Private equity exit pressure and secondary markets reshape liquidity

Aging NAV, weak distributions, stale valuations, tighter lending, elevated rates, succession risk, and the 2028–2029 maturity wall continue to pressure healthcare sponsors. Continuation funds, GP-led deals, structured regional sales, add-ons, private credit, co-investment, real-estate-backed transactions, and sum-of-the-parts exits are increasingly central; evergreen-fund restructuring and SEC valuation guidance underscore the need for current borrower data, defensible marks, and credible liquidity plans.