In the USA if there is no support from the payer side then things fall over pretty much instantly, this is a B2B (business to business) offer not a B2C (business to consumer). There was a pivot away from B2C model last year which resulted in some heavy selling and price suppression however that is now in the past. Should any of Ramsay(initially Joondaluop WA) or Sheba(Israel and beyond) or Hapvida (Brazil) or the Spanish deal get over the line then we have a company making proposition. Mednax is a different beast entirely, they do 200,000 high risk births per year alone and somewhere approaching 1.8m in total per year. To put that in perspective Joondalup is about 3000/year, Ramsay nationally is 25,000/year, Sheba is 11,000/year, the Spanish deal is likely to be in the 20,000/year mark and Brazil is 97 Hospitals and maternity facilities in total... none of those require the payments side in the same way as the USA, different health systems.
Mednax is a silver bullet. If it hits then don't worry about ANY OTHER metric. If Mednax is a no-go then Sheba, RHC, Hapvida etc are all materially significant events. Just Sheba is 5,000 x $800 USD/year as a minimum revenue target. Who knows how many 3rd world births would use a remote monitoring device that could be part of a virtual hospital?. Margin is high so that alone would make the share price double from here. Sheba is extending rapidly into the Middle East and Africa as well as some work in Brazil. They alone could provide more revenue than Ramsay in total.
So if Mednax misses due to the payment side and Sheba and RHC go full commercial then we have a market cap of a couple of hundred million or more as a starting point, maybe 7-10 times where we currently are. If Mednax, Sheba, RHC, Mayo (significant for validation more than 3000/year of births), Spain and Hapvida all fail then it is all over. 1 of them makes the company, 2 of them make buckets of cash, all of them will result in a swift ride to take-over level and we all have a fun little party in Tel Aviv!!
It is still very much binary but Mednax is the biggest cog in the machine of possibility, personally I don't factor it into my investment thesis as it results in a telephone number sort of valuation.
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