Selling a Pain and Spine Practice

The healthcare industry has been the target of significant merger and acquisition activity over the last decade with private equity firms and large consolidators rolling up specialty practices into nationwide platforms. Pain management has slowly gained traction with institutional investors, private equity, health systems, hospitals, and specialty management companies.

The combination of strong revenue, high reimbursement rates, and integrated ancillary services makes pain management groups an attractive target for investment. In the US, an aging population has led to strong demand for quality pain management and spine specialists and their practices. While a small and highly fragmented market, the interest in this specialty, both in a standalone environment and when combined with others, is building momentum

Physicians, executives, nursing staff, and support teams all play pivotal roles in the success of these organizations and understanding how these elements contribute to overall value is essential for any physician-owner who is considering a sale of their pain and spine practice.

The Market for Pain and Spine Practice Acquisitions

Investment, consolidations, and buyouts are reshaping every sector of healthcare, and pain and spine is a growing part of this trend. Large regional and national platforms are emerging, and while investment in pain and spine groups is not new, private equity’s interest in this specialty area continues to gain traction. Private equity buyers are looking for specialty practices like pain and spine because of their steady cash flow and strong growth potential. We expect this interest to continue.

There are now at least 20 private-equity and institutionally backed platforms actively pursuing pain and spine group deals. The chart below from The Journal of Orthopaedic Experience & Innovation shows recent private equity transactions beginning in  2017.

Used with Permission. IMAGE SOURCE: J Orthopaedic Experience & Innovation. Herschman, Gary, Dana Jacoby, and Hector Torres. 2023. “Private Equity Partnerships with Orthopedic Groups: 2022 Trends and Strategic Insights for 2023 Including Insights from Special Feature: Survey of Orthopedic Surgeons on ‘Life After Closing’ in Private Equity Deals.” Journal of Orthopaedic Experience & Innovation 4 (1). https:/​/​doi.org/​10.60118/​001c.70249.

Benefits of Selling a Pain and Spine Practice

Physician owners of pain and spine practices can realize many benefits from a sale to private equity or a partnership with a large MSO, consolidator, or hospital system. Naturally physicians focus on the immediate financial benefit that comes from the liquidity event at closing, but the operational advantages of consolidation are equally important to understand and consider.

Independent pain and spine practices today face substantial challenges that can strain resources and limit growth. Finding the right partner and negotiating the best terms can provide solutions to many of these challenges. Through joining a larger platform, practices gain access to scale, capital, and specialized expertise that would be difficult or impossible to develop independently. Specifically, large private equity backed organizations or MSOs are better positioned to manage:

  • Governance and Compliance
  • Physician and Staff Recruitment
  • Capital for Growth
  • Revenue Cycle Management
  • Payer Contracting
  • Infrastructure and Support Services

For physicians, retaining clinical autonomy while offloading much of the work associated with running and growing a practice can be an appealing option.

How to Sell a Pain and Spine Practice Practice: The PTA Process

Selling a pain and spine practice represents one of the most significant financial and professional decisions a physician will make in their career. For most physicians this is a once-in-a-lifetime event. However, the buyers and private equity firms across the negotiating table complete multiple transactions each year and are supported by teams of investment bankers, attorneys, and analysts whose primary goal is to structure deals in their favor. Without an experienced advisor, physicians are at a serious disadvantage when it comes to negotiating the best valuation and deal structure for their pain and spine practice.

Our industry leading team has help the physician owners of more groups than any other firm in the country, having successfully completed more than 300 transactions across multiple specialties, with deep expertise in pain and spine specifically. We serve as trusted partners to navigate complex transitions and maximize value during organizational change. Whether you’re exploring your options, in active discussions with buyers, or ready to move forward with a transaction, we provide the guidance necessary to successfully navigate every phase of the transaction. Our process is risk-free and cost-free until closing, aligning our success with yours. Our process to help you sell your pain and spine practice includes:

  • We take time to understand your goals and create a plan tailored to your needs.
  • We prepare a Confidential Information Memorandum (CIM) that highlights your organization’s strengths and future potential.
  • We identify the most qualified buyers from our extensive local and national network, and connect with strategic partners such as private equity firms, consolidators, hospitals, and other groups as needed.
  • Once we qualify potential buyers, we coordinate meetings and guide you through the evaluation process.
  • We handle marketing, organize meetings, gather bids, and negotiate pricing and terms on your behalf.
  • We help you meet buyers who make strong offers and are a good fit for your culture and strategy.
  • We set up a competitive process to give you the strongest position with potential buyers.
  • We offer guidance on choosing the right attorney.
  • We review all real estate details to make sure your assets are aligned and you are able to realize maximum value for all assets.
  • We work with you and your attorneys to make sure the Letter of Intent (LOI) includes the right terms and language.
  • We negotiate the main financial and structural terms of the deal for you.
  • We manage the quality of earnings and due diligence process with buyers and your team, drawing on our experience with over 100 buyers and 300 sellers.
  • We handle all pre-closing due diligence to keep your business running smoothly and help ensure a successful closing.
  • Our goal is to help owners achieve the best possible financial and non-financial results.

Our Recent Spine and Pain Center Transactions

With over 300 transactions closed, Physician Transaction Advisors has the expertise to achieve the best outcome. Below are some recent pain and spine center client transactions:

  • Florida Pain and Spine Group
  • Total Pain Care
  • Cascade Spine Center
  • St. Louis Spine Surgery Center

We are pleased to announce that our client, the Advanced Pain and Spine Centers and the Executive Surgery Center of Little Rock, AR, has entered into a strategic partnership agreement with DxTx Pain and Spine, a best-in-class nationwide network of physicians and healthcare professionals focused on diagnosing and treating the sources of pain.

Client Testimonial

“The team at PTA worked with us over an extended period to help us best position our group, never pushing us to go to market until we were ready, and then both enabled us to evaluate all of our strategic partnership options and realize what we believe is the best outcome for our organization. We could never have done this without their help and the expertise that they provided us throughout.”

Dr. Majid Saleem
Advanced Spine and Pain

Ready to Discuss Your Spine or Pain Practice?

Are you thinking of selling your spine or pain practice? Whether you’re exploring your options, in active discussions with buyers, or ready to move forward with a transaction, we can provide the guidance necessary to successfully navigate every phase of the transaction.