Established Family Medicine Practice, 37-Year Northern Virginia Primary Care

$937K

Revenue

$660K

SDE

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Full Editorial Writeup

This is a single-location family medicine practice with roughly 37 years of operating history in Alexandria, Virginia, one of the wealthiest and most densely populated corners of the DC metro. The practice delivers a broad primary care menu: routine visits, physicals, annual wellness exams, chronic disease management, in-house lab testing, cardiovascular diagnostics, ultrasound, remote blood pressure monitoring, and select office-based procedures. It participates with Medicare and a wide roster of major commercial payers, which supports a steady flow of new patients on top of a mature, returning panel.

The economics are the headline. On approximately $937,000 of 2025 gross revenue, the practice threw off about $660,000 in Seller's Discretionary Earnings, a roughly 70% SDE margin that is unusually high even for a lean solo primary care office. Revenue grew about 12.5% year over year, so this is not a practice coasting into a wind-down; demand is expanding. The broad ancillary services (lab, cardio, ultrasound) are doing real work lifting revenue per patient above a bare-bones visit-only model.

The buyer profile is clear: a physician wanting ownership, a regional group bolting on capacity, or a value-based-care platform looking for an established primary care base in an affluent market. Real estate is leased, so this is a clean operations sale. The obvious risk, as with any high-margin owner-physician practice, is how much of that $660,000 is tied to the departing doctor's own clinical production and personal patient relationships.

Why we like it

Earnings quality is the standout: about $660,000 of SDE on $937,000 of revenue is a roughly 70% margin, which tells you overhead is lean and the payer mix is healthy. Primary care with in-house lab, cardiovascular diagnostics, and ultrasound captures ancillary revenue that pure visit-only practices leave on the table. The 12.5% year-over-year revenue growth means you are buying momentum, not a plateau.
The moat is time and trust: 37 years of operating history builds a mature, sticky patient panel with strong community recognition, and patients rarely switch primary care doctors without a real reason. Broad participation with Medicare and major commercial plans keeps the referral and new-patient funnel open. In a densely populated, affluent Northern Virginia market, defensible demand plus insurance access is a durable combination.
Primary care is about as recession-resistant as healthcare gets, since patients keep chronic conditions managed and insurance keeps paying regardless of the economic cycle. The returning patient panel and payer relationships create genuinely recurring revenue rather than one-off transactions. This is the boring, essential cash flow that compounds while flashier businesses whipsaw.
Operator advantage is real for the right buyer: an incoming physician or group can immediately add a second provider or extended hours to lift capacity, since the demand and infrastructure already exist. The listed growth levers (expanded chronic care management, remote monitoring, value-based payer contracts) are executable upgrades, not moonshots. A strategic buyer gets an instant primary care base in a premium DC-adjacent market.

How to improve it

Recruit an advanced practice provider (nurse practitioner or PA) within the first 90 days to expand daily visit capacity at a fraction of a physician's cost. This directly addresses the single-doctor capacity ceiling and can lift revenue without proportionally raising fixed overhead. It also reduces key-person dependence on the selling physician.
Push chronic care management and remote patient monitoring programs harder, since these generate recurring per-member billing under existing CMS codes for the panel you already own. The practice already offers remote blood pressure monitoring, so the infrastructure exists to scale. This is high-margin recurring revenue layered on top of standard visits.
Audit and renegotiate payer contracts and fee schedules, because a 37-year practice often has stale commercial reimbursement rates that have not kept pace. Even modest rate improvements flow almost entirely to the bottom line given the fixed cost base. Bring in a payer-contracting specialist during the first year.
Optimize scheduling and extend operating hours to fill unused clinical slots, converting existing patient demand into incremental visits. Evening or early-morning blocks capture the working professionals abundant in the Alexandria market. Better throughput per exam room is nearly pure margin.
Deepen the ancillary services already in place (lab, cardiovascular diagnostics, ultrasound, office procedures) and add appropriate new ones to raise revenue per patient encounter. These captured services keep dollars in-house that would otherwise be referred out. Map utilization to identify which lines are underused relative to the panel size.
Formalize patient retention and reactivation systems, including recall campaigns for overdue wellness visits and lapsed chronic-care patients. A 37-year panel almost certainly has hundreds of dormant charts that can be reactivated at near-zero acquisition cost. This protects the base against any post-sale attrition when the founding physician leaves.
Explore value-based care and Medicare Advantage arrangements to add shared-savings upside on top of fee-for-service. Primary care panels with strong chronic-disease management are exactly what payers reward under these models. This diversifies revenue beyond volume-driven billing.

Diligence notes

Quantify how much of the $660,000 SDE depends on the selling physician's personal clinical production and patient relationships, because primary care attaches to the doctor, not just the office. Model attrition scenarios if a meaningful share of patients follow the retiring or exiting doctor. This is the central valuation risk and dictates how much transition time you need to lock in.
Verify the revenue and SDE against tax returns and payer remittance reports, and confirm the 12.5% growth is organic rather than a one-time coding, fee-schedule, or ancillary-service bump. A 70% SDE margin is high enough to warrant scrutiny of whether the addbacks are truly discretionary. Reconcile bank deposits to the reported gross revenue.
Review the payer mix in detail: Medicare versus commercial percentages, top-payer concentration, and current contracted rates versus regional benchmarks. Understand renewal dates and any at-risk contracts, since reimbursement changes can swing this margin quickly. Confirm the practice's credentialing transfers cleanly to a new owner.
Examine the lease terms, remaining runway, and renewal options, since this is a single leased location with no owned real estate. A short or unfavorable lease in a dense Alexandria submarket is a real risk if the landlord holds leverage. Confirm the facility can physically support added providers or extended hours.
Assess staff stability, credentials, and compensation, because clinical and front-office continuity drives patient retention through the ownership change. Identify any key employees whose departure would disrupt operations. Review malpractice history, licensing standing, and any pending regulatory or billing compliance issues.

Source

Originally listed on BizBuySell. View original listing →