Foundation Healthcare Valuation Multiples

HCA Healthcare is a Nashville-based healthcare provider organization operating the largest collection of acute-care hospitals in the United States. As of December 2025, the firm owned and operated 190 hospitals and over 2,500 outpatient facillities across 19 states and a small foothold in the United Kingdom.

Alcon is one of the leading visioncare companies in the world. Following nine years as a Novartis subsidiary, it was spun off as a public company in April 2019. Alcon operates in two segments: visioncare and surgical. Visioncare comprises contact lenses, lenscare solutions, and a suite of ocular health products. With brands like Dailies, Total1, and Air Optix, Alcon controls about one fourth of the US contact lens market. Surgical comprises intraocular lenses, ophthalmic surgical equipment, and consumables used during surgeries. Its main products include Centurion, a phacoemulsification device used during cataract surgeries, and a portfolio of IOLs including PanOptix and Vivity. Alcon has one of the largest installed bases of eye surgical equipment in the world.

Fresenius is a healthcare holding company based in Germany. The company owns a minority stake in dialysis service provider and equipment manufacturer Fresenius Medical Care. The Kabi segment manufactures intravenous drugs, nutrition products, infusion and transfusion therapies, and related pumps. The Helios segment operates private hospitals primarily in Germany and Spain.

Tenet Healthcare is a Dallas-based healthcare services organization. It operates acute and specialty hospitals (50 as of December 2025) and hundreds of ambulatory surgery centers and other outpatient facilities across the US, primarily in the South. Through its Conifer segment, Tenet also provides revenue cycle management solutions.

Dr Sulaiman Al Habib Medical Services Group provides private health and ancillary services in the Kingdom and the region through the establishment, management, and operation of hospitals, medical complexes, day surgery centers, pharmaceutical facilities, and other ancillary areas, including home health care, specialized laboratories, technology and information systems, facility maintenance, tele-medicine, revenue cycle management, medical equipment maintenance, and real estate activity. The company reports in three segments: Hospitals and Healthcare Facilities, Pharmacies, and HMG Solutions and Others. The majority of revenue comes from the Hospitals and Healthcare Facilities segment.

IHH Healthcare Bhd operates a network of healthcare clinics, hospitals, and postoperative rehabilitation centers. It also provides ancillary services, which include diagnostic laboratories, imaging centers, ambulatory care, and medical education facilities. The group’s reportable segments include Hospital and healthcare, Labs, PLife REIT, and Others. A majority of its revenue is generated from the Hospital and healthcare segment, which represents income generated from the provision of healthcare services through its hospitals and healthcare clinics across Singapore, Malaysia, India, Greater China, Turkiye and Europe, and Southeast Asia. Geographically, the group derives maximum revenue from Turkiye and Europe.

Aramark is an American food service and facilities services company headquartered in Center City, Philadelphia, Pennsylvania, and listed on the New York Stock Exchange. It runs cafeterias, catering, concessions and facility management under contract for clients in education, healthcare, business, corrections, sports and leisure, including major league sports venues and most of the food served on Amtrak trains. It operates in the United States and Canada and in 14 other countries, including the United Kingdom, Germany, Chile, Ireland and Spain, and earns contract revenue for the services it provides, buying food and supplies from manufacturers and distributors such as Sysco. Aramark reported revenue of US$18.5 billion and net income of US$326 million for its 2025 fiscal year, with 278,390 employees. It was founded in 1936 by Davre and Henry Davidson as Davidson Brothers, a vending business for aviation plant workers in Southern California, became Automatic Retailers of America in 1959 and adopted the Aramark name in 1994. A group led by long-time chief executive Joseph Neubauer with CCMP Capital, Goldman Sachs, Thomas H. Lee Partners and Warburg Pincus took it private in a deal completed in 2007. In 2023 it spun off its uniform business as the listed company Vestis; John Zillmer has been chief executive since October 2019.

Encompass Health Corp provides post-acute healthcare services in the United States through a network of inpatient rehabilitation hospitals. Inpatient rehabilitation contributes the majority of the firm's revenue and provides specialized rehabilitative treatment through a network of inpatient hospitals. These hospitals are concentrated in the eastern half of the United States and Texas.

Apollo Hospitals Enterprise Ltd operates a network of private hospitals in India through primary, secondary, and tertiary care facilities. The firm's tertiary care hospitals provide complex care in a variety of specialties that include cardiology, oncology, neuroscience, orthopedics, radiology, and gastroenterology. Apollo Hospitals also operates primary care and diagnostics clinics as well as telemedicine units and offers consulting, health insurance, education and training, and research services. Its reportable operating segments are; Healthcare Services (represents hospitals and hospitals services); Retail Health and Diagnostics (includes clinics and diagnostics); Digital Health and Pharmacy Distribution; and Others. Maximum revenue is generated from its Healthcare Services segment.

