This is Dr. Hassan’s story.
How to sell a medical practice at the right time, to the right buyer, for the right price was the question Dr. Reem Hassan had been turning over in her head for almost a year before she picked up the phone. When the right time came, Reem called CGK Business Sales. Reem, age 56, board-certified in internal medicine and an Egyptian-American Coptic Christian by family, ran a $4.5M revenue, $1.1M EBITDA primary care plus concierge plus in-office specialty platform out of St. Matthews, Kentucky, in the Norton Healthcare-adjacent commercial healthcare corridor on the Louisville east side. Twenty-two W-2 employees ran the practice: Reem herself as Medical Director, three additional staff physicians (two board-certified in internal medicine, one board-certified in family medicine), four advanced practice providers (two nurse practitioners, two physician assistants), six medical assistants, five administrative, billing, and scheduling personnel, three quality, compliance, and medical records team members, and one phlebotomist. The practice had two satellite consultation rooms in Crestwood and Anchorage that complemented the primary St. Matthews office on Shelbyville Road. Reem’s revenue mix was 55 percent primary care and general internal medicine (annual physicals, chronic disease management, preventive care, sick visits, geriatric care for Louisville’s aging baby-boomer population), 25 percent concierge and direct primary care (the $2,400-per-year tier she had launched in 2019, now serving roughly 280 patients with same-day appointments, thirty-minute visits, and direct physician access, the operational story a buyer would underwrite first), 15 percent in-office specialty consultations (Reem holds dermatology certifications and runs in-office mole removal, Botox, and cosmetic dermatology under medical supervision, plus the practice offers in-office vascular ultrasound and ABI testing for peripheral artery disease screening), and 5 percent telehealth-delivered chronic care management for Norton Healthcare-system patients. Approximately 3,800 active patients sat on the practice panel at any given time, with the 280 concierge patients driving disproportionate revenue (about 22 percent of revenue from 7 percent of the patient base, the value the practice had built). Insurance mix: 45 percent major commercial in-network (Anthem BCBS Kentucky, UnitedHealthcare, Cigna, Humana, Aetna), 30 percent Medicare Part B (Louisville’s aging population is the practice’s structural tailwind), 15 percent Kentucky Medicaid (Passport Health Plan, Aetna Better Health), and 10 percent concierge direct-pay self-funded patients. The practice was NCQA Patient-Centered Medical Home Level 3 recognized, a designation only about 12 percent of US primary care practices hold. Reem held a 4.9-star Google rating across more than 740 reviews and a measured 92 percent twelve-month patient retention rate, against an industry average closer to 75 to 80 percent. Her husband Marcos, a senior project manager at GE Appliances Park in Louisville, was approaching retirement. Their three children were launched: oldest daughter Maryam, a cardiologist at Cleveland Clinic, son Mina, a software engineer at JPMorgan in Columbus, Ohio, and youngest daughter Catherine, finishing pharmacy school at the University of Kentucky. Reem wanted to step into a part-time clinical role post-close (three days per week in the concierge tier, dropping the primary-care general medicine to one day per week), and she wanted to use the freed-up time to expand her involvement at Sts. Mary and Mina Coptic Orthodox Cathedral as a deacon’s wife and to mentor pre-medical students from Louisville’s Egyptian Christian community. She came to us because she did not know who else to talk to about how to sell a medical practice at this size, with a 280-patient concierge tier producing $672K in recurring annual revenue, a PCMH Level 3 recognition, a 92 percent patient retention rate, the GE Appliances Park employer partnership, and the bilingual English-Arabic intake service she had built specifically for the Louisville Egyptian Christian and Lebanese-American communities. This page is what happened next, and what could happen for you. Reem is a composite, not a single real CGK seller, but the patterns and details are pulled from real medical practice engagements.
The night before Reem decided to sell a medical practice.
