Healthcare businesses typically sell for 4.5x to 9.0x+ EBITDA, with multi-provider specialty practices, dental groups (DSOs), and behavioral health centers commanding higher multiples.

Due to Corporate Practice of Medicine (CPOM) laws, non-physician buyers acquire the non-clinical MSO entity (assets, billing, staff, facilities) and enter into a long-term management agreement with the clinical practice.

Key physicians and clinical providers typically enter into 3 to 5 year employment agreements with competitive production-based compensation and equity rollover opportunities.

Buyers conduct detailed historical billing and coding audits (HIPAA, Medicare, Medicaid) to ensure documentation supports all billed services and verify clean compliance.

Physician founders typically continue practicing clinically for 1 to 3 years post-closing while transitioning administrative and management duties to the acquiring group.