x 1.4x NA 7.3x 6.1x
eResearch Technology 4.46 51.9% 220 208 175 47.3% 2.8% 42.5% 26.1% 1.2x 1.2x 1.1x 4.6x 4.3x 3.3x
Median 51.7% 15.2% 7.4% 60.7% 21.8% 1.4x 1.4x 1.2x 8.9x 7.2x 5.9x
Physician IT
Allscripts Healthcare $18.02 77.9% $3,470 $3,470 $1,085 81.8% 6.1% 35.1% 11.6% 3.2x 2.4x 2.2x 27.7x 9.6x 8.2x
Solutions Inc.
Accretive Health Inc. 21.23 64.7% 2,146 1,995 676 20.9% 12.1% 22.5% 5.5% 3.0x 2.4x 1.8x 53.3x 25.2x 15.5x
Quality Systems Inc. 97.00 95.7% 2,852 2,722 371 21.1% 3.4% 64.3% 33.1% 7.3x 6.6x 5.6x 22.2x 20.5x 16.3x
athenahealth Inc. 59.55 81.9% 2,130 2,026 280 33.0% 11.4% 57.8% 17.8% 7.2x 6.3x 4.9x 40.5x 31.9x 23.4x
CompuGROUP 11.94 69.0% 635 986 484 29.8% 2.3% 25.2% 18.2% 2.0x 1.8x 1.6x 11.2x 9.3x 7.2x
Medical AG
Zix Corp. 2.67 54.7% 180 163 34 5.8% 1.7% 82.0% 26.7% 4.7x 4.2x 3.6x 17.7x 13.2x 10.1x
Median 73.5% 25.4% 4.7% 46.4% 18.0% 4.0x 3.3x 2.9x 24.9x 16.9x 12.8x
Services IT
Emdeon Inc. CI A $18.79 99.4% $1,716 $2,815 $1,075 16.0% 3.9% 21.5% 23.4% 2.6x 2.5x 2.3x 11.2x 9.3x 8.5x
Advisory Board Co. 64.53 94.6% 1,090 1,055 305 22.4% 5.7% 43.8% 11.8% 3.5x 3.1x 2.6x 29.4x 17.0x 13.4x
HealthStream Inc. 12.83 86.4% 300 273 74 26.4% 13.8% 56.4% 18.4% 3.7x 3.4x 2.9x 20.1x 16.8x 14.3x
Median 94.6% 22.4% 5.7% 43.8% 18.4% 3.5x 3.1x 2.6x 20.1x 16.8x 13.4x
ALL HCIT Companies 77.9% 21.0% 6.3% 50.5% 18.3% 2.5x 2.4x 2.0x 17.2x 10.4x 8.5x
7

8. Healthcare IT 2011
Figure 9: Precedent HCIT M&A Transactions
Source: Signal Hill
Date Enterprise
Announced Seller Buyer Value ($M) Revenue EBIT EBITDA Target Description
16-Aug-11 Vangent, Inc. General $960.0 1.3x 21.9x 11.7x Provider of health informatics and information
Dynamics exchange, electronic health records and data analytics,
as well as state-of-the-art business-process outsourcing
solutions to federal clients.
12-Aug-11 Zircadian Allocate Software $9.8 2.4x NA 30.4x SaaS provider of software used to plan the rotas of
Holdings Limited junior doctors and consultants in the NHS.
04-Aug-11 Emdeon, Inc. The Blackstone $3,061.0 2.8x 28.6x 12.2x Provider of revenue and payment cycle management
Group and clinical information exchange solutions connecting
payers, providers and patients in the United States
healthcare system.
01-Aug-11 Salar Inc. Transcend $11.0 2.8x 9.2x NA Developer of electronic clinical documentation and
Services, Inc. billing workflow software for the healthcare market.
11-Jul-11 M*Modal MedQuist Inc. $130.0 5.4x NA NA Provides speech recognition software and software
as a service (SaaS) for the purposes of clinical
documentation and transcription for the medical sector.
28-Jun-11 Medical Present Experian Group $185.0 4.1x NA NA Provides Web-based medical patient and insurance
Value, Inc. Ltd. provider payment, as well as revenue cycle management
software for the medical sector.
22-Jun-11 Portico Systems McKesson $90.0 4.6x NA NA Provides healthcare benefits provider network
Corporation management, administration and collaboration
software for health insurance providers.
06-Jun-11 Ophthalmic Merge Healthcare $32.3 1.8x NM NM Provides digital eye scanning systems and related
Imaging Systems image capture and management software for the
ophthalmology sector. Also provides related electronic
healthcare records (EHR) management software.
28-Apr-11 Vital Images, Inc. Toshiba Medical $152.1 2.5x 66.2x 27.0x Provider of advanced visualization and analysis
Systems software for physicians and healthcare specialists.
Corporation
27-Apr-11 Bloodhound Verisk Analytics, $82.0 8.2x NA NA Provider of real-time pre-adjudication claims editing
Technologies Inc. web-based software for healthcare payers.
11-Apr-11 Tribal Group plc / Capita plc $25.9 0.2x NA NA The Government and Health Businesses offers strategic
Government and and operational advisory and consultancy services to
Health Business government clients and the healthcare industry in
developing countries on behalf of government funded
donor organizations.
07-Mar-11 BioWisdom, Ltd Instem Life $2.4 1.0x NA NA Provides software to accelerate access to scientific
Science Systems information for better decision support during product
plc discovery, development and commercialization.
22-Feb-11 Gateway EDI The TriZetto $230.0 NA NA 20.2x Offers electronic claims processing and revenue cycle
Group management services to more than 70,000 physicians.
16-Dec-10 InfoLogix, Inc. Stanley Black & $61.2 0.7x NA NA Provider of enterprise mobility and advanced
Decker wireless asset tracking solutions for the healthcare
and commercial industries.
14-Dec-10 iSOFT Business The Capita Group $36.5 1.4x 7.6x 4.2x iSOFT Business Solutions offers financial management,
Solutions Plc purchasing and e-business solutions to customers
across both public and private sectors primarily in the
UK and Ireland.
04-Nov-10 Group DCA PDI, Inc. $55.0 2.9x NA 5.5x Interactive digital communications agency serving
biopharmaceutical companies that leverages the
strengths of the Internet, multimedia, tablet PCs,
dimensional direct mail, and its proprietary software
called DIAGRAM™.
22-Oct-10 Spryance, Inc. Transcend $8.5 0.5x NA NA Specializes in high-quality, full-service medical
(dba Heartland) Services, Inc. transcription services. The company interfaces with
various health information systems and software.
8

