Guide to Selling a GI & Hepatology Practice in Connecticut

A Guide for Practice Owners

The market for GI & Hepatology practices in Connecticut is changing fast. Significant consolidation and private equity interest are creating major opportunities for practice owners like you. Selling your practice for its maximum value requires a clear understanding of this new landscape and careful preparation. This guide provides a direct look at the key factors you need to consider for a successful sale.

Market Overview

If you own a GI practice in Connecticut, you are at the center of a dynamic market. The landscape is not what it was five years ago. Two major trends define the current environment.

The Consolidation Wave

Large health systems and private equity (PE) groups are actively acquiring independent practices across the state. This trend is robust in the gastroenterology sector. It means there are more well-funded buyers in the market than ever before. These buyers are looking for established practices to build regional platforms.

A Specialist-Rich Environment

Connecticut has one of the highest concentrations of gastroenterologists in the country. This creates a competitive, high-quality environment that is attractive to acquirers. Combined with strong growth in statewide healthcare spending, it signals a healthy and valuable market for GI services. This makes your practice a potentially prized asset.

Key Considerations

Selling your practice goes beyond the numbers on a profit and loss statement. Buyers today perform deep due diligence on your operations. You should be prepared to address new areas of scrutiny. State regulators are increasing their oversight of healthcare transactions, which can add complexity to the sale process. Cybersecurity has also become a major concern for acquirers, who will want to see proof of robust data protection. Beyond these risks, your greatest assets are often your people. A strong clinical team, experienced staff, and a well-developed referral network are powerful value drivers that must be clearly communicated to a potential buyer.

Market Activity

The consolidation trend in Connecticut is not theoretical. It is happening right now. The recent acquisition of Connecticut GI, the state’s largest gastroenterology group, by the private equity-backed GI Alliance is a clear signal of the market’s direction. This transaction demonstrates that sophisticated, well-capitalized buyers are actively seeking to partner with leading practices in the state. So, what are they looking for?

When we work with buyers, we see them focus on a few key areas:

1. Ancillary Services. Practices with in-house endoscopy, pathology, or infusion centers are highly attractive as they provide multiple revenue streams.
2. A Path to Growth. Buyers want to see potential. This could be opportunities to recruit more physicians, add locations, or expand services.
3. Operational Strength. A practice with modern EHR systems, efficient billing, and strong compliance programs is seen as a lower-risk, well-managed investment.
4. A Stable Team. Acquirers are not looking to replace your staff. They see your experienced physicians and team members as a core asset for future success.

The Sale Process

Many physicians think selling a practice starts with finding a buyer. In our experience, that comes much later. A successful sale begins with preparation, often one to two years before you plan to exit. The process generally follows five stages: Preparation, Valuation, Marketing, Due Diligence, and Closing. During preparation, you clean up your financials and operations to present the practice in the best possible light. A formal valuation then establishes a credible asking price. Only then do you confidentially approach a curated list of potential buyers. The most critical stage is often due diligence, where the buyer inspects every aspect of your business. This is where we see unprepared sellers run into trouble. Proper readiness ensures you control the narrative and navigate this phase smoothly toward a successful close.

Valuation

How much is your practice worth? The answer is more complex than a simple percentage of revenue. Sophisticated buyers value your practice based on a metric called Adjusted EBITDA. Think of this as your true cash flow, after adding back personal expenses run through the practice and normalizing any above-market owner salaries. This number is then multiplied by a “multiple” to determine the total value. While a practice with under $1M in Adjusted EBITDA might get a 5x to 7x multiple, a larger practice could command 8x or more. The multiple is not fixed. It changes based on several key factors.

An accurate valuation is the foundation of your entire exit strategy. It ensures you negotiate from a position of strength.

Post-Sale Considerations

The deal is not done when the papers are signed. Your role after the sale is a critical part of the negotiation. For many physicians, an outright sale is not the only option. Many private equity deals involve the owner “rolling over” a portion of their equity into the new, larger company. This allows you to take cash off the table now while participating in the future growth of the platform, offering a potential second payday down the road. The structure of your continued employment, clinical autonomy, and any performance-based “earnouts” are all key negotiating points. A well-structured deal protects not only your financial future but also the legacy of the practice you built and the careers of the staff who helped you build it.