Healthcare Information Technology - Business Valuation

One of the most challenging aspects of selling acompleted and, even though their customers that
healthcare information technology company iswere contemplating leaving did not immediately
coming up with a business valuation. Sometimesupgrade, they did not defect either. Apparently
the valuations provided by the market (translationthe devil that you know is better than the devil
- a completed transaction) defy all logic. In otheryou don't in the world of healthcare information
industry segments there are some pretty handytechnology.
rules of thumb for valuation metrics. In one3. Another arrow in our valuation driving quiver for
industry it may be 1 X Revenue, in another itour sellers is we restate historical financials using
could be 7.5 X EBITDA.the pricing power of the brand name acquirer. We
Since it is critical to our business to help ourhad one client that was a small healthcare IT
healthcare information technology clients maximizecompany that had developed a fine piece of
their business selling price, I have given thissoftware that compared favorably with a large,
considerable thought. Why are some of thesepublicly traded company's solution. Our product
software company valuations so high? It ishad the same functionality, ease of use, and open
because of the profitability leverage ofsystems platform, but there was one very
technology. A simple example is what isimportant difference. The end-user customer's
Microsoft's incremental cost to produce the nextperception of risk was far greater with the little
copy of Office Professional? It is probably $1.20IT company that could be "out of business
for three CD's and 80 cents for packaging. Let'stomorrow." We were literally able to double the
say the license cost is $400. The gross margin isfinancial performance of our client on paper and
north of 99%. That does not happen inpresent a compelling argument to the big
manufacturing or services or retail or most othercompany buyer that those economics would be
industries.immediately available to him post acquisition. It
One problem in selling a small healthcarecertainly was not GAP Accounting, but it was
technology company is that they do not haveeffective as a tool to drive transaction value.
any of the brand name, distribution, or standards4. Financials are important so we have to
leverage that the big companies possess. So, onacknowledge this aspect of buyer valuation as
their own, they cannot create this profitabilitywell. We generally like to build in a baseline value
leverage. The acquiring company, however, does(before we start adding the strategic value
not want to compensate the small seller for thecomponents) of 2 X contractually recurring
post acquisition results that are directlyrevenue during the current year. So, for example,
attributable to the buyer's market presence. Thisif the company has monthly maintenance
is what we refer to as the valuation gap.contracts of $100,000 times 12 months = $1.2
What we attempt to do is to help the buyermillion X 2 = $2.4 million as a baseline company
justify paying a much higher price than avalue component. Another component we add is
pre-acquisition financial valuation of the targetfor any contracts that extend beyond one year.
company. In other words, we want to getWe take an estimate of the gross margin
strategic value for our seller. Below are theproduced in the firm contract years beyond year
factors that we use in our analysis:one and assign a 5 X multiple to that and discount
1. Cost for the buyer to write the code internallyit to present value.
- Many years ago, Barry Boehm, in his book,Let's use an example where they had 4 years
Software Engineering Economics, developed aremaining on a services contract and the last 3
constructive cost model for projecting theyears were $200,000 per year in revenue with
programming costs for writing computer code. Heapproximately 50% gross margin. We would take
called it the COCOMO model. It was quite detailedthe final tree years of $100,000 annual gross
and complex, but I have boiled it down andmargin and present value it at a 5% discount rate
simplified it for our purposes. We have theresulting in $265,616. This would be added to the
advantage of estimating the "projects"earlier 2 X recurring year 1 revenue from above.
retrospectively because we already know theAgain, this financial analysis is to establish a
number of lines of code comprising our client'sbaseline, before we pile on the strategic value
products. In general terms he projected that itcomponents.
takes 3.6 person months to write one thousand5. We try to assign values for miscellaneous
SLOC (source lines of code). So if you looked at aassets that the seller is providing to the buyer.
senior software engineer at a $70,000 fully loadedDon't overlook the strategic value of Blue Chip
compensation package writing a program withAccounts. Those accounts become a platform for
15,000 SLOC, your calculation is as follows - 15 Xthe buyer's entire product suite being sold post
3.6 = 54 person months X $5,800 per month =acquisition into an "installed account." It is far
$313,200 divided by 15,000 = $20.88/SLOC.easier to sell add-on applications and products into
Before you guys with 1,000,000 million lines ofan existing account than it is to open up that new
code get too excited about your $20.88 millionaccount. These strategic accounts can have huge
business value, there are several caveats.value to a buyer.