9. Signal Hill
Source: Signal Hill
Date Enterprise
Announced Seller Buyer Value ($M) Revenue EBIT EBITDA Target Description
14-Sep-10 The Broadlane MedAssets, Inc. $850.0 5.1x NA 17.0x Provider of supply chain management, strategic sourcing
Group of supplies and services, capital equipment lifecycle
management, medical device or PPI cost management,
centralized procurement, clinical and lean process
consulting, and clinical workforce optimization.
30-Aug-10 A.D.A.M., Inc. Ebix, Inc. $67.0 2.4x 16.8x 10.1x Provider of consumer health information and benefits
technology solutions to healthcare organizations,
benefits brokers, employers, consumers, and
educational institutions.
26-Aug-10 Tela Sourcing, The TriZetto - NA NA NA Tela offers a wide range of solutions for BPO and
Inc Group, Inc. software application development with knowledge of
the healthcare, managed care, insurance markets and
operations management.
19-Aug-10 Akimeka LLC VSE $44.0 1.2x 6.8x NA Develops advanced IT solutions for government
Corporation customers. By blending top technical talent,
specialized domain knowledge, and customer
service, Akimeka delivers high-impact solutions for
high-priority challenges.
28-Jul-10 Pulse Systems, Cegedim SA $58.0 3.6x NA NA US healthcare software provider. Pulse offers EHR,
Inc. Practice Management, ePrescribing, and Revenue
Cycle Management (Billing and Collection Services)
used nationwide in 35 medical specialties and
subspecialties.
09-Jun-10 Eclipsys Allscripts $1,205.0 2.3x 59.6x 17.3x Provider of advanced integrated clinical, revenue
cycle and performance management software, clinical
content and professional services.
16-Apr-10 Phase Forward Oracle Corp. $575.9 2.7x 42.7x 18.4x Provider of integrated data management solutions for
clinical trials and drug safety. Specifically, its SaaS-
based Integrated Clinical Research Suite manages
clinical development and safety processes from Phase
1 clinical trials through regulatory submission and post-
approval monitoring.
05-Mar-10 AMICAS, Inc. Merge $240.1 3.3x NM 114.7x Offers a suite of image and information management
Healthcare solutions – from radiology PACS to cardiology PACS,
Incorporated from radiology information systems to cardiovascular
information systems, from revenue cycle management
solutions to enterprise content management tools
designed to power the imaging component of the
electronic medical record (EMR).
02-Mar-10 Cerrus Ltd Advanced $0.6 0.6x NA NA Cerrus' principal product is Saturn, a community
Computer care and support management solution, which
Software Plc manages the delivery of care, resource management
and organizational financial requirements for over 60
community health & social care providers.
02-Mar-10 Concuity The Advisory $34.5 6.9x NA NA Provider of revenue cycle management software and
Board Company services specializing in contract profitability, contract
compliance, denial management, and revenue process
and lifecycle improvement.
22-Feb-10 UltraGenda BV iSOFT Group $14.4 3.0x NA NA Provides an Enterprise-Wide Multi-Resource
Limited Scheduling software solution that enables healthcare
organizations to schedule and manage appointments
and resources to improve efficiencies within multiple
operational provider facilities
01-Feb-10 Global Med Haemonetics $62.6 2.0x 36.8x 20.2x Healthcare information technology company which
Technologies, Corporation markets a breadth of software solutions and services
Inc. that span the blood supply continuum, from blood
collection to the hospital transfusion center to the
patient care environment.
9

10. Healthcare IT 2011
References:
1. RNCOS
2. Ibid
3. PricewaterhouseCoopers’ Health Research Institute
4. American College of Surgeons
5. Ibid
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10

11. September 2011 September 2011 September 2011 August 2011 $97.5 Million August 2010
Mid-Atlantic Skilled
Nursing Group (“Sellers”)
a company has been acquired by has been acquired by has been acquired by has been acquired in a sale-
leaseback transaction by
has been acquired by
July 2011 July 2011 June 2011 May 2011 May 2011
Series B Private Placement has been acquired by has been acquired by $15,120,000 has been acquired by
Follow-On Offering
March 2011 February 2011 January 2011 October 2010 October 2010
has been acquired by has been acquired by has been acquired by has been acquired by has been acquired by
a subdivision of
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