Methodology

This tracker reconstructs the US OB-GYN and women’s health MSO PE roll-up cycle for the period January 1, 2024 through June 17, 2026. The reconstruction draws on primary-source filings, sponsor press releases, sell-side advisor white papers, Centers for Medicare and Medicaid Services rulemaking, US Preventive Services Task Force recommendations, Supreme Court opinions, Health Resources and Services Administration workforce projections, Centers for Disease Control birth statistics, and ACOG advocacy briefs. We treat the cycle as bookended by two pivot events: the Dobbs decision of June 24, 2022 (which restructured state-level operating risk) and the One Big Beautiful Bill Act 2.5% MPFS conversion factor support that took effect January 1, 2026 (CMS CY 2026 MPFS Final Rule fact sheet).

Each platform attribution is assigned a confidence grade (HIGH, MEDIUM, LOW, GAP). HIGH means the sponsor, entry date, and platform composition can be triangulated across at least two independent primary sources, typically a sponsor press release plus an SEC filing or advisor announcement. MEDIUM means at least one primary source is confirmed but a secondary corroboration is partial. LOW means we rely on a single sponsor or advisor-side disclosure. GAP indicates a known unknown that the published version of the tracker flags rather than guesses. We do not paraphrase deal sizes that have not been disclosed; absent a stated transaction value, we say so. Where third-party trackers (PitchBook, Tracxn, Mergr) provide partial data we cite them as references and flag confidence accordingly.

Multiples ranges reflect Physician Growth Partners’ Q1 2025 “State of Women’s Health Private Equity” white paper, FOCUS Investment Banking healthcare EBITDA dashboards, Provident Healthcare Partners case work, and observed transaction commentary where the value was disclosed (PGP Q1 2025 report; FOCUS dashboard; Provident). We deliberately do not cite Mertz Taggart for women’s health quarterlies; Mertz Taggart’s published cadence covers behavioral health and home-based care, not women’s health, and citing them would mislead readers (Mertz Taggart Q4 2025 behavioral health report).

Macro Spine: Workforce, Fee Schedule, Screening, and Births

Closest sibling tracker: fertility and IVF MSO is the sister sector to OB-GYN; CCRM rolled into Unified Women’s Healthcare Sept 2023 $775M. See the 2026 Fertility PE Roll-Up Tracker.

The investable opportunity in women’s health is bounded above by workforce supply, fee schedule compression, screening-driven volume, and birth rate trajectory. We treat each as a separate boundary condition.

ACOG Membership and Active US OB-GYN Count

The American College of Obstetricians and Gynecologists reports more than 62,000 members across 12 districts spanning the United States, Canada, and Central and South America (ACOG). The membership figure includes medical students, residents, practicing physicians, retirees, and allied health professionals, so it overstates the count of practicing US OB-GYNs. A 2024 to 2025 cohort study captured 60,085 practicing OB-GYNs across all 50 states, which is the load-bearing denominator for any geography-weighted workforce analysis (AJMC). Confidence: HIGH on the denominator; HIGH on the membership-versus-practicing gap.

HRSA Workforce Projections to 2038

HRSA projects the OB-GYN workforce will meet only 90% of national demand by 2030 and that the shortage will widen to 9,890 physicians by 2037, with a 46% shortage in nonmetro counties by 2038 (Caliber Health summary; Medscape; HRSA Bureau of Health Workforce). More than 5.5 million US women already live in counties with limited or no maternity care access (Caliber Health). For PE underwriting this is the labor-supply ceiling: any platform that does not have a deliberate midwife and nurse-practitioner integration plan trades against the supply curve, not with it. Confidence: HIGH.

CY 2026 Medicare Physician Fee Schedule

CMS issued the CY 2026 MPFS Final Rule (CMS-1832-F) on October 31, 2025, effective January 1, 2026. The 2026 conversion factor is $33.57 for advanced Alternative Payment Model qualifying participants (a 3.77% increase from 2025) and $33.40 for non-qualifying participants (a 3.26% increase), supported by a temporary 2.5% statutory increase under the One Big Beautiful Bill Act and a +0.49% budget-neutrality adjustment (CMS CY 2026 MPFS fact sheet; Holland & Knight; AMA).

The headline conversion factor masks a structural offset. CMS finalized a new “efficiency adjustment” that reduces work RVUs and corresponding intraservice time by 2.5% for most non-time-based services (Holland & Knight). Practically this means the work-RVU side of the calculation absorbs much of what the conversion factor side gives back, and the net rate effect varies by code mix. Comprehensive OB-GYN groups with heavy non-time-based code mix should expect a flatter realized rate than the headline 3.26% suggests. Confidence: HIGH on the conversion factor; HIGH on the efficiency adjustment direction; MEDIUM on the realized blended-code impact for a typical OB-GYN practice (this requires direct chart-level modeling).

Key OB-GYN CPT Code Economics in 2026

The codes that move OB-GYN deal models in 2026 are:

• CPT 59409 (vaginal delivery only): Defined as labor management from admission through delivery, and completion of postpartum orders and the birth certificate (Neolytix). Medicare rarely covers prenatal care, so this code primarily drives commercial and Medicaid rates that index off the MPFS rather than direct Medicare payment.
• CPT 59510 (cesarean delivery global package): A bundled global obstetric service. CMS does not publish a separate Medicare rate that meaningfully impacts deal economics because the payor mix is Medicaid-heavy in most markets.
• CPT 58150 (total abdominal hysterectomy): 2026 work RVU values are reported in the 14.25 to 16.88 range, with a 90-day global period, inpatient-only designation, and 2026 national average facility payment of approximately $938 (MD Clarity; FastRVU).

Confidence: HIGH on the headline work RVU range; MEDIUM on the locality-adjusted Medicare allowable amount (which requires direct CMS MPFS file pulls).

USPSTF Mammography Screening, April 2024

On April 30, 2024, the US Preventive Services Task Force formally lowered the recommended start age for biennial screening mammography from 50 to 40 for average-risk women, continuing through age 74 (Grade B) (USPSTF via PubMed; Radiology Ltd; Oncology Nursing News). The Task Force estimated approximately 19% more lives saved relative to the start-at-50 protocol. For PE, this is a 10-year volume expansion to in-house and partnered breast imaging. We treat this as a structurally repriced tailwind for Solis Mammography and for comprehensive OB-GYN platforms with integrated mammography. Confidence: HIGH on the recommendation; HIGH on the directional volume impact; MEDIUM on the magnitude of realized 2025 to 2026 incremental volume (because uptake lags recommendation).

USPSTF Cervical Screening Draft, December 2024

On December 10, 2024, USPSTF released a draft recommendation endorsing patient-collected high-risk HPV primary screening every five years for women aged 30 to 65, the first formal endorsement of self-collection (Medscape; USPSTF draft). Women aged 21 to 29 retain a three-year Pap protocol. Public comment closed January 13, 2025. For PE, self-collection shifts a portion of cervical screening from the OB-GYN office to either home-collection-plus-mail-back or pharmacy collection; the downside is a small unit-economic erosion on the well-woman visit, the upside is access expansion that drives net-new screening volume. Confidence: HIGH on the draft; MEDIUM on the final implementation timing.

Title X Family Planning Funding

Title X funding has been politically contested for the entire 2024 to 2026 window. FY2024 was enacted at $286.5 million, flat funding since FY2014 (Congressional Research Service IF10051). FY2025 was enacted at the same $286.5 million level under the Continuing Appropriations and Extensions Act, 2025 (P.L. 119-4) (CRS PDF). The Trump FY2026 Budget Request proposed elimination of Title X funding entirely (National Family Planning). In March 2025, HHS withheld $65.8 million in appropriated Title X funding from 16 grantees operating in 23 states, drawing congressional pushback (Pappas). House Democrats’ FY2026 letter requested $512 million (Fletcher letter). Confidence: HIGH on appropriation history; HIGH on the FY2026 political risk; MEDIUM on the practical impact on private-pay women’s health MSOs (limited direct exposure, but federally qualified health center referral patterns shift).