Madison Air Solutions Corp is an HVAC and indoor air-quality technology company. Its segments are Commercial and Residential. It generates the majority of its revenue from the Commercial segment, which includes Commercial businesses that deliver well-engineered, custom, and semi-custom air quality systems to support process control, regulatory compliance, energy efficiency, and productivity in mission-critical environments; and the Residential segment, anchored by trusted brands like AprilAire, Broan-NuTone, Zephyr, and Others. Its geographic areas are the U.S, the Americas, Europe, and Other. The group generates the majority of its revenue from the U.S market.

Rede D'Or São Luiz is a Brazilian hospital and diagnostic-services group founded by physician Jorge Moll in Rio de Janeiro. The company operates general and specialty hospitals, oncology services, diagnostic laboratories and outpatient facilities for privately insured and self-paying patients. At BTG Pactual's 2010 investment announcement, the network comprised thirteen operating hospitals, more than 2,000 beds, three hospitals under construction and forty-six diagnostic units. It also managed two hospitals for third parties at that time. Rede D'Or expanded through new facilities and acquisitions across major Brazilian metropolitan areas. The company later became publicly listed in Brazil and continues to earn revenue primarily from hospital treatment, clinical procedures, diagnostics and related healthcare services.

Aier Eye Hospital Group Co Ltd provides international ophthalmic technology and management services in China. The company offers services in myopia surgery, cataract surgery, pediatric eye plastic surgery, myopia prevention, and control to patients. The group also enables high-standard medical care.

Rentokil Initial is a British pest-control and hygiene services group based in southern England, listed on the London Stock Exchange (RTO) and the New York Stock Exchange and a member of the FTSE 100. It was founded in 1925 by Harold Maxwell-Lefroy as a pest-control company and grew through acquisitions, including BET plc in 1996, which added laundry and washroom services under the Initial brand. The group reported revenue of £6,908 million in 2025 and employs about 58,000 people, with operations across Europe, Australasia, Southeast Asia, the Caribbean, South Africa, North America and India. Its largest transaction was the acquisition of Terminix Global Holdings, announced in December 2021 at $6.7 billion and completed on 12 October 2022, which made North America its biggest market and created a business with about 4.9 million customers. Integration of Terminix has taken longer than first planned and is now expected to finish in 2026.

DaVita is the largest provider of dialysis services in the United States, boasting market share of about 35% when measured by clinics. The firm operates over 3,000 facilities worldwide, mostly in the US, and treats about 280,000 patients globally each year. Government payers dominate US dialysis reimbursement. DaVita receives about two thirds of US sales at government (primarily Medicare) reimbursement rates, with the remainder coming from commercial insurers. While commercial insurers represent only about 10% of US patients treated, they represent nearly all of the profits generated by DaVita in the US dialysis business.

Universal Health Services Inc owns and operates acute care hospitals, behavioral health centers, surgical hospitals, ambulatory surgery centers, and radiation oncology centers. The firm operates in two segments: Acute Care Hospital Services and Behavioral Health Care Services. The company generates the majority of its revenue from the Acute Care Hospital Services segment.

Sodexo is one of the largest food service companies globally, operating in 45 countries with annual sales exceeding EUR 20 billion. Sodexo's model rests on operating on-premises catering facilities, rather than centralized industrial kitchens. Food services remain the largest business segment, contributing 66% of revenue in 2024. Sodexo has its own group purchasing organization, or GPO, Entegra, with annual purchasing of over EUR 37 billion. The company spun off its benefits and service business, Pluxee, and now focuses on food services and its second business, facilities-management services.

Bangkok Dusit Medical Services PCL operates a network of hospitals throughout Thailand under the Bangkok Hospital, Phyathai Hospital, Samitivej Hospital, Paolo Hospital, BNH Hospital, and Royal International Hospital brands. The company has two business segments namely, hospital operations and other businesses that support hospital business such as medical laboratories, production and distribution of pharmaceutical products/medical equipment/saline, pharmacies, assets management for healthcare business, accounting services, technology and information services, training business and insurance broker. The company's hospital operations generate the vast majority of its revenue.

Max Healthcare Institute Ltd is a health care service provider. The company's facilities include third-party healthcare providers with whom the company has entered long-term service contracts for providing clinical, radiology, and pathology services. Its hospitals provide the full range of services through its Outpatient, Day Care, Emergency Room, and In-Patient departments to accommodate medical specialties such as orthopedics, internal medicine, general surgery, cardiac sciences, oncology, neurosciences, and obstetrics, as well as diagnostics. The group derives revenue from India.

