The world of healthcare mergers and acquisitions (M&A) has experienced a significant rollercoaster these past two years, primarily due to the events of COVID-19. Before the pandemic locked down our communities, M&A, particularly in the health and human services space, was experiencing a significant increase in activity. This was caused by several factors. Among them: Existing organizations — or strategic buyers — were witnessing the benefits of growth through acquisition to compete with larger businesses and prepare for managed care, while private equity investors saw this field as one worth investing in. With an excess of cash reserves (i.e., "dry powder"), these private equity investors started spending.

Does this sound familiar: The phone rings. You answer, and on the other end is someone who tells you that they represent a company eager to purchase your healthcare business.
These kinds of calls are happening every day, with some businesses receiving multiple calls a week. On the surface, these might seem like good calls to receive. After all, if someone is interested in buying your business, you must be running a good operation. And if you've been considering whether it's the right time to sell your business, such a call might be an avenue forward for you.
But seller beware: While it's good to answer the phone and hear what's presented to you, moving ahead on a transaction with a cold caller could be fraught with risk. Let me explain why.

Owners of healthcare companies, practices, and agencies often ask us how they can increase their businesses' market value. Buyers determine the value of a business based on return on investment and riskiness of the investment. Business owners create value by increasing the return on investment and decreasing the riskiness of ownership.

As you may or may not know, I have been an advisor to owners of provider agencies supporting individuals affected by an intellectual and/or developmental disability (I/DD) for more than 30 years. I am fortunate in that I love this work. It is enormously gratifying to earn a living by helping others reach their goals. I am able to help business owners reach their financial goals and buyers achieve their growth and value-creation goals while improving the lives of employees and clients alike through the right transaction.

I was recently speaking with one of the sellers I represented about the sale of his provider agency. I asked him what he thought was my most significant value during his long selling process. Without skipping a beat, he said, "'The emotional support you provided to me." He explained that it was helpful to talk with me when things got stressful or even a bit scary since I had been through the process of selling my own company.

The only constant for home healthcare agencies is change. For many owners of agencies, change is both demanding and fatiguing. At some point, owners start thinking about exiting their company. Some owners elect to pass ownership down to their adult children. Some stop taking on new clients/patients and simply close their doors. Others seek to sell their company in the marketplace. This column is written for those owners considering selling in the marketplace.

The above is a map put together by our team at VERTESS. This map identifies some of the larger intellectual and developmental disability (IDD) competitors in the country, the states in which they do business, and their owner or ownership structure. Every healthcare industry uses this tool. These maps provide valuable insight into the competitive landscape of the respective industries. They are also a way of demonstrating why a healthcare business owner would be wise to partner with a merger and acquisition (M&A) advisor when the owner decides it is time to begin pursuing a sale of the company. Along with business size and service lines, buyers are often categorized by the geographic markets in which they're seeking acquisitions. Advisors should be aware of who is looking for acquisitions where.

I often receive calls from owners of human services companies who say something along the lines of, "I don't know what I don't know" concerning selling their company. What's important to understand is that it's okay not to know everything about selling a company. It's a complex process, which is why most successful sales involve a team working together toward a common goal.

The concept of a "fundless sponsor" started in the 80's. Recognizing that this name might carry a negative connotation, it was changed to "independent sponsor" — a more palatable moniker. In a similar vein to independent sponsors is a "search fund," but for the purposes of this article, we will lump them together.

Volume 7 Issue 20, October 13, 2020 by Jeffrey S. Baird, Esq., Brown & Fortunato, P.C. Two common questions I am often asked by owners of healthcare businesses considering whether to sell their companies are: 1) If I sell my business, can I still get audited? 2) If I do get audited after selling my […]

While I would never claim to have a crystal ball, I can tell you that there are a few issues that will likely have significant effects on respiratory-focused durable medical equipment (DME) companies going into and during 2021. Here are three that stand out.

At VERTESS, we are often asked what value we can bring to sellers as they decide to sell their business. We often talk about our large contact list of buyers and our experience as a business operator/owner and seller or as a merger and acquisition (M&A) advisor.