This document provides an annual synopsis and outlook from TripleTree, an independent investment bank focused on mergers and acquisitions, capital formation, and strategic advisory for healthcare and technology firms. It discusses the challenging economic environment of 2009 and how some companies emerged as leaders through strategic acquisitions and capital raises. TripleTree also summarizes its research focus areas and recent reports on emerging trends in healthcare, technology, and other industries.

1. Acuity2009
Annual Middle Market Investment Banking Synopsis & Outlook
ALL RIGHTS RESERVED. NO PART OF THIS PUBLICATION MAY BE REPRODUCED OR UTILIZED IN ANY FORM OR BY ANY MEANS,
ELECTRONICALLY OR MECHANICALLY WITHOUT PRIOR PERMISSION IN WRITING FROM THE PUBLISHER.
COPYRIGHT © 2009 TripleTree, LLC

2. Independent | Insightful | Relevant
TripleTree, LLC is an independent, mid-market investment bank focused on mergers and
acquisitions, capital formation and strategic advisory for healthcare and technology firms.

3. sentiment
“We’ve been given this on a silver platter…we might as well use it as an opportunity…you can retrench, pull in your horns, protect the
balance sheet and preserve cash. Or you can realize that this is about humanity screaming for change.”
- Sam Palmisano, Chief Executive Officer, IBM
as quoted in Fortune Magazine, December 2008
“Almost by definition the entrepreneurs who have the moxie to walk through your door in tough times tend to have better ideas.”
- Michael Goguen, Managing Partner, Sequoia Capital
as quoted in www.businessweek.com, December 2008
“We’re very bullish…it’s during downturns like these where you get to prove yourself, where strong companies pull away from weak
ones…we think this environment presents a great opportunity…”
- Tien Tzuo, CEO, Zuora; former SVP of Salesforce.com
quote provided for Acuity2009
“The current market is a period of Darwinian change…the recession and shuttered IPO market will place tremendous pressure on portfo-
lio companies to tighten their belts and re-tool where necessary.’’
- Mark Heesen, President, National Venture Capital Association
as quoted in www.CBR.com, December 2008
“…businesses need to ask themselves…’what is our vision for where this industry is going with or without us’…’what is our differentiated
strategy within that vision’…’how are we going to execute in the next 12 to 18 months’…?”
John Chambers, Chief Executive Officer, Cisco Systems
as quoted in www.fastcompany.com, December 2008
1

4. viewpoint
Companies and their investors are trying to make sense of what to do next amid the most chaotic economic environment since the 1930s. While the
U.S. financial crises have had a direct impact on the global economy, stock markets are down markedly, short-term credit has dried up and all indicators
including consumer spending, employment, auto sales, retail sales, and factory outputs have the U.S. economy in need of fundamental changes.
During this shake out new leaders will emerge, and for mid-market firms the potential could be profound. TripleTree is telling clients that bold, strategic
thinking today can be game-changing tomorrow. For instance, fragmented industries like healthcare are ripe for innovation and opportunities are
materializing as players from retail, publishing, and financial services industries begin to address the unmet needs of consumers.
Every day we talk to strategic buyers, financial sponsors, and the best technology-enabled firms in North America. Their interest in acquiring high
growth businesses despite market conditions remains strong. Transaction terms for M&A will likely tilt more toward equity financing and away from
debt, but strategic valuations are possible and deals are getting done.
TripleTree’s M&A and advisory business grew over 50% in 2008. While we have a keen appreciation for the tenuous economic climate, we’re bullish
on 2009 because of our focus on proprietary research and dedication to a work product tailored specifically to middle market firms and their financial
sponsors.
We’re hopeful this issue of Acuity2009 provides useful perspective on the current market landscape and where TripleTree is providing investment
banking support. We look forward to reconnecting for an update on your business and learning how we can help your management team and
shareholders.
Sincerely,
Kevin Green, Co-Founder & Managing Partner
David Henderson, Co-Founder & Managing Partner
Peter Erickson, Managing Partner
Joe Schiesl, Managing Partner
Scott Tudor, Managing Partner
Chris Hoffmann, Senior Principal
Brian Klemenhagen, Senior Principal
2

