Multi-Location Counseling Practice, 30-Year McHenry County Illinois Behavioral Health Group

$4.0M

Revenue

$742K

SDE

3.2x

Multiple

Subscribe Free

Read the full deal writeup

Get Free Access

Already a member? Sign in

Full Editorial Writeup

This is a multi-location outpatient counseling and behavioral health practice serving the Chicagoland suburbs out of McHenry County, Illinois. Founded in 1988, it delivers therapy to children, adolescents, adults, couples, and families through a team of roughly 30 licensed clinicians and administrative staff. At nearly $4M in revenue and $742k in owner cash flow, it is a real operating business rather than a solo therapist practice, with an 18.6% cash flow margin that is respectable for a labor-intensive clinical services model.

What makes this durable is the demand profile and payer mix. Behavioral health need is structural and arguably counter-cyclical, and the practice participates with major commercial insurance carriers, which broadens patient accessibility and smooths collections. Patient acquisition is diversified across physician referrals, community partnerships, employee assistance programs, digital marketing, and a returning-client base, so it does not live or die on a single referral source.

The owners are retiring and offering a lengthy 26-week transition, which matters in a relationship-driven, license-dependent business. The listing frames obvious growth levers: adding provider capacity, expanding services, deepening referral relationships, and adding locations. This suits a behavioral health platform, a healthcare services consolidator, or an entrepreneurial operator comfortable managing clinicians and insurance revenue cycle.

Why we like it

Earnings quality is solid for the category: $742k of cash flow on $3.99M revenue is an 18.6% margin, and a chunk of collections flows through major commercial insurance carriers rather than cash-pay only. That payer participation supports a stable, repeat-visit revenue base with predictable reimbursement rather than one-off transactions.
The moat is 30-plus years of community trust, an established multi-location footprint, and a bench of roughly 30 licensed clinicians. In behavioral health the scarce asset is credentialed providers and referral relationships, and this practice already has both embedded across the Chicagoland suburbs.
Behavioral health demand is structural and holds up in downturns, with tailwinds from insurance parity, reduced stigma, and rising utilization. Unlike discretionary consumer services, therapy visits and EAP-driven volume tend to persist or grow when the economy weakens.
The revenue model behaves like recurring care: clients attend recurring sessions over weeks and months, and the practice enjoys a loyal returning base plus EAP and physician referral pipelines. This creates renewal-like visit continuity rather than constant net-new customer acquisition.
The retiring owners are committing to a full 26-week handover, which de-risks the biggest transfer concern in a license-driven, relationship-heavy practice. That runway gives a new operator time to retain clinicians, secure referral sources, and keep insurance credentialing intact.

How to improve it

Attack provider capacity utilization in the first 90 days by measuring each clinician's billable hours against target and filling open slots. Adding sessions to underloaded providers is the fastest margin lever because the fixed overhead is already in place.
Tighten revenue cycle management on the insurance book: reduce claim denials, shorten days-in-AR, and renegotiate reimbursement rates where volume justifies it. Small improvements in collections rate on nearly $4M of billings drop almost entirely to cash flow.
Recruit and credential additional licensed clinicians, including associate-level providers billing under supervision. Provider headcount is the direct constraint on growth, so building a repeatable hiring and onboarding pipeline compounds revenue.
Add higher-margin and adjacent services such as psychiatric medication management, telehealth, group therapy, and specialized programs. These expand revenue per patient and capture referrals that currently leave the practice.
Formalize and expand referral relationships with primary care physicians, schools, and employers running EAPs. Converting informal community goodwill into structured, tracked referral agreements makes the pipeline more durable and measurable.
Reduce owner dependence by promoting or hiring a clinical director and practice administrator before the 26-week transition ends. Institutionalizing the leadership the founders held ensures continuity and makes the asset more valuable at your own eventual exit.
Use the platform as a roll-up base by acquiring nearby solo or small counseling practices in the Chicagoland suburbs. The existing billing, credentialing, and admin infrastructure lets you fold in tuck-ins at attractive multiples.

Diligence notes

Scrutinize the payer mix and reimbursement rates in detail: what percentage of revenue is commercial insurance versus Medicaid or cash, and how are denial and collection rates trending. Concentration in low-reimbursement plans or a single carrier would pressure margins post-close.
Verify clinician retention risk and employment terms, since the value walks out the door if key providers leave. Confirm how many of the roughly 30 staff are W-2 versus contractor, whether non-competes exist, and how patient panels are distributed across providers.
Confirm the $742k cash flow is genuine SDE with clear add-backs, and quantify how much of it depends on the owners' own clinical billing versus true management earnings. If the retiring owners personally carry a large patient load, replacement provider costs will erode the reported number.
Review credentialing, licensing, and payer enrollment continuity through a change of ownership, because insurance contracts and Medicaid enrollment do not always transfer cleanly. Any lapse in credentialing or re-enrollment can interrupt cash flow for months.
Assess lease terms across the multiple locations, including remaining term, rent escalators, and transferability. Multi-site footprints add fixed cost, so understand occupancy economics and whether any sites are underperforming.
Check compliance and malpractice history, including documentation standards, HIPAA practices, and any prior claims or payer audits. Behavioral health billing scrutiny is real, and clawback exposure from improper coding should be quantified before closing.

Source

Originally listed on BizBuySell. View original listing →