eHealth Valuation Multiples

Visa is the largest payment processor in the world. In fiscal 2025, it processed almost $17 trillion in total volume. Visa operates in over 200 countries and processes transactions in over 160 currencies. Its systems are capable of processing over 65,000 transactions per second.

Johnson & Johnson is the world's largest and most diverse healthcare firm. It has two divisions: innovative medicine and medtech. These now represent all of the company's sales following the divestment of the consumer business, Kenvue, in 2023. After restructurings in 2023-24, the drug division focuses on three main therapeutic areas: immunology, oncology, and neurology. Geographically, just over half of total revenue is generated in the United States.

Mastercard is the second-largest payment processor in the world, having processed close to $10 trillion in volume during 2024. Mastercard operates in over 200 countries and processes transactions in over 150 currencies.

UnitedHealth Group is one of the largest private health insurers and provides medical benefits to about 51 million members globally, including 1 million outside the US as of December 2024. As a leader in employer-sponsored, self-directed, and government-backed insurance plans, UnitedHealth has obtained massive scale in medical insurance. Along with its insurance assets, UnitedHealth's Optum franchises help create a healthcare services colossus that spans everything from pharmaceutical benefits to providing outpatient care and analytics to both affiliated and third-party customers.

Siemens is a multi-industry company focused on the areas of automation, electrification, mobility, and healthcare. Its top three geographic regions—the United States, Germany, and China—contribute over half of group revenue. Siemens has a 71% investment in separately listed Siemens Healthineers. Recent portfolio activity included the listing of Siemens Energy, spinning out its power and gas and Siemens Gamesa business divisions in 2020.

American Express is a global financial institution, operating in about 130 countries, that provides consumers and businesses charge and credit card payment products. The company also operates a highly profitable merchant payment network. It operates in four segments: US consumer services, US commercial services, international card services, and global merchant and network services. In addition to payment products, the company's commercial business offers expense management tools, consulting services, and business loans.

Thermo Fisher Scientific sells scientific instruments and laboratory equipment, diagnostics consumables, and life science reagents. The firm operates through four segments as of year-end 2024 (revenue figures include some cross-segment revenue): analytical technologies (17% of sales); specialty diagnostic products (11%); life science solutions (23%); and lab products and services, which includes CRO services (the remainder).

Charles Schwab is one of the largest retail-oriented financial-services companies in the US, with $11.9 trillion in client assets across its brokerage, banking, asset management, custody, financial advisory, and wealth-management businesses at the end of 2025. While best known for its retail brokerage offering, Schwab generates the lion’s share of its revenue and profits through its Charles Schwab Bank and asset management segments. The firm is a dominant player in registered investment advisor custody, with over 40% market share, and has recently pushed into wealth management with robo-advisory, direct indexing, and other managed-investment solutions.

Abbott manufactures and markets cardiovascular and diabetes devices, adult and pediatric nutritional products, diagnostic equipment and testing kits, and branded generic drugs. Products include pacemakers, implantable cardioverter defibrillators, neuromodulation devices, coronary stents, catheters, infant formula, nutritional liquids for adults, continuous glucose monitors, and immunoassays and point-of-care diagnostic equipment. Abbott derives roughly 60% of sales outside the United States.

Uber Technologies is a technology provider that matches riders with drivers, hungry people with restaurants and food couriers, and shippers with carriers. The firm's on-demand technology platform is currently utilized by traditional cars as well as autonomous vehicles, but could eventually be used for additional products and services, such as delivery via drones or electronic vehicle take-off and landing (eVTOL) technology. Uber operates in over 70 countries, with over 202 million users who order rides or food at least once a month.

Intuitive develops, produces, and markets a robotic system for assisting minimally invasive surgery. It also provides the instrumentation, disposable accessories, and warranty services for the system. The company has placed more than 10,000 da Vinci systems in hospitals worldwide, with more than 6,000 installations in the US and a growing number in emerging markets.

Booking is the world's largest online travel agency by sales, offering booking and payment services for hotel and alternative accommodation rooms, airlines, rental cars, restaurants, cruises, experiences, and other vacation packages. The company operates several branded travel booking sites, including Booking.com, Agoda, OpenTable, Rentalcars.com, Kayak, and Momondo. Transaction fees for online bookings account for the bulk of revenue and profits.