Most physicians who decide to sell a medical practice have been sitting with the question quietly for months before they finally reach for the phone. Reem was no different. She was 56. For nineteen years she had been the founding Medical Director of a primary care plus concierge plus in-office specialty platform in St. Matthews, Kentucky, the physician who had personally signed the original lease in 2007 on the Shelbyville Road office after she left her hospitalist role at Norton Healthcare, the prescribing lead on the chronic disease management protocols, and the relationship lead on every payor contract across the practice. The practice did $4.5 million in annual revenue, $1.1 million in EBITDA in the mid-band of Louisville-area primary care norms (driven by the 280-patient concierge tier producing $672K in recurring annual revenue at $2,400 per patient per year, the 45 percent major commercial in-network mix on top of a 30 percent Medicare Part B book, the NCQA Patient-Centered Medical Home Level 3 recognition that placed the practice in the top 12 percent of US primary care providers, the 92 percent twelve-month patient retention rate against an industry average closer to 75 to 80 percent, and the GE Appliances Park employer partnership covering roughly 180 GE-employee primary-care patients), and a 22-person W-2 team. Reem led the practice clinically as Medical Director. Three additional staff physicians (two board-certified in internal medicine plus one board-certified in family medicine) carried the physician-led caseload alongside her. Four advanced practice providers (two nurse practitioners and two physician assistants) extended the panel reach across the chronic disease management and same-day-sick-visit lines. Six medical assistants ran rooming, vitals, and clinical-support work across the St. Matthews office and the two satellite consultation rooms in Crestwood and Anchorage. Five administrative, billing, and scheduling staff ran the front office, the payor billing rhythm, and the appointment book across the practice. A three-person quality, compliance, and medical records team owned the NCQA PCMH survey readiness, the HIPAA documentation, the medical records governance, and the payor credentialing rhythm. One phlebotomist handled in-office blood draws and lab specimen routing. Approximately 3,800 active patients sat on the practice panel at any given time. The 280 concierge patients drove a disproportionate share of revenue (about 22 percent of revenue from 7 percent of the patient base, the value the practice had built since the concierge tier launched in 2019 with 40 patients in year one and grew to 280 patients by 2025). Twelve-month patient retention ran at 92 percent across the full panel, against an industry average closer to 75 to 80 percent, the operational story a sophisticated buyer would underwrite first.
Why physicians decide to sell a medical practice
The Friday Reem finally submitted the form, she had been at the St. Matthews office on Shelbyville Road for the morning huddle when her husband Marcos called from GE Appliances Park to confirm his planned retirement timing. Marcos was a senior project manager at GE, and the two of them had been gentle but consistent in the kitchen-table conversations over the prior six months: Reem had built something at the practice, the primary care M&A market in 2025 and 2026 was extraordinarily active for in-network operators with concierge tiers, the children were launched (oldest daughter Maryam was a cardiologist at Cleveland Clinic, son Mina was a software engineer at JPMorgan in Columbus, Ohio, and youngest daughter Catherine was finishing pharmacy school at the University of Kentucky), and the next chapter (a part-time clinical role focused on the concierge tier with three days per week clinical and the freed-up time spent at Sts. Mary and Mina Coptic Orthodox Cathedral as a deacon’s wife and mentoring pre-medical students from Louisville’s Egyptian Christian community) was waiting if she wanted it. Her three staff physicians and her four advanced practice providers were committed to staying on post-close if the buyer kept the clinical-leadership structure intact, kept the concierge tier brand and operating model intact, and operated the St. Matthews office under its existing NCQA PCMH Level 3 recognition. Reem had been approached eleven times in the prior eighteen months: seven times by PE-backed primary care consolidators headquartered out of New York, Boston, Nashville, and a handful of national platforms operating in the One Medical, Privia Health, Oak Street Health, Aledade, and Agilon Health tier, three times by regional Kentucky-based and Mid-South-based primary care groups expanding their commercial-payor footprint, and once by Norton Healthcare itself, attempting to vertically integrate her primary care platform into its hospital-employed-physician group. Reem did not know what her practice was actually worth at $4.5 million revenue and $1.1 million EBITDA, with a 280-patient concierge tier, a PCMH Level 3 recognition, a 92 percent patient retention rate, the GE Appliances Park employer partnership, and the bilingual English-Arabic intake service. She did not know whether the firms calling her were the right buyers for her three staff physicians, her four advanced practice providers, or the concierge brand she had built across nineteen years. She did not know whether the 280-patient concierge tier with $672K in recurring annual revenue was a value driver or a structural premium-multiple anchor for a sophisticated PE-backed primary care consolidator. She did not have a single peer in her life who had ever sold a primary care plus concierge platform at this size, payor mix, and recurring-revenue concentration.