CDC Birth Rate Trajectory

Final CDC NCHS data for 2024: 3,628,934 registered US births, up 1% from 2023. General fertility rate per final data: 53.8 births per 1,000 women ages 15 to 44, a 1% decline from 2023 (CDC NCHS press release April 23, 2025; NCHS Data Brief 535; NCHS blog July 24, 2025). Provisional 2025: 3,606,400 births, down 1% from 2024, general fertility rate 53.1, also down 1% (CDC NCHS VSRR-043).

The trajectory is downward. Volume-only delivery-center theses are structurally pressured. Platforms with diversified service-line mix (GYN surgical, well-woman, fertility, perimenopause and menopause, aesthetics, mammography) absorb the birth-rate headwind better than pure-obstetric models, which is the operating logic behind Axia, Femwell, and Together Women’s Health expansion priorities. Confidence: HIGH on the trajectory; HIGH on the directional implication for delivery-only platforms.

BLS OB-GYN Wages and the MGMA Gap

BLS Occupational Employment and Wage Statistics reports the May 2024 mean wage for obstetricians and gynecologists at $239,120 (US News citing BLS). That number substantially understates market-clearing compensation because it lacks bonus and partnership distributions. MGMA 2024 data shows median total OB-GYN compensation of $399,519, and Physicians Thrive lists median national OB-GYN salary at $354,885 (Physicians Thrive; Panacea Financial). For PE deal modeling, the MGMA spread is the load-bearing number because it includes ancillary income that an MSO assumes and partially captures in a sale. Confidence: HIGH on BLS; HIGH on the MGMA gap; the structural rule is to underwrite at MGMA medians.

The Dobbs Decision and Bifurcated M&A Geography

Dobbs v. Jackson Women’s Health Organization, decided June 24, 2022, returned abortion regulation to the states. The aggregate national data is more nuanced than the trade-press framing. A cohort study of 60,085 OB-GYNs through 2024 found no statistically significant aggregate change in practice location distribution across policy environments, despite increased physician concerns (AJMC). The effect is concentrated in the most restrictive states and at the trainee pipeline level rather than at the practicing-physician level in aggregate.

But the M&A flow tells a different story. Every 2024 to 2026 platform launch and every material tuck-in we identified landed in protective-state or pre-ban-tightening-state geographies (Illinois, Michigan, Georgia, Florida pre-2024, New Jersey, Maryland, Pennsylvania, California, Tennessee, Virginia, Washington). The most restrictive states (Idaho, full-ban Texas geographies, Mississippi, Alabama) produced no significant 2024 to 2026 platform acquisitions. The press tends to frame Dobbs as a uniform shock; the deal data shows it created a two-tier asset market that PE is exploiting.

State-by-state status as of mid-2026:

• Idaho: Strict ban with rape, incest, and life-of-mother exceptions; EMTALA emergency carve-out preserved by the federal-court injunction (see Mifepristone and EMTALA section below).
• Texas: Near-total ban remains in effect through 2026.
• Florida: 15-week ban with limited exceptions; the 2024 ballot measure to embed abortion rights in the state constitution failed (Super Lawyers).
• Arizona: Voters approved a November 2024 ballot measure protecting abortion rights.
• Missouri, Nevada, Virginia: Ballot measures pending in November 2026.

The asset-pricing implication is concrete: protective-state OB-GYN platforms compete for both physician supply and patient volume against restricted-state out-migration patterns; restricted-state platforms face physician-recruitment headwinds and reimbursement risk if Medicaid family-planning carve-outs tighten further. Confidence: HIGH on the bifurcation pattern; HIGH on the geographic concentration of 2024 to 2026 platform activity.

Idaho: The 22% OB-GYN Loss and Residency Pipeline

Idaho is the most acute single-state workforce signal in the cycle. A JAMA Network Open study published mid-2024 documented that the state lost 35 of its 268 OB-GYNs (a 22% reduction) since the abortion ban took effect; none of those who left moved to similarly restrictive states (ABC News on JAMA Network Open; Idaho Capital Sun). Bonner General Health in Sandpoint shuttered its labor and delivery unit in 2023; all four resident OB-GYNs left (19th News). Patients now drive 40 or more miles to Coeur d’Alene or cross the Washington border to Spokane for delivery and high-risk care.

The residency pipeline pattern matches the practicing pattern but is sharper. 2024 ERAS data shows a 7% decrease in OB-GYN residency applications in states with abortion bans versus a less-than-1% increase in states where abortion is legal (European Society of Medicine; AAMC). AAMC’s pre-2024 cycle analysis showed a 6.4% decline in restrictive-state applicants, a 10.5% decline in ban states, and a 6.7% decline in states with complete bans versus a 0.4% increase in unrestricted states (AAMC). From the 2024 to 2025 application cycle onward, OB-GYN residencies moved to ResidencyCAS (replacing ERAS), so post-2024 trend data requires a new comparison baseline (NRMP; TechTarget).

For PE, the Idaho case is the canonical worked example of a state that has effectively repriced its OB-GYN asset base downward through policy. No 2024 to 2026 PE platform tucked in an Idaho group. Sellers in Idaho face a thin acquirer pool; sellers in adjacent protective-state geographies (Washington, Oregon) face a thicker pool because they capture out-migration patient volume. Confidence: HIGH on the headline 22% figure; HIGH on the residency-application pattern; MEDIUM on the projected Idaho OB-GYN headcount five years forward (no published projection).

The Mifepristone and EMTALA Rulings of June 2024

Two June 2024 Supreme Court rulings preserved access in the short term but left structural uncertainty.

Alliance for Hippocratic Medicine v. FDA was decided unanimously on June 13, 2024 (Justice Kavanaugh writing). The Court held that physician plaintiffs lacked standing to challenge FDA mifepristone access. The 2016 and 2021 FDA risk evaluation and mitigation strategy changes (including telehealth prescription and pharmacy dispensing without in-person visits, gestational age up to 10 weeks) remain intact (SCOTUS opinion 23-235; KFF). The challenge can be re-litigated by parties with standing; this is a temporal reprieve, not a substantive resolution.

Moyle v. United States and Idaho v. United States were dismissed as improvidently granted on June 27, 2024. The Court reinstated the district court injunction that bars enforcement of Idaho’s abortion ban against physicians providing EMTALA-mandated emergency abortion care (SCOTUS opinion 23-726; KFF EMTALA explainer). The case returns to the 9th Circuit; the EMTALA versus state-law preemption question remains unresolved. For PE, the EMTALA question is operationally material because hospital-based OB-GYN groups in restrictive states face contingent malpractice exposure that protective-state peers do not.

Confidence: HIGH on both rulings; HIGH on the temporal reprieve framing; MEDIUM on the probability of successful re-litigation through the 2026 to 2030 window.

USPSTF Mammography Age 40: A Quiet 10-Year Volume Tailwind

The April 30, 2024 USPSTF recommendation lowering the biennial mammography start age from 50 to 40 (Grade B) is the largest under-discussed PE-relevant catalyst in the cycle (USPSTF via PubMed). USPSTF projected approximately 19% more lives saved versus the start-at-50 protocol. For comprehensive women’s-health platforms with in-house or partner breast imaging, the structural read is a 10-year volume expansion overnight, because every cohort of women aged 40 to 49 was added to the recommended biennial-screening pool.

