OpEx Awards 21: Americas Small-cap winner – Francisco Partners

Francisco Partners built Landmark Health from scratch to provide in-home care for elderly patients with complex health needs.

In mid-2013, Francisco Partners, which invests in tech and tech-enabled businesses, partnered with an entrepreneurial management team to launch Landmark Health. The goal was to establish a new company that would provide in-home medical care to older adults and deliver on Francisco Partners’ vision to “change the paradigm of healthcare for elderly patients with multiple chronic illnesses”.

Through Landmark, Francisco Partners wanted to shift the incentive for providing care by assuming medical responsibility and financial risk for patients, thereby encouraging clinicians to focus on preventative healthcare measures and reducing avoidable hospital admissions.

To support Landmark’s growth, Francisco Partners invested $36 million into the company, including the initial capital for its launch, and helped the company raise additional capital from strategic investors. Over the course of the private equity firm’s investment, Landmark secured a number of contracts with large health plans in the US. Today, more than 130,000 patients in 17 states can access care from Landmark.

The company has formed numerous strategic partnerships in the healthcare sector. For example, in September 2020, it partnered with Aetna to bring physician-led services into the homes of Aetna’s Individual Medicare Advantage members with chronic health conditions in New York.

The company also operates a custom-built medical technology platform, which includes a mobile electronic medical record, an integrated case management system, home visit scheduling and logistics, as well as clinical analytics and reporting.

In 2020, just seven years after it was founded, Landmark recorded revenue of $1.75 billion and EBITDA of $163 million. Francisco Partners exited the company in early 2021. Its work with Landmark is understood to have generated a 27.2 multiple of money invested and a 75 percent internal rate of return.

“Francisco Partners created an incredible business focused on in-home care”

The judging panel viewed Francisco Partners’ ability to grow Landmark from a start-up to a provider of elderly care as “impressive”, praising it for “creating an industry to serve a great social need, and making a profit in doing so”.

As one judge noted: “It appears Francisco Partners created an incredible business focused on in-home care for those with acute healthcare challenges.”