Unfortunately the market does not care and will6. Finally, we use a customer acquisition cost
not pay for what it cost you to develop yourmodel to drive value in the eyes of a potential
product. Secondly, this information is designed tobuyer. Let's say that your sales person at 100%
help us understand what it might cost the buyerof Quota earns total salary and commissions of
to develop it internally so that he starts his own$125,000 and sells 5 net new accounts. That
build versus buy analysis. Thirdly, we have towould mean that your base customer acquisition
apply discounts to this analysis if the software iscost per account was $25,000. Add a
three generations old legacy code, for example. In20% company overhead for the 85 accounts, for
that case, it is discounted by 90%. You are noexample, and the company value, using this
longer a technology sale with high profitabilitymethodology would be $2,550,000.
leverage. They are essentially acquiring your7. Our final valuation component is what we call
customer base and the valuation will not be thatthe defensive factor. This is very real in the
exciting.healthcare information technology arena. What is
If, however, your application is a brand newthe value to a large firm of preventing his
application that has legs, start sizing your yacht.competitor from acquiring your technology and
Examples of this might be a click fraud application,improving their competitive position in the
Pay Pal, or Internet Telephony. The second highmarketplace. One of our clients had an outcomes
value platform would be where your softwaredatabase and nurse staffing software algorithm.
technology "leap frogs" a popular legacyThe owner was the recognized expert in this area
application. An example of this is when we sold aand had industry credibility. This was a small add
company that had completely rewritten theiron application to two large industry players'
legacy management platform in Microsoft .Net.integrated hospital applications suite. This module
They leap frogged the dominant player in thatwas viewed as providing a slight features
space that was supporting multiple secondadvantage to the company that could integrate it
generation solutions. Our client became awith their main systems. The selling price for one
compelling strategic acquisition. Fast forward oneof these major software systems to a hospital
year and I hear the acquirer is selling one of thesechain was often more than $50 million. The value
$100,000 systems per week. Now that's leverage!paid for our client was determined, not by the
2. Most acquirers could write the codefinancial performance of our client, but by the
themselves, but we suggest they analyze thecompetitive edge they could provide post
cost of their time to market delay. Believe me,acquisition. Our client did very well on her
with first mover advantage from a competitor or,company sale.
worse, customer defections, there is a very realAfter reading this you may be saying to yourself,
cost of not having your product today. We werecome on, this is a little far fetched. These
able to convince one buyer that they would becomponents do have real value, but that value is
able to justify our seller's entire purchase priceopen to a broad interpretation by the
based on the number of client defections theirmarketplace. We are attempting to assign metrics
acquisition would prevent. As it turned out, theto a very subjective set of components. The
buyer had a huge install base and through multiplebuyers are smart, and experienced in the
prior acquisitions was maintaining six disparateM&A process and quite frankly, they try to
software platforms to deliver essentially the samedeflect these artistic approaches to driving up
functionality.their financial outlay. The best leverage point we
This was very expensive to maintain and theyhave is that those buyers know that we are
passed those costs on to their disgruntled installpresenting the same analysis to their competitors
base. The buyer had been promising upgrades forand they don't know which component or
a few years, but nothing was delivered.components of value that we have presented will
Customers were beginning to sign on with theirresonate with their competition. In the final
major competitor. Our pitch to the buyer was toanalysis, we are just trying to provide the buyers
make this acquisition, demonstrate to your clientsome reasonable explanation for their board of
base that you are really providing an upgrade pathdirectors to justify paying 8 X revenues for an
and give notice of support withdrawal for 4 or 5acquisition.
of the other platforms. The acquisition was