5. questions
As a boutique investment bank, TripleTree’s community consists of three distinctive yet interrelated groups: Mid-Market Firms, Financial Sponsors, and Global
Aggregators. In addition, we maintain a network of active advisors, former clients and industry partners. In an environment of likely consolidation, each of our constituents
is searching for either new pockets of growth, new capital sources, or new strategic partners. As they seek answers, a range of questions have emerged:
VALUATION REALITIES
• Is now the right time to be pursuing a liquidity event?
• Given tough market conditions, is capital funding for growth companies or shareholder liquidity available?
• Are strategic valuations still possible and what factors drive top quartile outcomes?
• As scrutiny grows around M&A and investment activities, what perspectives are critical in assessing timing and approach?
SECTOR CONSIDERATIONS
• Have enterprise software buying habits been changed forever?
• How should we be considering federal initiatives and regulations on our industry in light of the incoming U.S. presidential administration?
• What is the potential for mass-market retailers like Wal-Mart, Amazon and Google to disrupt traditional industry verticals such as healthcare, telcom, insurance,
and banking?
• Are mobile solutions finally ready for a break-out move?
• In the technology industry, cloud computing is disassembling the “technology stack” as we’ve known it. Many are left asking where the best growth stories for
2009 will be centered. Integration? Data management? Content optimization? Vertical specialization?
• In the healthcare industry consumerism is growing as alternative care models disrupt traditional industry practices: payors are assessing whether their current
business model and legacy technologies support the ways that today’s consumers need to be serviced; providers are seeking best approaches for addressing issues
around reimbursement, smart devices and consumer transparency; and global healthcare services firms like Express Scripts, Walgreens and Johnson & Johnson
are seeking investments and acquisitions for new solutions to extend their traditional competencies.
• As mid-market firms take advantage of opportunities in new markets, how should partner ecosystems, go-it-alone strategies, consumerism, or other trends be
considered?
3

6. advice
We are of the mindset that preserving cash and hunkering down should not be a universal strategy for growth oriented businesses. As the marketplace filters
dozens of variables impacting sales, operations and executive thinking, we’re telling CEOs and investors to not simply assume that all activity in your sector
will come to a standstill. Rather, we’re asserting that a number of sectors will see new, non-traditional market leaders come forward and that strategic alternatives
should be assessed.
PREPARE FOR CONSIDER NEW BUSINESS MODELS
OVERTURES AND CHANGING THEMES
• Many of the better innovators are already being approached by potential • Realizing that the influence of consumerism can create growth
acquirers. For firms with On Demand or Software as a Service (SaaS) opportunities for solutions ranging from healthcare and financial
delivery, this is happening with the growing interest in subscription- applications to enterprise logistics and education.
based pricing and multi-tenant delivery models as highly leveraged
application platforms. • Acquisitions will not be limited to global firms. Mid-market players
with stable fundamentals will become acquisitive, especially seeking
• Having an appreciation for how your business will be viewed as a businesses with disruptive delivery models and recurring revenue
strategic asset given today’s market will impact thinking on timing and streams.
approach.
• Understand your current market landscape. Where it evolves is critical
• Preparing for strategic discussions today requires an approach beyond to visualizing new opportunities and building an innovative roadmap.
considering traditional financial synergies. Well articulated long-term For example, the convergence of media and content management
thinking, a focus on new markets, identification of strategic partners and strategies is beginning to shed light on the fact that ad-driven revenue
an understanding of disruptive delivery models are critical components models can’t offer long-term sustainability.
to these discussions.
• Some of the best business models we’re seeing are “assemblers” and
• In mature sectors like Enterprise Resource Planning (ERP), over half “hybrids”. Said differently, firms that are identifying specific marketplace
of vendor revenues are derived from single-digit maintenance and point and addressing them with solutions comprised of disparate pieces
professional services growth. Without the aid of acquisitions, the notion rather than suites represent a new approach to brand building.
of “high growth” will be nearly impossible and embracing new delivery
models like SaaS and industry specialized solutions will be critical for
accelerating revenues and remaining relevant.
4