In 1984, Danaher's founders transformed a real estate organization into an industrial-focused manufacturing company. Then, through a series of mergers, acquisitions, and divestitures, Danaher now focuses primarily on manufacturing scientific instruments and consumables in the life sciences and diagnostic industries after the late 2023 divestiture of its environmental and applied solutions group, Veralto.

S&P Global provides data and benchmarks to capital and commodity market participants. Its ratings business is the largest credit rating agency in the world and S&P's largest segment by profitability. S&P's largest segment by revenue is market intelligence, which provides desktop, data and advisory solutions, enterprise solutions, and credit/risk solutions mostly in the financial-services industry. S&P's other segments include energy (formerly commodity insights, this segment includes Platts and other data), mobility (Carfax), and indexes. S&P plans to spin off mobility in 2026.

Capital One is a diversified financial services holding company headquartered in McLean, Virginia. Originally a spinoff of Signet Financial’s credit card division in 1994, the company is now primarily involved in credit card lending, auto loans, and commercial lending. Following the acquisition of Discover in 2025, the firm also has a modest personal loan business, though credit card lending provides the majority of the bank's revenue.

Stryker designs, manufactures, and markets an array of medical equipment, instruments, consumable supplies, and implantable devices. The product portfolio includes hip and knee replacements, extremities, endoscopy systems, operating room equipment, embolic coils, hospital beds and gurneys, and orthopedic robotics. Stryker remains one of the three largest competitors in reconstructive orthopedic implants and holds the leadership position in operating room equipment. Roughly one-fourth of Stryker's total revenue currently comes from outside the United States.

Prosus is a consumer internet group with listed and unlisted platforms across 100 countries. Around 80% of Prosus’ net asset value is derived from its Tencent holdings, the world’s largest game publisher and operator of WeChat, China’s super app with 1.3 billion users. Prosus has approximately a 23% stake in Tencent. The rest of the group’s businesses and investments are organized into classifieds, food delivery, payments and fintech, and edtech. This includes ownership of iFood, Brazil’s largest food delivery app, and a 25% stake in Swiggy, the second-largest delivery platform in India.In 2019, Prosus was spun out of South Africa-based parent company Naspers Ltd and listed on the Euronext exchange. Naspers holds approximately 75% of Prosus’ shares.

Intuit serves small and midsize businesses with accounting software QuickBooks and online marketing platform Mailchimp. The company also operates retail tax filing tool TurboTax, personal finance platform Credit Karma, and a suite of professional tax offerings for accountants. Founded in the mid-1980s, Intuit enjoys a dominant market share for small-to-midsize business accounting and self-serve tax filing in the US.

Recruit is a holding company for various technology and employment-related businesses. Recruit’s primary business is its HR technology segment, in which it owns two out of three globally scaled employment-related platforms: www.indeed.com, an online marketplace for employment; and www.glassdoor.com, an online review site for employers. Recruit also owns various marketing businesses operating in Japan for life events and lifestyle, a software solutions business for small and medium-size enterprises, or SMEs, in Japan, and various staffing businesses operating throughout the developed world.

One of the largest medical-device companies, Medtronic develops and manufactures therapeutic medical devices for chronic diseases. Its portfolio includes pacemakers, defibrillators, transcatheter heart valves, stents, insulin pumps, spinal fixation devices, neurovascular products, advanced energy, ablation laser therapy, and surgical tools. The company primarily markets its products to healthcare institutions and physicians in the United States, Western Europe, and Japan. Foreign sales account for roughly 50% of the company's total sales.

Based in Chicago, CME Group operates exchanges giving investors, suppliers, and businesses the ability to trade futures and derivatives based on interest rates, equity indexes, foreign currencies, energy, metals, and commodities. The Chicago Mercantile Exchange was founded in 1898 and in 2002 completed its IPO. Since then, CME Group has consolidated parts of the industry by merging with crosstown rival CBOT Holdings in 2007 before acquiring Nymex Holdings in 2008 and NEX in 2018. In addition, the company has a 27% stake in S&P Dow Jones Indices, making the Chicago Mercantile Exchange the exclusive venue to trade and clear S&P futures contracts. Through CME's acquisition of NEX, it also expanded into cash foreign exchange, fixed-income trading, and collateral optimization.

