The Expanding Role of Secondaries — Takeaways from HPE Miami 2026

Vicky Valverde, Rob Rein, Fred Lee & Mike Boggs

3/11/2026

The Revelation Partners team was back in South Beach, Miami on March 4-5 for this year’s HPE Miami conference, joining a growing group of private equity investors and advisors gathering to discuss the evolving healthcare investment landscape. While we are sure the setting helps, it is great to see how much the conference has expanded over the past few years, becoming one of the go-to conferences to attend for healthcare private equity investors.

With fundraising conditions remaining challenging and LPs increasingly focused on distributions, one theme surfaced repeatedly: liquidity. Secondary transactions, and continuation vehicles in particular, featured prominently throughout panels and discussions. The broader market data reflects this shift as well. Global secondary transaction volume reached approximately $225 billion in 2025, representing a roughly 45% increase from the prior year and marking a record for the market.^{^[1]}

Below are several of our team’s key takeaways from the conference.

Liquidity Still Drives the Conversation

Liquidity remains one of the most pressing topics across the private equity ecosystem. Fundraising across private markets – including venture, private equity, and secondaries – was reported to be down roughly 14% year-over-year, creating a difficult environment for many managers. Exit activity has remained relatively flat in recent years, and while IPO markets have shown some green shoots, IPOs still represent a small portion of sponsor exits. In healthcare specifically, we estimate that healthcare private investors hold more than $800 billion of unrealized value in portfolio companies from vintages between 2010 and 2023, highlighting the scale of capital still awaiting liquidity.^{^[2]}

As a result, LPs are receiving fewer distributions and have less capital to recycle into new funds. Several investors noted that today’s environment reflects not only a lack of capital but also a lack of conviction among LPs. With more private market strategies competing for allocations, from venture and buyout to private credit and secondaries, LPs are becoming increasingly selective in where they deploy capital.

Secondaries Become a Core Liquidity Tool

Secondary transactions were one of the most widely discussed topics at the conference. In a live audience poll, more than 55% of investors indicated they expect to pursue a secondary transaction within the next two years, while another 32% said they were unsure, highlighting how broadly these strategies are being considered. This does not come as a surprise, as GP-led secondary volume alone has grown to more than $100 billion annually, representing a meaningful share of sponsor-backed exit activity.^{^[3]}

The perception of secondary transactions has also evolved significantly. Historically, some investors viewed these transactions as a last resort. In fact, prior to the global financial crisis, some managers even viewed selling through a secondary as a negative signal. Today, that stigma has largely disappeared. Increasingly, the ability to identify assets strong enough to support a continuation vehicle is viewed as a sign of quality rather than a sign of distress. And as LPs become more experienced in underwriting these deals, GPs are growing more comfortable using them as part of their liquidity toolkit.

The Secondary Toolkit Continues to Expand

While continuation vehicles remain a central feature of the secondary market, investors increasingly highlighted the growing range of transaction structures available to generate liquidity. What was once primarily an LP-driven market has evolved into a broader ecosystem that now includes single-asset and multi-asset continuation vehicles, minority secondary sales, preferred equity solutions, and other structured transactions.

As the market matures, sponsors are using these tools in a wider set of situations – from extending ownership of high-performing assets, transitioning from minority to majority control, or providing liquidity for rollover equity. The challenging fundraising environment is also creating new dynamics across the sponsor landscape, as experienced investors spin out to launch independent platforms, creating opportunities to back fundless sponsors on a deal-by-deal basis or support managers ahead of their next fundraise.

Final Thoughts

HPE Miami 2026 reinforced a theme that continues to shape the private equity market: liquidity remains the central issue of the current cycle. With traditional exit markets still uneven and fundraising pressures persisting, sponsors are increasingly turning to secondary transactions and other structured solutions to generate liquidity while maintaining exposure to high-quality assets.

At the same time, the continued maturation of the secondary market, along with greater LP familiarity and a broader range of transaction structures, is making these solutions more accessible and broadening the role secondaries play across the private equity ecosystem.

For Revelation Partners, these dynamics underscore the growing role of specialized secondary capital within healthcare private equity, particularly as sponsors look for flexible liquidity solutions in an evolving market environment.

[1] Campbell Lutyens Research, February 2026

[2] Revelation Partners Analysis, Pitchbook, Cambridge Associates Venture Capital Benchmarks.

[3] Jefferies State of the GP-Led Secondaries Market, February 2026

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