Value-Based Primary Care Practice, Florida Medicare Market

$3.3M

Revenue

$957K

SDE

2.2x

Multiple

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Full Editorial Writeup

This is a founder-led primary care practice operating in Florida, positioned in the value-based care model that ties reimbursement to patient outcomes and per-member-per-month capitation rather than pure fee-for-service volume. The business sits in one of the densest Medicare markets in the country, which matters because value-based primary care economics compound when you have a large panel of aging patients with recurring, predictable care needs. On roughly $3.3M in revenue it throws off $957K in cash flow, a 29% margin that is strong for a clinical services business and suggests either an efficient panel-management operation or favorable shared-savings contracts.

Value-based primary care is one of the more attractive corners of healthcare for a buyer because the revenue is sticky, recurring, and largely insulated from economic cycles. Medicare Advantage payers reward practices that keep patients healthy and out of the hospital, which creates a durable annuity-like cash stream tied to the enrolled panel rather than one-off visits. The founder-led nature and clean 2.19x multiple suggest a seller who has built real profitability but may not have institutionalized the operation beyond themselves.

The listing is thin on specifics: no disclosed founding year, no panel size, no payer mix, and no breakdown of capitated versus fee-for-service revenue. Those gaps are the entire ballgame in a value-based deal, because the quality of the payer contracts and the retention of the physician driving the relationships determine whether the $957K is transferable or walks out the door with the founder.

Why we like it

Earnings quality is strong for the category: $957K of cash flow on $3.3M revenue is a 29% margin, which in value-based primary care usually signals real shared-savings capture rather than just high-volume churn. If a meaningful slice is capitated per-member-per-month revenue, that is recurring and predictable, which is exactly what you underwrite against.
The moat is the payer relationships and the enrolled patient panel. In a value-based model, patients stick with their primary care doctor for years and the Medicare Advantage contracts renew, creating switching costs and an annuity-like base that is hard for a new entrant to replicate quickly.
Market tailwinds are as good as it gets in healthcare. Florida is one of the largest and fastest-aging Medicare populations in the country, and value-based care is where CMS and every major MA payer are pushing reimbursement dollars. Demand for this service grows structurally regardless of the macro environment.
The 2.19x cash flow multiple is cheap for a recurring-revenue healthcare asset. Value-based primary care platforms with clean contracts routinely trade at higher multiples to strategics and roll-ups, so if the panel and contracts diligence out, there is real headroom on exit.

How to improve it

Institutionalize the clinical relationships in the first 90 days by hiring or retaining a lead physician and mid-level providers so revenue is not tethered to the founder. In value-based care the panel follows the doctor, so protecting continuity of care is the single biggest lever on transferability and value.
Audit and renegotiate the Medicare Advantage and payer contracts to maximize capitation rates and shared-savings tiers. Small improvements in per-member-per-month economics or moving fee-for-service revenue into value-based arrangements drop almost entirely to the bottom line.
Grow the enrolled panel through payer-driven patient attribution and local marketing to physicians and community referral sources. Adding covered lives in a dense Medicare market is the cleanest path to scaling the existing cost base and lifting margin further.
Build out care-management and chronic-condition programs (remote patient monitoring, transitional care) that both improve outcomes and unlock additional CMS reimbursement codes. These programs raise shared-savings capture while making the panel stickier.
Implement standardized documentation and risk-adjustment coding processes to ensure accurate HCC capture. Under-coding leaves capitated revenue on the table, and disciplined coding directly increases per-member payments without adding patients.
Add a second clinic location or telehealth capacity to absorb overflow demand in the surrounding Medicare-heavy geography. This turns a single-site founder practice into a small platform with multiple points of leverage for a strategic buyer.

Diligence notes

Get the full payer mix and contract detail: what percentage of revenue is capitated versus fee-for-service, which Medicare Advantage plans, and the renewal terms. In a value-based deal the durability of the $957K cash flow lives entirely inside these contracts, so read every one.
Quantify the panel: number of attributed lives, patient retention, average age, and risk-adjustment scores. A shrinking or under-coded panel undermines the recurring revenue thesis and directly changes what you should pay.
Assess founder dependency hard. Determine whether patients and payers are contracted to the practice entity or to the founding physician personally, and structure a meaningful transition, non-compete, and earn-out to prevent revenue walking out the door post-close.
Verify the cash flow reconciliation to tax returns and separate true SDE from any add-backs. Confirm malpractice history, licensing, compliance status, and any pending payer audits, since a Medicare-facing practice carries regulatory and clawback risk that can erase the discount.
Confirm the year founded, staffing structure, and whether real estate or equipment is part of the deal, none of which the listing discloses. These gaps materially affect both the multiple and the operational lift required after close.

Source

Originally listed on DealStream. View original listing →