Guide to Selling a Sports Medicine & Performance Therapy Practice in Delaware

Selling your Sports Medicine & Performance Therapy practice in Delaware is a major decision. This guide offers a look at the current market, from state-specific regulations to what drives practice value. We will cover key factors facing owners like you, helping you understand the landscape. Proper planning is the foundation of a successful transition, and knowing what buyers look for is the first step.

Market Overview

If you are considering a sale, the timing in Delaware looks promising. The broader market shows strong fundamentals that create a favorable environment for sellers who are well-prepared.

A Strong Healthcare Economy

Delaware stands out nationally. The state was ranked #1 for hospital quality in 2025, a testament to its robust healthcare infrastructure. More importantly for practice owners, per capita healthcare spending grew by 9.1% in 2023, significantly outpacing national benchmarks. This demonstrates a healthy, growing demand for medical services, including specialized care like sports medicine.

National Tailwinds

The demand for physical and performance therapy is not just local. The U.S. market is projected to grow at 4.6% annually, reaching over $61 billion by 2030. This national trend supports strong buyer interest in well-run practices with a solid patient base and clear growth potential.

Key Considerations

Beyond the positive market trends, buyers will look closely at your practice’s operational and regulatory compliance. In Delaware, a few specific points often come under the microscope during due diligence.

1. Referral and Supervision Rules. Sophisticated buyers know Delaware’s regulations. They will verify that your practice adheres to the rule requiring a physician’s referral for treating athletic injuries (outside of minor issues) and follows the mandated supervision structures for athletic trainers.
2. PTA Staffing Ratios. Your staffing model is a key value driver. Buyers will check your compliance with Delaware’s specific 2-to-1 supervision ratio for Physical Therapist Assistants to Physical Therapists. Being over or under this ratio can raise red flags about efficiency or compliance.
3. Licensing and Board Adherence. Proving that all practitioners are in good standing with the Delaware Examining Board of Physical Therapists and Athletic Trainers is fundamental. Any unresolved issues can halt a transaction. Having this documentation prepared is a simple but powerful way to build buyer confidence.

Market Activity

The physical therapy and sports medicine sector is experiencing significant consolidation and investment. Large and small buyers, including private equity groups and strategic health systems, are actively acquiring practices. While specific Delaware transactions are often confidential, the national trends provide a clear picture of an active M&A environment.

Recent sales of practices like Fitness Quest Physical Therapy to Confluent Health and OrthoCarolina’s PT division to PT Solutions show a pattern of partnership and acquisition. Buyers are looking for well-run practices to expand their footprint.

A key metric buyers use is the price-to-revenue multiple. While every practice is unique, understanding the general range is a helpful starting point.

These multiples are just a benchmark. The final valuation depends heavily on profitability, growth, and how the practice is positioned.

The Sale Process

Selling a practice isn’t a single event but a structured process. While it can feel complex, it generally follows four main phases. Getting these right is key to a smooth transaction and achieving your goals.

Phase 1: Preparation

This is the most important stage. It happens long before your practice is shown to a single buyer. Here, we work with owners to clean up financial records, organize operational documents, and build a compelling story about the practice’s value and growth potential. This is also when we address the objection “I dont want to sell right now.” Starting this work 2-3 years in advance can dramatically increase your final valuation.

Phase 2: Confidential Marketing

Once prepared, the practice is confidentially marketed to a curated list of qualified buyers. This isn’t about listing your practice publicly. It is a discreet process designed to create competitive tension among the best-fit buyers while protecting your staff, patients, and reputation.

Phase 3: Negotiation and Due Diligence

After initial offers are received, you select the best partner and enter a period of exclusive due diligence. This is where the buyer validates all the information provided. It’s often the most challenging phase, as any surprises in your financials or operations can jeopardize the deal.

Phase 4: Closing

The final phase involves attorneys drafting the definitive purchase agreements. Once signed, the funds are transferred, and the transition to new ownership begins.

Valuation

Many owners believe their practice’s value is just a multiple of revenue. The reality is that sophisticated buyers value your practice based on its profitability and future cash flow. The most important metric in any sale is Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization). This figure represents your practice’s true cash flow by adding back owner-specific or one-time expenses to your net income. For example, a portion of an owner’s high salary or a vehicle lease run through the business might be added back. This single step can often increase a practices valuation significantly. Buyers then apply a multiple to that Adjusted EBITDA figure. The multiple itself is influenced by factors like your reliance on a single owner-provider, your payer mix, and your documented growth trajectory.

Post-Sale Considerations

The transaction closing is not the end of the journey. A successful sale includes a well-designed plan for what comes next, both for you and for the practice you built. Thinking about these three areas ahead of time is critical.

1. Your Transition Role. Buyers will expect you to stay on for a transition period. Defining this role early is important. Will you continue practicing clinically? For how long? Or will your role be purely administrative? A clear transition plan prevents future misunderstandings.
2. Structuring Your Proceeds. The deal structure often includes more than just cash at closing. You might encounter an “earnout,” where a portion of the sale price is paid later if the practice hits performance targets. You may also be offered “rollover equity,” allowing you to retain ownership in the larger company. This can provide a lucrative second payday when the larger entity is sold again.
3. Protecting Your Legacy and Staff. For many owners, ensuring their staff is cared for and their patients continue to receive excellent care is a top priority. The right buyer will share these values. A key part of the sale process is finding a partner whose culture aligns with yours and who is committed to investing in the team you built.