An investor’s view of the private market, and navigating AI-driven uncertainty | Conor Green (Truehelm)

Always excited to bring a good minister on to health technicians radio to chat about lifetime memberships and whether or not MAs should fund that as a benefit. Conor Green, who's a true home, has been investing in healthcare for Conor as long as I can remember our conversations going back. So excited to learn from you today about state of true home, how you guys are looking at the world. Thanks for having me. Yeah, I was jotting a couple notes down. I actually went to a lifetime this morning. So you guys are this is this is very timely for me. I appreciate it. We're in the noticeable lack of a fewer MA beneficiaries there. There were, you know, if you go, some days will go a little later, like all the have calls in the morning and go a little later. And there is a very clear like nine o'clock hour where it you can just tell that like some some group of MA beneficiaries has, I think it was silver sneakers at one point. I don't know what it is. And I'm like, unlike if Kim and we're there at nine AM, he probably be interviewing people for the, you know, for the blog and some content. But I have not done that. But it is a very noticeable shift in the demographics, let's say, there was going back in the start ship articles, Conor, there was a, I think it was 20 early 2025, they talked about how an interim step before they just they they took away like that memberships was they bracket the hours of it. So you could only show up. Yeah. And those were the senior hours. So I am sure there is something to that. To that dynamic. Yeah, yeah, happy to very happy to be here. You know, the Minneapolis St. Paul kind of the headquarters of of HTN or maybe the original headquarters. So honored to be here. I told my sung this morning that I was going to do a podcast with Kevin O'Leary. And he's a big shark tank fan. So I had to I unfortunately let him down a little bit after that. But you know, it's excited. I exist in a perpetual state of letting people down with the real and I am not that kind of a lyric. Conor, give us the latest on true home. I know you guys just went through a recent rebrand from triple tree capital partner to see P2 true home. Talk me through where you guys are at current state of investment thesis. Fun deployment, that kind of stuff. Yeah. A lot of pressure following Chris Clomp and the head of CCMI last week. CMMI last week. But I feel like I'm on the pod mostly because I emailed Kevin this week to just say we rebranded. And he was like, come on, I talk about it. But yes, we I've been at my firm for over a decade. We we spun out of triple tree, which is a leading healthcare and many advisory firm that started in Minneapolis and has now grown across the country. We started a investment firm inside of those four walls back in 2012 or 2013. We raised two funds inside of triple tree and then a few years back, triple tree got acquired by capital one. We spun our fund out. We kept our name, which had always been TT capital partners. And you know, what happened is we just eventually got tired of correcting people. There's just market confusion about who's the bank, who's the fund, who's triple tree, who's not. One of the one of the aha moments for us was that when we did spin out, we realized that a lot of advisors in the across the country were kind of withholding some of their better deals just because they thought if they sent it to us, it would get to the investment bank. And so some of the some of the advantages of being inside this four walls were probably overstated, maybe and being independent has actually been great for us. And so we just decided to take that kind of final step and rebrand. So hired a branding expert and I don't know if you guys have ever done some of that work. It's fun. The name part is a little bit. We're proud of the name. It's meant to invoke kind of a nautical, the helm theme, true being kind of like the true north, steady hand on the wheel kind of thing. You know, the name is probably less important than a real opportunity to kind of sit down and think about who are we as a firm, one of our principles. That kind of stuff is it's it just may be realized that it's important for you know, everybody to be doing that periodically because it lets you kind of reorient the company around what's important. And true helm is focused exclusively on healthcare, in the healthcare capital of the world, which is the greater Minneapolis St. Paul area. And I'm curious to hear a little bit about how you are thinking about deploying capital. What is the investment thesis that true helm true helm has? Yeah, so our thanks, Marn. So our lane is we really think of ourselves so we're healthcare only we really play in this kind of growth equity or sometimes we call ourselves growth buy out style investors. We're not a huge fund are we just raised our third fund, which is in the neighborhood of 250 million. So we're not the multi-dillion dollar, you know, VCs that I think we could get into and talk about a little bit if you like. But our power alley is really finding these usually still found around or found or control businesses that are tech enabled services companies that are selling into the industry. So they have hospitals or health plans or large employers or life sciences companies as their customers. I think under a different lens you might call that digital health. But you know, we really gravitate towards situations where they've kind of skipped adventure. You know, we really like these businesses that have been kind of bootstrap to have gotten to us a certain size and success and look around the corner and say, you know what, I can use some capital to maybe have a co-founder that wants to retire or maybe I want to go buy something or maybe I just see my competitors raising money and I've been really kind of stingy historically. But I'm ready to put my foot down on, you know, on pushing hard on like building out sales and marketing, for example. So our investors, you know, are composed of both traditional financial style, you know, university and diamonds and those kinds of things as well as health plans and hospitals that have invested either out of their, you know, some of their different vehicles are directly after balance sheet. And so the idea is that we can bring some of these parties to the table. We're really deep in the space, you know, the kind of the triple tree heritage has sort of made us think about this space now for going on two decades. And you know, the idea is just find great businesses and help them grow faster. That's where most of our returns come from. And so like just to