That is the night she found CGK and submitted the form. We called her back at 7:42 the next morning, while Reem was at the St. Matthews office finishing the morning chart-prep with her bilingual medical assistant Salma before the 8:30 a.m. clinical case conference.
The first call about how to sell a medical practice.
The first call was 51 minutes. We did most of the listening.
Physicians who think about how to sell a medical practice in their mid-fifties, like Reem, usually carry the same handful of pressures into the first call. Reem talked about her three staff physicians (the two board-certified internal medicine doctors and the board-certified family medicine doctor), about the way each had become a clinical anchor for a different cohort of the patient panel and a continuity figure for the long-tenure chronic disease management book. She talked about the four advanced practice providers (two nurse practitioners and two physician assistants) who carried the same-day-sick-visit and chronic disease management workflows. She talked about the six medical assistants, two of whom had been with the practice for more than ten years. She talked about the five administrative, billing, and scheduling staff who ran the front office across the practice, the three-person quality, compliance, and medical records team who owned the NCQA PCMH survey readiness, the HIPAA documentation, the medical records governance, and the payor credentialing rhythm, and the one phlebotomist who handled in-office blood draws. She talked about the 3,800 active patients on the practice panel, and the 280 concierge patients producing $672K in annual recurring revenue at $2,400 per patient per year. She talked about the concierge tier launch in 2019, which started with 40 patients in year one and grew to 280 patients by 2025, the operational story a sophisticated buyer would underwrite first because it represented high-margin recurring revenue with predictable cohort behavior. She talked about the 45 percent major commercial in-network mix (Anthem BCBS Kentucky, UnitedHealthcare, Cigna, Humana, Aetna), the 30 percent Medicare Part B book that captured the structural tailwind of Louisville’s aging baby-boomer population, the 15 percent Kentucky Medicaid book through Passport Health Plan and Aetna Better Health, and the 10 percent concierge direct-pay book. She talked about the NCQA Patient-Centered Medical Home Level 3 recognition (only about 12 percent of US primary care practices hold PCMH Level 3) and the way it placed her in the top tier of US primary care providers from a quality-and-recognition perspective. She talked about the 92 percent twelve-month patient retention rate, against an industry average closer to 75 to 80 percent. She talked about the athenahealth practice management and EMR system she had migrated to in 2017. She talked about the in-office specialty consultation lines: dermatology procedures (mole removal, Botox, cosmetic dermatology under medical supervision), in-office vascular ultrasound, and ABI testing for peripheral artery disease screening. She talked about the GE Appliances Park employer partnership covering roughly 180 GE-employee primary-care patients through the company’s preferred-provider arrangement. She talked about the bilingual English-Arabic intake service she had built specifically for the Louisville Egyptian Christian and Lebanese-American communities, and the way her bilingual medical assistant Salma was the connector for the immigrant patient base. She talked about Marcos, her three children, her parish at Sts. Mary and Mina Coptic Orthodox Cathedral, and the part-time clinical role she wanted to step into post-close. We asked about the practice the way you would ask if you were trying to understand it, not the way you would ask if you were trying to win the engagement. What we were listening for was not just the financials. We were listening for whether Reem was actually ready to sell, what she was working toward, and whether her expectations on price were grounded in what the primary care M&A market would actually support for an in-network, PCMH Level 3, concierge-anchored, employer-partnership-backed primary care platform of her size.
