Sell a Medical Practice or Pharmacy | Max Snitkovsky, Iconic

Healthcare services M&A in 2026

Buyers are everywhere. They are also pickier than they were.

Hospitals, insurers, distributors and private equity platforms keep buying practices. Pharmacies and staffing firms face tighter margins, so buyers now pay for clean, durable earnings.

82% of U.S. physicians now work for a hospital or corporate owner

That share was 52% in early 2018. About 13,900 practices were acquired in the two years to January 2026, and only 36.1% of practices are still independently owned.

Sources: Physicians Advocacy Institute and Avalere Health, physician employment and practice acquisitions 2018 to 2026, Becker's ASC, only 1 in 5 physicians is independent, May 2026

Physician groups were 46% of health services deals in Q1 2026

PwC counted 18% more physician practice deals year over year, the most active subsector. Becker's also reports buyers are getting more selective and favor platform add ons.

Sources: Becker's ASC on PwC Health Services Deals 2026 Midyear Outlook, Jun 2026, LevinPro HC, most active physician medical group buyers of 2025

Pharmacy prices rose while margins shrank

The median pharmacy sold for $600,000 in 2025, but discretionary earnings fell to 7.3% of revenue. A USC led study found independents were more than twice as likely to close as chains.

Sources: BizBuySell, pharmacy valuation benchmarks (sold 2021 to 2025), InvestigateTV via Valley News Live, pharmacies closing at an accelerating rate, Apr 2026

Healthcare staffing is growing again, slowly

SIA expects the U.S. market to grow 1% in 2026 to $39.0 billion after three years of contraction. Locum tenens leads at 4% growth, while per diem nursing is forecast to fall 7%.

Source: Staffing Industry Analysts, healthcare staffing rebounds, Sep 2026

What buyers are looking for

What a healthcare buyer checks first.

Hospitals, private equity platforms and first time buyers open with the same healthcare questions. I assemble these answers before a practice is shown to anyone.

Collections and payer mix

Net collections by payer for three years, with commercial, Medicare, Medicaid and self pay shown separately. Buyers price a commercial heavy mix higher.

Provider productivity

Visits, wRVUs and collections per physician and advanced practitioner. Buyers want to see how much of the revenue walks out the door with you.

AR aging and days in AR

Accounts receivable by age bucket and how fast claims turn into cash. Old AR and high denial rates read as billing risk.

Coding and billing audit

A recent independent audit of coding accuracy and documentation. Buyers fear inheriting overpayments that a payer can recoup later.

Payer contracts and credentialing

Current contracts, fee schedules and whether they transfer to a new owner. Credentialing gaps can stall cash for months after closing.

Licenses and permits

State licenses, DEA registrations, NPI numbers, CLIA certificates, pharmacy permits and behavioral health facility licenses, all current and in the right entity's name.

What moves a practice's price

What pushes your price down	What pushes your price up
The selling physician produces most of the collections and plans to leave	Associates and advanced practitioners produce most of the revenue
Heavy reliance on one payer, one PBM or one hospital client	A balanced, mostly commercial payer mix or a wide client base
No recent coding audit and high claim denial rates	A clean outside billing audit and low days in AR
Payer contracts and licenses tied to the owner personally	Contracts, credentialing and licenses held by the entity and ready to transfer
Paper charts and a patchwork of software	One EHR or pharmacy system with reports that tie to the tax returns
Flat or falling patient volume and provider turnover	Growing visits, open provider capacity and a stable team

Who is buying

Platforms, hospitals, insurers and staffing groups are all buying.

Private equity platforms lead on specialty add ons. Health systems and insurers buy primary care and multispecialty groups. Smaller practices and pharmacies also sell to individual clinicians and owner operators.

Buyer type	What they pay for	Active examples
Private equity backed specialty platformsFinancial (PE add on)	Established practices in dermatology, urology, aesthetics, eye care and other specialties that fit a regional platform. PE was involved in 58.4% of physician group deals VMG Health tracked.	Integrated Dermatology Group, Unio Specialty Care, Olympus Cosmetic Group, Dermatology Partners
Health systems and academic medical centersStrategic	Primary care and specialty groups that feed referrals and expand community access. Hospitals employed 59.7% of physicians in January 2026.	MUSC Health, Ellis Medicine, Rochester Regional Health
Insurers and drug distributorsStrategic	Large primary care networks for value based care and specialty groups that drive drug volume. Cardinal Health has made three billion dollar physician group deals in two years.	CenterWell (Humana), Cencora, Cardinal Health
Behavioral health operatorsStrategic	Psychiatry and therapy practices with insurance contracts and a stable clinician panel. Strategics made 68.2% of behavioral health deals tracked by Capstone in 2026.	Universal Health Services, Bloom Health Centers

Recent healthcare transactions.

