Partner with the best PE teams in the country and get the deal you deserve

This is the best market ever for physicians. Private equity groups are consolidating various specialties at an unprecedented pace, resulting in formidable wealth creation opportunities for physicians.

Private equity groups do not interfere in patient care. Instead, they provide the resources necessary to achieve the next phase of growth and alleviate physicians from the administrative burden inherent in owning a practice.

We initiate the dialogue with a simple question: are you willing to explore your options?

WHY ALKALINE

  • We are investment bankers focused exclusively on physician groups

  • We have working relationships with all the leading private equity funds in the space (200+ PE funds) as well as with the major corporations (e.g. Envision, USAP, Optum…)

  • We want to understand your ideal scenario and design a deal around it

  • We strive to get you the highest valuation and close your deal fast

  • Our fee structure is simple: a kickoff retainer charged against a success fee (i.e. commission received when your deal closes)

OUR SERVICES

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THE TRANSACTION TIMELINE

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GETTING TO THE LOI: Detailed Steps

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DILIGENCE & CLOSING

  • We support you throughout negotiation, diligence, and closing.

  • Once you agree to the general terms of an offer (Letter of Intent or Term Sheet), the diligence process begins.

  • During diligence, the buyer will review and inspect many documents and systems (financial, billing, compliance, HR, IT, etc.) to make sure the practice is unencumbered and the information previously presented is accurate.

  • After the diligence clears, legal documentation begins. The deal closes once all these documents are agreed to and executed.

  • We assist you in managing attorneys, accountants, and all other parties who are involved in these stages. We keep all parties focused on closing the deal.

VALUATION

  • Two concepts are important here, EBITDA and multiple.

  • EBITDA stands for Earnings Before Interest Taxes, Depreciation & Amortization. It is an approximate measure of cash flow. However, partners tend to distribute all income available, thus leaving very little “Earnings” on the income statement. As such, to arrive at a measure of EBITDA that is reflective of the group’s ability to generate cash flow, PE firms or other prospective buyers calculate EBITDA as the total difference between what partners are currently taking home versus what their market salary would be for their clinical role.

  • Valuation then becomes a function of EBITDA times a multiple. For example, provider groups with $1m to $3m of EBITDA tend to be valued between 6x and 8x EBITDA.

FACTORS AFFECTING VALUATION

  • Clinical quality, utilization, and risk management

  • Practice and physician reputation

  • Strength of key relationships: patients, referring physicians and hospitals, and payers

  • Scalability and growth prospects

  • Personnel turnover rates and experience of clinical and management staff

  • Owner interest in contributing to the general organization

  • Philosophy/workstyle fit

  • What can the buyer contribute to the practice

For answers to frequently asked questions, please visit the FAQs section or contact us directly.