Two-Practice Primary Care Group, Comal County Texas

$4.6M

Revenue

$648K

SDE

Subscribe Free

Read the full deal writeup

Get Free Access

Already a member? Sign in

Full Editorial Writeup

This is a two-location primary care group in Comal County, Texas, generating $4.62M in combined revenue and $648K in EBITDA. The practices sit in close proximity and offer complementary adult, family, and pediatric services, including preventive visits, chronic disease management, annual physicals, pediatric wellness, immunizations, in-office testing, and minor procedures. Additional revenue lines come from women's health, allergy care, nutritional counseling, and aviation medical examinations, which gives the group a diversified mix of recurring primary care and higher-margin ancillary services.

The listing is explicitly marketed to group buyers only, meaning the seller wants a platform operator, physician group, or PE-backed roll-up rather than a single buyer-operator. Importantly, both physician owners intend to remain clinically involved after the transaction, which de-risks the handoff of the patient panel and preserves physician leadership continuity. A meaningful share of production already comes from clinicians beyond the two owners, which reduces key-person concentration relative to a typical solo-doctor practice.

The strategic thesis here is consolidation. The two locations currently run separate back offices, and the obvious value creation path is centralizing billing, payroll, accounting, purchasing, IT, and marketing, then tightening revenue-cycle management. For a buyer with an existing MSO or management infrastructure, this is a tuck-in with immediate cost synergies plus a runway for provider recruitment and ancillary expansion.

Why we like it

Primary care is about as recession-resistant as healthcare gets, with revenue anchored to recurring patient panels, chronic disease management, and insurance reimbursement rather than discretionary spend. At $4.62M revenue and $648K EBITDA, the group clears a roughly 14% EBITDA margin, which is respectable for multi-provider primary care and leaves room to expand through back-office consolidation.
Revenue durability comes from a returning patient base plus payer contracts, not one-time transactions, and production is spread across multiple clinicians beyond the two owners. That provider depth lowers key-person risk and makes the panel more transferable than a single-doctor practice where goodwill walks out the door at close.
Both physician owners plan to stay clinically involved after the sale, which is the single biggest de-risker in a medical practice acquisition. Patient continuity, referral relationships, and payer credentialing all survive the transition, and you buy time to build out management before the sellers eventually wind down.
A group buyer gets two offices in close proximity that currently run duplicate back offices. Centralizing billing, payroll, IT, purchasing, and marketing, plus tightening revenue-cycle collections, is textbook synergy that can lift EBITDA without touching clinical volume.

How to improve it

Consolidate the two back offices into a single MSO layer covering billing, payroll, accounting, purchasing, IT, and marketing. Duplicate administrative overhead across two nearby sites is the fastest margin lever and can be executed within the first quarter under an existing management platform.
Audit and rebuild the revenue cycle, focusing on clean-claim rates, denial management, days-in-AR, and payer reporting. Primary care groups routinely leave 5 to 10 points of net collections on the table, and improving collections flows straight to EBITDA with no new patient volume required.
Review and renegotiate payer contracts across both practices to standardize fee schedules and capture any underpriced lines. Two separate practices often carry different reimbursement terms, and leveling them up to the better contract is pure margin.
Expand the higher-margin ancillary services already in place, including allergy care, aviation medical exams, nutritional counseling, and in-office testing. These lines carry better economics than standard E&M visits and can be scaled with existing physical space and staff.
Address appointment access and provider capacity by recruiting mid-level providers (NPs/PAs) to absorb demand and free physician time. Improved access directly drives visit volume and positions the group to grow the panel.
Lock down the sellers' post-sale employment terms and transition timeline in writing before close, including compensation, schedules, and a non-compete. The deal thesis depends on continuity, so the economics of keeping both physicians productive must be nailed down.
Use the standardized platform as a base to acquire or open additional regional primary care practices. The listing itself flags roll-up potential, and a clean two-site MSO is an ideal springboard for tuck-ins in the greater San Antonio corridor.

Diligence notes

Asking price is not disclosed, so the entire deal rests on what multiple the seller expects against $648K EBITDA. Confirm whether that EBITDA is already adjusted for fair-market physician compensation, because if the owners' pay is understated, normalized EBITDA could be materially lower once you install market-rate physician salaries post-sale.
Scrutinize payer mix and reimbursement concentration across Medicare, Medicaid, and commercial payers at both sites. A heavy Medicaid or single-payer skew changes the risk profile, and you need to understand how much revenue is tied to rates outside your control.
Verify the patient panel's size, retention, and dependence on each departing-eventually physician. Request panel attribution by provider so you can quantify how much revenue is at risk whenever the two owners ultimately reduce or stop clinical work.
Review both facility leases in detail, including rate, remaining term, renewal options, and whether either property is owned by the sellers or a related party. Real estate is leased per the listing, so confirm there are no above-market related-party rents inflating cost or masking the sellers' true take.
Confirm the regulatory and structuring path given this is a multi-physician practice sale in Texas, including corporate practice of medicine rules, MSO structuring, credentialing, and payer re-enrollment timelines. These can delay cash flow for months and must be mapped before close.
Dig into the revenue-cycle metrics and AR aging at both practices to validate the improvement thesis. If collections are already tight, the upside narrows, and you want hard data on current net collection rates rather than assuming easy wins.

Source

Originally listed on BizBuySell. View original listing →