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- Healthcare Private Equity Buyouts: The Market Reopens, But Not for Everyone
Healthcare Private Equity Buyouts: The Market Reopens, But Not for Everyone
Healthcare private equity entered 2025 with renewed momentum.
Gaston Brizuela Bosio
September 07, 2026
After two years constrained by higher financing costs, limited exits, and slower fundraising, dealmaking accelerated sharply, bringing healthcare buyout activity back toward—and by some measures beyond—the highs of 2021.
Global healthcare PE deal value reached an estimated $191 billion in 2025, up from $126 billion in 2024 and more than triple the 2023 level. At the same time, exit value rebounded to an estimated $156 billion, providing much-needed liquidity after several difficult years.
But this is not simply a return to the 2021 playbook.
The recovery is increasingly concentrated around larger transactions, sponsor-to-sponsor exits, and experienced healthcare managers. While capital is moving again, fundraising remains selective and emerging managers are capturing a shrinking share of healthcare specialist funds.
For investors, this points to a new phase of the healthcare PE cycle: one where scale, specialization, and proven execution increasingly determine who can raise, deploy, and recycle capital.
Healthcare Buyouts Return to Scale
Healthcare private equity dealmaking accelerated substantially in 2025. Estimated deal value reached a record $191 billion, representing a 52% increase from 2024 and more than three times the $61 billion recorded at the market’s 2023 trough.
Deal count tells a more nuanced story. Approximately 445 buyouts were estimated for 2025, up from 403 in 2024 but still below the 515 transactions recorded in 2021.
The divergence between value and volume suggests that the recovery is being disproportionately driven by larger transactions rather than simply more transactions. Bain reports that North America recorded 26 healthcare deals exceeding $1 billion through November 2025, compared with 14 during all of 2024.
Large-cap healthcare PE, in other words, has reopened.
Key Takeaways
Record Capital Deployment: Healthcare PE deal value increased from $61B in 2023 to $126B in 2024 and $191B in 2025E, representing a dramatic recovery from the post-2021 slowdown.
Volume Recovery Is More Moderate: Deal count increased to 445, approximately 10% above 2024 but still 14% below 2021's peak.
Average Deal Size Is Moving Higher: Deal value has recovered much faster than transaction count, signaling greater concentration in large-cap transactions.
Megadeals Are Back: North America recorded 26 deals above $1B through November 2025, nearly twice the number completed during all of 2024.
Sector Implication: Sponsors appear increasingly willing to underwrite scaled healthcare platforms after two years of greater financing and valuation uncertainty.
The Exit Market Finally Reopens
Capital deployment is only half of the PE equation. After several years of limited liquidity, healthcare sponsors also began finding buyers for mature portfolio companies again.
Healthcare PE exit value is estimated to have reached $156 billion in 2025, nearly tripling from $54 billion in 2024 and approaching the $179 billion record set in 2021. Exit count simultaneously increased from 147 to approximately 221 transactions.
The composition of those exits, however, is particularly important.
Sponsor-to-sponsor transactions accounted for an estimated 76% of healthcare PE exit value in 2025, up from 54% in 2024 and just 23% in 2023. Bain estimates that sponsor-to-sponsor activity exceeded 150 transactions and $110 billion in value.
Rather than waiting exclusively for strategic acquirers or IPO markets, PE firms are increasingly providing liquidity to each other.
Key Takeaways
Liquidity Is Returning: Healthcare PE exit value increased from $54B to $156B in one year, while exit count rose approximately 50%.
Large Exits Are Driving the Recovery: More than 40 exits above $1B were recorded in 2025, versus 16 in 2024.
Sponsor-to-Sponsor Dominates: Sponsor transactions represented approximately 76% of total exit value, a record share in the period analyzed.
The PE Ecosystem Is Recycling Assets: Strong secondary buyout activity is helping sponsors monetize older investments without depending exclusively on strategic M&A or IPOs.
Fundraising Implication: Higher distributions can ultimately help restore LP liquidity and create capacity for new fund commitments—an important step toward normalizing the PE capital cycle.
