Guide to Selling a Ortho & MSK Practice in Louisiana

Are you the owner of an Ortho & MSK practice in Louisiana? You may be thinking about your future, whether that means retirement, a strategic partnership, or simply a change of pace. The current market presents a significant opportunity for practice owners, but navigating it requires strategic preparation. This guide provides insight into the trends, processes, and key decisions you will face.

Market Overview

The market for Ortho & MSK practices in Louisiana is strong, influenced by powerful national trends. Across the country, private equity (PE) investors are showing unprecedented interest in the nearly $50 billion musculoskeletal sector. They are attracted by stable revenues, high-margin ancillary services like physical therapy and imaging, and the potential for consolidation.

While this creates a sellers market with the potential for premium valuations, Louisianas specific landscape adds another layer. The states documented physician shortages mean that established, well-run practices are in high demand and are seen as valuable, turn-key assets. For a prepared seller, this combination of national investment interest and local demand creates a unique window of opportunity. It also means buyers will be looking for stability and a clear path to growth.

Key Considerations

Selling your practice is more than a financial transaction. It is a major personal and professional decision. Success depends on focusing on the right details long before you go to market. For Ortho & MSK owners in Louisiana, here are three factors that can define your sale.

1. Showcase Your Ancillary Services. Is your practice more than just consultations and procedures? Buyers, especially sophisticated investors, place a high value on integrated ancillary services. Physical therapy, diagnostic imaging, and ambulatory surgery centers are not just revenue streams. They are powerful indicators of a mature, efficient, and profitable platform.

2. Plan for Staff and Patient Transition. Your team’s expertise and your loyal patient base are core components of your practices goodwill. A buyer will scrutinize your plan for retaining key staff. Communicating clearly with your team and having a thoughtful plan for patient transition is not just good practice. It directly protects the value of your business during the sale.

3. Understand Your Potential Buyer. The right buyer depends on your goals. Are you looking for a full exit or a partnership that allows you to continue practicing with fewer administrative burdens? Selling to a local health system is very different from partnering with a PE-backed group. Defining your ideal outcome helps identify the right type of buyer and shapes the entire negotiation.

Market Activity

Activity in the Ortho & MSK sector is driven by new, highly motivated buyers. Private equity firms and their management companies are actively acquiring practices to build regional and national platforms. In a single recent year, at least 15 significant orthopedic practice sales to PE-backed groups were completed nationally.

These are strategic buyers with clear financial goals. They often aim to grow a platform and resell it within three to five years, creating a “second bite of the apple” for physician partners who roll over equity. This model has driven competition and is a key reason for the premium valuations we see today. For physicians considering retirement or seeking a capital partner to manage rising costs, this wave of investment presents a compelling opportunity to secure their financial future while setting their practice up for its next phase of growth.

The Sale Process

Selling your practice is a process, not a single event. A well-managed process protects your confidentiality, creates competitive tension among buyers, and ultimately leads to a better outcome. While every sale is unique, the journey generally follows a few key stages.

1. Preparation and Team Assembly

This is the most important stage. It involves organizing your financial statements, legal documents, and operational data. This is also when you assemble your expert team: a lawyer for legal structures, an accountant for clean financials, and an M&A advisor to manage the entire process, from valuation to closing. We find that owners who prepare for 2-3 years, even if casually, have the best outcomes.

2. Marketing and Buyer Engagement

A professional process does not involve putting a “for sale” sign on the door. It involves confidentially approaching a curated list of qualified buyers. This can include private equity groups, regional health systems, and other large practices that match your goals. Creating a competitive environment with multiple interested parties is key to maximizing your practice’s value.

3. Due Diligence and Negotiation

Once you select a preferred buyer, they will begin a deep dive into your practice’s financials, operations, and legal standing. This due diligence process is where many deals face challenges. Being prepared in advance with organized data and expert support is critical. This stage also involves negotiating the final terms of the sale, from price to post-sale responsibilities.

Valuation

“What is my practice worth?” is the first question every owner asks. The answer is more complex than a simple rule of thumb. Sophisticated buyers value your practice based on its Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization). This is not just the profit on your tax return. It is your practice’s true cash flow, after normalizing for owner-specific expenses and one-time costs.

That Adjusted EBITDA is then multiplied by a specific number, a “multiple,” to determine the enterprise value. This multiple is not static. It changes based on risk and opportunity.

As you can see, scale, provider diversity, and ancillary revenue streams dramatically increase your valuation. An expert valuation does more than just give you a number. It builds the story of your practice’s potential, justifying the highest possible multiple to buyers.

Post-Sale Considerations

The day you sign the papers is a beginning, not just an end. The structure of your deal will shape your financial future and professional life for years to come. Thinking about these elements early in the process is critical to achieving your personal and professional goals.

1. The Structure of Your Payout. Your proceeds will likely be a mix of cash at closing, a potential earnout based on future performance, and rollover equity. Rollover equity, where you retain a minority stake in the new, larger company, offers a “second bite of the apple” and can lead to another significant payout when the parent company is sold again.

2. Your Ongoing Role and Legacy. Do you want to continue practicing? Transition to a purely leadership role? Or retire completely? A well-structured deal can accommodate any of these paths. The key is to find a partner whose vision for the future aligns with yours, ensuring the clinical standards and reputation you built are protected. This is a key way to address fears about losing control.

3. Protecting Your Team. The sale of your practice deeply impacts your long-time staff. A good buyer will see your team as a valuable asset, not a liability. Negotiating for employment agreements, retention bonuses, and a clear communication plan for your staff should be a key part of the deal structure, ensuring a smooth transition for the people who helped you succeed.

Your legacy and staff deserve protection during the transition to new ownership.