7. growth areas 2009
Traditionally, healthcare and government sectors are the most immune from economic downturns. During this time, forward thinking executives will be
provided with a great occasion to leverage disruptive approaches in both their legacy market and new adjacent areas.
TripleTree will continue its focus on the healthcare market and disruptive, technology-enabled solutions and services.
We will also apply resources to vertical industry solutions and where business applications are being influenced by consumerism and the need for better
analytical solutions.
In 2009, TripleTree will provide investment banking support and conduct primary research in the following areas:
TECHNOLOGY HEALTHCARE
• Analytics • Compliance
• Clean Tech & Green IT • Consumer Directed Health
• Cloud Computing & On Demand • Informatics & Analytics
• Collaboration & Content Management • mHealth
• Financial Applications • Pharma/Life Sciences
• Governance & Compliance • Retail
• Mobile Solutions • Revenue Cycle Management
• 1:1 Marketing • Seniors Market
• Procurement & Financial Value Chain
5

8. TripleTree Research supports our investment banking services, and is tailored to provide business builders and
investors with an independent and relevant perspective for creating value.
NEXT GENERATION mHEALTH SAAS PLATFORMS
COMPLIANCE REMOTE
ECOSYSTEMS EVOLVE TO MEET
THE NEEDS OF EMERGING SAAS
BUILDING A PLATFORM PATIENT MONITORING VENDORS
APPROACH TO ENTERPRISE
COMPLIANCE AND A TripleTree Industry Analysis
A TripleTree Industry Analysis A TripleTree Industry Analysis
SPOTLIGHT REPORT SPOTLIGHT REPORT SPOTLIGHT REPORT
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Report Summary Report Summary Report Summary
This Spotlight Report assesses why This Spotlight Report is a follow-up to This Spotlight Report identifies over a
compliance and risk management our spring 2007 report Telemedicine dozen vendors who have positioned
needs are top of mind for enterprises 2.0, which provides an overview of themselves as SaaS Platforms and
and where vendors are creating the entire field of wireless health highlights four components TripleTree
automated solutions to serve these and addresses more specifically has identified as a basic framework
evolving set of needs. It concludes with the convergence of clinical and for their success. It concludes with a
a viewpoint of how an enterprise-wide consumer applications through review of six differentiating functions
compliance platform and ecosystem mobile enablement. We provide an for this framework and offers some
will evolve in what is currently a highly update and continued exploration considerations for CEOs who are
fragmented market. into a particular area of telemedicine deciding how best to align with a SaaS
– Remote Patient Monitoring (RPM) Platform.
(Published Q1-2008) delivered to the home or to a mobile
(Published Q2-2008)
individual.
(Published Q2-2008)
6

9. In 2008, TripleTree published six Spotlight Reports (shown below) examining disruptive technologies and growing market trends.
COLLABORATION,
HEALTH & WELLNESS COMMUNITIES & THE NEXT EVOLUTION
ALTERNATIVE DELIVERY MODELS THE EXTENDED ENTERPRISE OF LIFE SCIENCES:
AND NEW APPROACHES TO AN INDUSTRY INTRODUCTION
HEALTH MANAGEMENT CONSUMERISM, THE SOCIAL
TO LIFE SICENCES SERVICES
GRAPH, AND APPLICATION
A TripleTree Industry Analysis PLATFORMS ARE CONVERGING TO
A TripleTree Industry Analysis
HELP ORGANIZATIONS LEVERAGE
RELATIONSHIPS AND ENHANCE
BUSINSS AGILITY
A TripleTree Industry Analysis
SPOTLIGHT REPORT SPOTLIGHT REPORT SPOTLIGHT REPORT
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Report Summary Report Summary Report Summary
This Spotlight Report examines This Spotlight Report examines This Spotlight Report marks TripleTree’s
new and innovative channels and the rapid change of enterprise first report focused exclusively on
methodologies firms are beginning to collaboration and social software the life sciences industry, identifying
implement in attracting and affecting solutions. The overarching TripleTree four key areas that are being shaped
the individual. To maximize their message to all aspiring “next by the sector’s unfolding evolution:
usefulness, TripleTree examines these generation” application providers patient safety; compliance; sales and
approaches and how they will need to is clear: “If you’re not engineering marketing; and collaboration. We
be delivered in flexible and convenient collaborative capabilities into your highlight the demands shaping the
channels while taking a more focused solution, you’re telling the world you’ve call for new technologies and services
and tailored approach that coincides decided to remain a legacy application driving these areas, while providing
with the disciplines and market vendor.” illustrative examples of solutions that
forces from other consumer-centric are leading the charge to enable the
industries. (Published January, 2009) industry’s transformation.
(Published Q3-2008) (Published Q1-2009)
7

