There's an often repeated story that, while at Cambridge in the 1970s, internationally recognized physicist Stephen Hawking was engaged in a conflict with the University over who would pay for the ramp that was needed for him to enter his workplace.  While eventually he prevailed, it is interesting to consider what would've happened had his growing fame and the country’s parliamentary law not been so persuasive.

One probably wonders how this story applies to the acquisition or merger of your own healthcare company. Simply put, it calls to mind how each organization needs to be constantly vigilant to assure that it is not creating barriers that will lead to employee dissatisfaction or turnover.  In fact, the focus should be on building a workplace culture that supports and inspires the very best performance and customer service.

The current healthcare marketplace is filled with entrepreneurial opportunities and many business owners are considering whether the time is right for their exit.  Each circumstance is unique and there are three important factors that today’s healthcare business principals are considering before finalizing their exit plans.

One of the biggest challenges in the healthcare middle market is finding accurate data on M+A transactions, including deal specifics like multiples of adjusted EBITDA.  This issue is even more pronounced in the lower middle market where hundreds of companies of $10-50 million revenue are sold each year.

Healthcare is an unusual industry.  It’s part business, part mission-driven service. It’s high tech and it’s high touch. The one indisputable truth is that every healthcare organization must generate more revenue than it spends.  As the saying goes: No margin, no mission.

For many, the haboob metaphor is relevant to the new behavioral healthcare marketplace – dramatic change and resulting anxiety that can obscure possibilities.

There are many real challenges of a fiscal and regulatory nature that you can read about in today’s publications.  Yet, as always, there are many opportunities for those who are patient in the storm and willing to consider a new look at the landscape.

Very simply, history repeats itself.

So it is in the intellectual/developmental disability (I/DD) marketplace.  What does this mean for today’s I/DD executives and owners, whether a for-profit or nonprofit organization?  Consider the following inter-related trends and their likely implications for your company’s future.

Jim Caldwell, the new coach of the Detroit Lions, has led a remarkable comeback for a team that almost won its division against a top opponent after a disastrous campaign last season.  He credits much of his success to focusing on the Finnish concept of “sisu,” which can be roughly understood as displaying courage, determination, and resilience in the face of adversity.  Sisu can be developed in any environment and Caldwell’s approach incorporates the following...

The following trends are not unique to late 2014 and early 2015.  They have been developing for many years and have now accelerated in our post-Great Recession and hyper-innovation era.  The VERTESS focus is on how they may impact your organization’s future.

Many business owners are so consumed by the day-to-day demands of their business operations that they lose sight of what really drives value from an investor’s or buyer’s perspective.  This is very understandable, especially at start up or during a crisis, yet it’s essential that over time you build your company with the eyes of buyers in mind.

So what do buyers look for?  That depends on the buyer’s objectives, but here are some common themes with practical steps that you can take to address them.

In today’s marketplace, we see the growing presence of private equity groups (PEGs) as buyers of lower middle market healthcare companies. PEGs have increasingly moved “downstream” to smaller companies with adjusted EBITDA as low as $500,000.  This has increased the opportunities for smaller companies as long as they understand that the “buyer eyes” of PEGs can be quite different from those of more familiar strategic buyers.

The Minute Clinic and similar operations across the US are evidence of the rapid retailing of healthcare.  As a result of this accelerating and disruptive innovation, I can receive treatment for a wide range of issues while I pick up a prescription and a birthday card.  Other options include behavioral healthcare at one of the urgent care centers seemingly accessible on every corner.  You cannot escape it.

While the world of durable medical equipment (DME) has experienced more than one random acorn via competitive bidding and related market turbulence, there remain tremendous opportunities for those than can see beyond self-imposed despair and false conclusions.

Here are four reasons that you may want to consider as you look for potential DME investments.