Fellow Health Partners, a Bay Shore, NY-based RCM services firm serving physician groups and ambulatory surgery centers, has received a strategic investment from Cleargate Capital Partners. Terms were not disclosed. This is exactly the kind of deal the market keeps producing — and there's a reason why.
Target: Fellow Health Partners (Bay Shore, NY) — RCM services for physician groups, ASCs, and healthcare organizations nationwide
Investor: Cleargate Capital Partners — healthcare-focused PE, founded 2025, lower middle market focus
Deal type: Strategic investment
Amount: Not disclosed
Announced: June 15, 2026
Fellow Health Partners provides end-to-end revenue cycle management services — billing, coding, denial management, collections — to physician groups and ambulatory surgery centers across the country. That's the segment everyone is fighting over right now: independent and physician-owned practices that don't have the scale to build internal RCM infrastructure but generate enough volume to make outsourcing economics work.
ASCs in particular are a high-value target. Procedure-heavy, often out-of-network or partly out-of-network, and historically underserved by the big RCM outsourcers who focus on hospital systems. The billing complexity — implants, modifier stacking, facility vs. professional split — creates real margin opportunity for firms that know the coding patterns cold.
Cleargate is a new entrant — founded in 2025 — with a declared focus on founder-led, lower middle market healthcare businesses. The "long-term partnership" language in the announcement is deliberate. It signals a buy-and-build orientation: acquire a platform, retain the founders, add adjacent capabilities or tuck-in acquisitions, and grow into something that commands a larger exit multiple in 5–7 years.
That's been the playbook for virtually every successful RCM PE deal of the last decade. Revenue cycle is sticky — once you're embedded in a practice's EHR workflows and payer contracts, you don't leave easily. The churn metrics look good on a diligence deck. Cleargate knows this.
RCM services firms at the $5M–$30M revenue range are genuinely difficult to sell to strategic acquirers — too small for the Ensemble/Optum tier, too undifferentiated for a technology premium. PE solves the liquidity problem for founders while providing operational capital to compete. Cleargate is betting that Fellow can grow into a platform worth 8–10x EBITDA instead of the 4–5x a typical small services business commands today.
A few things worth noting for RCM professionals watching M&A activity:
This deal won't change your workflow tomorrow. But it's another data point in a pattern that should inform how physician practice administrators and ASC revenue cycle directors think about their vendor relationships. PE-backed RCM vendors are under pressure to grow revenue quickly. That creates both opportunity (more competitive pricing, technology investment) and risk (staff turnover post-acquisition, service disruption during integration).
If Fellow Health Partners is your RCM vendor, or if you're evaluating them: ask directly about the Cleargate investment thesis, the timeline, and what operational changes are planned in the first 12 months. Those are the questions that separate informed buyers from ones who find out at contract renewal.
Related Research
Want to understand how PE-backed mid-market RCM outsourcers compare? Read our independent deep dive: Omega Healthcare: The Outsourcer That Became an AI Company
Denial trends, payer policy moves, vendor intel — delivered every morning. Free.
Source: BusinessWire, June 15, 2026