Healthcare Business Brokers & Advisory

There is no "standard" multiple. Small, owner-dependent practices may sell for 2x-3x SDE. Larger, multi-provider practices with strong EBITDA can sell for 5x-8x+ EBITDA depending on the specialty and buyer demand.

Heavy reliance on government payers generally lowers the multiple due to the risk of reimbursement rate cuts and heightened audit scrutiny compared to commercial insurance.

Yes. A CVA understands the specific nuances of healthcare accounting, ensuring add-backs are defensible to institutional buyers.

An earn-out is a portion of the purchase price paid post-closing, contingent on the practice hitting specific financial or retention metrics.

You can, but many owners choose to sell the practice and retain the real estate, charging the new buyer rent to create a passive, long-term income stream.

A/R is typically excluded from the purchase price and remains the property of the seller, collected post-closing, though it can be negotiated into working capital targets.

A QoE report is a deep financial audit performed by the buyer during due diligence to verify that your stated EBITDA is accurate and sustainable.

Yes, but you must have a clear narrative explaining the decline (e.g., intentional scale-back) and expect a lower valuation or a structure heavily weighted toward earn-outs.

The buyer acts as the custodian of records post-sale. Strict HIPAA guidelines dictate how the data is transferred and secured.

Usually, no. Most buyers acquire the business as an ongoing concern and will rehire your staff at their current compensation to ensure continuity.

An LOI is a non-binding document outlining the proposed terms of the purchase, including price, structure, and exclusivity period for due diligence.

Extremely. Buyers sign strict Non-Disclosure Agreements (NDAs) before receiving any identifying information, and marketing materials are heavily redacted.

You retain your individual medical license. The buyer is purchasing the corporate entity or the assets, not your personal credentials.

Yes. Buyers will require you to sign a non-compete agreement restricting you from practicing within a certain radius for a specified number of years.

In an asset sale, the buyer purchases the equipment, goodwill, and patient lists, leaving behind liabilities. In a stock sale, the buyer acquires the entire corporate entity, including historical liabilities.

Patients are typically notified post-closing via a carefully crafted joint letter from the seller and buyer, emphasizing continuity of care.

PE offers the highest upfront valuations, the ability to monetize your life's work, and the resources to scale the practice while removing administrative headaches.

In PE deals, sellers often roll 10% to 30% of their proceeds into the stock of the new parent company, allowing for a "second bite of the apple" when the PE firm eventually sells.

Rarely. Strategic hospital acquisitions usually require full integration into their IT systems, clinical protocols, and management hierarchies.

MSOs manage the business side (billing, HR, IT, marketing) for a management fee, while a distinct professional corporation (owned by a physician) handles all clinical care to comply with state laws.

A platform is a large, foundational practice PE buys to enter a market. A bolt-on is a smaller practice acquired later to merge into the platform's existing infrastructure.

Strategic buyers usually rebrand to their hospital name. PE firms may keep your local brand if it holds significant community goodwill.

Typically 60 to 120 days, depending on the complexity of your financials and the speed at which your team provides requested documents.

Private Equity and MSOs generally leave clinical decision-making to the providers, focusing entirely on operational efficiency.

Florida is arguably the premier state for healthcare M&A. The combination of an aging demographic, continuous population growth, and a generally favorable regulatory environment creates maximum buyer competition and premium multiples.

Tampa, Orlando, Naples, and Miami are currently experiencing the highest volume of PE and strategic acquisitions, driven by dense populations and affluent retiree migration.

Yes. Practices in specialties catering to older demographics (orthopedics, cardiology, ophthalmology, home health) command premium valuations because the demographic demand is guaranteed to grow over the next two decades.

The Agency for Health Care Administration (AHCA) requires a Change of Ownership (CHOW) application to be submitted 60 days before closing for licensed facilities. Failure to navigate this properly can delay or destroy a transaction.

Aggressively. Florida is a primary target state for PE firms executing roll-up strategies across dental, veterinary, dermatology, gastroenterology, and behavioral health sectors.

Specialties serving an aging population (cardiology, orthopedics), cash-pay aesthetics (dermatology, plastic surgery), and outpatient behavioral health are seeing peak demand.

From initial valuation to closing, the process typically takes 6 to 10 months. The AHCA CHOW timeline and extensive due diligence are the primary pacing factors.

Florida has a relatively relaxed CPOM doctrine compared to other states, making it easier for non-physician investors (like PE) to structure legal management models (MSOs) to acquire clinical practices.

Absolutely. Attempting a healthcare transaction without an attorney intimately familiar with Florida's AHCA regulations and state-level Stark Law equivalents is a massive liability.

Nursing and tech shortages in Florida are a concern for buyers. Practices with stable, long-tenured staff command higher multiples because they remove the immediate risk of post-sale recruitment.