Medical Rollups: 5 Proven Private Equity Frameworks Elite Operators Use to Build Massive Wealth Fast
Medical rollups have produced some of the most aggressive multiple expansion opportunities in private equity, with DSO groups trading at 12 to 19x EBITDA while individual practices still trade at 5 to 7x.
Key Takeaways
- Understand how medical rollups generate multiple expansion by acquiring individual practices at 5 to 7x EBITDA and consolidating them into groups that trade at 12 to 19x EBITDA.
- Consider the concentration risk embedded in premium-priced medical rollups acquisitions where a single high-performing doctor drives the majority of practice revenue.
- Learn how same-store growth discipline separates durable medical rollups from fragile assemblages of practices duct-taped together for a quick exit.
- Explore why the dental market, estimated at only 30% consolidated, still represents a long runway for medical rollups operators with the operational infrastructure to compete.
- Discover why medical rollups operators who prioritize servant leadership and long-term relationship capital consistently outperform short-term extractive approaches to building practice groups.
Medical Rollups and the Arbitrage Model That Started It All
Owner-operated dental, vet, or specialty practices
5–7x EBITDA per location (historically 3–4x)
Centralized ops, standardized protocols, same-store growth
34+ locations, multi-state footprint, institutional quality
12–19x EBITDA — capturing full multiple arbitrage spread
Framework: Austin Davis, Shared Practices Podcast
Medical rollups represent one of the clearest examples of multiple arbitrage in all of private equity, and understanding the mechanics is essential for any fund manager evaluating this space. According to Austin Davis, a dental group operator who has built 34 locations across 25 states since 2022, the fundamental thesis behind medical rollups is straightforward: buy fragmented individual practices at lower multiples and consolidate them into a group that commands a dramatically higher valuation. In dentistry, that spread historically ran from acquiring single practices at 3 to 4x EBITDA and rolling them into a Dental Service Organization, or DSO, that traded at 12 to 14x.
Medical rollups in the dental sector began gaining serious traction approximately a decade ago when early operators recognized that consolidation alone could triple the value of an acquired asset. Davis explains that while single-site multiples have compressed from that original 3 to 4x range to a current 5 to 7x range, the DSO exit multiple has held firm and in some cases expanded, with recent transactions reported at 17x and 19x EBITDA. That spread remains the engine of value creation in medical rollups today.
For fund managers evaluating medical rollups, the mechanics mirror what real estate operators call a value-add strategy: acquire an asset at one price, apply operational improvements and scale benefits, and exit at a higher valuation. The SEC’s educational resources on capital markets provide useful context on how private equity fund structures typically capture this kind of value creation for limited partners. Medical rollups apply this same financial logic to healthcare services, and the dental sector has become one of the most active proving grounds for the strategy.
Medical Rollups and the Concentration Risk Most Operators Underestimate
Medical rollups create significant wealth-building potential, but Davis is direct about the pitfalls that have cost operators badly in this space. The most common mistake, according to Davis, is acquiring large premium-priced practices without fully accounting for the concentration risk embedded in that premium. A practice generating one million dollars in EBITDA may look more attractive than a smaller one generating five hundred thousand, but if a single high-performing doctor is responsible for generating that revenue, the acquirer has effectively bought a person rather than a business.
Medical rollups that chase size over durability frequently encounter this problem at the worst possible moment. Davis explains that when the superstar doctor departs, revenue and EBITDA decline simultaneously while the acquirer still carries the debt load taken on to finance a premium acquisition multiple of 8 or 9x. In an environment of rising interest rates, that combination of declining cash flow and elevated debt service has pushed some medical rollups operators into serious financial distress.
The lesson Davis draws from this pattern in medical rollups is one that applies across private equity: understand the specific driver of any premium you pay, and stress-test what happens when that driver is removed. As Investopedia notes in its overview of concentration risk, over-reliance on a single revenue source is one of the most consistently underpriced risks in business acquisitions. Medical rollups operators who pay disciplined attention to revenue distribution across providers before acquiring a practice are better positioned to protect the thesis through ownership transitions.
