Confidential Oncology & Hematology Practice, 2-Location Southwestern Group

$19.3M

Revenue

$2.2M

SDE

4.6x

Multiple

Subscribe Free

Read the full deal writeup

Get Free Access

Already a member? Sign in

Full Editorial Writeup

This is a two-location medical oncology and hematology practice operating across two separate Southwestern states, with the primary site running for roughly 18 years and a second location opened about four years ago to expand into a new market. The business is built around infusion services (chemotherapy and specialty infusions), which drive approximately 80% of revenue, supplemented by in-house specialty pharmacy, Evaluation & Management visits (~14%), and in-office procedures like bone marrow biopsies. Both offices are fully staffed with Nurse Practitioners, Physician Assistants, and Medical Assistants, plus an in-house billing team, and the practice carries Medicare and most major commercial insurer contracts.

At $19.3M in 2025 gross revenue with $2.17M SDE and $1.62M adjusted EBITDA, this is a real operating platform, not a solo doc's book of business. The economics are driven by the infusion model: buy-and-bill drug margin plus ancillary pharmacy income create high-dollar-per-visit revenue that a pure E&M practice cannot match. The practice also runs a growing clinical research arm, expanding from four studies in 2025 to eleven planned for 2026, which adds a non-clinical, sponsor-funded revenue stream.

The defining risk and opportunity is key-person concentration. The seller is the sole oncologist, so the entire clinical engine depends on one licensed physician across both sites. That makes provider recruitment the number one value-creation lever: adding a second oncologist or scaling APP capacity, expanding hours, and layering in imaging and radiation therapy could meaningfully grow throughput in two underserved regional markets.

Why we like it

Earnings quality is anchored in high-margin infusion revenue that makes up about 80% of the top line, producing $2.17M SDE on $19.3M revenue. Oncology infusion is buy-and-bill economics with strong per-visit dollars, and the diversified Medicare-plus-commercial payer mix gives the cash flow a stable, non-cyclical base.
Oncology is among the most durable demand profiles in all of healthcare because cancer treatment is never deferred in a downturn. Patients on active chemotherapy and infusion protocols return on fixed clinical schedules, which creates recurring, contract-like revenue with near-zero discretionary sensitivity.
The practice sits in two distinct, described-as-underserved Southwestern markets with established referral relationships and community reputation built over 18 years. Referral-driven oncology practices are hard to displace once embedded with local primary care and hospital networks, giving this a real regional moat.
This is a turnkey platform with 12 full-time staff, an in-house billing team, and scalable workflows already in place across both sites. A buyer with the right clinical partnership inherits infrastructure and payer contracts rather than building from scratch, and the seller offers a rare 1-2 year transition.

How to improve it

Recruit a second full-time oncologist immediately to break single-provider dependence and unlock capacity. The seller himself flags this as the primary growth lever, and adding one provider on an existing patient panel and referral base can lift infusion and visit volume with limited incremental fixed cost.
Push infusion suite and in-house pharmacy utilization by expanding clinic hours and chair capacity. Since infusion drives 80% of revenue, incremental chair-hours and better scheduling density translate almost directly to margin, especially with buy-and-bill drug economics.
Scale the clinical research arm, which is already jumping from four studies in 2025 to eleven in 2026. Sponsor-funded trials add high-margin revenue, offset drug costs, and deepen referral relationships, so formalizing a dedicated research coordinator function could compound this stream.
Add ancillary service lines the seller identifies as gaps, specifically imaging and radiation therapy. Keeping imaging and radiation in-house captures revenue currently referred out and improves the patient experience, though it requires capital and regulatory diligence.
Optimize the in-house billing and coding operation to protect and improve infusion reimbursement. Oncology billing is complex and error-prone, and a payer contract review plus coding audit can recover leakage on the highest-dollar claims in the practice.
Deepen referral penetration in both underserved regional markets with a structured outreach program to local primary care and hospitals. Formalizing referral tracking and relationship management can grow new-patient starts, which directly feed the recurring infusion base.
Lock in provider and staff retention agreements before and at close given the key-person risk. Employment contracts, non-competes where enforceable, and retention incentives for the tenured clinical and billing teams protect the value you are paying for.

Diligence notes

The entire practice depends on one oncologist who is also the seller, so quantify exactly how revenue and patient panel behave if he steps back. Model whether the projected 2026 growth and current SDE survive under a hired replacement physician's compensation, which will materially compress the owner-earnings you are underwriting.
Scrutinize the buy-and-bill drug economics that underpin ~80% of revenue, because reimbursement changes, drug pricing, and payer policy shifts can swing infusion margin dramatically. Confirm actual net margin after drug acquisition cost, not just gross infusion revenue, and separate true clinical profit from pass-through pharmacy dollars.
Verify payer contracts, Medicare participation, and reimbursement rates across both states, since the two locations operate under separate state regulatory and licensing regimes. Confirm rates are assignable or renewable on change of ownership and understand any Stark, anti-kickback, and self-referral exposure tied to the in-house pharmacy and infusion model.
Reconcile the $2.17M SDE and $1.62M adjusted EBITDA against tax returns and confirm what add-backs were used, especially since 2026 is claimed to be trending substantially higher. Pin down whether the growth is real run-rate or one-time, and clarify that pharmacy inventory is excluded from the sale and what that costs to stock post-close.
Confirm the regulatory and licensing path for the buyer, because the listing explicitly requires relevant industry experience and this is a heavily regulated field. Non-physician buyers may face corporate-practice-of-medicine restrictions requiring an MSO structure or physician partner, which affects deal structure and financeability.
Review both facility leases, one expiring 04/01/2029 at $8,980 per month, and confirm renewal terms and any location-specific build-out obligations. Since the practice leases rather than owns, understand relocation risk and whether the infusion suite improvements are transferable or landlord-dependent.

Source

Originally listed on BizBuySell. View original listing →