The market for therapy practices is booming. National projections show significant growth for both speech and occupational therapy services through 2032. For owners of integrated practices in St. Louis, this presents a unique window of opportunity. Selling your practice is more than a transaction. It’s about securing your financial future and ensuring your legacy of care continues. This guide will walk you through the key factors to consider.
Curious about what your practice might be worth in today’s market?
A Strong Market for Therapy Practices in St. Louis
You are in a strong position. Nationally, the demand for speech and occupational therapy is expected to nearly double over the next decade. This creates a very favorable environment for practice owners looking to sell. Buyers, from private equity groups to larger strategic health systems, see the long-term value in practices like yours.
Here in St. Louis, this trend is amplified. We have a dense healthcare landscape with major players like BJC HealthCare and SSM Health constantly seeking to expand their service lines. The presence of well-regarded specialized clinics shows a clear, established demand for integrated pediatric and adult therapy. This means qualified buyers are actively looking for acquisition opportunities in our area. Your practice is not just a local clinic. It is a valuable asset in a dynamic regional market.
Key Considerations for Your Integrated Practice
Selling an integrated speech and occupational therapy practice involves more than just financials. The most successful sales we see are from owners who have thought through the operational details that buyers scrutinize.
Your Unique Service Mix
How your speech and occupational therapy services are integrated is a key value driver. Buyers will want to understand your referral patterns between disciplines, your payer mix, and the efficiency of your care delivery model. A practice that can demonstrate seamless internal collaboration is much more attractive than two separate service lines operating under one roof.
Staff and Client Retention
Your therapists and administrative team are the heart of your practice. A buyer’s biggest fear is that key personnel and the clients they serve will leave after the sale. Having clear staff roles, competitive compensation, and a plan for ensuring continuity of care is not just good practice. It is a critical part of protecting your practice’s value during a transition.
Missouri’s Regulatory Landscape
Transferring ownership smoothly requires careful navigation of state-specific licenses and accreditations. Any issues with compliance or credentialing can cause significant delays or even derail a deal. Ensuring all your documentation is in perfect order ahead of time prevents last-minute surprises during a buyer’s due diligence.
Every practice sale has unique considerations that require personalized guidance.
What Market Activity Looks Like Today
The market is not just strong. It is active. We are seeing a diverse range of buyers showing interest in well-run therapy practices in the St. Louis region. These typically fall into a few categories: larger, multi-state therapy groups looking to expand their footprint, local hospital systems like BJC or Mercy seeking to integrate therapy services, and private equity firms building regional platforms.
This activity is a clear signal of a market shift. Standalone practices are increasingly being acquired by larger, better-capitalized organizations. For a seller, this creates a competitive landscape where multiple bidders can be brought to the table. Running a structured process to engage these different buyer types is the best way to ensure you are not leaving money on the table. A single, unsolicited offer is rarely the best one you can get.
The Path to a Successful Sale
Many owners I speak with are unsure of what the selling process actually involves. While every deal is unique, a successful transaction generally follows a clear, four-stage path. We manage this process from start to finish to protect your confidentiality and create a competitive environment.
- Preparation and Valuation. This is the foundational step. We work with you to analyze your finances, normalize your earnings, and prepare a detailed marketing package. This phase concludes with a comprehensive valuation so you know exactly what your practice is worth before ever speaking to a buyer.
- Confidential Marketing. We then take your practice to market without disclosing its identity. We contact a curated list of qualified buyers from our proprietary database and manage all initial inquiries. This protects your relationships with staff and patients.
- Negotiating Offers and Due Diligence. After generating interest, we help you compare offers and negotiate the best terms. Once you accept an offer, the buyer begins a formal due diligence process. This is often the most intense phase, where buyers inspect your financials, contracts, and operations. Proper preparation in step one makes this stage go smoothly.
- Closing the Deal. The final stage involves working with attorneys to finalize the legal agreements. We oversee this process to ensure the terms that were negotiated are reflected in the final contracts, leading to a successful closing.
