Selling your radiology practice is one of the most significant financial and professional decisions you will ever make. For practice owners in New Hampshire, the current market presents a unique mix of opportunity and complexity. Strong buyer interest, fueled by a robust state healthcare economy, meets the specific challenges of radiology, from radiologist burnout to rapid technological change. This guide provides insights to help you navigate this landscape and position your practice for a successful transition.
Market Overview
The environment for selling a radiology practice in New Hampshire is strong. Your practice operates within the states largest industry. The healthcare and social assistance sector has been the biggest employer in New Hampshire since 2019. This creates a stable and predictable demand for diagnostic imaging services.
This robust healthcare economy attracts attention. Nationally, private equity firms and larger strategic health systems are deploying significant capital into the radiology space. They see the value in well-run practices with solid referral bases. This significant investor interest means that qualified buyers are actively looking for acquisition opportunities in markets like New Hampshire. Your practice is not just a local clinic. It is a valuable asset in a dynamic national marketplace.
Key Considerations for Sellers
While the market is favorable, a successful sale depends on addressing the issues that sophisticated buyers will scrutinize. Moving from “doing fine” to “ready to sell” involves focusing on a few key areas that directly impact your practice’s value.
Here are three factors that will shape your sale:
- Your Workforce Strategy. Buyers are acutely aware of radiologist shortages and staff burnout. A practice with a stable, experienced team and a clear plan for recruitment and retention is significantly more valuable. Demonstrating a healthy work culture and low turnover can directly address a major buyer concern.
- Your Technology Adoption. Investment in technology is a critical value driver. While 53% of hospitals have adopted at least one imaging AI product, only 33% of radiology practices have. If you have invested in modernizing your equipment, PACS, or billing systems, it should be a central part of your story.
- Your Financial Readiness. Profitability is important, but buyers value clean, verifiable financials even more. We often see owners hesitate to sell because they feel their practice is undervalued. The key is preparing your financial records to reflect your practice’s true earning power, not just the numbers on a tax return.
Market Activity
If you search for recent sales of radiology practices in New Hampshire, you likely will not find much specific information. Most transactions are private, and the details are not published. This lack of public data makes it impossible to find a reliable “price per practice” online.
However, the market is active. We see this in national trends, like Radiology Partners closing a $720 million growth equity investment, which shows the immense capital flowing into the sector. We also see it locally in strategic moves like Nashua Radiology and Atlantic Radiology partnering with management service organizations to streamline their operations. These are signs of a consolidating industry. The most attractive deals are often confidential transactions, sourced through professional networks rather than public listings. This underscores the importance of having an advisor who understands the true market landscape.
The Sale Process
Selling your practice is a structured process, not a single event. Understanding the key phases can help you prepare and avoid common pitfalls where deals often stumble. We’ve found that preparation is what allows owners to sell on their terms.
Phase 1: Preparation and Valuation
This is the most important stage. It involves organizing your financial and operational documents and, most critically, obtaining a comprehensive, professional valuation. This is where you uncover the true earning power of your practice and build the story that will attract premium buyers.
Phase 2: Buyer Engagement
With a clear strategy, your advisor confidentially approaches a curated list of qualified financial and strategic buyers. This process is designed to create competitive tension, which ensures you receive the best possible offers and terms, all while protecting the identity of your practice.
Phase 3: Due Diligence and Closing
Once an offer is accepted, the buyer conducts a deep dive into your practice’s financials, operations, and legal standing. This is where many deals fail due to poor preparation. An experienced advisor helps you anticipate and manage this process smoothly, leading to a successful closing.
Understanding Your Practice’s Valuation
Sellers are often concerned that valuations seem too low. This feeling usually comes from a misunderstanding of how sophisticated buyers determine value. They don’t use simple rules of thumb. They start with a metric called Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization).
Adjusted EBITDA normalizes your reported profit by adding back owner-specific or one-time expenses to show the practice’s true cash flow. For example, an owner’s an above-market salary or personal car lease would be added back. This adjusted number gives a clearer picture of profitability.
| Metric | Amount | Notes |
|---|---|---|
| Reported Profit | $500,000 | From your Profit & Loss statement. |
| Owner Salary Add-Back | +$150,000 | Adjusting owner’s $300k salary to a $150k market rate. |
| Adjusted EBITDA | $650,000 | This is the baseline for your valuation. |
This Adjusted EBITDA is then multiplied by a market-based multiple. The multiple is not static. It changes based on your practice size, payer mix, reliance on a single provider, and growth prospects. A professional valuation is the only way to accurately determine this figure.
Post-Sale Considerations
The transaction closing is a milestone, not the finish line. The structure of your deal has major implications for your future. Planning for life after the sale is just as important as preparing for the sale itself.
Here are a few things to consider early in the process:
- Your Future Role. Do you want to retire immediately, or would you prefer to continue practicing for a few years with less administrative burden? Your employment agreement is a key part of the negotiation and should align with your personal goals.
- Protecting Your Team and Legacy. For many owners, ensuring their staff is taken care of is a priority. The sale can be structured to protect your team and the clinical culture you have built over many years. This helps preserve the legacy you’ve created in the community.
- Optimizing Your Proceeds. The structure of your sale has major tax implications. Options like receiving a portion of the payment in rollover equity can give you a “second bite of the apple” when the new, larger entity sells in the future. Planning this in advance is critical to maximizing your net, after-tax proceeds.
Frequently Asked Questions
What makes the New Hampshire market favorable for selling a radiology practice?
The New Hampshire market is favorable due to its robust healthcare economy, being the state’s largest industry and biggest employer since 2019. This stability drives predictable demand for diagnostic imaging services. Additionally, significant investor interest from private equity firms and strategic health systems nationally increases acquisition opportunities.
What are the key factors buyers scrutinize when evaluating a radiology practice for sale?
Buyers focus on three main factors: 1) Workforce strategy, including team stability and plans for recruitment and retention; 2) Technology adoption, especially investment in modern imaging equipment and systems; 3) Financial readiness, emphasizing clean and verifiable financial records that reflect true earning power beyond basic tax return figures.
How is a radiology practice typically valued for a sale in New Hampshire?
Valuation is typically based on Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization), which normalizes profitability by adding back owner-specific or one-time expenses. This adjusted figure is then multiplied by a market-based multiple that varies with practice size, payer mix, provider reliance, and growth prospects. A professional valuation is crucial for accuracy.
What does the sale process of a radiology practice in New Hampshire generally involve?
The sale process involves three phases: 1) Preparation and valuation, organizing documents and obtaining a professional valuation; 2) Buyer engagement, where qualified buyers are confidentially approached to create competitive offers; 3) Due diligence and closing, involving detailed financial and operational review leading to deal completion.
What post-sale considerations should a seller of a New Hampshire radiology practice keep in mind?
Post-sale considerations include deciding on the future role, whether to retire or continue practicing under new terms; protecting the team and clinical culture to preserve legacy; and optimizing proceeds with strategic deal structure to maximize after-tax benefits, including options like rollover equity for future gains.