Elevance Health remains one of the leading health insurers in the US, providing medical benefits to 46 million medical members as of June 2025. The company offers employer, individual, and government-sponsored coverage plans. Elevance differs from its peers in its unique position as the largest single provider of Blue Cross Blue Shield branded coverage, operating as the licensee for the Blue Cross Blue Shield Association in 14 states. Through acquisitions, such as the Amerigroup deal in 2012 and MMM in 2021, Elevance's reach expands beyond those states through government-sponsored programs, such as Medicaid and Medicare Advantage plans, too. It is also an emerging player in pharmacy benefit management and other healthcare services.

MercadoLibre runs the largest e-commerce marketplace in Latin America, with about 150 million active users and more than 600 million active listings across 18 countries stitching into its commerce network or fintech solutions when last reported. The company operates a host of complementary businesses to its core online shop, with shipping solutions (Mercado Envios), a payment and financing operation (Mercado Pago and Mercado Credito), advertisements (Mercado Clics), classifieds, and a turnkey e-commerce solution (Mercado Shops) rounding out its arsenal. MercadoLibre generates revenue from final value fees, advertising royalties, payment processing, insertion fees, subscription fees, and interest income from consumer and small-business lending.

Intercontinental Exchange is a vertically integrated operator of financial exchanges and provides ancillary data products. Though the company is probably best known for its ownership of the New York Stock Exchange, which it acquired in 2013, ICE operates a large derivatives exchange, too. The company's largest commodity futures product is the ICE Brent crude futures contract. In addition to the exchanges business, which is about 54% of net revenue, Intercontinental Exchange has used a series of acquisitions to create its mortgage technology business (22% of net revenue) and fixed-income and data-services segment (24% of net revenue).

Airbnb is the world’s largest online alternative accommodation travel agency; it also offers booking services for boutique hotels, experiences, and hotel-like services. Airbnb’s platform offers over 9 million active accommodation listings. Listings from the company’s 5 million-plus hosts are spread over almost every country in the world. In 2025, 42% of revenue was from North America, 39% from Europe, the Middle East, and Africa, 10% from Latin America, and 9% from Asia-Pacific. Transaction fees for online bookings account for all its revenue.

Robinhood Markets Inc is creating a modern financial services platform. It designs its own products and services and delivers them through a single, app-based cloud platform supported by proprietary technology. Its vertically integrated platform has enabled the introduction of new products and services such as cryptocurrency trading, dividend reinvestment, fraud detection, derivatives, fractional shares, recurring investments, and others.

Moody’s, along with S&P Ratings, is a leading provider of credit ratings on fixed-income securities. The ratings segment, Moody’s Investors Service, includes corporates, structured finance, financial institutions, and public finance ratings. MIS represents a majority of the firm’s profit and often (depending on bond issuance levels) a majority of the firm's revenue. The other segment, Moody’s Analytics, consists of decision solutions, research and insights, and data and information.

Marsh McLennan is a professional services firm that provides advice and solutions in the areas of risk, strategy, and human capital. The company operates through two main segments: risk and insurance services and consulting. In risk and insurance services, the firm offers services via Marsh (an insurance broker) and Guy Carpenter (a risk and reinsurance specialist). The consulting division comprises Mercer (a provider of human resource services) and Oliver Wyman (a management and economic consultancy). About half of its revenue is generated outside the US.

Marsh McLennan is a professional services firm that provides advice and solutions in the areas of risk, strategy, and human capital. The company operates through two main segments: risk and insurance services and consulting. In risk and insurance services, the firm offers services via Marsh (an insurance broker) and Guy Carpenter (a risk and reinsurance specialist). The consulting division comprises Mercer (a provider of human resource services) and Oliver Wyman (a management and economic consultancy). About half of its revenue is generated outside the US.

