Afterburner & Council Exit Advanced Care Partners to Amulet

Afterburner Capital and Council Capital completed their exit from Advanced Care Partners, selling the physician-led home healthcare platform to Amulet Capital Partners in a deal that caps a three-year value creation strategy focused on geographic expansion and provider network density. The transaction, announced January 21, marks the second successful healthcare services exit for the partnership after their work building out Advanced Care's footprint across Alabama, Georgia, and Tennessee.

Advanced Care Partners operates as a physician-led, home-based primary care provider serving medically complex and frail patients — predominantly Medicare and Medicare Advantage beneficiaries who struggle with traditional office-based visits. The company's model sends clinicians directly to patients' homes, addressing a care gap that's grown more acute as the U.S. population ages and value-based care adoption accelerates across payer networks.

Amulet Capital Partners, a Stamford, Connecticut-based private equity firm managing over $4 billion in committed capital, will take the reins with plans to continue the platform's expansion strategy. The firm's healthcare vertical has built a track record in provider services, particularly platforms that align with Medicare Advantage growth trends and fee-for-value reimbursement models.

The deal comes as home-based care providers attract intensifying private equity interest. Medicare Advantage enrollment topped 33 million lives in 2024, with health plans increasingly contracting specialized providers like Advanced Care to manage high-cost, high-need populations. The sector's appeal: predictable revenue streams tied to capitated payments, strong unit economics when networks reach scale, and demographic tailwinds that aren't slowing down.

When Afterburner and Council first backed Advanced Care Partners, the platform operated primarily across Alabama and Georgia with a modest provider network. The investment thesis centered on geographic expansion into adjacent Southeast markets while deepening penetration in existing territories — a classic healthcare services buy-and-build playbook.

Under the sponsors' ownership, Advanced Care expanded into Tennessee, Florida, and South Carolina, growing its physician and advanced practice provider network to serve more than 6,000 patients. The company now operates across five states, building the kind of regional density that matters when you're trying to extract margin from capitated Medicare contracts.

Greg Graves, CEO of Advanced Care Partners, credited the sponsors with enabling the platform's clinical expansion while maintaining care quality — no small feat in a sector where rapid growth often strains operational infrastructure. "Their support allowed us to scale our mission-driven model while staying focused on outcomes," Graves said in a statement accompanying the announcement.

The build wasn't just about adding markets. Advanced Care invested in infrastructure that supports value-based contracts: care coordination technology, data analytics for risk stratification, and partnerships with Medicare Advantage plans that reward reduced hospitalizations and ER utilization. Those capabilities position the platform competitively as Amulet looks to accelerate growth in what remains a fragmented market.

The math behind home-based primary care is straightforward: Medicare Advantage plans pay providers a fixed per-member-per-month fee to manage patient populations. When those patients are elderly, chronically ill, and historically high utilizers of expensive services like hospital admissions, keeping them healthy at home generates margin.

Studies consistently show that home-based primary care reduces hospitalizations by 20-30% and cuts total medical costs by similar percentages for high-risk seniors. That creates alignment between health plans hunting for cost savings and providers building sustainable businesses around capitated payments.

Private equity has flooded into the space accordingly. Comparable transactions over the past 24 months include TPG's acquisition of Landmark Health, Oak HC/FT's backing of ChenMed, and Clayton, Dubilier & Rice's investment in Cano Health before its complicated public-to-private journey. The sector saw more than $8 billion in disclosed PE investment between 2022 and 2024, per PitchBook data.

But the sector isn't without execution risk. Scaling home-based care requires recruiting and retaining physicians willing to make house calls — a labor pool that's limited and expensive. Margins compress quickly if provider utilization falls or if Medicare Advantage plans renegotiate rates downward, as several major payers did in 2024 amid rising medical costs.

Advanced Care's multi-state expansion gave it negotiating leverage with national and regional Medicare Advantage plans. A provider network spanning Alabama, Georgia, Tennessee, Florida, and South Carolina means the company can bid on contracts that smaller, single-market competitors can't service. That geographic breadth also allows for centralized back-office functions — billing, credentialing, data analytics — that improve unit economics as patient volume grows.

Amulet Capital Partners manages approximately $4 billion in committed capital across healthcare services, technology-enabled services, and other sectors where operational improvement drives returns. The firm's healthcare portfolio leans heavily on provider businesses aligned with value-based care and government-funded reimbursement models.

The Advanced Care acquisition fits Amulet's pattern: physician-led platforms, Southeast geography, Medicare-heavy payer mix, and opportunity for continued buy-and-build. Amulet's history suggests the firm will look to bolt on additional home-based care providers in adjacent markets or add complementary service lines — think home health, palliative care, or remote patient monitoring — to deepen the relationship with existing patients.

Amulet's investment team emphasized the platform's clinical model and growth trajectory in the announcement. "Advanced Care Partners has built an exceptional reputation for delivering high-quality, compassionate care to vulnerable patient populations," said a spokesperson for Amulet in the release. The firm plans to support continued geographic expansion and invest in technology infrastructure to enhance care coordination.

For Advanced Care's leadership, the transition represents continuity more than disruption. Greg Graves and the existing management team will remain in place, and the company's clinical model and payer partnerships aren't changing. The bet is that Amulet's capital and operational resources will accelerate what Afterburner and Council started.