At the end of that call, we set up a working session: an in-person conversation where one of our Managing Directors would walk Reem through our valuation model and tell her honestly what her practice was likely to command. We did not promise her a written report. Written valuations involve substantially more work, and we charge for those when a seller actually needs one for partnership buyout, estate planning, a divorce, or another documentary purpose. The walkthrough was free because Reem was clearly thinking seriously about how to sell a medical practice, the way someone thinks about it before they actually do it. Whether that ends up being in a year, five years, or longer, we make the same call.
The valuation session was the following Tuesday at 7:00 a.m. at the St. Matthews office, before the 8:30 a.m. clinical case conference and after Reem had finished her morning chart-prep with Salma.
Reem was not ready to sell a medical practice yet. She went home and waited four months.
The valuation session showed Reem that her practice was worth meaningfully more than she had been hoping in some areas and meaningfully less in others, which is how these conversations usually go. The 280-patient concierge tier producing $672K in recurring annual revenue at $2,400 per patient per year (the single most important value driver for a primary care platform in 2026, because PE-backed consolidators specifically pay up for high-margin recurring revenue with predictable cohort behavior), the NCQA Patient-Centered Medical Home Level 3 recognition that placed her in the top 12 percent of US primary care providers, the 45 percent major commercial in-network mix on top of a 30 percent Medicare Part B book, the 92 percent twelve-month patient retention rate against an industry average closer to 75 to 80 percent, the GE Appliances Park employer partnership covering roughly 180 GE-employee primary-care patients, the in-office specialty consultation revenue lines (dermatology procedures, vascular ultrasound, ABI testing), the athenahealth practice management and EMR standardization, the nineteen-year operating history under a single physician founder, and the bilingual English-Arabic intake capacity were all premium-multiple drivers a sophisticated PE-backed primary care consolidator would pay up for. Three issues, though, were dragging the number down. The first was the concierge cohort retention curve documentation. Reem knew her concierge tier had grown from 40 patients in year one to 280 patients by 2025, but she had not built a documented cohort retention curve that broke retention out by year-of-enrollment cohort, by enrollment channel (organic referral, GE-employee referral, parish referral, online inquiry), and by patient demographic (age band, chronic disease load, employer affiliation). A buyer’s investment committee was going to want the cohort curve to underwrite the recurring-revenue thesis on the practice. The second was the payor credentialing-and-renewal calendar documentation. Reem knew her 45 percent commercial in-network mix had been built deliberately over nineteen years through individual contract negotiation, but she had not built a unified credentialing-and-renewal calendar that documented the next-renewal-date, the contract anniversary, the negotiated reimbursement rate, and the credentialing status across each major commercial carrier (Anthem BCBS Kentucky, UnitedHealthcare, Cigna, Humana, Aetna), each Kentucky Medicaid managed care organization (Passport Health Plan, Aetna Better Health), and Medicare Part B. A sophisticated PE-backed consolidator’s underwriter was going to want a single-source credentialing calendar to confirm continuity of the in-network premium through the post-close integration window. The third was the NCQA PCMH Level 3 survey-readiness binder refresh. The St. Matthews office carried a tight, audit-ready binder owned by the three-person quality, compliance, and medical records team. The two satellite consultation rooms in Crestwood and Anchorage carried thinner binders that had not been refreshed in the prior twelve months. A buyer’s diligence team was going to pressure-test the PCMH Level 3 survey readiness as part of LOI formulation, because PCMH continuity is a buyer-side quality-and-recognition factor that translates directly into multiple.