Cigna primarily provides pharmacy benefit management and health insurance services. Its PBM and specialty pharmacy services, which were greatly expanded by its 2018 merger with Express Scripts, are mostly sold to health insurance plans and employers. Its largest PBM contract is with the Department of Defense (current contract through 2029), and it recently won a multiyear deal with top-tier insurer Centene. In health insurance and other benefits, Cigna primarily serves employers through self-funding arrangements, and the company operates mostly in the US with 17 million US and 2 million international medical members covered as of December 2024.

Founded in 2013 within the confines of the San Francisco application renaissance, DoorDash is an online delivery demand aggregator. Consumers can use its app to order food on demand for delivery or in-store pickup from participating merchants. Following the 2022 acquisition of Wolt, the firm also provides this service in Europe and Asia. DoorDash creates a marketplace for merchants to establish an online presence, market their offerings, and meet demand through delivery. The firm provides similar services to non-restaurant businesses, such as grocery, retail, and pet supplies. DoorDash is also rolling out emerging technologies, such as drone delivery, to continually innovate and deliver the best possible service to both supply-side and demand-side participants in its marketplace.

Boston Scientific produces less invasive medical devices that are inserted into the human body through small openings or cuts. It manufactures products for use in angioplasty, blood clot filtration, kidney stone management, cardiac rhythm management, catheter-directed ultrasound imaging, upper gastrointestinal tract diagnostics, interventional oncology, neuromodulation for chronic pain, and treatment of incontinence. The firm markets its devices to healthcare professionals and institutions globally. Foreign sales account for roughly 36% of the firm's total sales.

Aon is a leading global provider of insurance and reinsurance brokerage and human resources solutions. Its operations are tilted toward its brokerage operations. Headquartered in London, Aon has about 50,000 employees and operations in over 120 countries.

Hong Kong Exchanges and Clearing is a vertically integrated securities exchange business offering listing, data, trading, clearing and settlement services across equities, debt and derivatives. HKEx, like Hong Kong itself, functions as a gateway between China and the rest of the world. HKEx serves as a preferred listing venue for Chinese companies outside of China and, through the Connect Scheme, offers two-way trading for a growing group of financial products with the Shanghai Stock Exchange and the Shenzhen Stock Exchange.

Nu Holdings Ltd provides digital banking services. It offers several financial services such as Credit cards, Personal accounts, Investments, Personal Loans, Insurance, Mobile payments, Business Accounts, and Rewards. The company earns the majority of its revenue in Brazil.

Meituan is the largest food delivery platform in China, with a 60%-70% share of the market in 2024, according to Morningstar estimates. In the third quarter of 2024, the firm generated 74% of its revenue from the core local commerce segment, which includes on-demand food delivery and retail, in-store services (such as visiting beauty and entertainment stores after purchasing deals on Meituan), and hotel and travel booking. The remaining 26% of revenue came from the new initiatives segment, such as the community group purchase business Meituan Select and the overseas food delivery business.

London Stock Exchange Group is a fully integrated financial exchange company covering the financial market value chain from primary and secondary markets across multiple asset classes over data, index, and analytics down to clearing and post-trading reporting. With the acquisition of Refinitiv, LSEG generates about two thirds of its revenue from data and analytics including its FTSE Russell and WM/Refinitiv benchmarks as well as data feeds and terminals. The group is also a majority shareholder in Tradeweb, one of the dominant global fixed-income trading venues, as well as LCH, the largest clearinghouse for over-the-counter swaps globally.

Bajaj Finance Ltd is the holding company for various financial services businesses under the Bajaj Group, which operates in India. The company is an NBFC in India offering payments, partnerships, services, and lending solutions to customers. The company's model is focused on the acquisition of customers and offering multiple loans and services on a cross-sell basis to meet their financial service needs. The company provides discretionary spending across consumer electronics, furniture, and digital products in India. The company's strategies and structure are closely aligned with those of commercial banks in India. All of its revenue is generated from India.

Founded in 1927 as a one-person agency, Gallagher's primary business is insurance brokerage, with a focus on serving middle-market companies. The company's risk management segment provides third-party claims adjustment to companies that choose to self-insure. Gallagher has about 56,000 employees and generates about a third of its revenue internationally, primarily in Australia, Canada, New Zealand, and the UK.

