Multi-Service Medical Practice, Cape Girardeau County MO

$2.0M

Revenue

$578K

SDE

3.0x

Multiple

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Full Editorial Writeup

This is an established multi-service medical practice in Cape Girardeau County, Missouri, operating since 2011 and generating roughly $1.99M in revenue and $578K in EBITDA. The practice bundles six complementary service lines under one roof: urgent care, primary care, mental health, chiropractic, weight loss, and telehealth. That diversification matters because it spreads revenue across both acute (urgent care walk-ins) and chronic/recurring (primary care panels, mental health, weight loss programs) demand, smoothing the cash flow profile that a single-discipline clinic lacks.

The practice serves approximately 5,400 active patients and is adding roughly 52 new patients per month in 2026, which signals a healthy acquisition engine rather than a static book. It runs out of a purpose-built 5,295 square foot facility with 16 exam rooms, 2 treatment rooms, a dedicated X-ray room, and about $170K in medical and telehealth equipment. A staff of roughly 20, including a nurse practitioner, chiropractor, and mental health personnel, provides operational continuity for a new owner.

The real estate is leased at $6,000 per month and is available for separate purchase, so the asking price is a clean operations sale. At 3.03x EBITDA this is priced reasonably for a diversified primary and urgent care practice with a growing patient panel and installed infrastructure that lets a buyer skip the capital and ramp cost of a de novo build.

Why we like it

Earnings quality is solid: $578K EBITDA on $1.99M revenue is a 29% margin, strong for a multi-disciplinary clinic, and the mix of urgent care, primary care, chiropractic, and recurring weight loss and mental health programs diversifies away from any single payer or service line. Healthcare demand is sticky and largely insurance-reimbursed, which insulates cash flow from downturns.
The moat is the installed patient panel and buildout. 5,400 active patients plus 16 exam rooms, an X-ray suite, and telehealth infrastructure represent years of accumulated goodwill and roughly $170K in equipment that a competitor would have to rebuild from zero. Replacing that patient base and capex is slow and expensive, which protects incumbency.
Market tailwinds favor this model. Primary care access gaps, demand for convenient one-stop urgent care, and the structural rise of mental health and medically-supervised weight loss (think GLP-1 driven volume) all point to sustained patient flow. The 52 new patients per month in 2026 confirms the acquisition engine is still running.
Operator advantage is clear: the growth plan is simply more providers and five-day operation. An engaged owner-operator or a healthcare group with provider recruiting and billing competence can extend hours and add visit capacity against existing fixed costs, converting the existing infrastructure into incremental margin.

How to improve it

Audit the payer mix and renegotiate reimbursement contracts within the first 90 days. Multi-service practices often leave money on the table with stale fee schedules, and even small per-visit rate gains flow almost entirely to EBITDA given fixed overhead.
Extend operating hours to a full five or six days and layer in evening urgent care slots. The facility and staff largely exist; filling underutilized exam room capacity is the cheapest revenue growth available and directly leverages the building's $6,000 monthly rent.
Build a formal, recurring weight loss and chronic care program around GLP-1 management and primary care wellness memberships. Converting episodic patients into monthly subscription or program revenue raises customer lifetime value and smooths the cash flow curve.
Add or recruit additional mid-level providers (nurse practitioners and physician assistants) to increase daily visit throughput. The 16 exam rooms are the binding constraint on revenue; adding billable providers against existing space and admin staff compounds margin fast.
Tighten revenue cycle management and reduce claim denials and A/R days. A dedicated billing review or outsourced RCM partner often recovers 3-7% of net collections in a practice this size, which is pure profit.
Launch targeted local digital marketing for urgent care and weight loss. At 52 new patients per month organically, a modest paid acquisition budget could meaningfully accelerate panel growth and is easy to measure against patient lifetime value.
Negotiate the real estate purchase or a long-term favorable lease to lock occupancy cost. At $6,000/month with the seller offering purchase flexibility, controlling the building protects against future rent increases and can add a stabilized real estate asset to the balance sheet.

Diligence notes

Confirm the provider dependency and credentialing. Identify whether revenue hinges on a single owner-physician whose departure threatens payer contracts and patient retention, and verify which clinicians are staying post-close and under what employment or non-compete terms.
Scrutinize the payer mix, reimbursement rates, and A/R aging. Pull 24-36 months of collections by service line and payer to confirm the $578K EBITDA is real, recurring, and not propped up by one-time items or favorable short-term contracts.
Investigate the 2026 growth claim and any pro forma assumptions. The listing repeatedly cites accelerating 2026 growth, so verify that the $1.99M revenue and $578K EBITDA are trailing actuals rather than projected, and reconcile the reported EBITDA against tax returns.
Validate billing compliance and regulatory exposure. Multi-service practices offering weight loss, mental health, and chiropractic carry coding, upcoding, and controlled-substance compliance risk, so a coding and compliance audit is essential before closing.
Clarify the real estate terms and total deal cost. The building is leased at $6,000/month and available for separate purchase, so model both the lease-only and purchase scenarios and confirm the lease is assignable at market rate.
Review the chiropractic and weight loss service lines for sustainability. Assess whether weight loss revenue is tied to GLP-1 demand that could shift, and whether chiropractic volume depends on a specific practitioner who may leave.

Source

Originally listed on BizBuySell. View original listing →