Guide to Selling a Fertility & IVF Practice in Washington

Selling your Fertility & IVF practice is one of the most significant decisions of your career. In Washington, the market is active, and valuations are strong, but the process is complex. This guide offers insights into the current market, what buyers look for, and how to navigate the sale of your practice. We will walk you through the key steps to help you achieve a successful and profitable transition.

Market Overview

The environment for selling a Fertility & IVF practice in Washington is strong. The states demand for fertility services is growing faster than the national average, creating a favorable landscape for practice owners considering an exit.

Washington’s Thriving Fertility Landscape

Demand in Washington is robust. IVF procedures accounted for 2.6% of all births in the state in 2021, a rate higher than the U.S. average. This high demand supports healthy practice revenues, with typical cycle costs ranging from $15,000 to $25,000. For a seller, this translates to a healthy and desirable patient base for potential buyers.

National Growth and Investor Interest

This local strength is matched by national trends. The U.S. assisted reproductive technology market is projected to grow by over 5% annually through 2030. This growth attracts significant attention from buyers, including private equity firms and large strategic health systems looking to enter or expand in the fertility sector. This high level of interest creates a competitive environment, which can lead to premium valuations for well-prepared practices.

Key Considerations

Beyond market tailwinds, a successful sale requires careful attention to the unique operational and regulatory details of your practice. Buyers will scrutinize every aspect of your business, and being prepared is a must. Washington has specific rules that need careful navigation.

Here are three areas that require your focus:

1. Navigating Buyer Due Diligence. A buyer will want to see everything. This includes corporate records, detailed financial statements, provider contracts, and proof of HIPAA compliance. Having these documents organized and ready demonstrates professionalism and can prevent delays or issues in the sale process.
2. Washington’s Regulatory Landscape. You must adhere to state and federal laws, including patient privacy laws and Washington’s specific policies on the transfer of medical records. Additionally, ongoing discussions about the corporate practice of medicine could affect how a sale to a non-physician entity is structured.
3. Planning for Your Legacy. A sale is not just a financial transaction. It impacts your staff and patients. A clear plan for transitioning patient care, managing employee contracts, and communicating the change is needed for a smooth transfer of ownership.

Market Activity

The M&A market for fertility clinics is more active than ever. We see a consistent flow of transactions driven by new types of buyers entering the space. This is not a market to enter unprepared. Many owners believe they should wait two or three years to sell, but the reality is that preparation should start now. Buyers pay for proven performance, not just potential. Starting the process early allows you to position your practice to sell on your terms.

Recent deal activity shows that well-run fertility practices are in high demand and command strong valuations. Sophisticated buyers like private equity groups are actively acquiring practices to build larger platforms. This competition can work in your favor, but only if you run a structured process to generate multiple offers. The value of a fertility clinic is often measured as a multiple of its Adjusted EBITDA, with buyer appetite influencing the final number.

Sale Process

A well-managed sale process protects your confidentiality and maximizes value. It moves through predictable stages, each with its own set of challenges. When we work with practice owners, we manage this entire process so you can continue focusing on patient care.

A typical sale unfolds in these five steps:

1. Preparation and Valuation. We begin by understanding your personal and financial goals. Then, we prepare a detailed valuation based on your practice’s financials, operations, and market position. This phase also involves organizing the documents needed for due diligence.
2. Confidential Marketing. We create a marketing package that highlights your practices strengths and growth opportunities. We then confidentially approach a curated list of qualified buyers from our proprietary database, protecting your identity and ensuring staff and patients remain unaware.
3. Negotiation and Offer. As interest builds, we solicit initial non-binding offers. We help you compare the financial and non-financial terms of each offer and negotiate to secure the best possible deal structure.
4. Due Diligence. Once you select an offer, the buyer conducts an in-depth review of your practice. Our preparation in step one makes this stage smoother and less disruptive.
5. Closing and Transition. We work with legal counsel to finalize the sale agreement. After closing, we assist with the transition plan to ensure a seamless handover to the new owners.

Valuation

Many practice owners we speak with are unsure of what their practice is truly worth. They sometimes assume its value is too low to sell or rely on simple rules of thumb. A proper valuation goes much deeper. It is about understanding your practices true profitability and framing its story for sophisticated buyers.

Beyond a Simple Formula

Your practice is more than just a multiple of revenue. Buyers look at the quality and sustainability of your cash flow. This is where a private-equity-grade approach to valuation makes a difference.

The Power of Adjusted EBITDA

The most important metric is Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization). We calculate this by taking your net income and adding back non-cash expenses as well as one-time or personal costs, like an above-market owner’s salary or a car lease run through the business. This gives a clear picture of the practice’s profitability to a new owner.

What Drives Your Multiple

The multiple applied to your Adjusted EBITDA is influenced by several factors: your practices scale, the experience of your clinical team, your use of advanced technology, and your market position within Washington. Practices that are less dependent on a single owner and have diverse revenue streams typically receive higher multiples.

Post-Sale Considerations

The day your practice sale closes is not the end of the journey. The structure of your deal will have long-term implications for you, your team, and your financial future. Thinking through these elements beforehand is a must for protecting your legacy.

Here are a few key areas to plan for:

1. Securing Your Team’s Future. Your staff is one of your practice’s most valuable assets. Negotiating employment agreements for key team members and ensuring a cultural fit with the new owner can provide stability and continuity.
2. Ensuring Patient Continuity. A smooth transition plan is needed to transfer patient records and care responsibilities. Clear communication with patients about the change in ownership is important for maintaining trust and goodwill.
3. Structuring Your Financial Exit. Your proceeds from the sale can be structured in different ways. Some deals include an earnout, where you receive additional payments if the practice hits future performance targets. Others may involve rolling over a portion of your equity, allowing you to share in the future success of the larger platform. This can be a great way to stay involved and benefit from a “second bite of the apple.”