1. Decide whether you actually want to sell
Before any process, the right question is not "what is my practice worth?" but "what do I want my next five years to look like?" A good banker pushes back here.
2. Get your numbers honest
Audit-grade financial statements, normalization adjustments, CPT-level revenue cuts. The work you do here directly translates into multiple, buyers price uncertainty.
3. Run a real process
The biggest valuation lift comes from competition. A structured process across PE platforms, strategics, and physician-led MSOs typically lifts the first inbound offer by 25%+.
4. Negotiate the structure, not just the headline
Earnouts, rollover equity, working capital targets, and indemnification all move the real economics far more than the headline number.
5. Protect the practice through transition
Provider retention, patient experience, and culture are what fail post-close, and what wipe out earnouts. Plan transition explicitly into the deal.