Selling your Ortho & MSK practice in Maryland presents an unprecedented opportunity, but it also comes with significant complexities. The Maryland market is active, with strong interest from private equity buyers looking for quality practices. This guide provides insights to help you navigate the process, understand your practice’s value, and plan for a successful transition. Proper preparation is key to a favorable outcome.
Market Overview
The market for Ortho & MSK practices in Maryland is particularly robust right now. This is not a coincidence. It is driven by several powerful trends converging at once. If you are a practice owner, understanding these forces is the first step toward making an informed decision about your future.
Here are the key drivers shaping the Maryland market:
1. Sustained Patient Demand: An aging population ensures a consistent and growing need for orthopedic and musculoskeletal services, creating a stable foundation for any practice.
2. Strong Private Equity Appetite: Private equity firms are actively investing in orthopedics to build regional density. They see value in well-run practices and are willing to pay for them.
3. A Unique Regulatory Environment: Maryland’s specific healthcare policies and reimbursement landscape present both challenges and opportunities. A practice that has successfully navigated this environment is highly attractive to buyers.
4. Shift to Value-Based Care: Buyers, particularly larger groups, are looking for partners who can help them succeed in value-based care models. Your experience here can be a significant value driver.
Key Considerations
As you consider selling, it is important to look inward at your practice. You need a clear story that answers the questions buyers will ask. How does your practice stand out against larger competitors like the Centers for Advanced Orthopaedics? Your financial records must be clean and demonstrate consistent profitability. Beyond the numbers, you have to think about your personal goals. What level of clinical autonomy do you want after the sale? What happens to your dedicated staff? Answering these questions early in the process ensures you find a partner who aligns with your vision for the future, not just one who offers the highest price.
Your legacy and staff deserve protection during the transition to new ownership.
Market Activity
The theoretical opportunity in the market is confirmed by real-world transactions. Both local and national buyers are actively pursuing partnerships in the region.
A Local Example
You don’t have to look far to see the trend. The acquisition of Shady Grove Orthopaedics by Aligned Orthopedic Partners in April 2022 is a prime example of private equity’s commitment to the Maryland orthopedic market. This kind of transaction shows that well-regarded local practices are high-priority targets for well-capitalized buyers.
Active National Buyers
The interest is not isolated. A growing number of national platforms are looking to expand their footprint in Maryland. Groups like United Musculoskeletal Partners, Orthopedic Care Partners, HOPCo, and Spire Orthopedic Partners are constantly seeking strategic additions. Knowing who these buyers are and what they look for is a major advantage in any sale process.
The Sale Process
Selling your practice follows a structured path. It begins long before you talk to a buyer. The first phase is preparation, where we help you organize your financials and craft the story of your practice. Next comes valuation, which establishes a clear, defensible understanding of what your practice is worth. Only then do we confidentially approach a curated list of qualified buyers to create a competitive environment. This leads to negotiating offers and selecting the right partner. The final stage is due diligence, where the buyer verifies all the information about your practice. This step is where many deals face a slowdown, but with proper preparation, it becomes a smooth final checkpoint before closing the transaction.
The due diligence process is where many practice sales encounter unexpected challenges.
How Your Practice is Valued
A practice’s value is not determined by a simple rule of thumb. Sophisticated buyers use a formula: Adjusted EBITDA x a Valuation Multiple. Adjusted EBITDA is your practice’s real cash flow after adding back owner-specific personal expenses and normalizing any above or below-market salaries. This figure gives a true picture of profitability. That number is then multiplied by a factor based on risk and growth potential. Many factors influence this multiple, and a higher multiple means a higher valuation for you.
| Factor that Increases Value | Why It Matters to a Buyer |
|---|---|
| Multiple Providers | Reduces reliance on a single owner, lowering risk. |
| Ancillary Services (PT, Imaging) | Provides diversified, high-margin revenue streams. |
| Strong Payer Contracts | Ensures stable and predictable reimbursement rates. |
| Demonstrated Growth | Shows a track record of success and future potential. |
Valuation multiples vary significantly based on specialty, location, and profitability.
Post-Sale Considerations
The transaction is not the end of the story. It is the beginning of a new chapter for you and your practice. A successful deal structure is one that is designed with your future in mind. For many physicians, this means retaining clinical autonomy while handing off the administrative burdens. It can also mean participating in the future success of the larger group through an equity rollover, which offers the potential for a second, often larger, financial return down the road. Defining these terms, ensuring a strong cultural fit, and protecting your staff are just as important as the sale price. It is about securing your financial future and preserving the legacy you have worked so hard to build.
The right exit approach depends on your personal and financial objectives.
Frequently Asked Questions
What drives the current demand for selling Ortho & MSK practices in Maryland?
The demand is driven by sustained patient demand due to an aging population, strong interest from private equity firms seeking regional density, Maryland’s unique healthcare regulatory environment, and a shift to value-based care models that appeal to buyers.
How should I prepare my Ortho & MSK practice for sale to attract the best buyers?
Preparation involves organizing clean financial records showing consistent profitability, creating a clear story that differentiates your practice from larger competitors, and aligning on your personal goals about clinical autonomy and staff protection post-sale.
Who are the typical buyers interested in Maryland Ortho & MSK practices?
Buyers include both local and national private equity-backed groups such as Aligned Orthopedic Partners, United Musculoskeletal Partners, Orthopedic Care Partners, HOPCo, and Spire Orthopedic Partners who actively seek quality practices in the region.
How is the value of an Ortho & MSK practice in Maryland determined?
Value is calculated using Adjusted EBITDA multiplied by a valuation multiple that reflects risk and growth potential. Factors that increase value include having multiple providers, ancillary services, strong payer contracts, and demonstrated growth.
What considerations are important after selling my practice?
Post-sale considerations include negotiating deal terms that allow for clinical autonomy, protecting staff, culturally fitting with the new ownership, and possibly participating in equity rollover for future financial upside.