Medical Rollups Require Same-Store Growth, Not Just Acquisition Volume
| Durable Platform | Fragile Platform |
|---|---|
| Same-store revenue growth at each location | Acquisition volume without operational improvement |
| Centralized support functions & standardized protocols | Loosely connected practices with no shared infrastructure |
| Revenue distributed across multiple providers | Revenue concentrated in one superstar doctor |
| Clean per-location financials ready for diligence | Declining per-location economics as location count rises |
| Capital deployment paced to operational capacity | Acquisition velocity outrunning integration capacity |
| Exits at 12–19x EBITDA with institutional credibility | Compressed multiples or failed transactions at exit |
Framework: Austin Davis, Shared Practices Podcast
Medical rollups operators who treat consolidation as the entire strategy, rather than the starting point, are building on an increasingly fragile foundation. Davis is explicit on this point: private equity buyers have grown significantly more sophisticated about DSO quality, and a group that has simply bolted practices together without improving underlying operations will face skepticism at exit. Same-store growth, the practice of demonstrably improving revenue and efficiency at each acquired location, is now a requirement rather than a differentiator in medical rollups.
Medical rollups that can show genuine operational improvements at the practice level tell a fundamentally different story to institutional buyers than those that cannot. Davis describes the discipline of focusing on improving operations, capturing efficiencies, and building what he calls a real business rather than an assemblage of random practices. For fund managers, this distinction maps directly to the quality of earnings conversation that any serious institutional buyer or LP will conduct during diligence on a medical rollups platform.
The operational infrastructure required to drive same-store growth in medical rollups is also what makes the strategy capital intensive and execution-dependent. According to research published by Harvard Business Review on private equity in healthcare, the firms that have generated the most durable value in healthcare services consolidation are those that invested in centralized support functions, standardized clinical protocols, and management systems that could scale across acquired locations. Medical rollups that skip this infrastructure phase in favor of rapid acquisition volume are borrowing against future execution capacity they do not yet have.
Medical Rollups and the Market Opportunity Still Available in Dentistry
Medical rollups in the dental sector remain in a relatively early stage of consolidation, which is a meaningful data point for fund managers evaluating entry timing. Davis estimates that approximately 30% of the dental market is currently consolidated into DSO-style corporate group practices, leaving 70% still in private hands. His projection is that DSO penetration will exceed 50% within five years, suggesting that the majority of the consolidation opportunity in dental medical rollups still lies ahead.
Medical rollups exit multiples in the DSO space have remained elevated throughout this consolidation cycle, with recent transactions documented at 17x and 19x EBITDA according to Davis. For context, these valuations reflect institutional buyers pricing in the platform value, centralized infrastructure, and growth runway of a scaled medical rollups group rather than the economics of any single practice. The premium between single-site acquisition multiples and DSO exit multiples has not compressed as many predicted, which speaks to persistent strategic demand from larger acquirers and institutional capital.
Fund managers considering medical rollups should also note that the vet space and certain medical specialties including dermatology follow similar consolidation dynamics to dental, according to Davis. The Wall Street Journal has documented this broader trend across healthcare services sectors, noting that the combination of fragmented markets, recurring revenue, and aging population demographics makes healthcare practice consolidation a long-duration opportunity for private equity. Medical rollups fund managers who build transferable operational infrastructure are positioned to extend their strategy across specialties as dental consolidation matures.
Medical Rollups Success Is Built on Long-Game Relationship Capital
Medical rollups require a network of relationships that extends far beyond financial counterparties, and Davis identifies short-term extractive behavior as one of the most reliable predictors of long-term failure in this space. His framework, which he describes as playing the long game, holds that operators who attempt to extract maximum value from every partner, vendor, employee, and seller relationship will develop a reputation that makes future deal sourcing and talent retention progressively more difficult. Medical rollups depend on trust as an operational input.
Medical rollups operators who approach acquired practices with servant leadership principles, a concept both Davis and Ryan Miller discuss in depth during this episode, report meaningfully different cultural outcomes during the integration phase. Miller describes the approach as being a savage servant: a leader who is formidable and results-oriented but whose primary operational posture is asking team members what they need to succeed rather than extracting compliance. In the context of medical rollups, where acquired practices come with existing staff, patient relationships, and cultural norms, this distinction can materially affect revenue retention through ownership transitions.
The financial case for relationship capital in medical rollups aligns with broader research on human capital in service businesses. Harvard Business Review has documented the connection between employee engagement, patient or client retention, and revenue stability in professional services environments. Medical rollups fund managers who build reputations as operators rather than extractors are better positioned to source off-market acquisitions, retain key clinical staff, and command credibility with institutional buyers who conduct management quality assessments during exit diligence.
