Transaction Update: Medical Practice Sale Tulare County California

JUST SOLD: Outright acquisition of an Internal Medicine Practice for Sale in Central California, Tulare County. Highly profitable solo practice with annual collections of ~$740,000+ with net income in excess of $520,000. Providing multi-site care in outpatient, inpatient, and skilled nursing care facilities. Ample medical office space in a newer-built professional medical building with convenient access to a nearby regional hospital. Payor mix well distributed between Medicare, PPO, and HMO insurance. Qualifying for increased HPSA designated regional area reimbursements with quarterly 10% Medicare incentive bonus. 100% medical practice financing was secured for this transaction.

Leasing space for a dental practice

An important component in the success of a dental practice is the lease agreement for the office space. Occupancy costs can be one of the largest expenses in a dental practice. More importantly, selection of a good location is critical to patient flow and income. Therefore, dentists should consider the lease of an office location not just as a necessary expense, but as an investment. If the location is poorly chosen or if the terms of the lease are overly slanted in the landlord’s favor, it can affect your finances as well as reduce the ability to transfer or sell the practice. A new dental practice buyer is unlikely to assume a highly unfavorable lease and purchase a challenging or unsuitable location.

Running and growing a dental practice is hard enough, and an above-market lease payment can be a drag on growth. New dentists sometimes fall into the trap of associating high-end, high-cost office space with high earning potential. These are not necessarily associated with one another. Be sure to conduct a feasibility study and formulate a detailed business plan before making the site selection.

Also, with the amount of extensive build out and lease-hold improvements done in a dental office, a dental practice cannot be easily moved. Once the build out has started, consider yourself committed to the location. It is important to remember that the property owner’s broker or attorney likely drafted the lease agreement. You should always seek the advice of your own broker or counsel before engaging in such an agreement. Failing to do your due diligence can be a costly mistake!

Charles Kim is a dental practice broker at Transition Consultants, a practice merger and acquisition firm. Mr. Kim provides transaction advisory and dental practice valuation services to dentists and dental groups nationwide. He can be contacted at 800-416-2055 (x224).

Dental Practice Valuations

Dental practice valuations can be a challenging task with many complexities. A professional valuation company can charge thousands of dollars to determine the fair market value of a practice. Before spending that money, it is important to do your homework and choose an appropriate valuation expert, and to properly understand the benefits and limitations of the valuation report.

Unfortunately, there is no standardized universally accepted formula or “rule of thumb” that a valuation company may use to establish the value of a dental practice. There are many objective factors that should be considered to determine the value, and there are as many subjective factors unique to the dental industry (and to each specialty within the dental industry) that are just as important.

In reality, a valuation of a dental practice is closer to providing a subjective opinion rather than using complex formulas or “industry standards”. Be sure to work with someone that understands the dental industry to develop a reasonable and useful dental practice valuation. This valuation should be discussed in further detail with your financial advisors to prepare for the transition process.

Naturally, the valuation will incorporate much of the financial data to analyze the “numbers” of the dental practice. Perhaps more helpful, will be analysis of the key factors of profitability and growth that are unique to the specific practice being evaluated. Each dental specialty has its own attributes that must be considered, such as different standards for reimbursements, payor mix, percentage of patients by referrals, etc.

Charles Kim is a dental practice broker at Transition Consultants, a practice merger and acquisition firm. Mr. Kim provides transaction advisory and dental practice valuation services to dentists and dental groups nationwide. He can be contacted at 800-416-2055 (x224).

Book Review: Guide to Healthcare Valuation (2010 Edition)

I am currently reading the Guide to Healthcare Valuation (2010 Edition), published by Business Valuation Resources (BVR) and the American Health Lawyer’s Association (AHLA). This is a great resource written by Dietrich and a number of other experienced authors. They cover a wide array of healthcare valuation topics and industry subsectors; it’s hard to find this collective wisdom all in one place. The book is thick…921 pages inclusive of appendices. A valuation book of this size typically means you’re in for a monster technical read, but this book is refreshingly different. There are plenty of practical insights and applications offered by multiple authors over diverse chapters. I was impressed by the 2009 edition of this book, which I would also recommend, and the 2010 edition clearly builds on the first issue in a major way. As I get through more of the book I’ll update this blog with reviews about specific topics and chapters. I’m especially looking forward to the chapters devoted to ambulatory surgery, dialysis, home health, and imaging. Stay tuned.

Q&A from the Institute of Business Appraisers

Great article on the Institute of Business Appraisers website entitled "Building on a History of Excellence – A Discussion with IBA Headquarters on the Future of Business Valuation in the United States". Great information about leadership, standards, and trends within the business valuation community. Visit IBA's News blog to read the entire Howard Lewis interview.