Healthcare Fundraising Remains Below Its Peak
Improving deal and exit markets have yet to translate into a broad fundraising recovery.
Healthcare specialist PE managers raised $18.3 billion across 22 funds in 2025, according to PitchBook. That compares with $19.1 billion across 41 funds in 2024 and the recent peak of $26.2 billion across 48 funds in 2023.
The decline in fund count is particularly notable. Capital raised declined approximately 30% from its 2023 peak, but the number of funds fell by more than half.
That suggests healthcare has not lost its appeal as an asset class. Instead, fewer managers are capturing larger pools of capital.
This mirrors a broader PE fundraising environment characterized by slower distributions and increasing LP selectivity. S&P Global reported that overall PE and VC fundraising declined 11% in 2025, while the ten largest funds captured more than one-third of total capital raised.
Key Takeaways
Fundraising Has Normalized: Healthcare specialist PE fundraising declined from its $26.2B 2023 peak to $18.3B in 2025.
Fund Count Has Fallen Faster: Only 22 healthcare specialist funds were raised in 2025, versus 48 in 2023 and 41 in 2024.
Capital Is Becoming More Concentrated: The relatively smaller decline in dollars versus fund count implies greater capital raised per successful fund.
LP Selectivity Is Increasing: Investors appear willing to maintain healthcare exposure while concentrating commitments among fewer managers.
Deployment and Fundraising Are Diverging: Healthcare deal value reached record levels precisely as specialist fund formation declined—evidence that established pools of capital are doing more of the work.
Experience Becomes a Competitive Advantage
The concentration becomes clearer when healthcare fundraising is broken down by manager experience.
In 2015, experienced firms represented only around one-third of healthcare specialist PE funds. Emerging managers accounted for the majority of fund formation.
A decade later, that relationship has almost reversed.
By 2025, experienced managers represented approximately three-quarters of healthcare specialist PE fund count, extending a structural shift that accelerated after 2021.
This matters because fundraising scale influences the rest of the buyout ecosystem. Managers capable of raising larger funds can pursue larger platforms, finance add-on strategies, hold assets through difficult exit environments, and participate in the sponsor-to-sponsor transactions increasingly driving healthcare liquidity.
The competitive advantage in healthcare PE is therefore moving beyond simply finding attractive assets. Access to capital itself is becoming a differentiator.
Key Takeaways
Experienced Managers Now Dominate: Their share of healthcare specialist funds increased from roughly 33% in 2015 to ~77% in 2025.
The Shift Accelerated Post-2021: Experienced managers have represented the majority of healthcare specialist fund formation in every year since 2022.
Emerging Managers Face a Tougher Market: Limited LP liquidity and greater manager scrutiny are raising the hurdle for newer firms.
Scale Creates Strategic Flexibility: Larger, established managers are better positioned to execute large-cap buyouts, fund follow-on acquisitions, and navigate longer holding periods.
Healthcare Expertise Is Becoming Institutionalized: As the asset class matures, LPs increasingly appear to favor managers with established sector expertise and realized track records.
Investor Implications: A More Selective Healthcare PE Cycle
The healthcare buyout market has clearly reopened. Deal value is at record levels, exits have accelerated, and large transactions are returning. Structural healthcare fundamentals—from aging populations and site-of-care shifts to healthcare technology and continued industry fragmentation—provide sponsors with a broad pipeline of opportunities.
But the recovery is not evenly distributed.
The same market that produced $191 billion of healthcare buyouts in 2025 produced only 22 new specialist PE funds. Sponsor-to-sponsor transactions now account for the majority of exit value, while experienced managers have captured an increasingly dominant share of fund formation.
Bottom Line
Healthcare PE is moving from a period of constrained liquidity into a more concentrated buyout cycle.
The winners will not simply be the investors willing to deploy capital into healthcare. They are increasingly likely to be the sponsors that can raise at scale, source differentiated assets, create institutional-quality platforms, and ultimately deliver an asset another sponsor or strategic buyer is willing to underwrite.
For investors and dealmakers, the question has shifted from “Are healthcare buyouts back?” to “Who is best positioned to capture the next cycle?”