10. outcomes 2008
- Top quartile valuations were attained
- Non-traditional global buyers made first-mover acquisitions
- Private equity firms showed substantial interest in good growth businesses
Paisley, the market leading platform provider of Governance, Risk and Compliance (GRC) software applications
solutions was acquired by Thomson Reuters, the global leader in publishing and intelligent information
brokerage.
About Paisley:
• #1 provider of GRC software applications solutions
• Customer-base includes Fortune 500 leaders with over 120,000 users in 40 countries worldwide
• Industry analysts at Forrester Research and Gartner rank as an elite leader within the Compliance
sector
SearchAmerica, the market leading provider of SaaS-based payment prediction software, automated Charity/
Medicaid processing, and address verification solutions for the hospital and physician sectors, was acquired by
Experian, the global leader in providing information, analytical, and marketing services.
About SearchAmerica:
• Leading provider of payment prediction data and analytics to the U.S. healthcare industry
• Nearly 200 clients across 500+ hospital and physician facilities, including many of the largest
TMG Health, the market leading BPO provider for government sponsored healthcare programs, was acquired
by Health Care Service Corporation (HCSC), the 4th largest US health insurer operated through BCBS plans of
Illinois, Oklahoma, Texas and New Mexico and various subsidiaries.
About TMG Health:
• Supports over 1.8 million Medicare and Medicaid members handling more than 20 million claims
annually
• Customer-base includes Medicare and Medicaid HMOs, employer retirement plans and other health
plans in all 50 states
• The markets’ only independent outsourced services provider within the complex managed government
programs market
MED3OOO, a leading provider of healthcare management, outsourcing, and data management solutions
was recapitalized by Mitsui & Co. (USA), Inc., a wholly owned subsidiary of the $55 billion Japanese-based
conglomerate, Mitsui & Co., Ltd.
About MED3000:
• Business consists of over 1,500 employees with operational centers nationwide
• Clients include 10,500 physicians,16,000 technology users, 100+ hospitals/health systems and IPA’s
(California, Florida, Illinois)
• $250 Million in Recurring Revenue under contract
8