We told Reem honestly: she could go to market now and accept the discount, or she could spend three to four months building a documented concierge cohort retention curve broken out by year-of-enrollment cohort, by enrollment channel, and by patient demographic, building a unified payor credentialing-and-renewal calendar across all major commercial, Kentucky Medicaid, and Medicare relationships, and refreshing the NCQA PCMH Level 3 survey-readiness binder to a uniform St. Matthews standard across the satellite consultation rooms with the three-person quality, compliance, and medical records team driving the work. We said the second path would likely command a meaningfully better number from a wider range of buyers, especially a PE-backed primary care consolidator with an underwriter that cared about concierge-cohort defensibility, in-network credentialing transferability, and PCMH Level 3 survey continuity. The realistic buyer pool for a $4.5 million revenue, $1.1 million EBITDA primary care platform with a 280-patient concierge tier, a PCMH Level 3 recognition, a 45 percent commercial in-network mix, and a 30 percent Medicare Part B book in the Louisville commercial-healthcare corridor is well-capitalized and increasingly active, and each band of buyer prices the same platform differently. CGK is an active member of the International Business Brokers Association and the M&A Source, both of which give us deep visibility into the active primary care buyer landscape, and we track the regulatory-and-payor environment through the American Academy of Family Physicians, the American College of Physicians, and NCQA on Patient-Centered Medical Home recognition. (For owners of practices that fit one of CGK’s specialty healthcare buckets, see our dedicated pages for dental practices, veterinary practices, med spas, physical therapy practices, pharmacies, home health agencies, addiction treatment centers, and behavioral health businesses, each of which has different buyer pools, multiple dynamics, and regulatory frameworks than general primary care.)
This is the part most brokers skip. Most brokers would have signed Reem that day, taken her to market, and made the commission whether or not the deal was the best one for her. We told her to wait, even though it meant we did not get paid for four months and might never get paid at all if she changed her mind.
Reem went home and waited. She spent the next four months working with her three-person quality, compliance, and medical records team to build the documented concierge cohort retention curve broken out by year-of-enrollment cohort (2019 through 2025), by enrollment channel, and by patient demographic, refreshing the NCQA PCMH Level 3 survey-readiness binders to a uniform St. Matthews standard across the Crestwood and Anchorage satellite consultation rooms, building the unified payor credentialing-and-renewal calendar across each commercial carrier, each Kentucky Medicaid managed care organization, and Medicare Part B, tightening the athenahealth EMR data hygiene across the trailing thirty-six months, and pulling together a GE Appliances Park employer-partnership attribution analysis that documented the 180 GE-employee primary-care patient panel, their utilization patterns, their chronic disease load distribution, and the per-patient revenue contribution. She read background material on primary care M&A through AAFP and on the regulatory-and-payor environment through ACP. She called us back about four months later and said she was ready to sell a medical practice that was finally in the shape it needed to be in.
What we did when Reem came back.
What it takes to sell a medical practice properly
When a physician is ready to sell a medical practice with CGK, the speed of the on-ramp surprises them. We took Reem’s practice to market in just under six weeks once she got us her updated financials, the documented concierge cohort retention curve broken out by year-of-enrollment cohort, by enrollment channel, and by patient demographic, the unified payor credentialing-and-renewal calendar across each commercial carrier and each Kentucky Medicaid managed care organization plus Medicare Part B, the refreshed NCQA PCMH Level 3 survey-readiness binders across St. Matthews, Crestwood, and Anchorage, the trailing thirty-six months of athenahealth EMR data hygiene, the per-physician and per-advanced-practice-provider patient panel breakouts, the per-program revenue analysis (primary care, concierge, in-office specialty, telehealth chronic care management), the per-payor reimbursement rate analysis, the GE Appliances Park employer-partnership attribution analysis, the in-office specialty consultation revenue breakouts (dermatology procedures, vascular ultrasound, ABI testing), the controlled-substances reconciliation history for the chronic disease management prescribing rhythm, the per-clinic real-property lease terms on Shelbyville Road, Crestwood, and Anchorage, and the full P&L breakouts across the four revenue lines.
