BH Practice M&A Guide — 2026

Current BH M&A Multiples

• Small practice (under $2M EBITDA): 3-5x EBITDA
• Mid practice ($2-10M EBITDA): 5-7x EBITDA
• Large practice ($10M+ EBITDA): 6-9x EBITDA
• Enterprise ($25M+ EBITDA): 8-12x EBITDA
• PE-backed rollup premium: +1-2x above above

Deal Structures

• All-cash (rare, typically at multiple discount)
• Cash + rollover equity (standard PE)
• Earn-out (bridge valuation gap)
• Seller financing (5-15% typical)
• Stock swap (health system deals)

Working Capital Adjustment

Typical net working capital target: 20-40 days of operating expenses. Adjustment mechanism: excess or deficit vs target at close.

Due Diligence Focus Areas

1. Financial DD (3 years audited financials)
2. Legal DD (contracts, litigation, IP)
3. Regulatory DD (compliance, licenses)
4. Clinical quality DD (outcomes, HEDIS)
5. Technology DD (EHR, integration)
6. HR DD (provider retention, benefits)
7. Real estate DD (leases, ownership)
8. Insurance panel DD (contracts, rates, retention)

Revenant Care M&A Advisory

– KD, Revenant Care