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Investment Banker·Behavioral Health

Steve Aguiar

Managing Director at Fifth Third Securities

Austin, Texas, USA

SA
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Why they matter

A 20-year healthcare sell-side banker who has publicly flagged behavioral health, autism therapy, and IDD services as the market's next consolidation wave.

Background

Steve Aguiar is a Managing Director in Fifth Third Securities' Healthcare Investment Banking group, which he joined in 2019, with nearly 20 years of investment banking experience focused on sell-side M&A for founders and private equity sponsors across healthcare services. Before Fifth Third he spent 15 years at Provident Healthcare Partners, rising to Managing Director and closing roughly 120 healthcare transactions spanning staffing, pain management, air medical transport, and physician practice management. He holds a B.S. in Corporate Finance and Accounting from Bentley University and an MBA from the McCombs School of Business at UT Austin.

Notable deals

  • 2017
    Advised Air Medical, LLC (Texas fixed-wing air ambulance operator) on its acquisition by AirMed International, a KKR-backed Air Medical Group Holdings subsidiary
  • 2017
    Advised GrapeTree Medical Staffing on its recapitalization with New MainStream Capital to fuel national expansion
  • 2015
    Advised PRC Associates, a Daytona Beach interventional pain management practice, on its sale to Alliance HealthCare Services
  • 2026
    Publicly quoted as Fifth Third's healthcare banking lead on continued behavioral health M&A momentum into 2026, flagging autism therapy and IDD services as outsized-interest subsectors

Call-prep brief

Background

  • MD, Healthcare Investment Banking at Fifth Third Securities (Austin, TX), since 2019
  • Prior 15 years at Provident Healthcare Partners (MD), ~120 healthcare transactions closed
  • Bentley University (B.S. Finance/Accounting); MBA, McCombs School of Business (UT Austin)

Current focus

  • Sell-side M&A for founders and PE sponsors across multi-site/physician practice management, healthcare staffing, pharmacy, post-acute care, digital health, and behavioral health
  • As of mid-2026, on record calling behavioral health M&A "strong" with continued momentum expected into 2026, citing large addressable market and unmet demand

What he cares about

  • Demand-supply imbalances in fragmented healthcare subsectors as the core investment thesis (explicitly named autism therapy and IDD services as areas of outsized interest)
  • Matching founders with the right strategic or financial partner for growth, not just maximizing headline price

Recent moves

  • Active speaker/panelist on the ACG Austin/San Antonio circuit (Private Equity Two-Step Conference), suggesting continued deal-sourcing focus in the Texas PE ecosystem

Potential sensitivities

  • Moved from a pure-play healthcare boutique (Provident) to a bank-owned platform (Fifth Third) — may have different deal-size sweet spot or conflict-check constraints now
  • As a broker-dealer rep (FINRA BrokerCheck registered), any outreach involving compensation discussion should route through compliance-appropriate channels

Questions to ask

  1. Which behavioral health subsectors (autism/IDD, outpatient MH, SUD) is he seeing the most active buyer interest in right now, and from whom (strategics vs. new PE entrants)?
  2. How does Fifth Third's healthcare banking mandate differ from his prior boutique experience in terms of deal size or sponsor relationships he can bring to the table?
  3. Based on his ~120-deal track record, what are the recurring diligence red flags he sees sink behavioral health platform deals?

Outreach draft

Subject
Behavioral health rollup — quick call?
Hi Steve, I saw your recent comments on the continued strength of behavioral health M&A, particularly around autism therapy and IDD services — that lines up closely with a platform investment thesis our team is actively building. Given your run advising healthcare services deals, both at Fifth Third and previously at Provident, I'd value 20 minutes to get your read on where buyer demand is concentrated right now and which operators are attracting the most competitive processes. Would you have time for a short call in the next week or two? Happy to work around your schedule. Best, [Placeholder Name]

Linked companies

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