Introduction
Closing a medical practice acquisition is exciting—but as any seasoned dealmaker will tell you, the difference between a win and a regret is what’s uncovered before the ink dries.
Inside the Due Diligence Vault: Lessons from the Field
What do hundreds of real-world due diligence projects reveal? The story is rarely found in the top-line numbers. Instead, deal success emerges in the details others might miss.
- Delayed Metrics: The inability to get timely, actionable operational data post-close is one of the top reasons integrations fail and issues fester.
- AR Surprises: AR over 120 days and “off-balance” contract disputes are usually the largest sources of hidden loss.
- Coding/Compliance Blind Spots: Small gaps can become significant losses if Medicare rules or audits shift.
- Team or Process Gaps: Practices lacking clear billing/RCM ownership or facing frequent staff turnover see the most post-close churn.
- Reliance on Spreadsheets: If ongoing reporting depends on spreadsheets, you don’t have a real handle on performance.
Protect EBITDA and Find Consistent Upside Opportunities
- Contract Improvement: Benchmark payer rates and don’t hesitate to renegotiate as a deal lever.
- Service Line Margins: Often, overlooked ancillary services are the highest-margin and fastest growth areas after close.
- Quick Wins: Proactive AR follow-up or regular coding reviews often pays for itself quickly, especially when you refocus your best talent on true productivity—instead of on endless rework.
5 Actionable Tips Before Your Next Acquisition
- Demand AR Detail by Age and Payor
- Audit Coding Practices
- Interview Billing, Operations, and Tech Staff Directly
- Evaluate Policy Manuals for Real-World Relevance
- Scenario-Plan for Key Staff Departures