11. TripleTree led eight investment banking transactions in 2008, totaling over $750M in deal volume. Most notable about our advisory work over the past 18
months has been the strong interest of global acquirers in the clients who offer platform solutions and the aggressiveness with which private equity firms are willing
to pursue best in class businesses in select sectors and industry verticals.
Sircon Corporation, a SaaS industry leader of compliance solutions for the insurance IT Industry, was acquired by
Vertafore, a Hellman & Friedman and JMI Equity-backed provider of insurance-related software and information
solutions.
About Sircon:
• SaaS leader that solves mission-critical problems in the $60 billion insurance IT market
• Client base including 1,500 carriers, 20,000 brokers/agencies, 250,000 individual producers/
agents, 18 U.S. states
Whole Health Management, a provider of comprehensive health services through the operation of on-site health
and wellness clinics for large, self-insured employers was acquired by Walgreens, the nation’s largest drugstore
chain.
About Whole Health:
• Clinics deliver significant savings to corporations through lower healthcare costs and increased
productivity.
• Serves more than 320,000 employees and dependents across large corporations and Fortune 500
companies
Connextions, a technology-based BPO firm with broad expertise in the healthcare industry and enterprise
market, acquired an ownership interest in Aha! Software, augmenting its predictive analytics capabilities.
About Connextions:
• 2,500+ professionals
• Serves Fortune 500 clients and healthcare organizations
• Industry recognition includes Deloitte & Touche’s Fast 50 and Inc. Magazine Fastest Growing Companies
OneNeck IT Services Corporation, a leading ERP outsourcing services provider to mid-market companies,
acquired the managed hosting business unit of Ensynch, an IT consulting infrastructure and staffing company.
About OneNeck:
• Provides tailored solutions for mid-market companies
• Supports 50+ customers at over 700 global sites
• Ranked as #1 ERP management outsourcer by industry publications
Fair Isaac Corporation’s insurance bill review business unit was acquired by Mitchell International, Inc., a leading
data and technology provider to the automotive repair and property and casualty insurance industries.
About the Insurance Bill Review Business Unit:
• SmartAdvisor software is the leading medical bill review platform for workers’ compensation and
automotive claims offered via a licensed or ASP model
• Service bureau operations provide outsourced bill review, case management, and utilization review
services
• Clients include large self-insured employers, insurance carriers, and third party administrators
9

12. capital markets (focus on U.S.)
Market realities have set a challenging M&A and capital formation environment for Companies that miss the unique window of opportunity to become a platform
2009. Because valuations may not materially change in the next 2-4 years, CEOs acquisition for interested acquirers in today’s market could be forgoing a
and financial sponsors need to closely consider real growth prospects, competitive strategic outcome, and may ultimately find themselves valued at more traditional
pressures, and the time value of investments relative to their interest in a liquidity financial metrics once the consolidation trends that begin in 2009 stretch over
event. the next several quarters.
MARKET OBSERVATIONS:
As 2008 came to a close, world political leaders and financial firms were coordinating Premium Separation: During a downturn, high quality companies tend to separate
efforts to reduce the current credit constraints and stabilize capital markets. Jobless themselves from competitors more quickly via differentiated solutions and unique
claims in the U.S. are at their highest levels in recent memory with over 2M jobs lost in value propositions. Examples of this include next generation companies offering
2008 and a current unemployment rate of 6.5%. Housing prices in most markets across on-demand (SaaS) delivery models and the incumbent benefits of scalability, strong
the country continued to post double-digit declines throughout the year, with one user adoption and cost effectiveness. Though on demand businesses saw value
out of ten homeowners either delinquent on their mortgage or already in foreclosure. compression as public market comparables retreated from the 6x – 9x revenue
Political sea changes in the U.S. are also significant as a new presidential administration multiples seen in Q108, we remain bullish on recurring revenue and SaaS business
takes office. All major U.S. and global indices are trading at multi-year lows and equity models, and view the popularity of cloud computing initiatives as additional validation
markets have fallen 50% from their 2007 highs with respective declines in 2008 of 35% that on demand solutions could be a bright spot for tech-enabled businesses in 2009.
for the DJIA; 40% for the S&P 500, and 42% for the NASDAQ. The popularity of cloud computing is multi-fold, including desirable operating and
financial attributes and the “greening of IT” (as cost cutting is at the top of the agenda
These figures validate the report of the National Bureau of Economic Research that for most CIOs).
the U.S. has been in a recession since late 2007, but unlike the market downturn of
2001 current impacts are much broader. With Q109 girding for likely increases in Looking back, 2008 will be remembered for notable bank failures including Bear Sterns
government regulation, slower economic growth, and shifting of business strategies, and Lehman Brothers, and massive economic uncertainty prompting discussions
TripleTree has a few perspectives for mid-market and emerging companies. of governmental intervention, the likes of which haven’t been seen since the Great
Depression. The chart and table to the right highlight notable financial news and
IPO Market: Countless S-1 filings have been pulled and the odds for public market events from 2008:
liquidity events are close to non-existent. According to industry sources, IPO filings
have decreased 70% from a year ago, and there were only two venture-backed
technology IPOs in 2008.
10

