How we think about healthcare and biotech.

The first question every practice owner asks is "what is my practice actually worth?", and the honest answer starts with recognizing that buyers do not pay for last year's tax return. They pay for normalized EBITDA, applied against a market multiple that in 2026 runs roughly 6 to 12× for physician practices and centers on a 7.9× median for ambulatory surgery centers, with regional platforms reaching 11 to 17×. The gap between a prepared seller and an unprepared one is often measured in millions of enterprise value.

Our transaction work is built on multi-method valuation, DCF, market comparables, EVA, and APV, triangulated and stress-tested, the same discipline whether we are valuing a practice, an ASC, or a public company. The downloadable guides below lay out exactly how buyers price your business and how the methods work.

The most common financial pain we hear from practice owners in 2026 is some version of "we are busy but not making money." A full schedule with flat cash is almost always a margin-visibility problem: revenue looks fine, but no one can say which providers, service lines, or payers actually produce margin versus workload. A bookkeeper records transactions; a fractional CFO answers the why behind them.

Our fractional CFO/COO work builds segmented reporting by provider and service line, tightens the revenue cycle to cut days in A/R (clients typically see a 20 to 30% reduction), and models growth so decisions are made on numbers rather than instinct, senior finance leadership without a full-time hire.

We publish investment calls with explicit theses, probability-weighted targets, and full return decomposition, then we track them in public. Our deepest lane: from a vindicated conservative valuation on Esperion to a full corporate valuation of a public operator, all built on the same multi-method discipline (DCF, comps, EVA, APV) and calibrated against actual closed transactions. This is not investment advice; it is how we think, shown on the record.

The Military Health System serves 9.4 million beneficiaries across 700+ facilities, and 2026 is a pivotal year, MHS GENESIS is fully deployed, the DHA faces a congressional mandate to reattract care to military treatment facilities, and the FY2027 defense health budget exceeds $72.5 billion. Our federal work is grounded in real program experience, including leadership on a $1.5B DoD healthcare consolidation.