L.A. Galyon, Managing Director, Brentwood Capital Advisors

In an interview with Invest:, L.A. Galyon, managing director at Brentwood Capital Advisors, highlighted how Nashville’s healthcare hub fuels the firm’s model. “Most of banking is still transactional. We’re relationship-driven,” Galyon pointed out while sharing how AI, behavioral health, and outsourced services are key growth areas as the firm scales steadily in a shifting market.

What major economic shifts over the past year have shaped your strategy at Brentwood Capital?

Usually when you have a down economy, it lasts a couple of years. I’d argue we’ve been in one for three — starting with inflation and the Fed raising rates in mid-2022, all the way through what some called “Liberation Day” this spring.

The market doesn’t like uncertainty, and that’s what we’ve had. High borrowing costs, rising labor expenses after the pandemic, and price instability all contributed to a tough environment. I think 2022 or 2023 was the worst IPO year on record, which really tells the story.

Now, turning the page into late 2024 and beyond, there’s more optimism. Maybe we’ll get a rate cut. The job market has softened slightly. There’s momentum building heading into 2025 and 2026.

What makes Nashville a strategic location for Brentwood Capital Advisors, especially given your focus on healthcare?

It’s a blessing to be based here. There are about 900 healthcare companies in the Middle Tennessee area and 17 that are publicly traded. If we were in Houston, we’d be doing oil and gas. If we were in D.C., it’d be aerospace and defense. But here, healthcare is right in our backyard.

That proximity allows us to call people at these companies, who may have been in the business or used certain vendors, and get their real-world perspective. It makes us more informed when we’re helping clients raise capital or sell a company.

A lot of the larger firms we compete with are generalists, covering 15 sectors broadly. But they lose industry expertise, and so that’s where we have an advantage.

How are Nashville’s healthcare, finance, and entrepreneurship sectors intersecting to drive growth and innovation?

Oracle moving its headquarters to Nashville from California by way of Austin is a great example. That’s a major vote of confidence in the city and the market.

I’m not an AI expert, but the impact of technology and AI on healthcare is going to be huge. Federal and state spending pressures mean providers won’t be able to rely on increasing reimbursement. Innovation will have to make up the difference.

Most of the companies we work with are either care providers in lower-cost settings like outpatient or home-based care, or tech companies that help providers operate more efficiently. That’s where the growth is happening.

Where are you seeing the most meaningful innovations in healthcare efficiency?

We recently represented a client in Chicago that processed about 40,000 claims a month. If a claim had a fraction of a penny off, it would get rejected. They had a back office full of people trying to fix that manually.

They built an internal AI platform that used three bots to automate the process. Revenue came in faster, and they reduced costs by repurposing staff.

We’re not going to see AI replacing clinicians in five years, but we’ll see it transform workflows, especially in the back office. Nurses shouldn’t spend 90 minutes downloading patient data in the morning. That should take five minutes. AI will handle that more efficiently.

What’s driving investor interest in behavioral health right now?

Behavioral health is probably 40 years behind the rest of medicine. It’s only in the last 10 years that services have started to be reimbursed more broadly.

Federal and state policymakers have realized that not covering these services is more expensive than covering them. A lot of our clients in this space provide outpatient or long-term care aimed at keeping people out of emergency rooms.

There’s also a strong connection between physical and mental health. Someone with a chronic physical condition often develops mental health needs. We’re not yet treating both together, but we will. It’s going to take 20-plus years to fully build out that behavioral health continuum, and that’s where a lot of our focus is.

How is Brentwood Capital Advisors expanding its industry coverage beyond core healthcare?

We’ve built internal teams to research new end-markets. We like pharma services, dental, and what I’d broadly call outsourced services.

Hospitals have always outsourced things like linens and food. But now we’re seeing more providers asking: ‘What are we really good at? What can we outsource to someone who can do it better?’

That could be staffing, tech-enabled services, or patient population management. We’ve always done a lot of software and revenue cycle work. Now we’re expanding to cover more of those support services that help providers operate more efficiently.

What do your recent internal promotions and team expansions signal about Brentwood’s growth and capacity?

We’re not going to double in size overnight, especially in this environment. But we’ve grown substantially in a tough market.

A lot of our competitors have sold to banks. In bake-offs, I’ll sometimes hear names of competitors I’ve never heard of before. That shows how much the landscape has shifted.

For us, stability, opportunity, and culture are what attract talent. I’ve worked at big firms, and culture often comes last. That’s not the case here. Our team approach is a big part of our success.

How does Brentwood Capital’s relationship-first approach influence deal outcomes?

The industry is largely reactive. Firms wait for opportunities to show up. That’s not our approach. We try to build relationships two or three years in advance. Know the team. Understand the business. When the opportunity arises, we’re already in position. When we know the management team and they trust us, our win rate is very high. When we don’t, it’s much lower.

Most investment banking is still transactional. We’re relationship-driven — that’s our philosophy.

What policy or market trends should leaders and investors be paying closer attention to?

Taxes are a major trend. Over the next 10 years, I think we’ll see fewer firms based in high-tax areas.

Look at JPMorgan. They now have more employees in Dallas-Fort Worth than in New York. Miami, Dallas, and Houston are leading the shift, but Nashville and Austin are catching up.

We’ve seen it firsthand how most of the funds based here weren’t started here. They moved here. When we’re working with a company in California, and their management team realizes they’ll be paying close to 50% in taxes, that becomes a real factor.

Even in recruiting, we’re already seeing young professionals pick Nashville over places like Chicago. They want a better quality of life, and even though costs have gone up here, it’s still nothing like New York or California.

What are your top priorities for Brentwood Capital over the next few years?

The silver lining of a tough market is that it forces people to work harder and be more disciplined.

We’ve had a strong year to date , and fall is looking very good. That didn’t happen by accident — it’s the result of people working their sectors hard, building pipelines, and not waiting for the phone to ring.

Now that we’ve built that muscle, it spreads throughout the firm. The behavioral team, for example, is eight bankers working together constantly. Even if we’re not the bank in a deal, we know the market extremely well.

Yes, when a deal gets to $1 billion or $2 billion, we might not be the first call. But, 80% of transactions in the U.S. are below $250 million, and that’s our sweet spot.