What next for Cano Health?
Firstly, we heard that against a backdrop of inflated valuations from 2020-2022, new clinic acquisitions that were larger and more expensive “did not perform like the rest of the company in terms of EBITDA or revenue”. In recent years Cano has also entered “five or six” new markets in a short period of time which is cash intensive and can take 3-7 years to mature. These, we heard, are among the factors that have caused liquidity challenges that the company announced are no longer sustainable. “This happened to not only Cano but there are a number of companies in this industry that are now suffering through this issue,” our expert said.
“Two things happened, one was expensive acquisitions that maybe didn’t perform or had integration risks, etc, that harmed rather than helped the balance sheet. Then the other challenge is you entered a bunch of markets, you know it’s going to take three, five, maybe seven years to… bring those markets to maturity.” – Former VP at Cano Health
Cano is now looking to shed non-core business lines and assets1https://canohealth.com/news/cano-health-announces-financial-results-for-the-second-quarter-2023/, which the specialist described as small markets outside of Florida that “never got off the ground”. Those assets could be attractive to the right organisation – even if not EBITDA positive – given the investment and membership growth to date, we heard.
On Cano’s potential sale, the expert said they do not envisage another player seeking to buy Cano in its entirety besides Humana. Although its debt profile makes the company on the whole unattractive (USD 1.2bn), certain pieces might make sense for the right strategic buyer, the expert said. “When you look at pieces of Cano, it might be much more attractive to strategics… that are interested in the ACO or MSO business specifically.”
We also heard the provider network for MSO and ACO are “tremendously valuable” as capital-light and potentially high-margin businesses, as doctors are not employed by Cano directly and there are no long-term leases to account for. “To me, assuming Cano is able to get through the bumps in the road here, they’re still going to have, I think, balance sheet issues, in the short and medium term, which is going to hamper the ability to grow. How do you grow if you have limited access to capital, you go to the capital-light model.”
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