The Doctor & The Finance Bro

The Doctor & The Finance Bro

Dr. Lisa Piercey went from pediatrician to hospital executive, Tennessee Commissioner of Health during COVID, and now independent sponsor preparing to close her 5th healthcare platform. Her edge is deep healthcare operating & policy expertise, particularly around reimbursement, aging, chronic disease, Medicaid, and value-based care.

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Lisa didn’t know much about private equity. After leaving Tennessee state government in 2022, she explored consulting and operating partner roles, and then someone suggested she raise a small fund. She joined Novastone, a search accelerator, for her first acquisition. In retrospect, she thinks she could’ve done it independently, but the structure helped reduce mistakes and shorten the learning curve. The decision of whether to join an accelerator comes down to risk tolerance, timing, and life situation. Her original plan was to buy 1 business and operate it through exit, but she “got bit by the deal bug.”

As the portfolio grew, Lisa moved from opportunistic acquisitions toward a more deliberate & synergistic strategy. Early deals ranged from specialty pharmacy to senior living and wellness. Once the deals got bigger, she needed more infrastructure: a finance-focused partner, clearer process, and a more formal approach. The goal shifted from buying good healthcare businesses individually to finding businesses that could create value across the portfolio.

Healthcare is still the constant. Lisa believes investors should buy businesses in sectors they actually understand. She’s focused on areas including aging, chronic disease, pediatric Medicaid, and value-based care. Plenty of “boring” healthcare businesses offer durable demand and attractive reimbursement models.

A covenant breach at her first specialty pharmacy forced another step-up in sophistication. An unexpected reimbursement policy change temporarily pushed the business outside its lender ratios. That didn’t wipe out the equity, but it sharpened the focus and led to increased reporting, better cost scrutiny, etc. The lenders temporarily adjusted the ratios and the company outperformed the revised thresholds within roughly 4-5 months. Lisa kept 2 practices from the experience: monthly finance committee meetings and a 13-week cash flow forecast circulated every 2 weeks.

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