kind of click into a couple recent examples out of our third fund that we've made. One is a behavioral health EHR called Contata. A really interesting sourcing story there. If you guys want to get back to that. Another one is called collaborating docs. That's a business that had been founded by an MD. She had raised no outside capital. She got the business to be north of 20 million in revenue. Very even doubt profitable. What they do is they they basically serve as a market place as one way to think of it between nurse practitioners that want to practice in a more entrepreneurial fashion. Maybe start their business or join one of these, you know, VC back companies that are kind of expanding across the country. And the docs that in 35 states are required to supervise their work. Right. So that business kind of touches a few different themes, staffing, compliance, you know, kind of the necessary grunt work of kind of succeeding as a healthcare company in this in this country that those are those are kind of the the situations that we gravitate towards. Yeah. Conrad D'Curie is kind of a state of the market from where you said, you know, where we sit in the ecosystem we hear a lot about AI activity. We see all the funding rounds. We see the AI ops platforms being built folks chasing after that. We see this dislocation between private public market valuation. Some of the exit concerns around credit markets. What's going on there? How would you articulate how you guys are looking to landscape kind of across those categories? It's the most confusing time of the certainly my last 12 or 13 years of doing this. It's just it's very confusing out there right now. And there's a big dislocation between what I or my colleagues might think of businesses worth and what others might think it's worth including people we compete with. Right. I think there's like the what is the market is sort of a it's it's sort of an end of one experience right now. You know, it's it's a bill cliche but like high quality businesses continue to drive great outcomes and great results but there's just a big messy middle right now of things that are going to require a little bit of work you know or still trying to figure out what is their business model going to be is AI going to be a going to help boost their gross margin or is it going to crush the revenue or both right. And so it is a very confusing time and then you kind of layer in just the unpredictable administer you know kind of government activities like the the level of the pace and and act level of change across the health industry in the last 12 months. And then you couple in like debt markets and oil prices and everything else it's it's it's been confusing. So I don't know how I'm answering your question but but but that's been the hard part you know one one anecdote that we were chatting about is look we're we're Midwestern we're conservative we we do our best not to overpay for for companies, we'd rather get around the table with somebody, create a lot of roll over where they're not taking a lot of chips up the table, especially if it's a founder that owns a lot of the company and we're trying to align with them. So the price that we paid it is should matter theoretically a little bit less than somebody who's taking a lot of chips up the table. So creating that alignment is hard. When you have bankers in the process, it's even harder because they're trying to drive the values up. And there's a number of situations over the last six or 12 months. This is we really liked in Rebs cycle and different kind of niches of the space where we put in what we thought was a good bid and we were told we were too low and that's not unusual. But then we track those situations in three, six, nine, 12 months later, you'd expect to see something or hear something. Those deals are some of them, a lot of them are not getting done. And so we don't, it's hard, unless you're like really inside the process, it's hard to know exactly what's going on. But our suspicion is that there's a lot of retraining going on in these processes where you're sort of, you're kind of bidding the book, we call it, you're just looking at the financials, bidding the book. And then you really get into it and understand the business and start thinking about the AI thread, which again, we try and front load some of those things and price a business for what we realistically think is going to happen. Our assumption is that some of these processes are just running into problems as people are like, wait, I'm taking on more risk than I thought. I need to slow down, I need to repress something, I need to push risk back onto the seller, and it just slows processes down a lot, right? And we're seeing a lot of evidence about it. And now we've got multiple processes and bankers that we're probably annoying, you know, sending every email every three or four weeks saying, hey, we really liked that business, you know, there's something to talk about. Let us know. And they're like, you know, we're good. We'll let you know. So anyway, I'm dabbling, but what else? And so far as you're willing to share, can you talk about what's interesting to you and to you true Helm thematically right now? Yeah. We again, the old cliche of there's riches in the niches, I think continues to be really true and across the healthcare industry. As I said, we're not a huge fund. So we don't, we don't approach the world and say, we're going to go create a huge roll up, right? Like again, classic example, like creating a dermatology role is not super interesting for us. You got it. Or even just like a multi phase or across all facets, revenue cycle provider is not a strategy. You really see us pursue because you just, you have to bring a huge capital can into that to be credible. And so we tend to gravitate toward the more specialized areas. And, you know, it's just healthcare is kind of endlessly fascinating on that as I'm sure you guys are very well aware. I mean, you, you feel multiple emails up a week and your Slack channel with just constant revelations about I didn't know this was a business and look how well these guys are doing. You know, affectionately, we kind of refer to what we do sometimes as hospital basement companies or health plan basement companies, right? It's sort of like the CEO probably doesn't know that this is a vendor they're using, but you couldn't like pry it out of, you know, somebody who's actually getting the work done, you couldn't pry it out of their cold dead hands, right? Or you have to pry it out of their cold dead hands. Those are the situations we look for. And so across, you know, Revcycle continues to just be endlessly interesting, even