Preparing properly for buyer due diligence can prevent unexpected issues.
How Your Practice is Valued
One of the first questions every owner asks is, “What is my practice worth?” The answer is based on more than just revenue. Sophisticated buyers value your practice based on its profitability, specifically a metric called Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization). Think of this as the true cash flow your business generates. We calculate this by taking your net income and adding back owner-specific personal expenses or a higher-than-market owner salary. Most owners are surprised to learn their Adjusted EBITDA is significantly higher than their reported profit.
This Adjusted EBITDA figure is then multiplied by a number called a “multiple” to arrive at your practice’s value. That multiple can vary widely. It depends on factors like your size, your reliance on a single owner-therapist, the diversity of your payer contracts, and your documented growth trajectory. A multi-provider practice with strong growth and a clean financial story will command a much higher multiple than a small practice dependent on one person. Our job is to build that compelling story to achieve the highest multiple possible.
A comprehensive valuation is the foundation of a successful practice transition strategy.
Planning for Life After the Sale
The deal is not done when the papers are signed. A successful transition is one where you have a clear plan for your role, your staff’s future, and your financial proceeds. Too many owners focus only on the sale price and forget to negotiate the terms that will define their life for the next one to three years. A good deal structure protects your legacy and maximizes what you take home.
We help you think through these critical post-sale elements during the negotiation phase.
| Post-Sale Element | What It Means for You |
|---|---|
| Transition Support | Clearly defining how long you will stay on and what your responsibilities will be to ensure a smooth handover of patients and operations. |
| Earnout Structures | An opportunity to earn additional sale proceeds, paid out in the future if the practice hits certain performance targets. |
| Equity Rollover | Keeping a minority ownership stake in the new, larger company. This allows you to benefit from the practice’s future growth and a potential “second sale” down the road. |
| Tax Planning | Structuring the sale from the beginning as either an asset or stock sale to legally minimize your tax burden on the proceeds. |
The structure of your practice sale has major implications for your after-tax proceeds.
Frequently Asked Questions
What is the current market outlook for selling a speech and occupational therapy integration practice in St. Louis?
The market for therapy practices in St. Louis is very strong and active, with demand for integrated speech and occupational therapy services expected to nearly double nationally through 2032. St. Louis has a dense healthcare landscape with major players like BJC HealthCare and SSM Health seeking to expand, creating favorable conditions for sellers with multiple qualified buyers interested.
What are the key factors buyers consider when evaluating an integrated speech and occupational therapy practice?
Buyers focus on the unique service mix and how well speech and occupational therapy services are integrated, referral patterns, payer mix, and efficiency of care delivery. They also scrutinize staff and client retention, looking for stable staff roles, competitive compensation, and plans to ensure continuity of care after sale, as well as compliance with Missouri’s regulatory requirements.
How is the value of a Speech & Occupational Therapy Integration practice determined?
Practice value is primarily determined using Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization) which reflects true cash flow. This figure is multiplied by a market-driven multiple influenced by factors like practice size, growth trajectory, payer contract diversity, and owner dependency. Practices with strong growth and multiple providers command higher multiples.
What are the typical stages involved in selling a therapy practice in St. Louis?
The typical sale process involves four stages:
- Preparation and Valuation: Analyzing finances, normalizing earnings, preparing marketing materials, and determining valuation.
- Confidential Marketing: Marketing the practice anonymously to qualified buyers.
- Negotiating Offers and Due Diligence: Comparing offers, negotiating terms, and facilitating buyer due diligence.
- Closing the Deal: Finalizing legal agreements and formally transferring ownership.
What should a practice owner plan for after the sale of their St. Louis therapy practice?
Owners should plan for transition support (clarifying their post-sale role and responsibilities), potential earnout structures to increase proceeds based on performance, equity rollover options to retain minority ownership, and tax planning strategies to minimize their tax burden. These elements help protect the owner’s legacy, maximize financial outcomes, and ensure a smooth transition.