Selling your Ohio oncology practice is one of the most significant decisions of your career. The market is shifting, with a clear trend toward consolidation and new investment creating both opportunities and complexities. This guide provides a direct look at the current landscape, what drives your practice’s value, and how to navigate the sale process. We will cover key market trends, valuation principles, and post-sale planning to help you make an informed decision.
Market Overview
The national healthcare landscape is changing. The share of physicians in private practice dropped from over 60% to under 47% in the last decade alone. This trend toward consolidation is very active here in Ohio. Large health systems and private equity groups see the immense value in specialized fields like oncology. We are seeing renewed optimism in the mergers and acquisitions market, with new buyers creating a competitive environment. For a practice owner in Ohio, this means there is significant interest in what you have built. This is not a time for passive waiting. It is a time to understand what this active market means for your future.
Key Considerations for the Seller
When you decide to sell, you are doing more than just listing a business. You are presenting the story and financial health of your life’s work. Getting this right from the start is critical. Here are a few areas that require your direct attention.
Your Financial Story
Buyers need to see clean, accurate financial records. This means having your income statements, balance sheets, and patient billing records organized and up to date. But it goes deeper than that. We help owners understand their Adjusted EBITDA. This is your earnings after we add back personal expenses or above-market owner salaries that a new owner would not incur. This single number is the foundation of your valuation.
Your Practice’s Goodwill
What is your reputation in the community worth? Goodwill is the value of your brand, your loyal patient base, and the trust you have built over years. It is a real asset. While it does not appear on a balance sheet, it directly influences the multiple a buyer is willing to pay. We help you articulate this value in a way that sophisticated buyers understand and appreciate.
Your Motivation for Selling
Buyers will want to know why you are selling. Having a clear and positive reason, such as retirement or a desire to focus purely on clinical work, provides confidence. It signals a stable transition and a seller who will be a transparent partner through the process. A vague or negative reason can create uncertainty and impact negotiations.
Market Activity
The oncology sector is attracting major investment right now. You can see the momentum in recent national headlines. Cardinal Health’s $1.12 billion acquisition of ION, an oncology network with a significant Ohio presence, shows the high valuations being placed on well-run practices. Similarly, Cencora’s $2.1 billion investment in OneOncology signals deep-pocketed interest in the community oncology model. This level of activity is good news for practice owners. It creates a competitive environment where strategic positioning can lead to premium offers. However, it also brings more regulatory scrutiny from bodies like the FTC. Navigating this landscape requires a guide who understands both the opportunity and the potential roadblocks.
The Sale Process
A successful sale is not an accident. It is the result of a deliberate, structured process that protects your interests and maximizes value. Many owners think about selling for years, but the real work starts long before a buyer is ever contacted. We find that owners who begin preparing 2-3 years ahead of their target date achieve the best outcomes, because buyers pay for proven performance, not just potential.
The journey typically follows these four stages:
- Strategic Preparation. This is where we work with you to clean up financials, calculate an accurate Adjusted EBITDA, and build a compelling story around your practice9s strengths and growth potential.
- Confidential Marketing. We do not just “list” your practice. We run a confidential, targeted process, approaching a curated list of qualified buyers from our proprietary database to create competitive tension.
- Managing Due Diligence. This is the buyer’s deep dive into your operations and financials. It is often where deals encounter challenges. We manage this entire process to prevent surprises and keep things moving forward smoothly.
- Final Negotiations. We help you evaluate offers not just on price, but also on structure, an buyer fit, ensuring the final deal aligns with your personal and financial goals.
Valuation
The first question every owner asks is, “What is my practice worth?” The answer is more complex than a simple multiple of your revenue. In today’s market, the most credible valuation is based on your Adjusted EBITDA. This metric provides the truest picture of your practice’s profitability to a potential buyer. We calculate this number by normalizing your financials for any one-time or owner-specific expenses.
Once we establish your Adjusted EBITDA, we determine a valuation multiple. For a specialty like oncology, this multiple is often higher than for general practices. Factors that drive it up include your payer mix, the strength of your referral network, your staff’s expertise, and your opportunities for growth. The goal is to present a clear case for why your practice deserves a premium multiple, transforming your numbers into a compelling growth story.
Post-Sale Considerations
The transaction closing is a major milestone, but it is not the end of the journey. The structure of your deal has long-term implications for your finances, your staff, and your legacy. Planning for this transition is as important as negotiating the sale price itself. It is crucial to consider these elements well before you reach the closing table.
| Consideration | Why It Matters |
|---|---|
| Staff & Patient Transition | A smooth handover protects your legacy and ensures continuity of care. A clear plan reassures staff and maintains patient trust. |
| Your Future Role | Will you stay on for a period? Is there an earnout tied to performance? These terms directly affect your final take-home value and lifestyle. |
| Tax Strategy | The structure of the sale (asset vs. stock) has a massive impact on your after-tax proceeds. Planning ahead can save you a significant amount. |
| Equity Rollover | Some deals involve retaining a minority stake in the new, larger entity. This offers a potential “second bite of the apple” when the larger group sells again. |
Frequently Asked Questions
What are the current market trends for selling an oncology practice in Ohio?
The market is shifting towards consolidation with large health systems and private equity groups showing high interest in specialized fields like oncology. There is renewed optimism and competitive environment for mergers and acquisitions in Ohio, creating opportunities for practice owners.
What financial information is crucial to prepare when selling an oncology practice?
Buyers need clean and accurate financial records including income statements, balance sheets, and patient billing records. Understanding and presenting the Adjusted EBITDA, which reflects earnings after adding back personal expenses or above-market owner salaries, is critical as it forms the foundation of your practice valuation.
How does goodwill impact the value of my oncology practice?
Goodwill represents your practice’s reputation, loyal patient base, and community trust. Although it doesn’t appear on financial statements, it is a significant asset that influences the valuation multiple a buyer is willing to pay. Articulating this value properly is important to showcase your practice’s worth beyond just financials.
What are the typical stages in the sale process of an oncology practice?
The sale process typically involves four stages: 1) Strategic Preparation – cleaning up financials and building a case for your practice’s value, 2) Confidential Marketing – targeting qualified buyers to generate competitive offers, 3) Managing Due Diligence – handling buyer investigations and keeping the deal moving, and 4) Final Negotiations – considering price, deal structure, and buyer fit to align with your goals.
What post-sale considerations should I plan for?
Key post-sale considerations include staff and patient transition plans to protect your legacy, decisions about your future role in the practice, understanding tax implications of sale structure (asset vs. stock), and opportunities for equity rollover which might allow continued financial benefit if the larger entity sells again.