The transactional consequence is that Solis Mammography’s May 2025 TowerBrook recapitalization from Madison Dearborn occurred against this tailwind (Radiology Business). Madison Dearborn had triple-baggered the platform from approximately 50 to 150-plus centers since 2018 (Benesch on the 2018 transaction). The OB-GYN platforms with the strongest mammography integration (Axia Women’s Health, Unified Women’s Healthcare, Mid-Atlantic Women’s Care) are structurally repriced upward; press coverage of the USPSTF change has been clinical rather than financial. Confidence: HIGH on the recommendation; HIGH on the directional repricing; MEDIUM on the magnitude of realized 2025 and 2026 incremental volume by platform (uptake data lags recommendation by two to three years in most prior screening recommendation changes).

Braidwood v. Becerra: The Under-Priced Tail Risk

The 5th Circuit’s June 21, 2024 ruling in Braidwood Management Inc. v. Becerra upheld the ACA’s preventive services mandate but ruled that the US Preventive Services Task Force must be confirmed by Congress, and remanded for lower-court review of the legal authority of the agencies setting contraception and vaccine mandates (Justia 5th Circuit; KFF Braidwood explainer). Coverage of preventive services (including contraception, USPSTF-graded screening) for more than 150 million people is at stake.

If a successor ruling or eventual Supreme Court review strikes down USPSTF-graded preventive coverage, the volume base for screening mammography, cervical screening, contraception counseling, gestational diabetes screening, and STI screening collapses, and OB-GYN MSO unit economics get worse. The directional effect is asymmetric: a hostile resolution removes a structural volume floor, while a favorable resolution simply preserves the status quo. PE pricing during 2024 to 2026 platform recaps does not appear to fully price this option. This is the single largest non-Dobbs regulatory risk facing the asset class. Confidence: HIGH on the legal status; HIGH on the directional volume risk; LOW on the probability-weighted resolution timeline.

The CY 2026 Work-RVU Efficiency Adjustment

The CY 2026 MPFS Final Rule contains a structural offset to the headline conversion-factor increase that does not appear in most sell-side platform pitches we reviewed. CMS finalized a new “efficiency adjustment” that reduces work RVUs and corresponding intraservice time by 2.5% for most non-time-based services (Holland & Knight; AMA).

The blended net effect for a typical comprehensive OB-GYN practice depends on the code mix. Time-based codes (extended counseling, complex prenatal management) escape the work-RVU haircut. Non-time-based codes (most surgical procedures, including hysterectomy code 58150) absorb the haircut. The headline 3.26% conversion-factor increase for non-qualifying participants is partially offset by the 2.5% work-RVU reduction on the affected codes. We have not modeled a chart-level blended impact for a representative OB-GYN code mix in this version of the tracker; the structural point is that any buyer underwriting based purely on the headline conversion-factor change overstates 2026 rate growth. Confidence: HIGH on the rule mechanic; MEDIUM on the realized blended impact for a typical OB-GYN practice.

Active 2024 to 2026 PE Platforms

The table below summarizes the active US OB-GYN and women’s health MSO PE platforms we tracked during the cycle. Sponsor attributions reflect primary-source verification as of June 17, 2026. Common-misattribution sponsors are flagged in the notes column.

Segment Breakdowns

The cycle is best understood as eight distinct sub-segments, each with its own multiple profile and operating moat. Aggregating them into a single “women’s health” bucket understates the dispersion in unit economics and exit pricing.

Comprehensive OB-GYN MSO

The dominant segment. Unified Women’s Healthcare, Women’s Care Enterprises, Axia Women’s Health, Together Women’s Health, Nova Women’s Health Partners, and Femwell Group Health all sit here. The operating model integrates obstetric delivery, GYN surgical, well-woman care, and a stack of ancillaries (lab, imaging, urogyn, aesthetics, sometimes fertility). The strongest platforms hit 250+ physicians in a single multi-state footprint with diversified payor mix. Multiples are 10x to 14x for scaled, ancillary-stacked groups (PGP Q1 2025). Confidence: HIGH on the segment definition; HIGH on the multiple range.

Maternal-Fetal Medicine

MFM is the highest-acuity, highest-margin sub-specialty in women’s health. It is hospital-anchored, referral-driven, structurally short on supply, and disproportionately commercial-payor-weighted. Pediatrix retained MFM as its only office-based segment when it divested the rest of its office-based portfolio, which is the strongest revealed-preference signal in the market (HCI Innovation Group). Together Women’s Health added its first MFM affiliate (The Perinatal Group) in June 2025, signaling that platforms are now actively building MFM legs onto comprehensive OB-GYN bodies. Multiples on standalone MFM groups command a premium to comprehensive averages (estimated 12x to 16x for scaled groups, though no publicly disclosed standalone MFM platform transaction in 2024 to 2026 confirms this directly). Confidence: HIGH on the segment characterization; MEDIUM on the standalone multiple estimate.

GYN-Only and Surgical Specialty

GYN-only and surgical-specialty groups trade lower than comprehensive platforms because deliveries drive patient relationships even if they are lower-margin individually. The structural argument is that a comprehensive group captures the woman through her reproductive career and then transitions her to GYN surgical, menopause, and post-menopause care; a GYN-only group has to acquire patients at the most price-sensitive moment. Multiples sit in the 6x to 9x range for scaled groups, and sub-scale groups in the 4x to 6x add-on range. No major standalone GYN-only PE platform launched in 2024 to 2026. Confidence: MEDIUM (no disclosed platform transactions specifically support the multiple range).

Postpartum, Pelvic Floor, and Urogyn Ancillary

Pelvic floor and urogynecology are growing add-on lanes inside comprehensive platforms. Axia Women’s Health has a formal urogyn service line. Pelvic-floor specialty groups have not formed a national PE platform during 2024 to 2026, but tuck-in activity into comprehensive platforms is rising. The structural read: pelvic floor and urogyn are revenue per visit higher than well-woman, lower than delivery, and pull cash-pay devices and procedures. Confidence: MEDIUM on the segment momentum; LOW on multiples (limited disclosed transactions).

Digital Women’s Health

Three sub-segments matter: employer-sold digital benefit (Maven Clinic), DTC primary care and GYN (Tia, Almond ObGyn), and specialty virtual care (Midi Health for menopause). Maven Clinic at $1.7B post-money in October 2024 (CNBC) and Midi Health at $1B+ valuation in Series D 2025 (Fierce Healthcare) are the cycle’s two digital-women’s-health unicorns. The structural risk is that digital-women’s-health unit economics depend heavily on ACA preventive-services coverage, contraception coverage, and employer-benefit budgets, all three of which face 2026 to 2030 political risk. Confidence: HIGH on the headline valuations; MEDIUM on durable unit economics.

OB Hospitalist Staffing

OB Hospitalist Group is the only major scaled platform in this sub-segment. Kohlberg & Company and IMCO have held the asset since September 27, 2021, acquired from Gryphon Investors (Kohlberg). The Sun Capital misattribution is the most common error in industry source decks; Sun Capital does not hold OBHG. The segment is durable because the underlying demand (24/7 in-house obstetric coverage on hospital L&D units) is structurally driven by Joint Commission and CMS quality measures plus malpractice insurance pricing rather than discretionary buyer choice. Confidence: HIGH on Kohlberg and IMCO ownership; HIGH on the structural demand thesis.

Breast Imaging

Solis Mammography is the only national pure-play. TowerBrook acquired Solis from Madison Dearborn in May 2025 (Radiology Business). Madison Dearborn had triple-baggered the platform from approximately 50 to 150-plus centers since 2018. The USPSTF April 2024 mammography start-age reduction from 50 to 40 is the explicit structural tailwind. Comprehensive OB-GYN platforms with integrated mammography (Axia, Unified, Mid-Atlantic Women’s Care) capture some of this volume directly; Solis captures the standalone referral pool. Confidence: HIGH.

