The market for hospice and geriatric care in Wisconsin is driven by powerful demographic tailwinds. An aging population is fueling a growing demand for services, creating strong buyer interest for well-run practices. For practice owners, this presents a significant opportunity to realize the value of their life’s work. However, capitalizing on these conditions requires strategic preparation and a clear understanding of the path ahead. This guide provides the insights you need to navigate the process.
A Market Primed for Opportunity
The decision to sell your practice is significant. In Wisconsin, the timing for hospice and geriatric practice owners is supported by compelling market fundamentals. This isn’t just a feeling; it’s backed by clear demographic data that every serious buyer is watching.
Two key factors are creating this favorable climate:
- An Aging Population. Wisconsin’s population of residents aged 65 and older stands at 19.1%, already higher than the national average. This group is the primary user of hospice and geriatric services.
- Projected Growth. The trend is accelerating. Projections show Wisconsin’s senior population will grow by 30% by 2030. The 75-plus demographic is expected to increase by an even more dramatic 41% in the same period. This ensures sustained, long-term demand for the services you provide.
Key Considerations Beyond the Numbers
While market demand is strong, sophisticated buyers look well beyond demographics. They will perform deep due diligence on the operational health of your practice. Before you begin a sale process, you should review your practice from a buyer’s perspective. Pay close attention to your regulatory standing. The Wisconsin DHS regularly conducts surveys, and a clean compliance history is a major asset. Buyers will also analyze your staffing stability and referral sources. With a projected need for 10,000 more elder care workers in the state, demonstrating low turnover and a diverse, reliable network of patient referrals can significantly differentiate your practice and increase its value.
Market Activity: Consolidation is Underway
The healthcare landscape in Wisconsin is active, with significant investment and consolidation. While individual private practice sales are confidential, a look at recent public activity reveals a clear trend. Large, well-capitalized groups are expanding their footprint in the state, seeking to build regional density in post-acute care, including hospice and home health. This activity signals a healthy and competitive buyer environment for attractive practices.
| Recent Acquirer / Investor | Focus Area in Wisconsin |
|---|---|
| The Ensign Group | Acquired assets of home health & hospice providers. |
| Aspirus Health | Buying hospitals and clinics in central & northern WI. |
| CIBC Bank USA | Provided $67M in financing for skilled nursing acquisitions. |
| National Trend | Significant growth in for-profit hospice investment. |
The Sale Process: More Than a Handshake
Selling a medical practice is a multi-stage journey that requires careful management. It begins long before a buyer is involved. The first step is preparation, where you organize your financial and operational documents and get a clear-eyed valuation. Next, an advisor confidentially markets the opportunity to a curated list of qualified buyers, managing inquiries and initial negotiations. Once a promising offer is accepted, the most intense phase begins: due diligence. Here, the buyer and their team will scrutinize every aspect of your practice. This is where many deals encounter problems if the initial preparation was not thorough. The final stage involves legal documentation and the successful closing of the transaction.
How Your Practice is Valued
Your practice’s value isn’t based on revenue or a simple rule of thumb. Sophisticated buyers determine value using a formula: Adjusted EBITDA x a Market Multiple. EBITDA is your Earnings Before Interest, Taxes, Depreciation, and Amortization. We then adjust it by adding back one-time or owner-specific expenses, like an above-market salary, to find the true cash flow of the business. This Adjusted EBITDA is then multiplied by a number (the multiple) to arrive at your practice’s enterprise value.
Your multiple isn’t set in stone. We find it is influenced by several key factors:
- Payer Mix: A stable base of Medicare, Medicaid, and private insurance is viewed favorably.
- Provider Reliance: Practices that can operate without being 100% dependent on the owner command higher multiples.
- Regulatory Record: A clean compliance history with the DHS reduces perceived risk for a buyer.
- Referral Network: Diverse and strong referral relationships from hospitals, physicians, and facilities are a major value driver.
Planning for Life After the Sale
The transaction is not the end of the story. A successful sale also involves planning for what comes next for you, your staff, and your patients. Your future clinical role, if any, is an important point of negotiation. For many owners, ensuring their professional legacy and protecting their team is just as important as the sale price. The right deal structure can help you achieve these goals. For instance, some owners choose to retain a portion of ownership (rollover equity) to participate in future growth. Thinking through these personal and financial objectives from the beginning ensures the final agreement aligns with the future you envision.
Frequently Asked Questions
What makes now a good time to sell a Hospice & Geriatric practice in Wisconsin?
Wisconsin’s aging population, which is above the national average at 19.1% for residents aged 65 and older, coupled with projections showing a 30% growth in the senior population by 2030, is driving strong buyer interest. This demographic trend ensures a sustained demand for hospice and geriatric services, creating a favorable market for practice sales.
What operational aspects do buyers consider when evaluating a Hospice & Geriatric practice?
Buyers look beyond demographics and analyze the operational health of the practice, including regulatory standing, compliance history with Wisconsin DHS, staffing stability, and the diversity and reliability of the referral network. Practices with low staff turnover and strong, diverse patient referral sources are more attractive and can command higher valuation.
How is the value of a Hospice & Geriatric practice determined?
The practice’s value is calculated using Adjusted EBITDA multiplied by a market multiple. Adjusted EBITDA is the Earnings Before Interest, Taxes, Depreciation, and Amortization with owner-specific or one-time expenses added back to reflect true cash flow. Factors influencing the multiple include payer mix, provider reliance, regulatory record, and referral network strength.
What should I expect during the sale process of my Hospice & Geriatric practice?
The sale process involves multiple stages: preparation (organizing financial and operational documents and valuation), confidential marketing to qualified buyers managed by an advisor, due diligence (the buyer’s detailed review of the practice), and final legal documentation leading to closing. Thorough preparation is critical to avoid challenges during due diligence.
How can I plan for life after selling my Hospice & Geriatric practice?
Planning for life after the sale includes negotiating your future clinical role if any, protecting your professional legacy, and ensuring support for your staff and patients. Deal structures like rollover equity allow you to retain partial ownership and participate in future growth. Aligning the sale terms with your personal and financial goals is essential for a successful transition.