Axios Pro Exclusive Content

InTandem's musculoskeletal care play

Illustration of a spine with the vertebrae made out of dollars.

Illustration: Gabriella Turrisi/Axios

InTandem Capital Partners has acquired OrthoNebraska, a musculoskeletal care provider with 10 locations, with plans to roll up a fragmented industry.

Why it matters: Musculoskeletal care spending is $381 billion annually in the U.S., and will continue to grow as the population ages.

By the numbers: OrthoNebraska is generating nearly $30 million of EBIDTA, up from $11 million last year, sources tell Axios.

  • InTandem paid a multiple of around 12x, implying a valuation above $350 million, per the sources.
  • The firm declined to comment on terms or financials.

Details: Goodwin Procter served as legal counsel for InTandem, and Houlihan Lokey served as the financial adviser.

  • Quadriga Partners served as financial adviser and Koley Jessen as legal counsel for OrthoNebraska.
  • Audax Private Debt participated as a joint lead arranger.

What they're saying: "During our diligence process, it was clear to us that OrthoNebraska had established itself as the brand of choice for orthopedic services in the greater Omaha region," InTandem Capital principal Evan Brower says.

  • "Organically, we are already seeing great traction, having hired six new physicians in the first half of the year with several more joining in the coming months," he says.

What's next: The firm will look to capitalize on the fragmented nature of the MSK industry through strategic add-ons and de-novo unit openings, Brower says.

  • Most providers are independent and are looking for a capital provider to help expand service lines, he explains.
  • The company offers non-operative pain management, physical therapy, hand therapy, orthopedic urgent care, emergency services, imaging and surgical services.
Go deeper