despite all the consolidation that's gone on. You know, I personally am spending time looking at some of the changes across like the employer and payer tech and able services space. There's just huge changes. You know, we kicked tires for a while on some of the different IKRA providers. You guys talk a lot about that. I think that's just more indicative of some of the huge market shifts that are happening across that space right now. And if you just think, if you just step back globally and think like what we try and think about is, is a business that we're investing on the, on the right side of the, of the industry. And is it, is it working on bending that curve back towards something that's sustainable and not going up into the right end, bus lane? The shifts that are going on, especially in the employer space of how they fund healthcare is super interesting, right? And so, just in the past six months, we've been looking across like different ways of playing stop loss, you know, the captive space. I mean, Pareto kind of created that market, but there's a lot of fast followers. So I don't know, those are at least a few of the themes that we've been spending time on. Connor, maybe one last question for you. Hold you run be curious, you're taking on exit market these days. One of the things we're picking up on more and more is virtually every healthcare public company had seen and not every, but a lot of the smaller ones are saying, "Doximity was asked by Daniel Wilson last earnings call." Like, why are you guys public at the moment given where you're trading at, given what we think you can be trading at on private markets? It seems like that window is not quite open, given that dynamic strategic players are struggling in a variety of different ways, right? The big MA plans facing headlines in that market for the past few years. How do you see that exit landscape right now for businesses? How are you guys thinking about that as you think about capital deployment over the coming years? Does it change how you view things in terms of what you're looking at from a ROI calculation or how you view in that world? It does. Yeah, there's a couple things at play here right now. One is that I think you guys have talked about this, but there's just a hope that's kind of log jam right now in the private markets among like middle market private equity funds. And it just has all these cascading effects, right? There's a lot of funds that put a lot of capital out in 21, 22, 23 at market peaks, especially into areas like healthcare services, like, you know, physician practice rollups across a bunch of different strategies. And a lot of those businesses don't have natural homes right now, right? The joke here in Minneapolis, as you know, Kevin, is if the United Health isn't buying companies this year, like it's pretty tricky to figure out where to sell some of these things, too, right? And so that has had a cascading effects across LPs and other funds being able to raise a new fund across the strategy that might be differentiated. The LPs are kind of waiting for capital to come back. What we're seeing right now is the market, at least the bankers who tend to be kind of the canary and the coal mine, they're pretty optimistic about the pace of pitches that they're being asked to do. And I think one of the things that has needed to happen is just, again, it's around a lining expectations, right? So a lot of those investors that bought in at high values, they underwrote to get three or four times their money. The LPs have been applying pressure to get money back. I think at some point that market settles and people start settling for, you know, maybe two times their money because they want to stay in business and raise another fund, right? That will clear a log jam, that will allow a bunch of money to flow in a bunch of new directions, including to other PE firms that it could show up as good buyers for, you know, businesses across digital health, for example. You know, the public markets are tricky. And I think we're all kind of watching the giant, the giant players in the space, right? But everything's kind of following AI right now. Economic growth right now is kind of based on AI and caring for, you know, our elderly parents, right? And so like what's interesting is sitting at the intersection of those two things as a healthcare investor means we're all, I think we're all kind of hoping that some of these businesses that have raised a lot of money can get out. And then what'll happen is that businesses that are burning a lot less cash look relatively safe in comparison and should be able to, again, create liquidity events for founders and investors. The one thing I talk with the people that we meet a lot is, and I, you know, people that ask for advice is, I think like three or four years ago, there was more of a premium on how big of a round can I raise and how high of a value. And I do think like this period of market dislocation has pointed out the effects of that to founders. And what I'm seeing is that a lot of founders are a little bit more reticent around raising huge amounts of capital. They're a little less focused on the high price. They're more focused on if I raise this money, what does that mean about how long before I can exit and who will that exit come from? And I think all those things are really healthy, right? I think like we, whether we, whether we have to live through like a big dislocation or not, there has been a bubble. We need to let some of that air out of that bubble. I think the hard part right now is figuring out like what does that look like and what is, what's the timeline, right? That's a lot of people like me get paid to try and predict that and it's, it's very challenging. What I would say is like we didn't do any new deals last year because we just could not figure out what the, what, you know, where the right landing spot was. And I didn't want to close it the all on Friday and call my investors on Monday and say, hey, there's been a big change at the HHS level and this business is now worthless, right? And I think like some of that does needs to settle for, for, for the, you know, the exit markets to kind of pick back up. Yeah. Appreciate these insights. We know we've kept you a bit after time. Where can folks get in touch if they have a business they want to sell? Yeah. Yeah. I really appreciate it. We are truhelm.com and I hope you enjoy. and enjoy our new website and our new branding. And there's a button on there if you want to talk to anybody, or just pincaven and open chain types with me. - Yep. We'll see you at lifetime soon Connor. - Sounds great guys, thanks very much. - See you. - Bye.