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Chronicles

The story behind the story

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EQT and Canada's state pension fund buy a majority stake in Waystar, a provider of revenue cycle management software for healthcare orgs, at a $2.7B valuation

Heather Landi / FierceHealthcare :

FierceHealthcare Heather Landi

Context & Ripple Effects

This deal is the opening move of a now-complete arc: EQT and Canada's pension fund took control of healthcare revenue-cycle-management software maker Waystar at a $2.7B valuation in 2019, then held it through two defining steps — Waystar's $450M+ acquisition of patient billing and payments vendor Patientco in 2021, which pushed it beyond claims processing into consumer-facing payments, and its 2024 return to public markets.

That IPO priced at $21.50/share to raise $968M at a roughly $3.6B market value ([[a:866901]]), meaning the buyout consortium's entry valuation cleared with room even before post-listing drift. For EQT specifically, Waystar sits alongside a string of mid-market software take-privates — including its ~$3B acquisition of compliance software firm Avetta and its majority stake in API company WSO2 — marking it as one of the most active software consolidators of this cycle.

First-order effects

  • Waystar's existing backers sell control to EQT and Canada's pension fund at a $2.7B valuation, handing the revenue-cycle-management vendor a sponsor with capital and M&A appetite for its next phase.

Second-order effects

  • Under private ownership, Waystar broadened from back-office RCM into patient billing and payments via the Patientco deal, forcing rival health-payments vendors to compete on a wider front than claims workflow alone.

Third-order effects

  • The buy-to-build-to-IPO path — majority stake, bolt-on acquisition, public listing at a higher valuation — is becoming the template for how pension-backed PE firms like EQT monetize vertical software, as seen again in Avetta and WSO2.

The trend: Pension-fund-backed private equity is systematically taking vertical SaaS vendors private, building them up through bolt-ons, and exiting via public listings — with healthcare payments among the clearest examples.