Amulet has dry powder to deploy. The firm closed its fourth fund in 2022 at $1.5 billion and has been actively investing in healthcare services platforms since. Advanced Care becomes one of several active portfolio companies in Amulet's healthcare vertical, which also includes businesses in behavioral health, specialty pharmacy, and post-acute care.

Afterburner Capital, based in Charlotte, North Carolina, and Council Capital, headquartered in Nashville, Tennessee, partnered on the initial investment in Advanced Care Partners as part of a broader collaboration across healthcare services deals. Both firms specialize in lower-middle-market healthcare and business services platforms, typically targeting companies with enterprise values between $25 million and $250 million.

The sponsors declined to disclose financial terms of the exit, but healthcare services platforms of Advanced Care's scale — serving 6,000+ patients across five states with strong payer relationships — typically command valuations in the 8x-12x EBITDA range, depending on growth rates and contract quality. The three-year hold period suggests the sponsors executed their value creation plan on schedule, avoiding the longer hold periods that have become more common as exit markets tightened in 2023 and 2024.

Providence Strategic Advisors served as the exclusive financial advisor to Afterburner Capital and Council Capital on the transaction. Bass, Berry & Sims PLC provided legal counsel to the sellers. Amulet Capital Partners was advised by Ropes & Gray LLP on legal matters and conducted financial due diligence with support from an undisclosed accounting firm.

The transaction structure wasn't disclosed, but healthcare services deals of this size typically involve a combination of equity rollover from management, seller financing or earnouts tied to performance milestones, and new debt from senior lenders or private credit funds. Management's equity rollover — if any — would signal confidence in Amulet's growth plans and align incentives for the next chapter.

Providence Strategic Advisors has built a niche advising lower-middle-market healthcare services sellers, particularly in the Southeast. The firm's involvement suggests a managed auction process with multiple potential buyers evaluating the platform. That Amulet won likely means they offered the most compelling combination of valuation, cultural fit, and operational resources.

Medicare Advantage penetration crossed 50% of all Medicare beneficiaries in 2024, a milestone that fundamentally reshapes how care is delivered and paid for in the U.S. As traditional fee-for-service Medicare shrinks, providers either adapt to value-based contracts or watch margins erode.

Home-based primary care sits at the intersection of three trends: aging demographics, value-based care adoption, and labor shortages in traditional clinical settings. The model addresses all three. It serves an older, sicker population. It aligns financial incentives around outcomes rather than volume. And it offers physicians an alternative to high-patient-volume office practices.

But the sector faces headwinds too. CMS reduced Medicare Advantage benchmark rates for 2025, pressuring health plans to cut costs. Many responded by tightening provider networks or renegotiating capitation rates downward. Providers without scale or strong clinical outcomes data found themselves squeezed.

Advanced Care's timing works in its favor. The company built density in Southeast markets before competition intensified and locked in multi-year contracts with major Medicare Advantage plans during a period of aggressive plan growth. Those contracts provide revenue visibility that newer entrants lack.

Amulet's immediate priorities will likely focus on three areas: expanding into new geographies, deepening market penetration in existing states, and adding ancillary services that increase revenue per patient without proportionally increasing costs.

Geographic expansion could mean entering North Carolina, Virginia, or other Southeast states where Advanced Care doesn't yet operate. The company's existing infrastructure — care coordination technology, billing systems, clinical protocols — can scale to new markets without full reinvestment, which is how buy-and-build healthcare platforms generate returns.

Deepening market penetration means adding providers in cities where Advanced Care already operates but hasn't saturated the addressable patient population. Birmingham, Atlanta, Nashville, Jacksonville — all have thousands of Medicare Advantage beneficiaries who meet the clinical criteria for home-based care but aren't yet enrolled.

Adding ancillary services — home health aides, remote monitoring devices, specialty pharmacy coordination — allows Advanced Care to capture more of the total cost of care for its patient population. That drives up per-patient revenue and strengthens the value proposition to health plans, who'd rather contract with one integrated provider than coordinate across multiple vendors.

The Advanced Care transaction offers a data point on exit viability in healthcare services after two years of challenged M&A markets. Strategic buyers and well-capitalized PE buyers remain active in sectors with defensive characteristics — recurring revenue, government reimbursement, demographic tailwinds.

But deals are taking longer to close, valuations have compressed from 2021-2022 peaks, and buyers are more focused on near-term cash flow than growth projections. Afterburner and Council likely accepted a multiple below what they might've commanded 18 months ago, but they secured an exit at a time when many sponsors are still holding assets bought at higher valuations.

Healthcare services remains one of the few sectors where private equity can still deploy capital confidently. The combination of regulatory complexity, operational intensity, and fragmentation creates opportunities for firms that know how to build and scale platforms. Home-based care, behavioral health, specialty pharmacy, and post-acute services all fit that profile.

What's less clear is how long the current valuation environment persists. If interest rates stabilize and debt markets continue reopening, valuations could firm up. If Medicare Advantage rate pressure accelerates or regulatory scrutiny intensifies, buyers will demand steeper discounts. Advanced Care's exit suggests the market is functional — not frothy, but workable for quality assets with real earnings.