These practice, pharmacy and agency deals were announced in 2025 and 2026. Few small healthcare sales are ever disclosed, so treat this as a buyer list.

Date	Buyer	Target	Type	Value
Sep 2026	Ellis Medicine	CareNet Medical GroupCapital Region, New York; independent OB GYN practice since 1983; four physicians and one PA	Health system	Undisclosed
Sep 2026	Olympus Cosmetic Group (VSS Capital Partners)	Gallaher Plastic Surgery & Med SpaKnoxville, Tennessee; surgeon founded practice; buyer's ninth state	PE add on	Undisclosed
Aug 2026	Integrated Dermatology Group (Bregal Sagemount)	Knuckles DermatologyCorbin and Richmond, Kentucky; two location practice; buyer active in 29 states	PE add on	Undisclosed
Jul 2026	Dermatology Partners	Practice of Elizabeth Spiers, MDDoylestown, Pennsylvania; solo dermatology practice opened in 2002	Add on	Undisclosed

Show all 15 deals

Date	Buyer	Target	Type	Value
Jul 2026	Unio Specialty Care (Triton Pacific Capital Partners)	Golden Gate UrologyBay Area, California; 13 physicians at six sites	PE add on	Undisclosed
Jul 2026	Bloom Health Centers	Insight PhysiciansRichmond, Virginia; psychiatry practice founded 1984; two offices; selling partners stayed on	Strategic	Undisclosed
Jun 2026	Soleo Health (H.I.G. Capital)	Realo Specialty Care Pharmacy and BluHaven ManagementMid Atlantic; specialty pharmacy founded 2015 plus an infusion center manager	PE add on	Undisclosed
May 2026	Frazier Healthcare Partners	AltruixHunt Valley, Maryland; behavioral health focused specialty pharmacy with 17 locations	PE platform	Undisclosed
May 2026	Knox Lane	Cross Country HealthcareNational nurse and allied staffing firm; take private at $13.25 per share	PE take private	$437M
Apr 2026	Optigy	StaffHealthVirginia Beach, Virginia; PRN healthcare staffing platform founded 2012; buyer's second deal of 2026	Strategic	Undisclosed
Mar 2026	MUSC Health	Palmetto Primary Care PhysiciansSouth Carolina; 31 physicians, 95 advanced practitioners, 40 practices	Health system	$111M
Mar 2026	Universal Health Services	TalkspaceNational virtual therapy and psychiatry provider; insurance covered workforce	Strategic	About $835M
Mar 2026	Cencora	EyeSouth Partners retina businessPhysicians join Retina Consultants of America, Cencora's management services organization	Strategic	$1.1B
Feb 2026	CenterWell (Humana)	MaxHealthWest and South Florida; 54 primary care clinics, more than 120,000 patients; sold by Arsenal Capital Partners	Strategic	Undisclosed (about $1B reported)
Jan 2026	Elite365 Family of Brands (Regal Healthcare Capital Partners)	Focus StaffDallas, Texas; travel nurse and allied staffing in all 50 states	PE add on	Undisclosed

Industry valuation estimator

What is your medical practice or healthcare business worth?

Owner run practices, pharmacies and small agencies are valued on SDE. Groups with administrators and a management layer are valued on adjusted EBITDA.

Annual owner earnings: SDE, or adjusted EBITDA if you have a paid manager ($) Who produces the revenue todayHow concentrated is your revenueHow stable is your clinical teamBilling, licensing and compliance records

Estimated value range

Enter your earnings

Illustrative only, not a valuation.

Get a real valuation from Max

Published ranges for this industry

Medical practices sold from 2021 to 2025: median 2.05x SDE, middle half 1.46x to 2.94x, 2025 average 2.58x (BizBuySell)
Pharmacies sold from 2021 to 2025: median 2.45x SDE, middle half 1.69x to 3.75x, revenue median 0.29x (BizBuySell)
Multispecialty medical practices: 5.6x EBITDA at $1M to $3M, 7.1x at $3M to $5M, 8.8x at $5M to $10M (FOCUS Investment Banking)
Physician practice add ons in 2026: primary care 3x to 6x, OB GYN 5x to 8x, cardiology 8x to 12x EBITDA (FOCUS Investment Banking)

These bands begin with the healthcare multiples above. How much production, payers, team and compliance move them is my call, so read the result as a first look.

