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Insurance market ripe for consolidation; Gauge Capital to merge Urology America; reimbursement trends drive PE interest in autism therapy

Morning Hubsters,

John R Fischer here with the US Wire from the New York newsroom.

In times of uncertainty and slow dealmaking like now, investors look to fragmented markets to keep activity flowing. The insurance market is one of them. PE Hub’s Iris Dorbian rounded up eight deals in 2025 that sum up why firms like Ares, GTCR and Lightyear Capital are flocking toward the sector.

Another space that investors are looking to consolidate is the urology market. In this week’s Friday Focus, we take a look at a merger agreement between a Gauge Capital portfolio company and a business recently sold by Apollo.

Fragmentation is also among the reasons private equity is drawn towards the autism therapy segment. This morning, we delve into Bourne Partner’s Autism Therapy Market Update that points out another unique trend that may help increase PE involvement in the space.

Ripe for consolidation

Even with the current dealmaking slump, PE dollars continue to flow into the insurance sector.

PE Hub ‘s Iris Dorbian tracked eight notable deals in this segment that have transpired since the beginning of this year.

Upgrade to the premium version of the Wire to read the full list of deals in the insurance space.  

Friday Focus

Earlier this week, Gauge Capital announced an agreement to merge its portfolio company Urology America, a management service organization of independent urology practices, with GI Alliance, a physician-led gastroenterology practice based in Southlake, Texas.

To learn more about this deal and the trends driving dealmakers toward the urology sector, check out the premium Wire.

Reimbursement drivers

Pressures on fee-per-service reimbursement is driving autism therapy providers to explore transitioning to value-based reimbursement, which may drive many of these companies to become PE-backed, according to Bourne Partners’ Autism Therapy Market Update report.

The autism sector has many tailwinds that make it highly attractive to PE, many of which I covered in my autism mini-feature – the most read story at PE Hub in April with over 3,500 page views – where I spoke with Calex, Goldman Sachs Alternatives and Shore Capital Partners.

Check out the premium version of the Wire to read more of my insights from the report.

Well, that’s it for me. As always, if you have any questions, thoughts or want to chat, please email me at john.fischer@pei.group.

A scheduling note before I sign off: with Monday being a bank holiday in the UK, the next Europe edition of the Wire will hit inboxes Tuesday. The US edition will go ahead as normal on Monday.

Rafael Canton fills in for MK Flynn in the US chair, while Craig McGlashan will bring you the Europe edition on Tuesday.

Cheers,

John

Read the full wire commentary on PE Hub ...

Also of note (may require subscriptions)

KKR has raised 70 percent of the $20 billion target for its 14th flagship buyout fund despite a slow market aggravated by fresh uncertainty (Buyouts).

KKR has said the majority of its $209 billion private equity portfolio does not have material exposure to the impact of US imposed tariffs and that the firm is ready to play offence on behalf of its clients. (Private Equity International)

Private Equity International is out with a new report on the democratization of private equity. Among the features:

• GPs discuss valuation challenges as regulatory scrutiny rises
• 5 ways democratisation is changing private equity
• Family offices stick with tradition amid democratisation wave
• How PE giants plan to tap the 401(k) market
• How global PE firms can access China’s private wealth market
• Build your own public and private markets adventure
• What will retail investing look like under Trump 2.0?

Dealmakers are bullish about the education sector, as demand for accessible and good quality education grows. PE Hub rounds up seven PE-backed deals in Europe and the US since February.

Two Lexington Partners secondaries funds could get a boost from the New Jersey State Investment Council, which is proposing an up to $600 million investment into a separately managed account. (Secondaries Investor)

A second chance for endowments: Yale's sizeable portfolio sale could spur a number of endowments to follow suit – with programmatic seller Harvard in market alongside it. (Secondaries Investor)

Cibus Capital has co-led a $25 million funding round for US-based agri-fintech company Growers Edge. Capital was deployed from Cibus Enterprise Fund II and marks the $135 million vehicle’s first foray into the agri-fintech sector. (Agri Investor)

Ara Partners, a decarbonization-focused private markets firm, has raised more than $800 million for its debut infrastructure fund through a combination of Ara Infrastructure Fund I and associated co-investment vehicles. Its original target for the fund was $500 million. (New Private Markets)

Data – how to collect it, interpret it and present it to investors – has received substantial attention from impact investors over the last few years. With good reason: quality impact data is crucial for substantiating the claims made by managers, and it allows LPs to compare the outcomes of different investment approaches. This is to say nothing of the sustainability reporting regulations that are now a part of the global regulatory landscape. However, some LPs are now noting the drawbacks to an approach to impact that is overly data-focused. (New Private Markets)

Deals

They said it

“Resilient business models, which possess strong recurring revenues and cashflows over long economic cycles.”

— Mark Vassallo, managing partner at Lightyear Capital, on why PE firms are pursuing deals in the insurance market.

Today's letter was prepared by John R Fischer

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