Gastroenterology was fragmented. Thousands of independent GI practices dotted the country, most of them small, most of them running their own billing, staffing, and administrative operations without much coordination. Reeve Waud saw the same pattern he had recognized years earlier in behavioral health, when he built Acadia Healthcare from scratch into a national hospital system.
Waud Capital Partners formed GI Alliance in 2018 alongside a physician executive team led by James Weber, M.D. The starting footprint covered just two states. Four years later, the company operated across 14 states with nearly 700 gastroenterologists, making it the largest independent GI practice management platform in the United States.
How the Platform Took Shape
GI Alliance wasn’t built by snapping up random practices. Reeve Waud’s firm picked out high-quality gastroenterology groups and affiliated them under a shared management structure, allowing physicians to retain clinical autonomy while gaining access to centralized operations, technology, and administrative resources.
The physician count grew nearly fivefold during WCP’s ownership. David Neighbours, a partner at Waud Capital, worked closely with Dr. Weber to recruit GI groups across Texas, Florida, Illinois, Colorado, Arizona, and eight other states. Each affiliation added scale, and each new market reinforced the network’s position with payors and suppliers.
A $2.2 Billion Exit
The exit came in September 2022 through a physician-led buyout and recapitalization backed by Apollo Global Management. The transaction valued GI Alliance at approximately $2.2 billion. Waud Capital sold its controlling equity interest while the physician owners maintained a large stake and continued running clinical operations.
The deal structure reflected what Reeve Waud has consistently prioritized: building a company to a point where it can attract a top-tier buyer without leaning on debt loads or financial engineering to juice returns. Apollo, which manages more than $500 billion in assets, was on the other end of the transaction.
What the GI Alliance Model Shows
Reeve Waud has spoken publicly about WCP’s preference for fragmented healthcare niches where a well-capitalized buyer can assemble a platform around experienced management. GI Alliance fit that description precisely. Gastroenterology is procedure-heavy, insulated from many of the reimbursement pressures affecting other specialties, and had no dominant national player before GI Alliance came along.
The playbook mirrors what WCP executed with Acadia Healthcare in behavioral health and Center for Vein Restoration in vein disease: identify a specialty with scattered independent operators, recruit a physician leader, deploy capital for acquisitions, and exit when the platform reaches a size that commands attention from institutional buyers.