Medical Rollups Operators Who Protect White Space Outperform Those Who Do Not
Medical rollups at the pace Davis has executed, reaching 34 locations across 25 states in under two years, creates an operational tempo that can rapidly consume a founder’s capacity for strategic thinking. Davis identifies schedule discipline, specifically the deliberate creation of unscheduled white space in his calendar, as one of the most impactful operational decisions he has made. The logic is straightforward: medical rollups generate unpredictable high-priority problems, and an operator whose calendar is fully committed cannot respond effectively when those problems surface.
Medical rollups leaders who over-schedule themselves optimize for the appearance of productivity while undermining their ability to address the most important issue of any given day. Davis explains that his most important daily task is frequently not knowable in advance, which means that a rigid schedule creates structural conflict between his formal commitments and his actual highest-value work. His approach is to protect deep work blocks rigorously while keeping the surrounding calendar deliberately open, targeting no more than 60% scheduled time as a maximum ceiling, a framework that echoes principles taught by management educators including the late Stephen Covey.
The discipline of protecting cognitive capacity is increasingly recognized as a competitive variable in private equity at the operator level. Harvard Business Review’s research on energy management suggests that knowledge-intensive work, including the deal sourcing, integration management, and capital allocation decisions at the core of medical rollups, degrades significantly under conditions of cognitive overload. Fund managers who treat schedule architecture as an operational discipline rather than a personal preference are better positioned to sustain the decision quality required to manage complex medical rollups platforms over multi-year holding periods.
Medical Rollups Operators Who Build the Whole Person Build Better Businesses
Medical rollups at scale demands sustained high performance from founders and operators, and both Davis and Miller are direct about the structural failure mode they observe most frequently among young entrepreneurs: the collapse of personal foundation in pursuit of the next deal. Davis, who has maintained a daily gym practice for 15 years, frames physical and relational health not as lifestyle considerations but as operational prerequisites for building a durable medical rollups business. His observation is unambiguous: you cannot build a successful business on an unsuccessful home life.
Medical rollups operators who allow relationship capital with family and partners to erode while building their platforms tend to discover the cost at inflection points, precisely when the business demands the most from them personally. Davis references Naval Ravikant’s principle of ensuring your own foundation is sound before attempting to solve larger problems, a principle that maps directly to the risk management discipline required of any fund manager. Medical rollups are long-duration projects, and the operator’s personal sustainability is a material variable in the outcome.
Miller’s own framework for sustaining performance through medical rollups or any capital-intensive venture combines daily meditation or reflective practice, physical training, and deliberate learning through reading and skill-building. The integration of these practices, rather than treating them as competing demands on entrepreneurial time, reflects a systems approach to personal capital that mirrors the same-store growth discipline required of a medical rollups platform. Forbes has documented the morning routine practices of high-performing founders and operators, consistently finding that structured personal practices are correlated with sustained professional output. Medical rollups operators who invest in building themselves with the same intentionality they bring to building their platforms are better positioned for long-term execution.
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About the Guest
Austin Davis is a private equity operator in the medical practice space with direct experience on both sides of the DSO transaction market, having previously founded and sold his own dental practices to private equity before building his own group. Since 2022, Davis has grown his dental group to 34 locations across 25 states, making him one of the more active builders in the medical rollups space. He is also the host of the Shared Practices podcast, ranked in the top 0.5% of podcasts globally, where he covers DSO industry strategy and business building.
In addition to his dental group work, Davis hosts the Doctors at DeFi podcast, which focuses on cryptocurrency and decentralized finance topics for medical professionals. Listeners interested in the dental-specific dimensions of medical rollups and DSO strategy can access his content at sharedpractices.com. His dual background as both a former practice owner and a current rollups operator gives him a perspective on medical rollups that spans the full transaction lifecycle.
Questions Answered in This Article
How do private equity firms execute medical practice roll-ups profitably?
Private equity firms execute medical practice roll-ups by acquiring individual practices at lower single-site multiples and consolidating them into a larger group, which commands a significantly higher valuation multiple. A single dental practice might be acquired at five to seven times EBITDA, then incorporated into a dental group where that same EBITDA is valued at 12 to 14 times. The strategy depends on achieving operational efficiencies, demonstrating same-store growth, and building a cohesive enterprise rather than simply assembling unrelated practices.
What valuation multiples do PE firms pay for medical practice acquisitions?
