Guide to Selling a Ortho & MSK Practice in Miami, FL

Selling your Ortho & MSK practice is one of the biggest financial decisions you will ever make. The Miami market is particularly active right now, filled with unique opportunities and challenges, especially with the rise of private equity investment. Making the right move requires the right strategy. This guide will walk you through the key market dynamics, valuation principles, and process steps you need to understand for a successful transition.

Market Overview

The market for orthopedic and MSK practices in Miami is dynamic and competitive. If you are an independent practice owner, you are likely feeling the pressures of a changing healthcare landscape.

The Private Equity Factor

Florida, and Miami in particular, is a focal point for private equity (PE) acquisitions in the orthopedic sector. These investment groups are actively seeking to partner with or acquire established practices to build larger platforms. This trend introduces both new opportunities for a high-value exit and new competitive pressures for those who remain independent.

Pressures on Independent Practices

Beyond PE interest, many physicians are considering a sale for other reasons. Shifting regulations, declining reimbursement rates, and rising operational costs make it increasingly difficult to thrive alone. For many, selling or merging with a larger entity offers a path to reduce administrative burdens, achieve cost savings, and focus more on clinical care.

Key Considerations Before You Sell

Thinking about a sale involves more than just finding a buyer. How you prepare can dramatically impact your final outcome. Here are three things to focus on from the start.

1. Define Your Sale Structure. You don’t have to sell the entire practice outright. You could sell specific assets or merge with another group. Each path has very different financial and tax implications. Understanding your options upfront is critical.

2. Tell Your Profitability Story. Orthopedic practices are highly attractive to buyers, often showing an average net profit margin around 45%. However, buyers don’t just look at the top line. They want to see clean, well-organized financial statements that clearly demonstrate this profitability.

3. Assemble Your Expert Team. A successful sale requires a team. You will need your accountant for financials and a lawyer for legal documents. Critically, you also need an M&A advisor who understands the medical space, has connections to the right buyers, and can manage the process to get you the best terms.

Miami’s Market Activity

The theoretical trends are playing out in real-time across South Florida. The transaction landscape is active, with both private equity firms and strategic health systems making significant moves.

The PE Playbook in Action

Private equity’s interest is not just talk. A recent major transaction saw Resurgens, a large orthopedic group, partner with a private equity firm to create United Musculoskeletal Partners. This is the model many investors are following. They are looking for successful practices, often with an EBITDA of $2-3 million or more, to serve as “platform” investments they can build upon.

Strategic University Partnerships

It isn’t only private equity driving the market. Large local players a re also expanding. The University of Miami Health System, for example, is collaborating with other top-tier institutions to broaden its musculoskeletal care footprint in South Florida. This creates another potential class of buyer for your practice: a strategic partner looking to grow its regional presence.

The Practice Sale Process

Selling a practice follows a structured path, but it can have pitfalls. Being prepared for each stage is the key to a smooth and successful transaction. The journey generally follows five key phases.

While it seems straightforward, the due diligence phase is where many deals get delayed or fall apart. Small, undiscovered issues can become major roadblocks. Professional guidance is critical to anticipate buyer questions and ensure you are ready.

Understanding Your Practice’s Value

What is your practice actually worth? The answer is more complex than a simple percentage of revenue. Sophisticated buyers look at your practice’s value through a specific lens.

It Starts with Adjusted EBITDA

Buyers look at profitability, not just revenue. The key metric is Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization). This figure starts with your net income and adds back owner-specific expenses, like an above-market salary or personal car lease, to show the true, underlying profitability of the business itself. Getting this number right is the foundation of your entire valuation.

Applying the Right Multiple

Once your Adjusted EBITDA is calculated, a multiple is applied to it to determine your practice’s enterprise value. For a practice with over $1 million in EBITDA, this multiple could range from 5.5x to 7.5x, or even higher. The exact multiple depends on factors like your number of providers, your growth profile, and your payer mix. It is not just math. It is about telling a compelling story that a buyer will pay a premium for.

After the Sale: Planning Your Transition

The day your deal closes is not the end of the story. A successful transition is planned long before the final papers are signed. Thinking through these post-sale realities is just as important as negotiating the price.

1. Protecting Your Team and Legacy. What happens to your long-serving staff and loyal patients? A well-structured deal includes a clear communication plan to ensure a smooth transition, reassure your team about their future, and protect the reputation you spent years building.

2. Defining Your Future Role. Selling doesn’t always mean walking away. Many deals are structured with earnouts (where you receive additional payments for hitting performance targets) or with you retaining equity in the new, larger company. This allows you to benefit from the future growth you help create.

3. Preserving Clinical Autonomy. A primary concern for physicians is losing control over how they practice medicine. The right partner and the right deal structure can protect your clinical autonomy. We specialize in finding partners and creating agreements that keep physicians at the helm of patient care decisions.