Fertility Adjacency

Fertility is not the focus of this tracker (CT Acquisitions covers fertility as a sibling vertical at /how-to-sell-a-fertility-clinic/), but the adjacency is operationally material. Unified Women’s Healthcare’s June 2021 strategic partnership with CCRM Fertility (BusinessWire 2021) is the canonical reference for OB-GYN platforms integrating fertility as a service line. Whether CCRM has since been more deeply integrated into Unified, spun out, or partially recapped is not visible in public 2025 to 2026 sources. Confidence: HIGH on the original partnership; GAP on current integration status.

Deal Flow Timeline, 2024 to 2026

The cycle’s transactional cadence falls into three buckets: sponsor-to-sponsor recapitalizations, platform tuck-ins, and de novo platform launches.

Sponsor-to-Sponsor Recapitalizations

The Solis Mammography recapitalization from Madison Dearborn to TowerBrook Capital in May 2025 is the only major women’s-health sponsor-to-sponsor recap of the cycle (Radiology Business). Madison Dearborn held the asset since 2018 (Benesch). The transaction value was not publicly disclosed.

Notable non-events: Unified Women’s Healthcare has not recapped since August 2021 despite a typical PE hold horizon of five to seven years suggesting a 2026 to 2028 exit window. Women’s Care Enterprises has not recapped since December 2020. Axia Women’s Health has not recapped since May 2021. The next 24 months should produce at least two of these recapitalizations or sales if the asset class is healthy; absence of recaps would itself be a market signal. Confidence: HIGH on the recap inventory; MEDIUM on the projected forward recap timeline.

De Novo Platform Launches

Nova Women’s Health Partners is the cycle’s only major de novo women’s-health platform launch. Webster Equity Partners founded the platform in December 2024 and revealed it publicly in March 2025. The founding practices (Women’s HealthFirst plus WomanCare in Illinois; Midtown OB/GYN plus Pink Monarch Breast Centers in Georgia) collectively brought 60+ providers to the platform at launch (Atlanta Daily World). Both Illinois founding practices were Physician Growth Partners advised (PGP). Confidence: HIGH.

Platform Tuck-In Cadence

Together Women’s Health was the cycle’s most active tuck-in platform. Five Michigan affiliations plus 2024 and 2025 entries into Georgia, Missouri, and Tennessee, plus the first maternal-fetal medicine affiliate (The Perinatal Group, June 2025), brought the platform to 12 total affiliations by August 2025 (Together Women’s Health).

Unified Women’s Healthcare continued private tuck-ins through both 2024 and 2025. The cap table remained essentially unchanged since the August 2021 Altas entry. Tracxn lists three confirmed acquisitions across the platform’s history; specific 2025 add-on names and prices are not in the public domain (Tracxn).

Femwell Group Health’s April 2024 addition of The Woman’s Group (Tampa, 30+ providers) was the cycle’s largest single 2024 OB-GYN add-on transaction (PGP; Levin). Subsequent Femwell expansion has been national in scope.

Women’s Care Enterprises’s Complete Women Care southern California add-on extended the platform’s California footprint (PrivSource); specific 2024 to 2025 tuck-in cadence beyond that is limited in public sources. Confidence on the tuck-in inventory: HIGH for Together; HIGH for Femwell; MEDIUM for Unified specifics; LOW for Women’s Care Enterprises specifics.

Public Comparable Company Activity

Privia Health’s September 2025 Evolent Health ACO acquisition added 120,000+ MSSP attributed lives, taking total VBC attributed lives to approximately 1.5 million. The transaction was $100M cash plus up to $13M earnout. FY2025 revenue $2.12B (+22.3%) and adjusted EBITDA $125.5M (+38.8%) framed the company’s 2026 guide (Privia press). Implied EV/EBITDA on $2.7B market cap and 2026 EBITDA guide midpoint of approximately $150M is about 18x (Stock Analysis; Simply Wall St).

Pediatrix Medical Group continued office-based divestitures throughout 2024. The MFM segment was retained as the only office-based business line. 2025 adjusted EBITDA guide was $215 million to $235 million; revenue settled in the $1.9 to $2.0 billion run-rate post-divestitures (SEC 8-K). Confidence: HIGH on both public comp data points.

Multiples by Segment

The 2025 to 2026 women’s-health multiples range, grounded in Physician Growth Partners’ Q1 2025 white paper and FOCUS Investment Banking healthcare dashboards, is:

• Add-on acquisitions: Mid-single-digit EBITDA multiples (typically 4x to 6x) (PGP Q1 2025, summarized at FOCUS).
• Platform-ready groups with $5M+ normalized EBITDA: 10x to 14x (PGP Q1 2025).
• OB-GYN with aesthetics and cosmetic ancillaries: Higher end of the 10x to 14x range. The cash-pay aesthetic mix is the premium driver; the Femwell and Tampa Woman’s Group April 2024 transaction is the canonical reference for ancillary-stacked OB-GYN values (PGP case study).
• Standalone MFM (estimated): 12x to 16x for scaled groups, on the basis of structural undersupply and commercial-payor mix; no disclosed standalone 2024 to 2026 MFM platform transaction directly confirms this band.
• Standalone breast imaging: Implied premium given the Solis recap timing post-USPSTF April 2024 mammography start-age change.

Public-comparable anchors confirm the directional read. Privia Health trades at approximately 18x forward EV/EBITDA on the 2026 guide; the public healthcare services median EV/EBITDA was approximately 11.5x in 2025, down from 14.5x in 2024 (First Page Sage). Q2 2025 multiple expansion drove 68% of enterprise value growth across public healthcare operators (FOCUS dashboard). The implication for private OB-GYN multiples: the public market is rerating women’s-health-adjacent comps upward, and private platform sellers in 2026 should expect modest multiple expansion on top of the 10x to 14x band when ancillary mix is strong and growth is durable. Confidence: HIGH on the headline ranges; MEDIUM on the standalone MFM estimate.

Six Contrarian Findings

Finding 1: Dobbs created state-by-state M&A divergence the press underreports

Aggregate national OB-GYN counts have not shifted materially (60,085 in 2024 to 2025; no statistically significant practice-location change at the cohort level per AJMC). The headline-grabbing exodus is concentrated in Idaho (a 22% state-workforce decline) and in restrictive-state rural counties. But M&A flow has bifurcated decisively: every 2024 to 2026 platform launch and material tuck-in occurred in protective or pre-ban-tightening states. The trade press frames Dobbs as a uniform shock; the deal data shows it created a two-tier asset market that PE is exploiting.

Finding 2: Unified Women’s Healthcare cap table is widely mistracked

Unified is commonly described as “Altas-backed” or “Ares-backed” in press, but the actual stack since August 2021 is Altas Partners (lead) plus Ares Management plus Oak HC/FT plus physician partners. Ares has been an investor since the 2013 founding; Altas became the largest investor (not sole) in August 2021; Oak HC/FT remained from the 2017 round. The Women’s Health USA combination (also August 2021) brought Sverica Capital rollover equity for an additional 18-month period. No sponsor-to-sponsor recapitalization has occurred since August 2021 (Altas; PE Hub; BusinessWire 2021). Three-investor stacks complicate exit-timing modeling and create misaligned-incentive risks; this is poorly understood by sell-side analysts citing the platform.