Ramsay Health Care is one of the largest private healthcare providers in the world, with roughly 600 facilities across 10 countries. The key markets in which it operates are Australia, France, the UK, and Sweden. It is the largest private hospital group in each of these markets except for the UK. Ramsay Sante, which operates the European regions other than the UK, is a 53%-owned subsidiary of Ramsay Health Care. The company typically earns about 60% of consolidated earnings in Australia and 30% in France. Ramsay Health Care undertakes both private and publicly funded healthcare.

Manipal Health Enterprises Ltd is engaged in the business of running/managing hospitals and providing healthcare services. The company operates through various Hospitals/clinics providing Healthcare services and diagnostic centres in India. It offers clinical services across several specialties, with a focus on tertiary and quaternary care, particularly in cardiac sciences, oncology, neurosciences, gastro sciences, orthopedics, and renal sciences. It has a single business segment, namely engaged in the business of healthcare services. The company generates revenue by providing inpatient care at its hospitals.

Odontoprev SA is engaged in providing private dental care plans. The firm operates in three segments which include Corporate, Small And Medium-Sized Enterprises, Individual, and other.

PureHealth is an Abu Dhabi-listed healthcare group that operates hospitals, diagnostics, insurance, procurement and related health services. Its platform includes hospital networks, laboratory and screening operations, a health insurer and medical-supply businesses serving patients, employers and government programs. Revenue comes from clinical services, testing, insurance premiums, procurement and the sale or distribution of medical products. The group was assembled through several combinations of healthcare assets and later listed on the Abu Dhabi Securities Exchange. ADQ first obtained a 27% interest by contributing Rafed and Union71 and cash, then increased its interest by contributing SEHA, Daman and The Life Corner. Those negotiated asset-for-equity transactions are separate from the later public offering and are treated as direct strategic investments.

PACS Group Inc is a post-acute healthcare company mainly focused on delivering high-quality skilled nursing care through a portfolio of independently operated facilities Its is a nursing providers in the United States based on number of facilities, with over 200 post-acute care facilities across nine states serving over 20,000 patients daily. It also provide senior care, assisted living, and independent living options in some of communities.

PT Sejahteraraya Anugrahjaya Tbk operates hospitals and offers health care services. It operates and offers medical centers, which include neuroscience, Uro-nephrology, obstetrics and gynecology, cardiovascular, orthopedic, pediatric, oncology, immunology, pulmonology, and internal medicine. The company's business segments are Inpatient, and outpatients for patients, of which prime revenue is derived from the Inpatient segment. Group is divided into four geographical areas: namely DKI Jakarta, Banten, West Java, and East Java.

ISS AS is a provider of workplace and facility service solutions with a focus on cleaning, property, catering, support, security, and facility management. It has four segments: Financial services, Professional services, Technology, and Life sciences. Its core services offered to customers consist of cleaning, food, technical, and workplace services. Revenue is mainly generated in European end markets, with the majority earned in the United Kingdom.

Aster DM Quality Care is an Indian hospital group listed on the Indian stock exchanges, formed by the merger of Aster DM Healthcare and Quality Care India Limited, and it began operating as one organisation on 1 July 2026. The group unites four healthcare brands, Aster DM, CARE Hospitals, Evercare and KIMSHEALTH, and earns its revenue from patient services delivered in its own hospitals and clinics. Before the merger was completed the combined business was described as comprising 38 hospitals and more than 10,150 beds, with a strong presence across south and central India, and it aims to rank among the three largest hospital chains in the country by revenue and beds. Dr Azad Moopen, whose family manages the Aster business, continues as Executive Chairman, and Varun Khanna, formerly group managing director of Quality Care, serves as Managing Director and Group CEO. Blackstone is a significant shareholder alongside the Aster promoters and public investors. In August 2026 the group acquired a 14.21% stake in Bangladesh-based STS Holdings through a Mauritius subsidiary.

Fortis Healthcare Ltd provides integrated healthcare delivery services in India. The company manages healthcare centers including hospitals, diagnostics, and day care specialty facilities. The company's key specialty in its hospital business is cardiac sciences. It is predominantly engaged in the business of healthcare services which is the only reportable segment. The company's key hospitals include Fortis Escorts Heart Institute in Dehli, Fortis Mulund in Mumbai, and Fortis Hospital in Bengaluru. The majority of the company's revenue is derived from India.

