Thriving Pediatric Practice, PCMH-Certified, Lee County FL

$2.0M

Revenue

$922K

SDE

1.9x

Multiple

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Full Editorial Writeup

This is a full-service pediatric practice in Lee County, Florida, founded in 2005 and operating for roughly two decades. It delivers comprehensive care from newborns through age twenty-five (and to thirty for special-needs patients), spanning well-child exams, immunizations, chronic condition management, school and sports physicals, plus behavioral health and developmental screening. The practice is Patient-Centered Medical Home (PCMH) certified and runs out of a Class A, fully equipped, child-friendly medical office that is turnkey from day one.

The revenue base is diversified across well-visits, chronic care, diagnostics, and specialized services, with a balanced payer mix of Medicaid, commercial insurance, and cash-pay. The patient panel is loyal and multi-generational, supported by a referral network that includes local hospitals, birthing centers, OB/GYN groups, and developmental/behavioral organizations. That recurring patient demand is what drives the predictable cash flow this listing leans on.

The headline numbers are strong: $2.0M in revenue against $921K of cash flow, a 46% margin that reflects a lean 6-employee operation. At a $1.795M ask, the 1.95x cash flow multiple is aggressive on the low side for a healthcare asset, though the buyer pool is deliberately narrow: inquiries are restricted to licensed physicians or investors backing one. Retirement is the stated reason for sale, and the selling physician will stay up to two years.

Why we like it

Earnings quality is the standout here: $921K of cash flow on $2.0M revenue is a 46% margin, run with only six employees. A diversified mix of well-visits, chronic care, diagnostics, and specialty services smooths the revenue line rather than concentrating it in one procedure code.
The moat is real and sticky. Two decades of operating history, a multi-generational patient panel, PCMH certification, and a referral network of hospitals, birthing centers, and OB/GYN groups make this hard to replicate and expensive to dislodge.
Pediatric care is about as recession-resistant as healthcare gets. Parents do not defer their kids' immunizations, well-child exams, or chronic condition management when the economy turns, and the balanced Medicaid/commercial/cash payer mix diversifies collection risk.
The growth levers are already identified and near-term: adding NPs/PAs against existing demand, formalizing Saturday and extended hours, telehealth, and digital marketing in a market with a steady influx of young families. These are capacity-expansion plays, not speculative bets.

How to improve it

Add mid-level providers (NPs/PAs) against the existing patient demand within the first 90 days. The listing explicitly states capacity exists today, and layering in lower-cost providers behind an established panel is the fastest path to incremental margin without proportional cost.
Formalize Saturday and extended-access hours to capture working-parent volume that currently goes to urgent care or competitors. Pediatric families reward convenience, and extended windows monetize the existing fixed overhead of the Class A facility.
Stand up a telehealth offering for routine follow-ups, behavioral health check-ins, and after-hours triage. This expands effective capacity, reduces no-shows, and opens a reimbursable revenue line with minimal incremental cost.
Audit the payer mix and renegotiate commercial contracts. With a balanced Medicaid/commercial base, even a few points of improvement on commercial reimbursement rates flows almost entirely to the bottom line given the lean cost structure.
Invest in targeted digital and community outreach to capture the steady influx of young families the listing cites. Partner formally with the birthing centers and OB/GYN groups already in the referral network to institutionalize new-patient flow.
Implement or upgrade a patient recall and no-show reduction system for well-visits and immunizations. Recurring well-child cadence is the lifeblood of the model, and tightening recall directly protects and grows the recurring revenue base.
Document SOPs and cross-train the six-person staff ahead of the transition. Codifying how the practice runs de-risks the dependence on the selling physician and makes the asset more durable and more sellable at exit.

Diligence notes

Scrutinize provider dependence: how much of the $921K cash flow is the selling physician's personal production versus the practice panel. The two-year stay helps, but you need to know what the business earns without that physician and whether patients follow the doctor or the brand.
Verify the cash flow add-backs and confirm the $921K is sustainable SDE after a market-rate physician salary is subtracted. A buyer-physician's replacement compensation materially changes the real economic return versus the headline 1.95x multiple.
Pull the payer mix detail and reimbursement trends. Medicaid rates and pediatric reimbursement are policy-sensitive, so understand the Medicaid-to-commercial split, denial rates, days in AR, and any exposure to state budget or rate changes.
Confirm the facility lease terms and whether the Class A office is secure long-term. Real estate is not included, so the lease rate, remaining term, and renewal options directly affect both continuity of care and go-forward margin.
Validate the restricted buyer pool implications. The physician-only requirement limits resale liquidity and means financing, credentialing, and payer re-enrollment timelines must be mapped before close to avoid a revenue gap at transition.

Source

Originally listed on BizBuySell. View original listing →