End-to-End M&A Advisory for Healthcare
From initial valuation to final close, we provide specialized advisory services exclusively for healthcare businesses — with the discretion and expertise your transaction demands.
Not a General Business Broker. A Healthcare M&A Specialist.
Most business brokers treat a medical practice like a hardware store. They apply generic multiples, misread payer dynamics, and fail to account for the regulatory complexity that defines healthcare transactions. We don't. Every engagement at Billable Health Advisors is led by advisors who have spent careers inside healthcare — as operators, investors, and dealmakers. That specialization is the difference between a good outcome and the best possible outcome.
Healthcare Only
We work exclusively in healthcare — no restaurants, no retail, no manufacturing. 100% of our expertise is focused on your sector.
Proprietary Network
Direct relationships with 300+ qualified buyers including health systems, PE-backed platforms, and strategic acquirers actively seeking acquisitions.
Outcome-Based Fees
We earn our fee only when your transaction closes. Our success is tied directly to yours — no retainers, no hourly billing.
Sell-Side Representation
When you've spent years — or decades — building a healthcare business, the decision to sell is one of the most consequential of your career. We manage every aspect of the process so you can focus on running your business while we run your transaction.
- Pre-sale business preparation and EBITDA normalization
- Confidential Information Memorandum (CIM) preparation
- Targeted outreach to qualified buyers under NDA
- Buyer vetting, management presentations, and site visits
- Offer evaluation, LOI negotiation, and deal structuring
- Due diligence management and transaction close
Typical Transaction Timeline
Weeks 1–2
Engagement & Prep
Business assessment, document collection, EBITDA normalization, and CIM drafting.
Weeks 3–6
Market Launch
Confidential outreach to pre-qualified buyers, NDA execution, and CIM distribution.
Weeks 7–12
Offers & LOI
Management presentations, offer review, LOI negotiation, and exclusivity.
Weeks 13–20
Due Diligence & Close
Buyer due diligence, definitive agreement, regulatory approvals, and closing.
Buy-Side Advisory
Whether you're a health system expanding your network, a private equity firm building a platform, or an operator seeking a strategic add-on, we provide the intelligence and execution support to find, evaluate, and close the right acquisition.
- Acquisition criteria development and market mapping
- Proprietary target identification and outreach
- Financial analysis, quality of earnings, and valuation review
- Letter of intent drafting and deal structuring
- Due diligence coordination across financial, clinical, and legal workstreams
- Negotiation strategy and transaction close management
Typical Transaction Timeline
Weeks 1–3
Strategy & Targeting
Define acquisition criteria, map the market, and identify priority targets.
Weeks 4–8
Outreach & Evaluation
Confidential outreach, NDA execution, preliminary financial review.
Weeks 9–14
Offer & Negotiation
LOI preparation, management meetings, offer negotiation, and exclusivity.
Weeks 15–22
Due Diligence & Close
Full diligence, definitive agreement, regulatory filings, and closing.
Valuation & Exit Planning
A healthcare business valuation is not a simple EBITDA multiple. It requires deep understanding of payer mix, revenue cycle health, provider dependency, regulatory standing, and market comparables. Our valuations are built to withstand scrutiny — from buyers, lenders, and advisors.
- Healthcare-specific EBITDA normalization and add-back analysis
- Payer mix assessment and revenue cycle quality review
- Comparable transaction analysis (precedent transactions)
- Provider dependency and key-person risk assessment
- Regulatory and compliance risk review
- Strategic exit planning and value enhancement roadmap
Valuation Methodologies We Use
EBITDA Multiple
The most common healthcare valuation method. We normalize EBITDA for owner compensation, one-time expenses, and non-recurring items — then apply sector-specific multiples based on size, specialty, and market conditions.
Precedent Transactions
We maintain a proprietary database of closed healthcare transactions to benchmark your business against comparable deals — by specialty, geography, revenue size, and payer mix.
Discounted Cash Flow
For businesses with strong growth trajectories, a DCF analysis captures future value that a trailing EBITDA multiple may understate. We use this to support premium valuations in competitive processes.
Revenue Multiple
Applied in early-stage or high-growth healthcare businesses where EBITDA is not yet the primary value driver. Common in behavioral health, telehealth, and technology-enabled care models.
Key Structural Considerations
Asset vs. Stock Sale
Tax treatment differs significantly — often worth 5–15% of deal value
Earnout Design
Properly structured earnouts bridge valuation gaps without creating disputes
Rollover Equity
Retaining equity in the acquiring entity can significantly increase total proceeds
Working Capital Peg
Poorly negotiated WC adjustments are among the most common post-close disputes
Deal Structuring & Negotiation
Price is only one dimension of a transaction. The structure — how you're paid, when you're paid, and what obligations you carry post-close — can be worth as much as the headline number. We advise on every structural element to optimize your total outcome.
- Asset vs. stock sale analysis and tax implications
- Earnout design, milestones, and dispute mechanisms
- Rollover equity structuring and minority interest terms
- Working capital peg, adjustments, and true-up mechanics
- Representation and warranty insurance guidance
- Non-compete, transition services, and employment agreement terms
Key Structural Considerations
Asset vs. Stock Sale
Tax treatment differs significantly — often worth 5–15% of deal value
Earnout Design
Properly structured earnouts bridge valuation gaps without creating disputes
Rollover Equity
Retaining equity in the acquiring entity can significantly increase total proceeds
Working Capital Peg
Poorly negotiated WC adjustments are among the most common post-close disputes
What Sets Us Apart from General Business Brokers
Healthcare Regulatory Expertise
We understand CON laws, HIPAA implications in M&A, Stark Law, Anti-Kickback Statute, and state licensure transfer requirements — issues that derail transactions when advisors don't anticipate them.
Payer Mix Intelligence
We know how to read a payer mix, normalize for managed care contracts, and position your revenue cycle as an asset — not a liability — in buyer due diligence.
Specialty-Specific Multiples
EBITDA multiples vary significantly by specialty, geography, and buyer type. We know current market rates for primary care, behavioral health, dental, home health, urgent care, and more.
Confidential Process Management
We never list your business publicly. Every buyer is pre-qualified and under NDA before receiving any information. Your staff, patients, and competitors never know you're exploring a transaction.
No Conflicts of Interest
We represent one side of each transaction — either the buyer or the seller, never both. That single-minded focus means our advice is always in your interest, not the deal's.
Post-Close Transition Support
Our relationship doesn't end at closing. We help structure transition service agreements, employment terms, and earnout monitoring to protect your interests through the full post-close period.
"We don't just close deals. We protect legacies."
Let's Discuss Your Transaction
Whether you're ready to move or just exploring your options, a confidential conversation is always the right first step.