Path 02 of 08

Considering an Acquisition

A learning path for healthcare operators evaluating buying an existing practice. Valuation methodology, due diligence, financing, and deal structure for acquisitions done well.

Buying an existing practice is a different financial decision than starting from scratch. Faster ramp, established cash flow, but higher purchase price and inherited operational characteristics. This path covers the valuation methodology, financial due diligence, financing approach, and deal structures used in independent healthcare practice acquisitions.

Sequenced Reading

The path, in order

Step 01

How Practice Transitions Work in Canada and the US

The mechanics of practice transitions, how they differ between Canadian and US markets, and the typical timeline from initial conversation to closing.

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Step 02

How to Finance a Clinic Acquisition

The financing structures used for healthcare practice acquisitions, including SBA in the US, BDC and chartered banks in Canada, and the role of seller financing in many deals.

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Step 03

How Healthcare Practice Valuations Are Calculated

EBITDA multiples vs. revenue multiples, normalization adjustments, and how valuation actually works for independent healthcare practices across specialties.

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Step 04

Practice Valuation Multiples for Independent Operators

The multiple ranges that apply to different specialties, what drives multiple variation, and how to read seller asking prices skeptically.

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Step 05

Factors That Reduce Practice Valuation

What discounts a practice's value: practitioner concentration, patient concentration, lease problems, equipment age, and the operational issues buyers and lenders identify in due diligence.

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Step 06

What a Letter of Intent for a Practice Sale Contains

The standard contents of an LOI for a healthcare practice acquisition. Price, structure, contingencies, exclusivity, and the items worth negotiating before signing.

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Step 07

Financial Due Diligence When Buying a Healthcare Practice

What to verify in seller financials, the red flags that show up in tax returns vs. operational reports, and the patterns that distinguish a clean deal from one with hidden problems.

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Step 08

Seller Financing in Healthcare Practice Transactions

When seller financing is appropriate, the typical terms, why sellers offer it, and how it affects acquisition financing structure and risk profile for buyers.

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Specialty-Specific Guidance

Need specialty-specific resources?

The path above covers universal acquisition concepts. For specialty-specific acquisition dynamics — dental DSO buyer landscape, optometry retail vs. clinical valuation, medical aesthetic patient base concentration — the specialty resource pages cover specialty-specific considerations.

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After You've Read the Path

Tools for acquisition analysis

The Practice Valuation Reference helps you sanity-check seller asking prices. The Capital Structure Tool models acquisition financing scenarios. The Profitability Calculator stress-tests the seller's numbers under your operating assumptions.

Open Tools Hub →