Finding 3: Privia Health is the under-tracked public comp for women’s health MSOs

Privia is not OB-GYN-pure, but it operates Privia Women’s Health, has a Texas OB-GYN initiative through Privia Medical Group Gulf Coast partnered with Iron Health, and trades at approximately 18x forward EV/EBITDA. Most women’s-health analysts cite Pediatrix as the only public comp; that misstates the universe because Pediatrix is hospital-based MFM and NICU. Privia is the closest scaled public proxy for an MSO operating value-based care with women’s-health volume. Its 22.3% revenue growth and 38.8% EBITDA growth in FY2025 establish the multi-payor playbook private platforms model toward (Privia press; Privia Women’s Health; MobiHealthNews).

Finding 4: OB Hospitalist Group is consistently miscategorized as Sun Capital-sponsored

OBHG has been a Kohlberg & Company plus IMCO portfolio company since September 27, 2021, acquired from Gryphon Investors. Sun Capital has no current ownership stake. This misattribution shows up in industry source decks and brokerage notes; it is one of the easiest fact-checking wins for a tracker (Kohlberg; PRNewswire 2021; PE Hub 2021).

Finding 5: USPSTF 2024 mammography age reduction is a quietly large platform-value driver

USPSTF dropped the recommended biennial mammography start age from 50 to 40 in April 2024 (USPSTF via PubMed). The Task Force projected 19% more lives saved versus the start-at-50 protocol. The structural read for PE: comprehensive women’s-health platforms with in-house mammography (or partnerships with breast-imaging platforms like Solis) gained a 10-year volume expansion overnight. Solis Mammography’s May 2025 TowerBrook recap from Madison Dearborn occurred against this tailwind. The OB-GYN platforms with the strongest mammography integration (Axia, Unified, Mid-Atlantic Women’s Care) are structurally repriced upward; press coverage of the USPSTF change has been clinical rather than financial.

Finding 6: Braidwood v. Becerra is the biggest under-reported tail risk to women’s-health PE

The 5th Circuit’s June 2024 partial ruling upheld the ACA preventive services mandate but ordered the contraception and vaccine coverage authorities to lower-court review (KFF Braidwood explainer). If a successor ruling (or eventual Supreme Court review) strikes down USPSTF-graded preventive coverage, the volume base for screening mammography, cervical screening, contraception counseling, gestational diabetes screening, and STI screening collapses, and OB-GYN MSO unit economics get worse. This is the single largest non-Dobbs regulatory risk facing the asset class and it is significantly under-priced in 2025 to 2026 platform valuations.

Bonus Finding 7: The midwife labor-arbitrage gap is the cheapest unexploited margin lever

Certified Nurse-Midwives and Certified Midwives attend only 10.9% of US births despite a WHO-standard gap of approximately 8,200 midwives (ACNM Essential Facts 2024). PE platforms with structurally integrated midwifery (Women’s Care Enterprises with 130+ midwives, Together Women’s Health with growing midwife pods) capture labor-cost arbitrage versus pure-physician platforms. As OB-GYN supply tightens through 2030, the midwife integration capability becomes the most defensible operating moat, not the most-cited ancillary mix.

Workforce: OB-GYN Shortage and Post-Dobbs Residency Dynamics

The workforce story across the 2024 to 2026 cycle is the boundary condition for every platform’s volume thesis. HRSA projects the OB-GYN workforce will meet only 90% of national demand by 2030, with a 9,890 physician shortage by 2037 and a 46% shortage in nonmetro counties by 2038 (HRSA; Medscape). More than 5.5 million US women already live in counties with limited or no maternity care access (Caliber Health).

ACOG’s “Issue Brief: Training and Workforce after Dobbs” tracks the post-Dobbs workforce flows and policy advocacy (ACOG). The 2024 ERAS data showed a 7% decrease in OB-GYN residency applications in states with abortion bans versus a less-than-1% increase in states where abortion is legal (European Society of Medicine; AAMC). The directional read: the supply pipeline into restrictive-state OB-GYN is structurally constrained, and the gap will widen over the 2025 to 2035 window.

The Society of Family Planning Complex Family Planning Fellowship is the formal post-residency abortion-training pathway. New ACGME-approved programs (Duke launched 2024 to 2025) signal continued institutional investment, but fellowship-eligible residents in restrictive states face training gaps; the Kenneth J. Ryan Residency Training Program handles residency-level integration (Duke OB-GYN; Ryan Program; Society of Family Planning).

The nurse-midwife integration story is the largest underpriced labor-arbitrage opportunity in women’s-health PE. As of August 2023 there were 14,215 CNMs and CMs in the United States attending 10.9% of US births (ACNM Essential Facts 2024). The WHO standard of 6 midwives per 1,000 live births implies a US need of approximately 22,000, a gap of approximately 8,200. Average midwife age is 49; the majority practice in hospitals; 15% to 21% of new certificants identify as midwives of color (slow diversification) (PubMed 37283414). Midwives cost a fraction of OB-GYN labor for low-risk delivery and well-woman care; PE platforms that build midwife capacity capture both volume and margin. Confidence: HIGH on all workforce points.

Seller-Fit Matrix

A short matrix for OB-GYN and women’s-health MSO sellers considering 2026 to 2027 exits.

Confidence: HIGH on the headline matrix; MEDIUM on the specific multiple bands by segment (which require continuous market calibration).

Limitations and Open Questions

This tracker is constrained by several disclosure gaps and forward-looking unknowns. The following items could not be independently verified to primary-source confidence levels and should be treated as GAP rather than assertion.

• Unified Women’s Healthcare 2025 to 2026 specific tuck-in cadence. Tracxn lists three confirmed acquisitions across the platform’s history; specific 2025 add-on names and prices are not in the public domain. Source confidence: MEDIUM.
• Women’s Care Enterprises 2024 to 2026 tuck-in cadence beyond Complete Women Care. Limited public disclosure. Source confidence: LOW for 2025 to 2026 specifics.
• Mid-Atlantic Women’s Care current PE sponsor (if any). Provident Healthcare Partners references the platform as an active practice but does not confirm a current institutional sponsor in published sources. Source confidence: LOW.
• Tia 2024 to 2026 Series C or later funding. No primary confirmation of a 2024 to 2026 close. Source confidence: LOW.
• Almond ObGyn Series A. No primary confirmation; the $7M seed remains the most recent confirmed round. Source confidence: LOW.
• Femwell exact platform AUM, EBITDA, and 2024 to 2026 add-on count. Beyond The Woman’s Group April 2024 (the largest disclosed), Femwell’s full tuck-in inventory is not public. Source confidence: MEDIUM.
• OB Hospitalist Group 2024 to 2026 financial performance. As a private company, only contract and segment growth references are public; no EBITDA or revenue disclosure. Source confidence: LOW on financials.
• CY 2026 locality-specific Medicare allowable amounts for CPT 59409, 59510, 58150. The 2026 conversion factor and the work-RVU efficiency adjustment are confirmed; precise per-code 2026 Medicare allowable amounts at the locality level require direct CMS MPFS file pulls. Source confidence: MEDIUM on headline RVU; LOW on locality-specific dollar amounts.
• Mertz Taggart women’s health quarterly. Mertz Taggart’s published quarterly cadence covers behavioral health and home-based care, not women’s health. FOCUS, Provident, and PGP are the correct primary sources for women’s-health-specific data.
• CCRM Fertility independence versus Unified integration as of 2026. The June 2021 strategic partnership is confirmed; whether CCRM has since been more deeply integrated, spun out, or partially recapped is not visible in public 2025 to 2026 sources.
• Birth-rate-driven impact on platform unit economics 2026 forward. The 1% provisional 2025 decline (53.1 births per 1,000 women 15 to 44) is fresh; the elasticity of OB-GYN volume to fertility decline is poorly modeled in PE valuations.

