Scoop: Linden Capital snaps up RCM specialist Aspirion

Linden Capital Partners has agreed to acquire a majority stake in Aspirion from Aquiline Capital Partners, sources familiar with the matter tell Axios.

• The deal is said to value the Columbus, Georgia-based revenue cycle management specialist between $650 million and $700 million.

Why it matters: Aspirion collects complex claims revenue from payors (not patients) that is otherwise lost, playing a critical role for health systems that are operating with big losses and labor shortages.

Details: Linden's acquisition concludes a Baird-run sale process that we scooped in early May.

• Aquiline, which bought Aspirion in 2018, is set to roll a minority investment, sources say.
• Projected run-rate EBITDA for 2022 is around $35 million-plus, indicating a forward multiple between 18x and 20x.
• Welsh, Carson, Anderson & Stowe-backed Argos Health was the runner-up, while other suitors included Ensemble Health Partners, backed by Warburg Pincus and Berkshire Partners.

State of play: Aspirion plays in a niche pocket of RCM that differs from the R1's and Change Healthcare's of the world: complex claims.

• That involves recovering claims revenue on behalf of hospitals from more challenging sources — motor vehicle accidents, workers’ compensation, the Veterans Affairs, and TRICARE — plus from out-of-state Medicaid, Medicaid eligibility, underpayments and denials.
• Competitors include Revecore, which GrowthCurve Capital recently bought in a $500m-plus deal, and Enablecomp, acquired by WCAS's Argos in December.

The bottom line: The complex claims market is growing organically in the mid-teens to 20%, with Aspirion said to be outpacing that average.

• Along with a vast M&A opportunity, investment into AI and process automation could turbocharge organic growth, sources add.

Linden, Aquiline and Baird declined to comment.