Single-site medical and dental practices currently trade at acquisition multiples in the range of five to seven times EBITDA, up from the three to four times multiples seen when roll-ups first emerged roughly a decade ago. Once integrated into a larger group, those practices contribute to a platform that commands 12 to 14 times EBITDA at exit. Select transactions in the past 18 to 24 months have closed at multiples as high as 17 to 19 times, reflecting strong institutional demand for scaled healthcare platforms.
How can fund managers build wealth through healthcare private equity investments?
Fund managers can build substantial wealth in healthcare private equity by capitalizing on the valuation arbitrage between fragmented single-site practices and consolidated group platforms. Austin Davis illustrates this path directly, having sold his own practices to a private equity acquirer and then building a dental group spanning 34 locations across 25 states within roughly two years of launch in 2022. Focusing on same-store growth and operational improvement, rather than simply bolting practices together, is what separates durable returns from short-term gains.
What are the biggest risks of private equity ownership in medical practices?
One of the most significant risks is acquiring a large, premium-priced practice whose performance depends on a single high-producing clinician, because when that individual departs, revenue and EBITDA can decline sharply against a debt load sized for peak performance. Overpaying at eight or nine times EBITDA for such a practice, particularly in a rising interest rate environment, compounds that exposure considerably. A second major risk is neglecting same-store growth after acquisition, which produces a loosely connected group of practices rather than an integrated business with defensible enterprise value.
Which medical specialties offer the best private equity roll-up opportunities?
Dentistry has been one of the most active roll-up sectors, with an estimated 30% of the dental market already consolidated into corporate group practices and projections pointing toward 50% or more within five years. Veterinary medicine and dermatology are also cited as specialties where the same arbitrage dynamics apply. The common thread across these fields is a highly fragmented base of owner-operated practices, which creates a long runway for continued consolidation.
How do dental and medical practice roll-ups generate returns for investors?
Returns are generated primarily through multiple expansion, where practices purchased at five to seven times EBITDA are revalued at 12 to 14 times or higher once incorporated into a scaled group. Operational improvements, cost efficiencies, and consistent same-store growth add to EBITDA at the platform level, amplifying the effect of that multiple expansion at exit. Investors who entered the dental roll-up space early benefited from even wider spreads, as single-site acquisition multiples were as low as three to four times EBITDA in the early years of the strategy.
What is the typical exit timeline for private equity healthcare investments?
The episode does not specify a standard holding period, but the pace of Austin Davis’s own group, which reached 34 locations across 25 states in under two years from a 2022 start, illustrates that scaled platforms can be assembled relatively quickly with sufficient capital and deal flow. The broader dental market is expected to move from roughly 30% consolidation today to above 50% within approximately five years, suggesting active exit opportunities throughout that window. Sustained institutional interest, evidenced by recent transactions pricing at 17 to 19 times EBITDA, indicates a receptive buyer market for well-constructed platforms.
Why are private equity firms investing over one trillion dollars in healthcare?
The episode points to structural factors that make healthcare practice consolidation persistently attractive: a large base of fragmented, privately owned practices, a proven valuation arbitrage between single-site and group multiples, and consistent institutional demand for scaled platforms. The dental market alone remains roughly 70% unconsolidated, representing a substantial volume of acquisition targets still available at single-site multiples. Combined with recurring patient demand and the relative defensibility of healthcare cash flows, these characteristics continue to draw significant private capital into the sector.
Topics Covered in This Article
- How medical rollups generate multiple arbitrage between single-site and DSO exit valuations
- The concentration risk embedded in premium medical rollups acquisitions driven by single high-performing doctors
- Why same-store growth discipline is now a baseline requirement for credible medical rollups platforms
- Current DSO market consolidation levels and the remaining runway for medical rollups operators
- Recent medical rollups transaction multiples including reported DSO exits at 17x and 19x EBITDA
- How servant leadership principles improve integration outcomes in medical rollups acquisitions
- Schedule architecture and white space discipline for medical rollups founders managing rapid growth
- The long-game relationship capital framework that distinguishes durable medical rollups operators from short-term extractors
- How personal foundation practices including physical health and family relationships support sustained medical rollups execution
- Parallels between medical rollups value-add strategy and real estate value-add acquisition frameworks
Medical Rollups and the Capital Deployment Discipline That Separates Durable Platforms
Medical rollups at the pace Davis has executed require a rigorous framework for deploying capital across acquisitions without outrunning the operational infrastructure needed to support each new location. Davis explains that one of the structural lessons from building 34 locations across 25 states is that inorganic growth creates compounding integration demands, and operators who deploy capital faster than they can absorb new practices tend to create fragility at the platform level rather than scale. In this episode, Davis is clear that the discipline of knowing when not to acquire is as important as the ability to source the next deal.