Related CT Acquisitions Research

This OB-GYN and women’s health tracker is part of CT Acquisitions’ active PE roll-up tracker series:

• Private Equity Roll-Up Platform Map (master index)
• Home Health PE Roll-Up Tracker
• Behavioral Health PE Roll-Up Tracker
• ABA Therapy PE Roll-Up Tracker
• Veterinary PE Roll-Up Tracker
• Dermatology PE Roll-Up Tracker
• Dental DSO PE Roll-Up Tracker
• Physical Therapy PE Roll-Up Tracker
• Ophthalmology PE Roll-Up Tracker
• Gastroenterology PE Roll-Up Tracker
• Orthopedics PE Roll-Up Tracker
• How to Sell a Fertility Clinic (sibling vertical guide)

Sources

1. ACOG, About: https://www.acog.org/about
2. AJMC, “No Major Shifts in OB-GYN Practice Locations Found Post-Dobbs”: https://www.ajmc.com/view/no-major-shifts-in-obgyn-practice-locations-found-post-dobbs-decision
3. HRSA Bureau of Health Workforce: https://bhw.hrsa.gov/data-research/projecting-health-workforce-supply-demand
4. Caliber Health, OB-GYN Job Outlook: https://www.caliberhealth.com/blog/ob-gyn-job-outlook
5. Medscape, OB-GYN Workforce Projections: https://www.medscape.com/viewarticle/ob-gyn-workforce-projections-suggest-substantial-shortfalls-2026a100023e
6. CMS, CY 2026 MPFS Final Rule fact sheet: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-final-rule-cms-1832-f
7. Holland & Knight, CMS CY 2026 MPFS Final Rule analysis: https://www.hklaw.com/en/insights/publications/2025/11/cms-releases-cy-2026-medicare-physician-fee-schedule-final-rule
8. AMA, 2026 MPFS Final Rule summary: https://www.ama-assn.org/system/files/2026-mpfs-final-rule-summary-analysis.pdf
9. Neolytix, Maternity OB Billing Guide: https://neolytix.com/billing-coding-guides/maternity-obstetrical-care-medical-billing/
10. MD Clarity, CPT 58150: https://www.mdclarity.com/cpt-code/58150
11. FastRVU, CPT Code RVU Lookup: https://fastrvu.com/articles/cpt-code-rvu-lookup
12. USPSTF Breast Cancer Screening 2024 (JAMA via PubMed): https://pubmed.ncbi.nlm.nih.gov/38687503/
13. Radiology Ltd, 2024 USPSTF mammogram update: https://radltd.com/the-2024-uspstf-recommendations-for-screening-mammograms/
14. Oncology Nursing News, USPSTF Mammogram at 40: https://www.oncnursingnews.com/view/uspstf-recommends-women-begin-undergoing-mammograms-at-40-years-old
15. Medscape, USPSTF Cervical Cancer Screening 2024: https://www.medscape.com/viewarticle/uspstf-updates-recommendations-cervical-cancer-screening-2024a1000mv8
16. USPSTF Draft Cervical Cancer Screening: https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/cervical-cancer-screening-adults-adolescents
17. Congressional Research Service IF10051, Title X: https://www.congress.gov/crs-product/IF10051
18. CRS PDF, Title X update: https://www.congress.gov/crs_external_products/IF/PDF/IF10051/IF10051.28.pdf
19. National Family Planning, Title X Budget Appropriations: https://www.nationalfamilyplanning.org/title-x_budget-appropriations
20. Pappas press release on Title X: https://pappas.house.gov/media/press-releases/pappas-and-over-120-members-urge-hhs-to-fund-title-x-grants-to-protect-critical-reproductive-care-after-significant-delay
21. Fletcher FY26 Title X Letter: https://fletcher.house.gov/uploadedfiles/fy26_title_x_family_planning_letter.pdf
22. ABC News on Idaho OB-GYN exodus (JAMA Network Open): https://abcnews.go.com/Health/dozens-ob-gyns-fled-idaho-after-abortion-ban/story?id=124780389
23. Idaho Capital Sun, Idaho OB-GYN exodus: https://idahocapitalsun.com/2024/06/25/idahos-ob-gyn-exodus-throws-women-rural-towns-care-void/
24. 19th News, Idaho OB-GYN losses: https://19thnews.org/2024/04/idaho-losing-obgyns-abortion-ban-health-exceptions/
25. Super Lawyers, Abortion Access by State: https://www.superlawyers.com/resources/health-care/abortion-access-restrictions-by-state/
26. CDC NCHS Press Release April 23, 2025: https://cdc.gov/nchs/pressroom/releases/20250423.html
27. NCHS Data Brief 535: https://www.cdc.gov/nchs/data/databriefs/db535.pdf
28. NCHS Blog July 24 2025: https://blogs.cdc.gov/nchs/2025/07/24/7819/
29. CDC NCHS VSRR-043: https://www.cdc.gov/nchs/data/vsrr/vsrr043.pdf
30. US News on BLS OB-GYN compensation: https://money.usnews.com/careers/best-jobs/obstetrician-and-gynecologist
31. Physicians Thrive, OB-GYN Salary: https://physiciansthrive.com/physician-compensation/ob-gyn-salary/
32. Panacea Financial OB-GYN Salary: https://panaceafinancial.com/resources/what-is-the-average-ob-gyn-physician-salary/
33. Altas Partners, Unified investment: https://www.altas.com/news/unified-womens-healthcare-announces-new-investment-from-altas-partners
34. PE Hub, Altas joins Ares in Unified: https://www.pehub.com/altas-joins-ares-as-investor-in-unified-womens-healthcare/
35. BusinessWire 2021 (Unified / WHUSA combination): https://www.businesswire.com/news/home/20210824005773/en/
36. Tracxn, Unified Women’s Healthcare acquisitions: https://tracxn.com/d/acquisitions/acquisitions-by-unified-womens-healthcare/__13KdYm7ecX1-4h-Tao4b9osffBLFzxyROklWOZFUoS0
37. BC Partners, Women’s Care Enterprises: https://www.bcpartners.com/portfolio/womens-care-enterprises/
38. Healthcare Deal Flow, BC Partners acquires Women’s Care: https://healthcaredealflow.com/bc-partners-acquires-womens-care-enterprises/
39. PrivSource, Women’s Care plus Complete Women Care: https://www.privsource.com/acquisitions/deal/women-s-care-enterprises-adds-complete-women-care-to-its-southern-california-network-1RGSlk
40. Partners Group, Axia Women’s Health: https://www.partnersgroup.com/news-and-views/press-releases/investment-news/detail?news_id=afea7cb7-2ed8-48ad-9e08-c2121d11c44a
41. Audax PE, Sale of Axia to Partners Group: https://www.audaxprivateequity.com/news/audax-private-equity-to-sell-axia-womens-health-to-partners-group
42. ROI-NJ, Partners Group buys Axia: https://www.roi-nj.com/2021/05/06/healthcare/private-markets-firm-buys-voorhees-based-axia-for-reported-800m/
43. Buzztum, Partners Group acquires Axia: https://buzztum.com/partners-group-acquires-axia-womens-health/
44. Mergr, Shore Capital acquires Together Women’s Health: https://mergr.com/transaction/shore-capital-partners-acquires-together-women-s-health
45. Together Women’s Health, Shore Capital founding announcement: https://togetherwomenshealth.com/partnership/resources/news/shore-capital-partners-announces-founding-of-together-womens-health
46. Livingstone, Women’s Health Associates affiliated with Together: https://livingstonepartners.com/en-us/transactions/womens-health-associates-has-affiliated-with-together-womens-health
47. BusinessWire, Together Women’s Health Tennessee expansion: https://www.businesswire.com/news/home/20250604381844/en/Together-Womens-Health-Expands-into-Tennessee-Through-Strategic-Partnership-with-MidSouth-OBGYN
48. Together Women’s Health, Women First OB/GYN affiliation: https://togetherwomenshealth.com/partnership/resources/news/together-womens-health-accelerates-growth-in-michigan-through-an-exciting-affiliation-with-women-first-obgyn-center
49. PGP, Women’s HealthFirst founds Nova Women’s Health Partners: https://physiciangrowthpartners.com/press-release/physician-growth-partners-advises-womens-healthfirst-as-a-founding-practice-of-nova-womens-health-partners/
50. PGP, Women’s HealthFirst partners with Webster Equity: https://physiciangrowthpartners.com/transactions_post/womens-healthfirst-partners-with-webster-equity-to-form-nova-womens-health-partners/