13. 1
100
2 3 4
5 67 8 9
90 10
80
11 12
70
60
50
Jan-08 Feb-08 Mar-08 Apr-08 May-08 Jun-08 Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Dec-08
1 Jan 08 – Oil passes $100 a barrel for the first time in history 7 Sept 08 – Freddie Mac/Fannie May seek government protection from
bankruptcy
2 Feb 08 – Global inflation hits 10-20 year high
8 Sept 08 – Lehman Brothers files for bankruptcy, Bank of America purchases
3 Mar 08 – JP Morgan purchases Bear Stearns Merrill Lynch, AIG seeks bridge loan
4 Jul 08 – Beginning of “credit crunch” with loss of confidence by investors 9 Sept 08 – JP Morgan purchases Washington Mutual
in the value of securitized mortgages in the U.S .resulting in liquidity
issues 10 Oct 08 – U.S. House of Reps votes 263-171 to pass $700B bailout bill, Presi-
dent Bush signs into law hours later
5 Jul 08 – Oil peaks at $147 a barrel before gradually declining to below $50
11
a barrel in December of ‘08 Nov 08 – U.S. Presidential election
6 Sept 08 – Unemployment hits 6.1%, its highest point in 5 years 12 Dec 08 - The National Bureau of Economic Research (NBER) declared that the
U.S. entered a recession in December of 2007
11

14. m&a markets
MARKET OBSERVATIONS:
Overall M&A spending and deal volume declined in 2008. According to The 451 Group, technology related M&A spending and deal volume (including mega merger deals)
was down nearly 40% Y/Y and 23% Y/Y respectively.
Not surprisingly, emerging and mid-market businesses fared somewhat better than most and saw an increase in M&A activity in 2008. Independent industry sources
show that 2008 saw an increase in M&A deals of approximately 10% over 2007 for businesses at or below $750M enterprise value threshold.
Mid-Market M&A (Industry Agnostic) by # of Deals
# of deals
k
5,000
+ 10%
4,000 Below
$50M
3,000
$50M -
$250m
2,000
$250M -
1,000 $720M
0
2002 2003 2004 2005 2006 2007 2008
* Includes North American transactions only
12

15. TripleTree offers the following outlook for 2009 M&A activity:
General M&A: Global acquirers will continue to be acquisitive and most M&A activity Deal Size: Mega mergers and $1B deals decreased in volume as a function of tighter
will consist of tuck-under acquisitions of complementary solutions. Some enterprises market conditions and bearish attitudes. According to The 451 Group, deals valued at
will pursue more aggressive M&A strategies to enter entirely new markets and capture more than $1B in 2008 will account for less than half the number of total deals done
expansion opportunities in tumultuous market conditions. in any of the past three years.
Shifting Market Consolidators: Enterprise class vendors have historically led M&A Deal Structure: The lack of debt financing at the mega-deal level is having a trickle
activity in most sectors. Changing market dynamics such as consumerism, cloud down effect and more conservative deal terms considering profitability, cash flow
computing, healthcare transparency, and content management will likely change visibility, and sector specific parameters are now evident.
this trend. Global leaders will remain active but many mid-market firms will step
up their M&A activities to acquire weakened competitors and address white space No Parallel Processes for Sellers: The non-existent IPO market will set a new playing
opportunities. field for M&A discussions as global aggregators and financial sponsors focus on a deal
without the competitive distraction of public market liquidity options.
Technology M&A (2004-2008)* Healthcare M&A (2004-2008)*
# of deals # of deals $ Billions # of deals # of deals $ Billions
2,500 Deal size $250 1,200 Deal size $200
2,000 $200 1,000
$150
800
1,500 $150
600 $100
1,000 $100
400
$50
500 $50 200
0 $0 0 $0
2004 2005 2006 2007 2008 2004 2005 2006 2007 2008
* Includes North American transactions only
13