Medical rollups that maintain acquisition velocity without corresponding investment in centralized support functions, management systems, and clinical standardization tend to face deteriorating same-store performance precisely when a buyer’s diligence team is evaluating the platform for exit. According to Davis, private equity buyers have grown significantly more sophisticated in how they evaluate DSO quality, and a platform that shows declining per-location economics alongside rising location count tells a story that compresses exit multiples rather than expanding them. The capital allocation decision in medical rollups is therefore not simply how much to deploy, but how to sequence deployment against operational capacity.
For fund managers structuring medical rollups vehicles, the SEC’s regulatory framework for private fund structures provides important context on how capital deployment timelines and concentration limits are typically disclosed to limited partners in alternative asset vehicles. Medical rollups fund managers who build explicit acquisition pacing criteria into their investment policy statements are better positioned to demonstrate institutional-grade discipline to LP allocators evaluating the strategy for the first time.
Medical Rollups Demand an Operator Mindset, Not Just a Financier Mindset
Medical rollups are frequently evaluated through a purely financial lens by fund managers entering the space, but Davis draws a sharp distinction between operators who understand the clinical and human dynamics of acquired practices and financiers who treat them as interchangeable cash flow assets. In this episode, Davis explains that the seller community in dental medical rollups is relatively small and highly networked, meaning that a reputation for treating acquired practices as assets rather than relationships can close off deal flow in ways that do not appear on any financial model. The operator mindset, according to Davis, is what generates proprietary deal sourcing over time.
Medical rollups operators who have direct experience as practice owners, as Davis does having previously founded and sold his own dental practices to private equity, carry a credibility with selling dentists that pure financial buyers cannot replicate. Davis notes that sellers in the dental space are often making a once-in-a-career decision about their practice, and they are acutely sensitive to whether the buyer understands what they have built. Medical rollups platforms that invest in this seller relationship quality tend to source better acquisitions at more reasonable multiples than those that compete purely on price.
The distinction between operator-led and financier-led medical rollups also surfaces during portfolio company management, where clinical staff, office managers, and long-tenured employees respond very differently to leadership that understands the practice environment. As Harvard Business Review’s research on team dynamics documents, trust and communication quality within acquired organizations are primary determinants of whether integration preserves or destroys the revenue relationships that justified the acquisition price. Medical rollups managers who bring operational credibility to the integration process are better positioned to retain the human capital that drives same-store performance.
Medical Rollups Founders Who Build Personal Systems Sustain Execution Over Multi-Year Holds
Daily training practice maintained for 15+ years. Physical recovery is an operational input, not a lifestyle choice.
Family and partner relationships maintained as a prerequisite. Cannot build a successful business on an unsuccessful home life.
Max 60% scheduled time. White space reserved for unpredictable high-priority decisions that define the day.
Daily reflective practice, deliberate learning, and skill-building compounding over the full holding period.
Framework: Austin Davis & Ryan Miller, Making Billions Podcast
Medical rollups are multi-year projects that require sustained high-quality decision-making from the operators responsible for sourcing, integrating, and scaling acquired practices, and both Davis and Miller address the personal infrastructure required to support that execution in this episode. Davis, who has maintained a daily physical training practice for 15 years, frames this not as a lifestyle preference but as an operational input directly connected to the cognitive and relational demands of running a rapidly scaling medical rollups platform. His observation is direct: the operator is the most important asset in the business, and neglecting that asset creates platform risk that no amount of financial engineering can offset.
Medical rollups leaders who allow the pace of deal flow and integration management to crowd out personal recovery, physical health, and relational maintenance tend to encounter deteriorating decision quality at the precise moments when the platform demands the most from them. Davis references the principle articulated by Naval Ravikant that you cannot build a successful business on an unsuccessful home life, framing personal foundation not as a competing priority but as a prerequisite for sustained medical rollups execution. Miller adds that the integration of daily reflective practice, physical training, and deliberate learning creates a compounding personal capital base that mirrors the same-store growth logic applied to the platform itself.
