Industry briefing · Healthcare practices
What healthcare practices sell for, and why
Dental practices sold on BizBuySell from 2021 to 2025 went for a median 2.48x owner earnings. Buyers weigh key-person risk first. Fewer than half of US physicians now work in a practice that physicians own, down from six in ten in 2012. Group buyers price a practice on what it earns without its owner: how much of the production walks out of the door with the owner, and how much of it stays.
At a glance
- Published median
- 2.48xon owner earnings
- Typical range at sale
- 5x to 8xon EBITDA
- Who buys
- DSOs and MSOs, PE-backed groups, hospital systems, associates
- Weighed first
- KpKey-Person Risk
What are healthcare practices worth?
2.48x owner earnings was the median multiple paid for dental practices sold on BizBuySell from 2021 to 2025. The measure sits beside each figure, because multiples of owner earnings, EBITDA, and revenue do not compare with each other.
| Multiple | On | Source |
|---|---|---|
| 2.48x | Owner earnings | Owner earnings multiple, dental practicesBizBuySell, Dental Practice Business Valuation Multiples & Financial Benchmarks (businesses sold 2021–2025) |
| 5x to 8x | EBITDA | Typical range at saleFNDRS industry briefing |
| 5x to 8x | EBITDA | Dental add-ons and platformsFOCUS Investment Banking, 2025 |
| 3x to 6x | EBITDA | Primary care prices lowerFOCUS Investment Banking, 2026 |
- Owner earnings
- Profit before the owner's own pay and perks, interest, taxes, and depreciation. Small, owner-run businesses are priced on it.
- EBITDA
- Earnings before interest, taxes, depreciation, and amortization, with the owner paid like a hired manager. Larger companies are priced on it.
Who buys healthcare practices?
Hospitals and corporate owners, including private equity firms and insurers, now own most physician practices, with corporates ahead. In dentistry, about 130 private equity-backed DSOs buy practices, most making several add-ons a year.
- DSOs and MSOs
- PE-backed groups
- hospital systems
- associates
- Hospitals and private equity. In 2024, 34.5 percent of physicians worked in hospital-owned practices, against 23.4 percent in 2012, and 6.5 percent in private equity-owned ones, against about 4.5 in 2022. American Medical Association, 2024
- Corporate owners passed hospitals. From 2024 to 2026, corporate entities such as private equity firms and insurers acquired 8,000 physician practices and hospitals 5,800; corporates now own 33.2 percent against 30.6. Physicians Advocacy Institute and Avalere Health, 2026
- About 130 PE-backed DSOs. FOCUS counted about 130 private equity-backed dental support organizations as of June 2025; most are practised buyers completing several add-on deals a year. FOCUS Investment Banking, 2025
What do buyers check first in a practice?
Group buyers test how much of the work depends on the owner and reset the owner's pay to market. Larger deals in some states also wait on a state review before closing. The owner is usually the top producer and the reason patients come back. A group buyer prices the practice on what it earns after the owner is paid a market salary, and after the owner is gone.
Owner production above half of collections is the single largest discount in a practice sale.
Associates on retention agreements, with a share of production, are what make the earnings transferable.
Recall and reactivation rates show whether the patient base is an asset or a memory.
Payer mix and fee schedules are read line by line. A fee schedule that has not moved in years is a gap a buyer keeps.
Compliance, credentialing, and the lease are on the diligence list before the numbers are.
- Provider risk drives decisions. FOCUS says provider risk became a primary decision driver for dental buyers in 2026, and was among the top reasons DSOs walked away from deals in 2025. FOCUS Investment Banking, 2026
- Owner pay reset to market. Buyers add back owner pay above market and reset it to what an associate producing at the owner's level would cost, often a share of collections. FOCUS Investment Banking, 2026
- State review before closing. Oregon requires filing at least 180 days before closing when one party has $25 million and the other $10 million in average annual revenue; oral health providers are covered. Latham & Watkins, 2025
The element buyers weigh first
Key-Person Risk
Employees whose departure would break a function. Scored as control: higher is safer.
What it measures. Roles where a single departure would halt a function, and the depth of cross-training or succession behind each.
Today and prepared, side by side
The difference is preparation, and in healthcare practices it shows up in a handful of measurable places. This is the shape of it, drafted for the industry and read against what buyers actually pay.
| Today | Prepared | |
|---|---|---|
| Multiple on EBITDA | 4.5x | 7.2x |
| Collections produced by the owner | 70% | 30% |
| Associates on retention agreements | 0 | 3 |
| Recall rate on active patients | 55% | 80% |
Illustrative figures for healthcare practices. Your numbers come from the calculator.
Know what your practice is worth before a buyer tells you
Fifteen minutes for the exit score, then a conversation with the deal team.