The Buyout Show with Fexingo: Private Equity, Roll-Ups, and Business Acquisitions

Fexingo

Lucas and Luna examine private equity through the lens of actual deals — roll-ups in HVAC, veterinary clinics, and funeral services; buy-and-build strategies; and the mechanics of leveraged buyouts. Each episode dissects a specific transaction, from sourcing to exit, using real numbers, term sheets, and public filings. The show serves founders weighing an offer, analysts building models, and investors tracking the industry. Expect critical discussions on valuation multiples, earnouts, debt covenants, and the cultural friction between PE operators and portfolio-company management. Lucas, a journalist with a decade covering dealmaking, guides the numbers; Luna, an engaged interlocutor, presses on execution risk and founder psychology. Together they ask: What separates a value-destroying roll-up from a platform that compounds for a decade? No hype, no jargon — just the tradecraft of buying and scaling businesses. #PrivateEquity #LBO #RollUp #BuyAndBuild #PE #DueDiligence #Valuation #MergersAndAcquisitions #FamilyBusinessExit #SearchFund #EBITDA #DealSourcing #SMB #BusinessAcquisition #FexingoBusiness #BusinessPodcast #Finance #Podcast Keep every episode free: buymeacoffee.com/fexingo

  1. 2d ago

    How Private Equity Is Buying Up Hearing Aid Practices

    Private equity has been quietly consolidating independent hearing aid practices across the U.S., rolling up a fragmented $8 billion market dominated by aging baby boomers. In this episode, Lucas and Luna examine the strategy behind audiology roll-ups: why PE firms are buying mom-and-pop clinics, how they're leveraging insurance reimbursement changes, and what it means for patient care. We focus on one specific example—Audiology Holdings, LLC, a mid-market platform that acquired 47 independent practices between 2020 and 2025. We break down the typical deal structure, the multiples paid (around 6-8x EBITDA), and the operational playbook. Lucas explains the revenue uplift from centralizing billing and negotiating better rates with manufacturers like Sonova and Demant. Luna asks whether consolidation actually improves patient outcomes or just pads margins. We also touch on the regulatory landscape, including FDA over-the-counter hearing aid rules that took effect in 2022 and how they've changed competition. By the end, you'll understand why your local hearing aid clinic might soon be owned by a PE-backed roll-up—and whether that's good or bad for your ears. #PrivateEquity #HearingAids #AudiologyRollUp #BusinessAcquisitions #HealthcareInvesting #BabyBoomers #AudiologyHoldings #Sonova #Demant #OTC #FexingoBusiness #BusinessPodcast #TheBuyoutShow #RollUps #EBITDA #InsuranceReimbursement #FragmentedIndustry #PatientCare Keep every episode free: buymeacoffee.com/fexingo

    8 min
  2. 2d ago

    How Private Equity Is Consolidating the Pharmacy Benefit Manager Industry

    Episode 32 of The Buyout Show dives into one of the most opaque corners of American healthcare: pharmacy benefit managers, or PBMs. Lucas and Luna unpack the recent roll-up of mid-tier PBMs by private equity firms, focusing on the 2025 acquisition of EmpiRx Health by a consortium led by New Mountain Capital. They walk through how PBMs sit between insurers, drug manufacturers, and patients, and why PE sees massive margin potential in aggregating these middlemen. With the three largest PBMs (Caremark, Express Scripts, OptumRx) controlling nearly 80% of the market, the playbook has shifted to buying regional players and consolidating claims-processing technology. Lucas cites data showing that the average PBM margin on a generic prescription is roughly $1.20, while branded margins can exceed 15% — creating a lucrative spread for firms that can scale procurement. They also discuss regulatory headwinds, including the FTC's ongoing probe into PBM rebate practices, and how PE-owned PBMs are structuring contracts to avoid disclosure. The episode closes with a question: if these roll-ups continue, will the savings ever reach the patient? #PrivateEquity #PharmacyBenefitManagers #PBMConsolidation #HealthcareRollUps #NewMountainCapital #EmpiRxHealth #DrugPricing #FTC #GenericDrugs #RebateTraps #Business #Podcast #FexingoBusiness #BusinessPodcast #TheBuyoutShow #MergersAndAcquisitions #HealthcareInvesting #PrescriptionDrugs Keep every episode free: buymeacoffee.com/fexingo

    7 min

About

Lucas and Luna examine private equity through the lens of actual deals — roll-ups in HVAC, veterinary clinics, and funeral services; buy-and-build strategies; and the mechanics of leveraged buyouts. Each episode dissects a specific transaction, from sourcing to exit, using real numbers, term sheets, and public filings. The show serves founders weighing an offer, analysts building models, and investors tracking the industry. Expect critical discussions on valuation multiples, earnouts, debt covenants, and the cultural friction between PE operators and portfolio-company management. Lucas, a journalist with a decade covering dealmaking, guides the numbers; Luna, an engaged interlocutor, presses on execution risk and founder psychology. Together they ask: What separates a value-destroying roll-up from a platform that compounds for a decade? No hype, no jargon — just the tradecraft of buying and scaling businesses. #PrivateEquity #LBO #RollUp #BuyAndBuild #PE #DueDiligence #Valuation #MergersAndAcquisitions #FamilyBusinessExit #SearchFund #EBITDA #DealSourcing #SMB #BusinessAcquisition #FexingoBusiness #BusinessPodcast #Finance #Podcast Keep every episode free: buymeacoffee.com/fexingo