16. venture capital
MARKET OBSERVATIONS:
According to the National Venture Capital Association, venture capital firms predict Portfolio Trimming: Given limited liquidity options, TripleTree expects
they will reduce investments in 2009 by at least 10%. As funds and their limited underperforming companies or those with long-time horizons for growth to be
partners feel squeezed and retrench, many businesses will struggle and hope to trimmed from some portfolios, largely though M&A.
survive on current cash flows or raise a small round to add sustenance until 2010,
when funding spigots may open beyond a trickle. Trend Investing: Early-stage interest persists in Green-tech / Clean-tech, much of
healthcare, and areas engendering IT optimization and cost management, like cloud
Cash is King: The challenge for venture backed companies will be balancing growth computing.
and conserving cash. Realistic forecasts showing a pathway to positive cash flow in
the near-term may include a re-evaluation of operating metrics, sales focus, and cost
cutting.
Technology VC Investment (2004-2008)* Healthcare VC Investment (2004-2008)*
# of deals # of deals $ Billions # of deals # of deals $ Billions
Deal size Deal size
2,000 $15 800 $12
1,600
600 $9
$10
1,200
400 $6
800
$5
200 $3
400
0 $0 0 $0
2004 2005 2006 2007 2008 2004 2005 2006 2007 2008
* Includes North American transactions only
14

17. private equity
MARKET OBSERVATIONS:
Private equity investments dropped to a five-year low in 2008. Globally, private equity Issues will persist for hedge funds, pension funds, and endowments. Accounting
activity was $188B, down 72% Y/Y; and buyout deals comprised less than 10% of for billions of dollars in U.S. private equity firms, investments and fiduciary requirements
total M&A volume, down 21% from 2006 (Source: Thomson Reuters). In 2009, many for these types of investors will add further confusion to the landscape.
PE firms will seek exit advice for current portfolio companies and some new growth
investment. Public perceptions will trend negative. Some would give private equity firms a black
eye for poor performance but news about mismanagement and unethical activity is
Private Equity portfolio companies will become acquisitive. As PE firms reevaluate also top of mind. Blackstone Group is down 81% from its celebrated high of $35/share
their portfolios, reduced valuations will offer new opportunities to invigorate growth in mid-2007 and recent news of mismanagement at other firms has contributed to
into some current investments. billions of dollars lost, negative headlines, and sagging investor confidence.
Support from LPs will be problematic. The “chicken and egg” analogy of seeking
opportunistic investments while capital calls are placed to cynical LP’s will markedly
impact the success of many PE firms.
Technology PE Investment (2004-2008)* Healthcare PE Investment (2004-2008)*
# of deals # of deals $ Billions # of deals # of deals $ Billions
Deal size Deal size
250 $3.0 140 $2.0
120
200 $2.5
100 $1.5
$2.0
150 80
$1.5 $1.0
100 60
$1.0
40
$0.5
50 $0.5 20
0 $0.0 0 $0.0
2004 2005 2006 2007 2008 2004 2005 2006 2007 2008
* Includes North American transactions only
15

18. about
TripleTree’s investment banking and advisory practice is focused on the intersection of disruptive technology delivery
models, business services, and vertical industry specialization.
Our commitment since our founding in 1997 has been to provide best in class private businesses with independent
perspectives, insight based on proprietary research, and candid advice regardless of popularity.
TripleTree’s principals bring decades of experience as former operators of technology-based businesses in healthcare,
financial services, professional services, telco and distribution. We have led over 100 sell-side M&A transactions totaling
$5B in enterprise value with clients and buyers on three continents. Our recapitalization practice is growing quickly and
since 2006 our team has concluded over a dozen financing transactions with an enterprise value in excess of $1B.
After you have considered the perspectives offered in Acuity2009, we look forward to learning more about your
organization, the opportunities you’re facing, and how we can accelerate your success through unique and insightful
investment banking support.
7601 France Avenue South, Suite 150, Minneapolis, MN 55435 | 952-253-5300 | www.triple-tree.com
16

19. a - c u - i - ty (noun)
sharpness; acuteness; keenness: acuity of vision; acuity of mind.
In 2009, TripleTree Research adopted green publishing practices and will print only limited
quantities of reports. While we remain committed to a rigorous primary research agenda, we’re
encouraging readers to download online versions of our content.