The connection between founder personal sustainability and platform performance is increasingly recognized in institutional investment circles as a material due diligence consideration. Forbes has documented the relationship between founder health practices and business performance outcomes, noting that cognitive load, stress management, and physical recovery directly affect the quality of strategic decisions in high-growth operational environments. Medical rollups fund managers who assess operator sustainability as part of their pre-acquisition or team evaluation frameworks are applying a risk lens that purely financial diligence frameworks tend to omit.
Medical Rollups Exit Readiness Requires Building for the Buyer You Have Not Yet Met
Medical rollups platforms that are built with exit readiness as an operating principle from day one tend to command meaningfully different conversations with institutional acquirers than those that begin preparing for exit only when a transaction is imminent. Davis explains in this episode that sophisticated institutional buyers evaluating a medical rollups platform are conducting a quality of earnings analysis, a management quality assessment, and an operational infrastructure review simultaneously, and any gaps discovered during that process compress the multiple or kill the transaction. Building for that scrutiny from the first acquisition rather than the last is what separates platforms that transact cleanly from those that do not.
Medical rollups exit readiness encompasses several dimensions that Davis identifies as consistently underprepared in platforms he has observed: clean financial reporting at the individual practice level, documented clinical and operational protocols that do not depend on any single individual, and demonstrable same-store growth trends that can be attributed to repeatable management practices rather than favorable market conditions. Each of these elements requires investment during the build phase that creates friction against the acquisition pace some operators prefer, but that friction is precisely the discipline that institutional buyers reward at exit. In the context of medical rollups, building for an unknown future buyer means treating every operational decision as a data point that will eventually appear in a diligence data room.
The standards that institutional buyers apply to medical rollups platforms during exit diligence are not materially different from the standards that institutional LPs apply to fund managers during capital raising, a parallel that Ryan Miller draws explicitly in this episode. Bloomberg’s coverage of private equity-backed dental group transactions has documented the increasing rigor that institutional acquirers bring to DSO diligence, including management quality assessment and operational infrastructure review as standard components of the process. Medical rollups operators who build with institutional scrutiny in mind from the outset are better positioned to capture the full value of the multiple arbitrage thesis when exit conditions align.
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This is not a course. This is not a community. This is direct access to the frameworks, relationships, and infrastructure used by fund managers operating at the highest levels of the alternative asset industry.
About the Guest
Austin Davis is a private equity operator specializing in the medical practice space who brings direct experience from both sides of the DSO transaction market, having previously founded and sold his own dental practices to private equity before building his current group. Since 2022, Davis has grown his dental group to 34 locations across 25 states, establishing him as one of the more active builders in the medical rollups space. He is also the host of the Shared Practices podcast, ranked in the top 0.5% of podcasts globally, where he covers DSO industry strategy and dental practice business building for professionals in the field.
Davis additionally hosts the Doctors at DeFi podcast, which addresses cryptocurrency and decentralized finance topics for medical professionals. His dual background as a former dental practice owner and a current medical rollups operator gives him a perspective on the full transaction lifecycle that spans the seller experience, the integration phase, and the institutional exit process. Listeners can access his content and resources at sharedpractices.com.
Questions Answered in This Article
How do private equity firms execute medical practice roll-ups profitably?
Private equity firms execute medical practice roll-ups by acquiring individual practices at lower single-site multiples and consolidating them into a larger group, which commands a significantly higher valuation multiple. A single dental practice might be acquired at five to seven times EBITDA, then incorporated into a dental group where that same EBITDA is valued at 12 to 14 times. The strategy depends on achieving operational efficiencies, demonstrating same-store growth, and building a cohesive enterprise rather than simply assembling unrelated practices.
What valuation multiples do PE firms pay for medical practice acquisitions?
Single-site medical and dental practices currently trade at acquisition multiples in the range of five to seven times EBITDA, up from the three to four times multiples seen when roll-ups first emerged roughly a decade ago. Once integrated into a larger group, those practices contribute to a platform that commands 12 to 14 times EBITDA at exit. Select transactions in the past 18 to 24 months have closed at multiples as high as 17 to 19 times, reflecting strong institutional demand for scaled healthcare platforms.
How can fund managers build wealth through healthcare private equity investments?
Fund managers can build substantial wealth in healthcare private equity by capitalizing on the valuation arbitrage between fragmented single-site practices and consolidated group platforms. Austin Davis illustrates this path directly, having sold his own practices to a private equity acquirer and then building a dental group spanning 34 locations across 25 states within roughly two years of launch in 2022. Focusing on same-store growth and operational improvement, rather than simply bolting practices together