51. Atlanta Daily World, Nova Women’s Health Partners launch: https://atlantadailyworld.com/2025/03/10/nova-womens-health-partners-debuts-and-unites-leading-independent-ob-gyn-practices-in-georgia-and-illinois/
52. PitchBook, Femwell Group Health: https://pitchbook.com/profiles/company/238742-29
53. PGP, The Woman’s Group plus Femwell: https://physiciangrowthpartners.com/press-release/physician-growth-partners-advises-the-womans-group-in-partnership-with-femwell/
54. Levin, Femwell plus The Woman’s Group: https://healthcare.levinassociates.com/2024/04/03/physician-growth-partners-advises-the-womans-group-in-its-acquisition-by-femwell/
55. Kohlberg & Company, OBHG partnership: https://www.kohlberg.com/ob-hospitalist-group-announces-partnership-with-kohlberg-company/
56. PRNewswire, OBHG partnership with Kohlberg: https://www.prnewswire.com/news-releases/ob-hospitalist-group-announces-partnership-with-kohlberg–company-301385973.html
57. PE Hub 2021, Kohlberg acquires OBHG: https://www.pehub.com/kohlberg-co-acquires-ob-hospitalist-group-from-gryphon-investors/
58. Pediatrix SEC 8-K FY2025: https://www.sec.gov/Archives/edgar/data/0000893949/000095017025023723/md-ex99_1.htm
59. HCI Innovation Group on Pediatrix divestitures: https://www.hcinnovationgroup.com/finance-revenue-cycle/article/55131317/pediatrix-fully-underway-with-sales-of-most-office-based-practices
60. Privia Investor Relations: https://ir.priviahealth.com/news-releases/news-release-details/privia-health-reports-third-quarter-2025-financial-results
61. Privia Health FY2025 press: https://www.priviahealth.com/press-release/privia-health-reports-fourth-quarter-and-full-year-2025/
62. Privia Women’s Health: https://www.priviahealth.com/who-we-support/physicians/privia-womens-health/
63. MobiHealthNews on Privia and Iron Health: https://www.mobihealthnews.com/news/privia-health-backed-texas-medical-group-launches-obgyn-initiative
64. StockTitan Privia FY2025: https://www.stocktitan.net/news/PRVA/privia-health-reports-fourth-quarter-and-full-year-2025-financial-edgaekeeu263.html
65. Stock Analysis PRVA: https://stockanalysis.com/stocks/prva/
66. Simply Wall St PRVA: https://simplywall.st/stocks/us/healthcare/nasdaq-prva/privia-health-group/news/a-look-at-privia-health-group-prva-valuation-after-strong-20
67. Maven Clinic Series F announcement: https://www.mavenclinic.com/post/maven-series-f-announcement
68. Sacra on Maven Clinic ARR: https://sacra.com/research/maven-clinic-at-268m-arr/
69. CNBC on Maven Clinic $1.7B valuation: https://www.cnbc.com/2024/10/08/womens-health-startup-maven-clinic-raises-at-1point7-billion-valuation.html
70. Femtech Insider, Almond seed: https://femtechinsider.com/almond-seed-round/
71. LA Business Journal, Almond ObGyn: https://labusinessjournal.com/healthcare/startup-gets-into-obgyn-health-care/
72. Fierce Healthcare on Midi Health Series D: https://www.fiercehealthcare.com/health-tech/womens-health-clinic-midi-health-closes-100m-series-d-round-hitting-1b-valuation
73. Radiology Business on Solis TowerBrook recap: https://radiologybusiness.com/topics/healthcare-management/mergers-and-acquisitions/private-equity-firm-sells-ownership-stake-solis-mammography
74. Benesch on Madison Dearborn Solis: https://www.beneschlaw.com/experience/represented-madison-dearborn-partners-in-its-acquisition-of-solis-mammography-a-leading-provider-of-mammography-and-breast-imaging-services-from-the-audax-group.html
75. SCOTUS opinion 23-235 (Alliance for Hippocratic Medicine v. FDA): https://www.supremecourt.gov/opinions/23pdf/23-235_n7ip.pdf
76. KFF on mifepristone ruling: https://www.kff.org/womens-health-policy/looking-to-the-future-implications-of-the-scotus-ruling-on-mifepristone/
77. SCOTUS opinion 23-726 (Moyle/Idaho v. United States): https://www.supremecourt.gov/opinions/23pdf/23-726_6jgm.pdf
78. KFF EMTALA explainer: https://www.kff.org/womens-health-policy/emergency-abortion-care-scotus-emtala/
79. Justia 5th Circuit, Braidwood v. Becerra: https://law.justia.com/cases/federal/appellate-courts/ca5/23-10326/23-10326-2024-06-21.html
80. KFF Braidwood explainer: https://www.kff.org/womens-health-policy/explaining-litigation-challenging-the-acas-preventive-services-requirements-braidwood-management-inc-v-becerra/
81. CMS TMaH Model: https://www.cms.gov/priorities/innovation/innovation-models/tmah
82. Healthcare Innovation Group, TMaH selections: https://www.hcinnovationgroup.com/population-health-management/maternal-healthcare-and-obstetrics/news/55253216/cms-announces-15-states-selected-for-transformative-maternal-health-model
83. CCF Georgetown on TMaH: https://ccf.georgetown.edu/2025/01/09/cms-announces-state-recipients-of-the-transforming-maternal-health-tmah-model/
84. Congress.gov H.R.3305 (Momnibus 118th): https://www.congress.gov/bill/118th-congress/house-bill/3305
85. CCF Georgetown on state Momnibus: https://ccf.georgetown.edu/2025/05/22/state-momentum-for-maternal-health-legislation-continues-congressional-cuts-would-turn-back-the-clock/
86. ACOG Issue Brief, Training and Workforce after Dobbs: https://www.acog.org/advocacy/abortion-is-essential/trending-issues/issue-brief-training-and-workforce-after-dobbs
87. European Society of Medicine on Dobbs and residency applications: https://esmed.org/impact-of-dobbs-on-obgyn-residency-applications/
88. AAMC, Post-Dobbs 2024: https://www.aamc.org/about-us/mission-areas/health-care/post-dobbs-2024
89. AAMC, Training Location Preferences Post-Dobbs: https://www.aamc.org/about-us/mission-areas/clinical-care/training-location-preferences-us-medical-school-graduates-post-dobbs-v-jackson-women-s-health
90. NRMP, ResidencyCAS application service announcement: https://www.nrmp.org/about/news/2023/08/policy-announcement-and-faqs-application-service/
91. TechTarget, OB-GYN ERAS transition: https://www.techtarget.com/pharmalifesciences/news/366608156/OB-GYN-Residencies-Will-Stop-Using-the-AAMC-ERAS-Application
92. Duke OB-GYN Complex Family Planning Fellowship: https://obgyn.duke.edu/education-training/fellowship-programs/complex-family-planning
93. Ryan Program: https://ryanprogram.org/
94. Society of Family Planning Fellowship: https://societyfp.org/fellowship/apply-to-fellowship/
95. ACNM Essential Facts 2024 (midwife data): https://midwife.org/wp-content/uploads/2024/10/Essential-Facts-about-Midwives.pdf
96. PubMed 37283414 (midwife workforce): https://pubmed.ncbi.nlm.nih.gov/37283414/
97. PGP Q1 2025 State of Women’s Health PE: https://physiciangrowthpartners.com/white-paper/state-of-womens-health-private-equity-q1-2025/
98. PGP case study, Femwell and The Woman’s Group: https://physiciangrowthpartners.com/case-studies/partnership-alignment-the-womans-group-and-femwell/
99. FOCUS, OB-GYN Practice Valuation: https://focusbankers.com/obgyn-practice-valuation/
100. FOCUS, Healthcare EBITDA Multiples Dashboard: https://focusbankers.com/healthcare-ebitda-multiples/
101. FOCUS, Physician Practice M&A Multiples: https://focusbankers.com/physician-practice-ma-multiples/
102. First Page Sage, Healthcare EBITDA Valuation Multiples: https://firstpagesage.com/business/healthcare-ebitda-valuation-multiples/
103. Provident on Mid-Atlantic Women’s Care: https://www.providenthp.com/expertise/mid-atlantic-womens-care/
104. Mertz Taggart Q4 2025 (behavioral health, NOT women’s health): https://www.mertztaggart.com/post/q4-2025-behavioral-health-m-a-report