Brookfield Business Partners LP is a business services and industrials company. It focused on operating businesses that are either low-cost producers and benefit from high barriers to entry. The company's operating segment includes Business services; Infrastructure services; Industrials and Corporate and other. It generates maximum revenue from the Business Services segment. Geographically operates in USA, Europe, Australia, Brazil, Canada, UK, Mexico and Other, majority of revenue is from UK.

Sunway Healthcare Holdings Bhd is an investment holding company. Through its subsidiaries, it is principally involved in the (i) operation of medical centres; (ii) provision of a wide range of facilities and services for persons in need of senior living care and assistance; (iii) provision of ambulatory care services; and (iv) operation of TCM centres. The company operates two segments: Hospital services, which include medical centre operations and consultation services, and Others, which include investment holding, financial services, senior living care, TCM centres, nursing and ambulatory care, training, property leasing, and related activities. The majority of revenue is generated from the Hospital services segment. Geographically, the maximum revenue is generated from Malaysia.

Elis SA provides rental-maintenance and circular service solutions to customers across the hospitality, healthcare, industrial, trade and services sectors. Its offerings include flat linen, workwear, washroom hygiene equipment, floor protection, cleanroom garments, pest-control services and other workplace well-being solutions. The company operates across Europe, Latin America and Asia.

RadNet Inc is a national provider of diagnostic imaging services that operates in two business segments: Imaging Center segment and Digital Health segment. The Imaging Center segment provides physicians with imaging capabilities to facilitate the diagnosis and treatment of diseases and disorders. Services include magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), nuclear medicine, mammography, ultrasound, diagnostic radiology (X-ray), and fluoroscopy. The Digital Health segment develops and deploys clinical applications to enhance the interpretation of medical images and improve patient outcomes with an emphasis on brain, breast, prostate, and pulmonary diagnostics.

HD Hyundai Marine Solution is a South Korean ship and engine aftermarket services company that was established in 2016 by integrating the vessel service organisation of HD Hyundai Heavy Industries, and was formerly named Hyundai Global Service. It provides maintenance, repair and management services for ships and for engines installed on them, including warranty agency work for vessels built by the HD Hyundai group. Its business lines also include marine fuel bunkering, eco-friendly conversion and retrofit of vessels, and software-defined vessel solutions. Its customers are shipowners and ship managers worldwide, and it is part of the HD Hyundai group. The company is listed on the Korea Exchange, where it went public in 2024, and it earns revenue mainly from services and parts.

Concentra Group Holdings Parent Inc is a provider of occupational health services in the United States. The business is organized into three operating segments: occupational health centers, onsite health clinics, and other businesses.

LifeStance Health Group Inc is a mental healthcare company that operates as a provider of outpatient mental health services, spanning psychiatric evaluations and treatment, psychological and neuropsychological testing, and individual, family and group therapy. The group y has a single operating and reportable segment of mental health services.

Option Care Health Inc. is the nation's largest independent provider of home and alternate site infusion services, headquartered in Moline, Illinois. The company serves more than 308,000 patients annually through over 197 locations across the United States, providing infusion therapy for a broad spectrum of acute and chronic conditions including IV antibiotics, nutrition support, immunoglobulin therapy, neurological disorders, oncology therapies and bleeding disorders. Option Care Health works with pharmaceutical manufacturers, insurance providers and healthcare systems to deliver seamless clinical and administrative support, combining expert clinicians with customized patient care pathways. The company generated $5.649 billion in revenue in fiscal 2025 and employs over 4,500 clinicians providing high-quality, cost-effective infusion therapy solutions.

Bumrungrad Hospital PCL operates a private hospital business in Bangkok. It is a healthcare provider in Thailand providing complete healthcare services for both outpatients and inpatients. The company is the owner and operator of multiple healthcare-related entities. The company has only one main reportable operating segment, which is the hospital and health care center business, and the geographical area of its operations is Thailand.

UniFirst Corp provides workplace uniforms and protective clothing in North America. Its products and services include designing, manufacturing, personalizing, renting, cleaning, delivering, and selling uniforms, protective clothing, industrial wiping and cleaning products, floor mats, facility service products, restroom and cleaning supplies, first aid cabinet services, safety supplies, and safety training. Its segments are Uniform & Facility Service Solutions, which generates maximum revenue, First Aid & Safety Solutions, and Other. The Uniform & Facility Service Solutions segment designs, manufactures, purchases, rents, cleans, delivers, and sells uniforms, protective clothing, and non-garment items in the U.S. and Canada.

