Established Ocala Primary Care Practice - 29-Year Florida Practice

$3.3M

Revenue

$855K

SDE

4.3x

Multiple

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Full Editorial Writeup

This is a primary care medical practice that has served the Ocala, Florida area for nearly 30 years, generating roughly $3.26M in annual revenue and $855K in cash flow. The practice offers comprehensive primary care alongside ancillary services, which is the smart play in medicine because in-house labs, imaging, or other add-on services capture revenue that would otherwise leak to outside providers. With multiple insurance contracts in place and a patient base built over decades, this is the kind of boring, durable healthcare asset that keeps producing through cycles.

The economics here are attractive: a 26% cash flow margin on $3.26M of revenue is healthy for primary care, and the 4.29x multiple on $855K of cash flow is reasonable for an established practice with a deep moat and recurring patient relationships. Ocala sits in one of the fastest-growing retiree regions in the country, which means demographic tailwinds are pushing demand for primary and chronic care steadily upward. The experienced staff is expected to remain, which de-risks the transition meaningfully.

The key open question is provider dependency. If the bulk of the patient relationships and billings run through the selling physician personally, the buyer needs a credentialed physician ready to step in or a strategic group already operating in the market. For a physician buyer, a healthcare group, or a platform rolling up Florida primary care, this is a clean, proven cash flow asset in a market with structural demand growth.

Why we like it

Earnings quality is strong with $855K of cash flow on $3.26M of revenue, a 26% margin that signals a well-run primary care practice with ancillary services adding profitability. Multiple insurance contracts and decades of billing history mean the revenue is contracted, recurring, and not dependent on marketing spend or seasonal swings.
The moat is real and built over 29 years: a loyal patient base, established insurance contracts, and a respected community reputation that takes decades to replicate. In primary care, patient stickiness is exceptional because people rarely switch their doctor once relationships and medical records are established.
Ocala is one of the fastest-growing retiree markets in Florida, and an aging population is the single most reliable demand driver in healthcare. More retirees means more chronic care management, more office visits, and more ancillary service utilization, all of which compound the existing book.
Healthcare is about as recession-proof as it gets, and primary care sits at the most defensive end of that spectrum. People do not skip their doctor in a downturn, and insurance reimbursement keeps cash flow steady regardless of the broader economy.

How to improve it

Audit the payer mix and renegotiate underperforming insurance contracts within the first 90 days. Primary care margins live and die on reimbursement rates, and many long-tenured practices leave money on the table by never revisiting contract terms with major carriers.
Expand ancillary services that capture revenue currently leaking to outside providers. In-house lab draws, point-of-care testing, chronic care management programs, and remote patient monitoring carry high margins and are reimbursable, directly lifting cash flow without adding patient acquisition cost.
Add mid-level providers such as nurse practitioners or physician assistants to increase patient throughput per physician. This is the cleanest lever for growing visit volume in a demand-rich market without proportionally increasing physician overhead.
Implement Medicare Annual Wellness Visits and chronic care management billing if not already maximized. With an Ocala retiree population, these are recurring, reimbursable touchpoints that most practices underutilize and that can add six figures of high-margin revenue.
Modernize patient acquisition with a basic digital presence, online scheduling, and referral relationships with local specialists. A 29-year practice often runs entirely on word of mouth, leaving obvious organic growth on the table in a rapidly expanding market.
Tighten front-office billing and collections to reduce denied claims and shorten the revenue cycle. Even small improvements in clean-claim rates and days in accounts receivable convert directly into cash flow in a practice this size.

Diligence notes

Quantify provider dependency immediately: determine what share of revenue and patient relationships flow through the selling physician personally versus the broader provider team. If the seller drives the majority of billings, the buyer must have a credentialed physician ready to step in or the cash flow could erode post-close.
Verify the payer mix and reimbursement detail behind the $3.26M in revenue. Confirm the split between Medicare, commercial insurance, and self-pay, and stress-test exposure to any pending reimbursement cuts or value-based care transitions that could compress margins.
Scrutinize the long-term lease terms, including remaining duration, renewal options, and rent escalations. Since no real estate is included, lease security is critical to protecting the going-concern value and the buyer should confirm assignability to a new owner.
Confirm the ancillary services driving profitability are properly credentialed, compliant, and sustainable under current billing rules. Validate that the experienced staff and providers will actually remain by reviewing employment agreements, non-competes, and any retention risk tied to the ownership change.
Review the medical equipment included in the sale for age, condition, and any deferred capital needs. Turnkey claims should be verified so the buyer is not facing immediate replacement costs that effectively raise the true purchase price.

Source

Originally listed on DealStream. View original listing →