Selling your fertility practice is one of the most significant financial and professional decisions you will ever make. For owners in Oregon, the path to a successful exit has unique opportunities and specific regulatory hurdles. This guide provides a clear overview of the current market, key preparations, and the process, showing how strategic preparation is the foundation for maximizing your practice’s value and securing your legacy. The journey requires careful thought.
Market Overview
The national market for fertility practices is strong. Patient demand is rising due to factors like increased awareness and more people starting families later in life. This has attracted significant interest from buyers, including large fertility networks and private equity firms looking to expand. The global fertility market is projected to grow substantially, reaching over $36 billion by 2028, which signals a healthy M&A environment.
However, selling in Oregon is different. The states Corporate Practice of Medicine (CPOM) law is one of the nation’s strictest, generally requiring that physicians hold a majority ownership stake in a medical practice. This rule changes the landscape of potential buyers and the structure of a potential deal. It does not close the door on a sale. It just means you need a partner who understands how to navigate these specific regulations to find the right qualified buyer.
Key Considerations for a Successful Sale
If you are thinking about selling in the next two to five years, the time to start preparing is now. Buyers pay for proven performance, not just potential. Focusing on a few key areas can dramatically improve your final outcome.
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Strategic Timing is Everything. The entire sale process, from initial planning to closing, can take one to three years. Starting the preparation process early allows you to control the timeline and sell when your practice is at its peak, not when you are forced to by burnout or retirement.
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Financial Health is Your Foundation. The most attractive practices have clean, clear financials. We find that focusing on increasing top-line revenue and optimizing expenses in the years leading up to a sale has a direct impact on the final valuation. This goes beyond basic accounting. It involves positioning your finances to be understood by sophisticated buyers.
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Operational Excellence Attracts Buyers. Is your facility and equipment up to date? Are your processes well-documented? Buyers look for well-run businesses that they can integrate smoothly. An organized practice is seen as less risky and therefore more valuable.
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Your Clinical Outcomes Matter. As a fertility practice, your IVF success rates are a critical performance indicator. Being able to present clear, SART-reported data that demonstrates the quality of your clinical care is a powerful asset during a sale.
Market Activity and What It Means for You
The fertility sector has seen a wave of M&A activity, with dozens of transactions taking place in recent years. This consolidation is driven by well-capitalized buyers looking to build regional and national platforms. You can see this happening right here in Oregon. The acquisition of Oregon Reproductive Medicine (ORM) by Pinnacle Fertility is a prime example of how major players are entering the market.
While this activity is positive, buyers have also become more prudent. The record-high valuation multiples of a few years ago have stabilized. Today, deals are often structured more carefully. You may see terms like earn-outs, where a portion of the sale price is tied to the practices future performance. This trend makes it more important than ever to have an expert negotiator on your side to structure a deal that protects your interests.
Understanding the Sale Process
From the outside, selling a practice can seem like a complicated puzzle. But when you work with an advisor, it becomes a structured, manageable process designed to protect your confidentiality and maximize your outcome. At its core, the process can be broken down into four main phases.
| Phase | What It Means for You |
|---|---|
| 1. Preparation & Valuation | Getting your financial and operational house in order. We work with you to understand your practice’s true value based on normalized cash flow, not just tax returns. |
| 2. Confidential Marketing | We identify and discretely approach a curated list of qualified buyers. Your staff, patients, and competitors will not know your practice is for sale. |
| 3. Buyer Due Diligence | This is where the buyer examines every detail of your practice. Proper preparation here is critical to prevent surprises that could derail a deal. |
| 4. Negotiation & Closing | We help you secure the best possible terms, from the final price to your post-sale role, and manage the legal process through to completion. |
How Your Practice is Valued
Many physicians believe their practice’s value is based on a simple rule of thumb or a percentage of revenue. This is rarely accurate. Sophisticated buyers value your practice based on a multiple of its Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization). Adjusted EBITDA represents your practices true cash flow, adding back owner-specific personal expenses or a below-market salary to show the full earnings potential to a buyer.
The multiple applied to that EBITDA figure is influenced by many factors. Fertility practices typically command high multiples. However, a practice with multiple providers, strong growth, and efficient operations will receive a higher multiple than a solo practice reliant on one person. We have seen that preparing a professional valuation that tells a compelling story about your practices strengths and future potential can often double what an owner initially thought their practice was worth.
Planning for Life After the Sale
A successful transaction isn’t just about the closing day. It is about setting yourself, your staff, and your legacy up for a smooth transition. Thinking about these elements early in the process is key to a fulfilling exit.
Your Future Role
What do you want to do after the sale? Some physicians want to retire immediately, while others prefer to continue working for a few years, focusing purely on clinical care without the headaches of management. We help you negotiate an arrangement that aligns with your personal and professional goals.
Protecting Your Legacy
You have spent a career building your practice and caring for your patients and staff. A good deal structure includes provisions to ensure continuity of care and protect your team. This is a critical part of finding the right buyer, not just any buyer.
The Financial Aftermath
The structure of your sale has major implications for your after-tax proceeds. Proper tax planning is not an afterthought. It is an integral part of the deal. Furthermore, many owners choose to “roll over” a portion of their equity into the new, larger organization. This can provide a “second bite of the apple,” giving you the potential for another significant payday when the larger platform is eventually sold.
Frequently Asked Questions
What makes selling a Fertility & IVF practice in Oregon unique compared to other states?
Oregon’s Corporate Practice of Medicine (CPOM) law requires that physicians hold a majority ownership stake in a medical practice. This restricts potential buyers and changes the structure of deals, meaning you’ll need a knowledgeable partner familiar with these regulations to find the right buyer.
How long does the process of selling a fertility practice typically take?
The sale process usually takes between one to three years from initial planning to closing. Early preparation is critical to control the timeline and sell when the practice is at its peak performance.
How is the value of a Fertility & IVF practice determined?
Practice value is typically based on a multiple of Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization), which reflects true cash flow by adding back owner-specific expenses or below-market salary. Factors like multiple providers, growth, and operational efficiency can increase this multiple.
What key areas should I focus on to maximize the value of my practice before selling?
- Strategic timing to sell at peak performance.
- Financial health by increasing revenue and optimizing expenses.
- Operational excellence with up-to-date facilities and documented processes.
- Clinical outcomes with strong IVF success rates using clear, SART-reported data.
What should I consider about my role and legacy after selling my practice?
Consider whether you want to retire immediately or continue working in a clinical role, and negotiate accordingly. Protecting your legacy means structuring the deal to ensure continuity of care and staff protection. Also plan for the financial implications, including tax and the possibility of rolling over equity into the larger organization for future gains.