Alliance Laundry Holdings Inc is designer and manufacturer of commercial laundry systems, serving diverse international markets. The company offers premium, durable laundry equipment under brands like Speed Queen, UniMac, Huebsch, Primus, IPSO, and others. It serves commercial laundry needs across healthcare, hotels, laundromats, and residential markets.

Medicover AB is an international healthcare and diagnostic services, provider. It offers a broad spectrum of healthcare services via an extensive network of ambulatory clinics, hospitals, specialty-care facilities, and laboratories. The company offers its services through two segments; Diagnostic Services offer a broad range of laboratory testing in all clinical pathology areas in Germany, Romania, Poland, and Ukraine; and Healthcare Services offer high-quality care based on an Integrated Healthcare Model and Fee-For-Service in Poland, India, and Romania. It generates maximum revenue from the Healthcare Services segment. Geographically, it derives a majority of its revenue from Poland and also has a presence in Romania; Germany; Ukraine; India, and Other Countries.

Narayana Hrudayalaya Ltd is an India-based medical and healthcare service provider. The company is engaged in the business of running and operating hospitals, clinics, health centers, nursing homes, and other related activities. The Company’s sole operating segment is Medical and Healthcare Related Services. It also provides surgery services such as Cardiac Surgery, nephrology, urology, neurology, neurosurgery, endocrinology, orthopaedics, internal medicine, obstetrics, gynaecology, paediatrics, neonatology, gastroenterology, and oncology. It has business operations in India and the Rest of the world, of which the maximum revenue is generated from the business operations in India.

Wuchan Zhongda Group Co Ltd is engaged in industrial investment, equity investment, asset management, investment management, management consulting, information consulting services. It is also engaged in car sales and leasing, e-commerce technology services, used car transactions and services.

Global Health Ltd operates as a private multi-specialty tertiary care provider operating in the North and East regions of India, with key specialties of cardiology and cardiac science, neurosciences, oncology, digestive and hepatobiliary sciences, orthopedics, liver transplant, and kidney and urology. Under the Medanta brand, it has a network of hospitals in operation (Gurugram, Indore, Ranchi, and Lucknow), a hospital that is under construction with an operational outpatient facility (Patna), and a hospital (Noida) planned for development. The Group operates Healthcare services as a single business segment in India, constituting a single geographical segment.

MITIE Group PLC is a U.K.-based company. The company's reportable segments include Technical services, Business services, Central Government & Defence, Communities, and Corporate Centre. The company generates the majority of its revenue from the technical services and business services segments. Geographically, the company generates a majority of its revenue from the United Kingdom.

Krishna Institute of Medical Sciences Ltd is a healthcare group in Secunderabad and Telangana. It offers a comprehensive range of healthcare services, including oncology, cardiac sciences, neurosciences, gastric sciences, orthopedics, renal sciences, organ transplantation, mother and child care, and many more. The firm generates key revenue from Hospital services and Pharmacy.

ABM Industries Inc is a provider of integrated facility solutions. It offers its solutions through five segments: Business and Industry, Manufacturing and Distribution, Education, Aviation and Technical solutions. The company derives the majority of its revenue from the business and industry segment, which encompasses janitorial, facilities engineering, and parking services for commercial real estate properties and sports and entertainment venues, hospitals, as well as vehicle maintenance and other services to rental car providers. The company mainly operates in the United States of America.

Inventurus Knowledge Solutions Ltd is a technology enabled healthcare solutions provider, serving the U.S healthcare market. The group offer a comprehensive care enablement platform that supports healthcare enterprises across outpatient and inpatient care settings. It is operates in in Care Enablement, empowering healthcare organizations to deliver high-quality care efficiently and sustainably through an integrated platform that combines technology and deep human expertise. The Company operates in one reportable segment which is Healthcare. Its solutions are Revenue Cycle Management, Clinical Support, and Value-Based Care.

Surgery Partners Inc is a healthcare services company with an integrated outpatient delivery model focused on providing quality, cost-effective solutions for surgical and related ancillary care in support of both patients and physicians. It has one reportable segment: Surgical Facilities which includes the operation of ASCs, surgical hospitals, anesthesia services, and multi-specialty physician practices, which earns revenues from contracts with patients in which the performance obligations are to provide health care services.

KPJ Healthcare Bhd is a healthcare services firm in the Asia-Pacific region. KPJ operates in the Malaysian private healthcare industry and generates almost all its revenue in Malaysia. Its main healthcare business includes hospital operations, new hospital developments, clinical operations, ambulatory care, ancillary services, diagnostic services, and senior and assisted living care. KPJ also renders healthcare solutions and treatments in Indonesia, Thailand, Bangladesh, and Australia.