Deutsche Boerse is a financial exchange company headquartered in Frankfurt, Germany. The company primarily generates revenue through its Eurex and Clearstream segments. Eurex allows for the trading and clearing of derivatives. Clearstream offers custody and settlement services for domestic and international securities, as well as collateral management services. Other segments include Xetra, which generates revenue through trading and clearing cash equities, STOXX (an index business), and several others.

Founded in 1971, Nasdaq is primarily known for its equity exchange, but in addition to its trading business (about 22.5% of sales), the company sells market and financial data to investors, offers Nasdaq-branded indexes, and lists companies through its capital access segment (42.5%). Nasdaq's newest segment, financial technology, was primarily constructed through the acquisitions of Verafin and Adenza and has expanded the company into capital management, financial crime, and regulatory compliance software (35%) as it seeks to become a diversified technology company.

Carvana Co is an e-commerce platform for buying and selling used cars. The company derives revenue from used vehicle sales, wholesale vehicle sales and other sales and revenues. The other sales and revenues include sales of loans originated and sold in securitization transactions or to financing partners, commissions received on VSCs and sales of GAP waiver coverage. The foundation of the business is retail vehicle unit sales. This drives the majority of the revenue and allows the company to capture additional revenue streams associated with financing, VSCs, auto insurance and GAP waiver coverage, as well as trade-in vehicles.

Spun off from Baxter International in 2000, Edwards Lifesciences designs, manufactures, and markets a range of medical devices and equipment for advanced stages of structural heart disease. It has established itself as a leader across key products, including surgical tissue heart valves, transcatheter aortic valves, and transcatheter mitral and tricuspid valve technologies. The firm derives about 60% of its total sales from outside the US.

Founded in 2012, Coinbase is the leading cryptocurrency exchange platform in the United States. The company intends to be the safe and regulation-compliant point of entry for retail investors and institutions into the cryptocurrency economy. Users can establish an account directly with the firm, instead of using an intermediary, and many choose to allow Coinbase to act as a custodian for their cryptocurrency, giving the company breadth beyond that of a traditional financial exchange. While the company still generates the majority of its revenue from transaction fees charged to its retail customers, Coinbase uses internal investment and acquisitions to expand into adjacent businesses, such as prime brokerage and data analytics.

MSCI has described its mission as enabling investors to build better portfolios for a better world. MSCI's largest and most profitable segment is its index segment, where it provides benchmarking to asset managers and asset owners. MSCI boasts over $18 trillion in benchmarked assets, including over $2.3 trillion in ETF assets linked to MSCI indexes. The MSCI analytics segment provides portfolio management and risk management analytics software to asset managers and asset owners. In its sustainability and climate segment, MSCI provides ESG data to the investment industry. In private assets, MSCI provides real restate reporting, market data, benchmarking, and analytics to investors and real estate managers.

Siemens Healthineers is engaged in therapeutic imaging, radiotherapy, laboratory, and point-of-care diagnostics. The imaging segment (56% of sales in fiscal 2025) includes magnetic resonance imaging, computed tomography, X-ray systems, molecular imaging, and ultrasound. The Varian segment (18% of sales) offers radiotherapy and other oncology solutions. The diagnostics segment (19%) includes in vitro diagnostics and point-of-care diagnostics. The advanced therapies (now part of precision therapy) segment (9%) products are designed to support image-guided minimally invasive treatments in cardiology, interventional radiology, and surgery. The Americas represents 44% of total sales, Europe, Middle East, and Africa 32%, and Asia-Pacific, including China (11%), the remainder.

Founded in 2009, Block provides payment services to merchants, along with related services. The company also launched Cash App, a person-to-person payment network. In 2024, Square's payment volume was almost USD 250 million.

Constellation Software is an acquirer, manager, and developer of vertical market software, or VMS, businesses globally. VMS differentiates from horizontal software in that it provides mission critical solutions within a specific industry for customers in a particular market. Constellation operates through a decentralized model in which each business operates as its own independent entity. Managers of individual businesses are incentivized to optimize their business for returns on invested capital and revenue growth. Excess cash generated by the individual businesses is repatriated to portfolio managers who focus on allocating as much capital as possible on new acquisitions. As of 2025, Constellation consisted of over 1,000 individual businesses and 64,000 employees.