Page 24 - DIY Investor Magazine - Issue 28

ARE THE UNDERLYING INVESTMENT THEMES IN HEALTHCARE ACCELERATING? Change is rarely easy, especially in an industry that is incredibly complicated and yet so vitally important to so many – by James Douglas and Gareth Powell of Polar Capital Global Healthcare Trust plc. The healthcare industry is going through a period of significant structural change as it tries to address the challenges of ever- rising demand in the face of limited resources. Importantly, this structural change is creating new and exciting themes in healthcare, which then generate specific investment opportunities offering growth over the next 5-10 years. While not an exhaustive list, we would highlight the following themes that are becoming ever more visible and possibly accelerating: disrupting the delivery of healthcare services; consolidation; outsourcing; prevention. 2021 has produced tangible evidence that some of the themes mentioned above are already gaining traction. Material changes to the delivery of healthcare are critical given there is an acute need for systems globally to generate greater efficiencies in order to deliver more healthcare to more people for less money. We have seen a number of examples of the industry investing in technologies and services this year that are designed to do precisely that – generate efficiencies. ‘STRUCTURAL CHANGE IS CREATING NEW AND EXCITING THEMES IN HEALTHCARE’ In February, for example, Brookdale Senior Living announced it has agreed to sell 80% of the equity in its hospice, home health and outpatient business to US hospital operator HCA Holdings. This is an interesting investment by HCA Holdings in a business that operates 84 outpatient centres, 57 home health agencies and 22 hospices – all locations that could offer lower- cost settings to deliver care. Along similar lines of delivering care in a lower-cost setting, US health services companies Cigna and UnitedHealth both announced investments that are geared towards generating efficiencies. Cigna announced its intention to acquire MDLive, one of the largest telehealth vendors in the US with a particular expertise in the fields of behavioural care and dermatology, and UnitedHealth is looking to acquire Change Healthcare, a business that uses data analytics to improve clinical decision- making. The healthcare industry is highly fragmented, with the more established and more mature industry participants boasting strong balance sheets and robust cashflows. Those observations lead us to believe consolidation will be an ongoing theme as management teams look to complement internal assets and optimise future growth prospects. ‘CONSOLIDATION WILL BE AN ONGOING THEME AS MANAGEMENT TEAMS LOOK TO COMPLEMENT INTERNAL ASSETS AND OPTIMISE FUTURE GROWTH PROSPECTS’ Indeed, there has already been a number of deals in 2021 in the areas of healthcare services, contract research, medical devices, biotechnology and pharmaceuticals. We expect that trend to continue. Outsourcing is another theme we believe has a durable growth outlook as customers look to retain flexibility, rationalise costs and distance themselves from non-core activities. Outsourcing is another theme we believe has a durable growth outlook as customers look to retain flexibility, rationalise costs and distance themselves from non-core activities. DIY Investor Magazine | Apr 2021 24