For Ortho & MSK practice owners in Orlando, the current market presents a unique window of opportunity. Fueled by national growth and strong private equity interest in Florida, the environment for a strategic sale has rarely been better. Navigating this landscape to secure your legacy and financial future requires careful preparation and a clear understanding of the process. This guide provides the initial insights you need to start planning.
Market Overview
The U.S. orthopedics market is in a period of significant expansion. Valued at $57.3 billion in 2023, it is projected to climb to $74.1 billion by 2028. This growth is attracting considerable investment. Both hospital systems and private equity (PE) firms are actively seeking to acquire or partner with high-performing practices.
Florida, and Orlando in particular, sits at the center of this activity. The states favorable demographics and business environment make it a top target for acquirers looking to build regional platforms. For you as a practice owner, this means there is a healthy demand and a competitive landscape for well-run Ortho & MSK practices. It is a seller’s market, but one that requires a clear strategy to navigate.
Key Considerations for Orlando Practices
While the market is strong, a successful sale in Orlando requires attention to several critical details. It’s more than just finding a buyer. It’s about being prepared.
Navigating Floridas Regulatory Waters
Florida has specific rules regarding healthcare transactions. While the state is generally friendly to the corporate practice of medicine, issues around fee splitting and other regulations require careful legal navigation. Working with professionals who understand Florida healthcare law is not just recommended. It is a requirement for a smooth closing.
Preparing for Buyer Scrutiny
The due diligence process is where many deals face challenges. Sophisticated buyers will scrutinize your financials, provider contracts, payer agreements, and operational workflows. We find that owners who prepare their documents and normalize their financials well in advance have a much smoother process and often command higher offers.
Protecting Your Practice’s Identity
Many doctors we talk to are concerned about their practice losing its identity or becoming “too corporate.” This is a valid concern. A key part of the process is finding a partner whose vision aligns with yours. The goal should be to professionalize the business operations while preserving the clinical autonomy and culture you worked hard to build.
Market Activity
The high level of interest in Orlando’s Ortho & MSK space is not just theoretical. It is translating into real transactions. Private equity has become a dominant force, with a significant percentage of all orthopedic practice acquisitions in recent years being PE-backed. These groups are often building larger platforms, and they look for well-managed practices to serve as cornerstones or valuable additions.
Alongside PE, regional hospital systems remain active acquirers. They are often looking to secure their referral networks and expand their musculoskeletal service lines. These two buyer types have different goals, offer different deal structures, and create different post-sale realities for the physician owner. Understanding which type of partner aligns with your personal and financial goals is one of the most important decisions you will make.
The 5 Stages of a Practice Sale
Selling a practice isn’t a single event. It is a process with clear stages. When managed correctly, it allows you to maintain control and confidentiality while driving a competitive outcome.
- Preparation and Valuation. This is the foundation. It involves getting your financials in order, understanding your practice’s true market value, and defining your goals for the transition. Buyers pay for proven performance, and this stage is about preparing your story.
- Confidential Marketing. Your practice is presented, without revealing its identity, to a curated list of qualified financial and strategic buyers. The goal is to generate interest from multiple parties without disrupting your staff or patients.
- Negotiation and Letter of Intent (LOI). After initial conversations, serious buyers submit offers. We help you compare these offers not just on price, but on structure and terms, before selecting a partner and signing a non-binding LOI.
- Due Diligence and Closing. This is the buyer’s formal review period. They verify all financial, legal, and operational information. Proper preparation in stage one makes this step much smoother, leading to the signing of the final purchase agreement.
- Post-Sale Transition. The journey doesn’t end at the closing table. A well-planned transition ensures a seamless handover for your staff, patients, and the new owner, protecting the legacy you’ve built.
What Is Your Orlando Practice Really Worth?
A common question we hear is, “What’s my practice worth?” The answer is more complex than a simple multiple of revenue. Sophisticated buyers value your practice based on its Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization). This figure normalizes your profit by adding back owner-specific personal expenses or above-market salaries to show the true cash flow of the business.
That Adjusted EBITDA figure is then multiplied by a number that reflects your practice’s quality and future potential. In Florida, valuation multiples for medical practices are often higher than the national average. However, the exact multiple depends on several factors.
| Factor | Contributes to Lower Multiple | Contributes to Higher Multiple |
|---|---|---|
| Provider Model | Reliant on a single owner | Multi-provider, associate-driven |
| Ancillary Services | Core orthopedics only | Integrated PT, imaging, or ASC |
| Technology | Paper charts or outdated EMR | Modern, integrated tech stack |
| Payer Mix | High concentration of low-reimbursement plans | Diverse mix with favorable contracts |
Ultimately, buyers are not just buying your past performance. They are buying a story about future growth. The work you do before the sale to improve these factors and frame that story can have a major impact on your final valuation.
Planning for Life After the Sale
The transaction itself is just one part of the journey. A successful plan must also account for what your life and finances will look like after the deal is closed. This is determined during negotiations, not after.
Defining Your New Role
For most physician owners, selling doesn’t mean immediately retiring. You will likely continue to practice for a period of several years. A key part of the deal is defining your role, compensation, and level of clinical autonomy post-sale. Finding a partner who respects your expertise and wants you to remain a clinical leader is critical.
Structuring Your Financial Upside
The price is not the only thing to negotiate. Many modern deals include structures that allow you to share in the future success of the practice.
* Earnouts: These are additional payments you receive over one to three years if the practice hits certain performance targets.
* Rollover Equity: This allows you to “roll” a portion of your sale proceeds (typically 10-30%) into equity in the new, larger company. This provides the potential for a “second bite of the apple”12a second, often larger, payout when the new parent company is sold in the future.
These structures can significantly increase your total economic outcome, and they are a hallmark of a well-negotiated, forward-thinking deal.
Frequently Asked Questions
What makes Orlando, FL a unique market for selling an Ortho & MSK practice?
Orlando is at the center of strong market activity fueled by favorable demographics and a business-friendly environment in Florida. The state attracts significant private equity interest and hospital systems looking to acquire or partner with high-performing Ortho & MSK practices, creating a seller’s market with healthy demand and competitive offers.
What legal considerations should I be aware of when selling my Ortho & MSK practice in Florida?
Florida has specific healthcare transaction rules, particularly around fee splitting and other regulations. It is crucial to work with legal professionals familiar with Florida healthcare law to ensure a smooth transaction and compliance with state regulations.
How is the value of an Ortho & MSK practice in Orlando determined?
Practice value is based primarily on Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization), which reflects true cash flow by normalizing profits. This figure is then multiplied by a valuation multiple influenced by factors like provider model, ancillary services, technology used, and payer mix, with Florida practices often achieving higher multiples than the national average.
What are the typical stages involved in selling an Ortho & MSK practice in Orlando?
The sale process includes five stages: 1) Preparation and Valuation, 2) Confidential Marketing, 3) Negotiation and Letter of Intent (LOI), 4) Due Diligence and Closing, and 5) Post-Sale Transition. Each stage helps maintain control, confidentiality, and drive competitive offers while ensuring a smooth transition for staff and patients.
How can I maximize my financial benefits after selling my practice?
Beyond the sale price, you can negotiate structures like earnouts—additional payments based on future practice performance—and rollover equity, which lets you invest some proceeds into the new entity for potential future gains. Defining your post-sale role and compensation during negotiations is also key to aligning your ongoing involvement and financial upside.