Frequently Asked Questions

Who actually owns Unified Women’s Healthcare?

Unified Women’s Healthcare is a three-investor stack as of mid-2026: Altas Partners (lead investor since August 2021), Ares Management (since the 2013 founding), Oak HC/FT (since the 2017 round), and physician partners. The platform has not undergone a sponsor-to-sponsor recapitalization since August 2021. Press coverage that describes Unified as “Altas-backed” or “Ares-backed” alone is incomplete (Altas; PE Hub).

Is Sun Capital still the sponsor of OB Hospitalist Group?

No. OB Hospitalist Group (OBHG) has been a portfolio company of Kohlberg & Company and IMCO since September 27, 2021, when the partnership was acquired from Gryphon Investors. Sun Capital has no current ownership stake. The “Sun Capital” attribution that appears in some industry source decks is incorrect (Kohlberg; PRNewswire).

Who owns Solis Mammography after May 2025?

TowerBrook Capital Partners acquired Solis Mammography in May 2025 from Madison Dearborn Partners. Madison Dearborn had held the platform since 2018, having acquired it from Audax Group. Solis operates 100+ centers across 13 markets including Texas, Arizona, Colorado, Florida, Maryland, Ohio, Pennsylvania, Tennessee, Virginia, and the District of Columbia (Radiology Business; Benesch).

What multiples can a comprehensive OB-GYN group expect in 2026?

Add-on acquisitions trade at mid-single-digit EBITDA multiples, typically 4x to 6x. Platform-ready groups with $5 million or more in normalized EBITDA can command 10x to 14x. OB-GYN groups with aesthetics and cosmetic ancillaries trade at the higher end of the 10x to 14x band; the Femwell and Tampa Woman’s Group transaction is the canonical reference (PGP Q1 2025).

What changed with USPSTF mammography screening in April 2024?

The US Preventive Services Task Force lowered the recommended start age for biennial screening mammography from 50 to 40 for average-risk women on April 30, 2024 (Grade B). The Task Force estimated approximately 19% more lives saved versus the start-at-50 protocol. For PE-backed women’s health platforms, this represents a 10-year volume expansion to breast-imaging service lines and partnered breast-imaging platforms (USPSTF via PubMed).

What is Braidwood v. Becerra and why does it matter?

Braidwood Management Inc. v. Becerra is a 5th Circuit case (ruled June 21, 2024) that upheld the ACA preventive services mandate but ruled that the US Preventive Services Task Force must be confirmed by Congress, and remanded for lower-court review of the legal authority of agencies setting contraception and vaccine mandates. Coverage of preventive services for more than 150 million people is at stake. If a successor ruling strikes down USPSTF-graded preventive coverage, the volume base for screening mammography, cervical screening, contraception counseling, gestational diabetes screening, and STI screening collapses (KFF).

How has Dobbs affected the OB-GYN PE deal flow geography?

The aggregate national OB-GYN count has not shifted materially (about 60,085 in 2024 to 2025, per a cohort study covering all 50 states). But the M&A flow has bifurcated decisively. Every 2024 to 2026 platform launch and material tuck-in occurred in protective or pre-ban-tightening states (Illinois, Michigan, Georgia, Florida pre-2024, New Jersey, Maryland, Pennsylvania, California, Tennessee). The most restrictive states (Idaho, full-ban Texas geographies, Mississippi, Alabama) produced no significant 2024 to 2026 platform acquisitions (AJMC).

How does the 2026 Medicare Physician Fee Schedule actually affect OB-GYN economics?

The headline 2026 conversion factor of $33.57 for advanced APM qualifying participants (a 3.77% increase) and $33.40 for non-qualifying participants (a 3.26% increase) is partially offset by a new 2.5% work-RVU efficiency adjustment on most non-time-based services. The net rate effect for a typical OB-GYN practice depends on the code mix. Comprehensive OB-GYN groups with heavy non-time-based surgical mix should expect a flatter realized rate than the headline conversion-factor change suggests (CMS; Holland & Knight).

Which states are part of the CMS Transforming Maternal Health Model?

The Transforming Maternal Health (TMaH) Model launched January 1, 2026 for a 10-year run (three-year pre-implementation, seven-year implementation). The 15 selected Medicaid state agencies are: Alabama, Arkansas, California, the District of Columbia, Illinois, Kansas, Louisiana, Maine, Minnesota, Mississippi, New Jersey, Oklahoma, South Carolina, West Virginia, and Wisconsin. Each can receive up to $17 million in cooperative agreement funding (CMS TMaH).

Is Maven Clinic profitable and what is its current valuation?

Maven Clinic closed a $125 million Series F in October 2024 at a $1.7 billion post-money valuation, led by StepStone Group. Annual run-rate revenue was estimated at $268 million for 2024 (up 26% year over year), with 2,000+ employer clients across 175 countries. Profitability has not been publicly disclosed (CNBC; Sacra).

What is the midwife shortage and why does it matter for PE roll-ups?

As of August 2023 there were 14,215 Certified Nurse-Midwives and Certified Midwives in the United States attending 10.9% of US births. The WHO standard of 6 midwives per 1,000 live births implies a US need of approximately 22,000 midwives, a gap of approximately 8,200. PE platforms that build midwife capacity (Women’s Care Enterprises with 130+ midwives; Together Women’s Health with growing midwife pods) capture labor-cost arbitrage that pure-physician platforms cannot match (ACNM Essential Facts 2024).

Does Mertz Taggart publish a women’s health M&A quarterly?

No. Mertz Taggart’s published quarterly cadence covers behavioral health and home-based care, not women’s health. Sources that cite “Mertz Taggart women’s health quarterly” are inaccurate; FOCUS Investment Banking, Provident Healthcare Partners, and Physician Growth Partners are the correct primary sources for women’s-health-specific data (Mertz Taggart).

About the Author

This tracker was authored by the CT Acquisitions research desk. CT Acquisitions advises sellers of physician practices, MSOs, and healthcare services platforms on PE roll-up timing, sponsor selection, multiple expansion strategies, and exit preparation. Our methodology is primary-source first: every numerical claim is cited inline; every sponsor attribution is triangulated against at least two independent sources; and every confidence grade reflects the auditability of the underlying claim. We do not publish “industry sentiment” untethered from filings or sponsor press releases.

Direct corrections and source updates to the CT Acquisitions research desk via the contact channel at ctacquisitions.com/contact.

Last updated: June 17, 2026.