Costly practice sale mistakes

Where healthcare owners lose money in a sale.

Practices, pharmacies and agencies tend to trip on the same issues. A year or two of runway is usually enough to fix them.

Waiting until you are ready to stop working

Buyers pay for revenue that stays after you leave. If you are the main producer, start recruiting and transitioning patients early.

Cost: A lower multiple or a long earnout tied to your own production

Skipping the coding audit

Buyers will audit your claims anyway. Finding problems first lets you fix them and explain them on your terms.

Cost: Price cuts, escrow holdbacks or a buyer walking away late

Assuming practice payer contracts carry over

Many contracts and enrollments sit with the owner or need payer consent. Gaps after closing freeze cash collections.

Cost: Months of delayed cash and a lower price to cover it

Ignoring state ownership rules

Many states limit who can own a medical practice, and 26 states introduced bills on private equity in healthcare in 2026. Structure decides who can buy.

Cost: A smaller buyer pool or a deal restructured at the last minute

Letting one client or payer dominate

A staffing agency tied to one hospital or a pharmacy tied to one PBM looks fragile. Buyers price that risk directly.

Cost: A discount to the multiple or a holdback

Messy owner expenses

Personal costs, family on payroll and cash pay services blur your true earnings. Clean addbacks need documents behind them.

Cost: Addbacks rejected and earnings cut in diligence

FAQ

What practice and healthcare owners ask me before they sell.

What is my medical practice worth?

Smaller practices sold from 2021 to 2025 at a median 2.05x SDE and 0.62x revenue, per BizBuySell. Larger groups sell on EBITDA, from about 5.6x at $1M to $3M of EBITDA to 8.8x at $5M to $10M, per FOCUS.

Who is buying physician practices now?

Hospitals, insurers, drug distributors and private equity platforms. By January 2026, hospitals and corporate entities owned 63.9% of U.S. practices, up from 29.8% in 2018.

Is private equity still paying top prices?

Less than before. FOCUS found the median PE backed healthcare deal fell from 15.3x EBITDA in 2025 to 10.7x in Q1 2026. Strategic buyers rose to a 13.4x median.

Will I have to keep working after the sale?

Usually for a period, especially if you produce much of the revenue. In one 2026 Richmond psychiatry deal, all three selling partners stayed with the buyer.

How long does it take to sell a practice or pharmacy?

Medical practices on BizBuySell sat a median 205 days, pharmacies 163. Iconic publishes a 5.2 month median time to close.

Is now a good time to sell a pharmacy?

Prices held up, with a 2025 median sale of $600,000 on BizBuySell. Margins fell to 7.3% of revenue in 2025, so buyers look hard at reimbursement and PBM exposure.

What are healthcare staffing agencies selling for?

FOCUS puts small local agencies at 2.5x to 5.0x EBITDA and firms with $1M to $10M of EBITDA at 4.0x to 7.0x. Diversified clients and specialties such as locum tenens earn more.

How is the behavioral health deal market?

Slower in 2026. Mertz Taggart counted 69 closed deals in the first half, down 20%. Capstone found strategic buyers made 68.2% of deals, while private equity add ons were subdued.

Terms buyers will use

SDE: Profit plus owner pay, perks and one time costs. It is the yardstick for most practices and healthcare companies earning under a few million.
Adjusted EBITDA: Earnings before interest, taxes, depreciation and amortization, with owner pay reset to a market rate for the role and one time items removed.
Platform: The first, larger practice a private equity firm buys in a specialty, which becomes the base for more acquisitions.
Add on: A smaller practice or business bought by an existing platform and folded into its systems.
MSO: Management services organization: a company that owns the business side of a practice and provides billing, staff and administration.
Corporate practice of medicine: State rules that limit who can own a medical practice or employ physicians.
Payer mix: The share of collections from commercial insurers, Medicare, Medicaid and self pay patients.
wRVU: Work relative value unit: a Medicare based measure of physician work used to compare provider productivity.
Days in AR: How many days on average it takes to collect a claim after the service is billed.
Credentialing: The process of enrolling a provider or entity with insurers so claims can be paid.
PBM: Pharmacy benefit manager: the company that sets pharmacy reimbursement and networks for health plans.
Locum tenens: Temporary physician coverage, placed by a staffing agency to fill gaps at hospitals and practices.
Rollover equity: Part of the price paid as ownership in the buyer, which can pay out again when the buyer sells.
Tail coverage: Malpractice insurance that covers claims made after a policy ends for care given while it was in force.

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Selling a medical practice or healthcare business