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Insights & Guides

Practical guides for practice owners considering a sale.

A library of research, guides, and market commentary written specifically for middle-market healthcare practice owners — covering EBITDA optimization, rollover equity mechanics, buyer landscapes, and the deal structures most sellers never see until they're inside a process.

Speak with an advisor: (800) 815-0590

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100% confidential. No obligation.

Written By

1st Med Capital Partners senior advisors, drawing on closed engagements across six specialty practice areas

Audience

Healthcare practice owners 6–24 months from a sale, and those simply gathering information

Featured Guide

2026

The Middle-Market Healthcare Practice Seller's Guide

1st Med Capital Partners · Annual Edition

Annual Flagship Guide

Everything middle-market practice owners need to understand before fielding a single offer.

A 90-page guide drawing on the past year of closed engagements across dental, dermatology, plastic surgery, orthopedics, gastroenterology, and ophthalmology. Written for practice owners 6 to 24 months from an active sale.

In this guide

  • Current multiple ranges by specialty, practice profile, and buyer type
  • EBITDA optimization and add-back framework for healthcare practices
  • Rollover equity mechanics, second-exit dynamics, and governance terms
  • Buyer landscape: PE platforms, family offices, strategics, DSOs
  • The 90-day diligence preparation checklist
  • LOI and definitive agreement red flags — what to negotiate, what to walk from
90 pages · PDF ~45 min read Released Jan 2026
Download the 2026 Guide

Topical Guides

Deep dives on the specific decisions you're weighing

Each guide is gated behind an email and routes to the senior advisor team. Most run 24–44 pages and reflect the structure, financial mechanics, and buyer behavior we see in actual engagements — not theory.

Strategy

EBITDA Optimization for Healthcare Practice Sellers

How to identify, document, and defend the add-backs, normalizations, and trajectory adjustments that determine the multiple your practice commands.

32 pages Email required
Download guide
Deal Structure

Understanding Rollover Equity

The mechanics, risks, and upside of rolling equity into a PE-backed platform — including how second exits, dilution, and governance terms actually work.

28 pages Email required
Download guide
Market Report

The 2026 Dental DSO Buyer Landscape

A market-by-market view of the active PE-backed DSOs, recent platform recapitalizations, and current valuation ranges by practice profile.

44 pages Email required
Download guide
Market Report

The Dermatology PE Market: 2026

Active platforms, recent recapitalizations, multiple ranges by practice profile, and where family offices are paying premium for aesthetic-heavy practices.

38 pages Email required
Download guide
Process

Preparing for Diligence

A 90-day checklist for getting your financial, operational, legal, and clinical records into the shape a sophisticated buyer's diligence team will require.

24 pages Email required
Download guide
Negotiation

LOI Negotiation Essentials

What to look for beyond the headline price: earn-outs, rollover terms, working capital adjustments, exclusivity periods, and the conditions that get re-traded in diligence.

30 pages Email required
Download guide

Articles & Commentary

Recent thinking from the senior advisor team

View all articles →
March 2026 Market Commentary

Why PE-backed dental platforms are paying premium multiples in 2026

The competitive dynamics among DSO platforms have shifted again. Three of the largest platforms have moved into active-buyer mode after their own recapitalizations, and the multiples available to mid-market practices have moved with them.

Read article
February 2026 Specialty Spotlight

Five things every plastic surgery practice owner should know before fielding direct offers

Plastic surgery has the widest multiple range of any specialty we cover. Before a practice owner agrees to an exclusive conversation with any platform, family office, or strategic, there are five things worth understanding about how each will think about valuation.

Read article
January 2026 Deal Retrospective

How rollover equity actually pays out: a five-year retrospective

Rollover equity is the most-discussed and least-understood part of a typical middle-market healthcare transaction. We looked back at engagements closed in 2020 and 2021 to see how the rollover positions our clients took have actually performed through second exits.

Read article
December 2025 Specialty Spotlight

What the recent ophthalmology MSO consolidation means for sellers

Four major ophthalmology MSOs have recapitalized in the past eighteen months, and the resulting competitive landscape has materially shifted what a quality comprehensive eye care practice can command in a structured process.

Read article

Move Beyond the Reading

Or skip the guides and talk to a partner directly.

If you've been thinking about a sale long enough to be reading guides about it, you're probably ready for a conversation. Every Capital Partners conversation begins under NDA and carries no obligation. Most practice owners who reach out are 6 to 24 months from an active sale.

(800) 815-0590

Request a Confidential Valuation

Senior advisor will respond within one business day.

100% confidential. No obligation.