Multi-Location Therapy Practice, Denver Manager-Run Healthcare Group

$4.2M

Revenue

$756K

SDE

6.6x

Multiple

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Full Editorial Writeup

This is a multi-location therapy services business operating in the Denver metro market. The practice generates roughly $4.17M in annual revenue and about $756K in cash flow, delivered through an experienced leadership team, diversified insurance contracts, and a network of referral relationships. A key structural feature is that the business can be owned and operated by a non-licensed individual, which widens the buyer pool considerably versus a clinician-only sale.

The model is built on recurring, insurance-reimbursed patient visits rather than one-off transactions. Patients cycle through episodes of care over weeks and months, and steady referral pipelines from physicians and other providers refill the top of the funnel. Multiple locations diffuse single-site risk and give the acquirer a platform to add providers, specialties, and additional clinics.

At a 6.61x cash flow multiple with SBA prequalification and seller financing available, the deal is positioned as a lender-friendly, manager-run healthcare asset. The listing emphasizes limited owner involvement and scalable operations, framing this as a semi-passive platform for a financial buyer or a strategic looking to consolidate the fragmented Denver therapy market.

Why we like it

Earnings quality is anchored in insurance-reimbursed, recurring patient visits across multiple locations, which smooths revenue versus a single-clinic operation. Cash flow of roughly $756K on $4.17M revenue implies an 18% margin, healthy for a therapy services group and consistent with diversified payer contracts. Diversified insurance and referral sources reduce reliance on any one payer or physician relationship.
The durability comes from being an essential, non-discretionary healthcare service that patients continue during downturns, often paid substantially by insurance rather than cash from the patient's pocket. Referral relationships and established payer contracts function as a real switching-cost moat that a new entrant cannot replicate quickly. Multi-site presence and regional reputation compound this defensibility.
Market tailwinds favor outpatient therapy driven by aging demographics, chronic condition management, and a payer preference for lower-cost outpatient settings over hospital care. Denver is a growing metro with in-migration, supporting patient volume and provider recruitment. Therapy remains a fragmented category ripe for roll-up.
The operator advantage here is unusual: the business can be owned by a non-licensed individual and is described as manager-run with limited owner involvement. That means a capital allocator can acquire without a clinical license and focus on adding providers, specialties, and locations. An experienced leadership team already in place lowers key-person risk on day one.

How to improve it

Audit payer mix and renegotiate the lowest-reimbursing insurance contracts within the first quarter, since even small per-visit rate improvements flow almost entirely to the bottom line at this margin. Identify which contracts drive volume versus which merely fill schedules at breakeven. Drop or renegotiate the worst performers.
Attack provider utilization and schedule density, because clinician productivity is the primary profit lever in therapy. Measure visits per clinician per day against benchmarks and close gaps with scheduling software, cancellation and no-show policies, and waitlist management. Recovering even a few visits per clinician weekly materially lifts cash flow.
Formalize and expand referral relationships with physician groups, orthopedic surgeons, and primary care networks through a dedicated liaison. Referral inflow is the growth engine, and most independent practices under-invest in structured outreach. Track referral source performance and double down on the highest converters.
Add cash-pay and specialty service lines such as pelvic health, hand therapy, dry needling, or sports performance that carry higher margins and reduce insurance dependence. These require modest incremental training or hires but expand the revenue per patient. Cash-pay also insulates a slice of revenue from reimbursement pressure.
Open or acquire an additional clinic in an underserved Denver submarket to leverage the existing back office, billing, and leadership team. The infrastructure to run multiple sites already exists, so incremental locations should carry higher marginal margins. This is the clearest path to justifying the 6.61x on a larger earnings base.
Bring billing and collections under tighter management to reduce days sales outstanding and denial rates, which quietly erode cash in insurance-based practices. A focused revenue-cycle review often uncovers underbilled codes and recoverable denials. Cleaner collections improve both cash flow and working capital.

Diligence notes

Verify the payer mix and reimbursement trend line, since therapy reimbursement rates have faced downward pressure from Medicare and commercial payers. Pull the last three years of per-visit reimbursement by payer to confirm the $756K cash flow is stable and not propped up by rates that are being cut. Concentration in any single payer is a red flag.
Confirm the true level of owner involvement and the depth of the leadership team, because the entire thesis rests on this being manager-run. Interview key clinicians and administrators about retention, compensation, and whether any are flight risks post-close. Absentee claims in small practices are frequently overstated.
Scrutinize provider staffing, credentialing, and any non-competes, as clinician turnover directly cuts revenue in a visit-based model. Confirm how many clinicians are employees versus contractors and whether their licenses and payer credentialing transfer cleanly. Understand the recruiting pipeline in a competitive labor market.
Validate the referral concentration and the durability of those relationships, since a few physician sources often drive a disproportionate share of new patients. Quantify what percentage of referrals come from the top three sources and whether any are tied personally to the seller. Loss of a key referrer could impair the earnings base.
Reconcile the $756K cash flow to tax returns and confirm add-backs, especially any owner-replacement salary needed if the buyer is non-clinical and must hire management. Clarify the year founded and years in business, which the listing leaves as unknown. Confirm lease terms across all locations and any deferred maintenance or capex needs.

Source

Originally listed on BusinessBroker.net. View original listing →