Why the 280-patient concierge tier is the multiple anchor
This is the most important paragraph on the page, so we will say it directly. The 280-patient concierge tier producing $672K in recurring annual revenue at $2,400 per patient per year is what made Reem’s practice command a premium primary care multiple, and what made buyers willing to pay top-of-band price. PE-backed primary care consolidators in 2026 structurally pay up for concierge and direct primary care recurring-revenue books for three reasons. First, the recurring-revenue characteristic of a $2,400-per-patient-per-year concierge subscription is materially closer to a SaaS or membership cash flow than to a fee-for-service primary care book, and a sophisticated underwriter can multiple-expand the concierge revenue line on the recurring-revenue characteristic alone. Second, the patient-cohort behavior of a concierge tier is structurally more retentive than a fee-for-service primary care book, with annualized retention rates often above 90 percent in the year-over-year cohort because the patient relationship is anchored on direct physician access rather than transactional encounter billing. Third, the operational model of a concierge tier is structurally insulated from the federal No Surprises Act, the qualifying-payment-amount methodology, the CMS Medicare physician fee schedule revisions, and the commercial payor reimbursement compression that have squeezed primary care fee-for-service margins across 2022 to 2026, because the $2,400-per-year fee is paid directly by the patient outside the third-party payor system. The result is that a primary care platform with a meaningful concierge tier (Reem’s 280 patients producing 22 percent of revenue from 7 percent of the patient base) commands a meaningful premium over a comparable primary care platform without a concierge book, often a one-to-two-turn EBITDA premium, because the buyer’s underwriter can stand behind the concierge recurring-revenue line and the cohort retention defensibility independent of payor reimbursement compression.
The buyer pool for a PCMH Level 3, concierge-anchored primary care platform
We sent the blind teaser out to 33 buyers we had pre-qualified. Twenty-four signed NDAs and received the full Confidential Information Memorandum. Fourteen submitted Indications of Interest after data-room review. Eight advanced to Letters of Intent. We narrowed to five for management presentations. Three re-submitted refined LOIs after the management meetings. Two went into a final-final negotiation cycle. Buyers fell across four buckets we routinely use to think about how to sell a medical practice: PE-backed primary care consolidators (active across the One Medical, Privia Health, Oak Street Health, Aledade, and Agilon Health tier, typically running multi-state roll-up theses with central admin, billing, insurance contracting, and IT support, usually pricing on a 5.5x to 7x EBITDA band on diligence-clean in-network primary care platforms with documented PCMH survey readiness, payor credentialing transferability, concierge cohort retention defensibility, and physician-and-APP succession plans, and typically operating acquired practices under their original brand names with central support layered behind it rather than absorbing them into a single national identity), regional primary care groups (privately held, often physician-founded, expanding their state or regional footprint through targeted acquisitions and typically operating acquired practices under their original brand names with central administrative support, usually pricing on a 4.5x to 6x EBITDA band with stronger physician continuity expectations than PE buyers), hospital health systems running employed-physician-group expansion theses (in Reem’s case, Norton Healthcare itself, attempting to vertically integrate her primary care platform into its hospital-employed-physician group, occasionally pricing at or above PE multiples when the strategic fit is right but slower to close because of board approval cycles and W-2 employment-versus-affiliation negotiation), and individual physician-buyer or small-physician-group-buyer acquisitions (the rarest buyer pool at this band because the EBITDA size pushes deal value above SBA capacity, typically focused on smaller single-physician primary care practices in the $200K to $500K EBITDA range). Each bucket prices the same platform differently. The CGK page you are reading sits as the hub for general physician practices that do not have their own dedicated CGK page (general internal medicine like Reem’s, family medicine, pediatrics, OB/GYN, cardiology, dermatology, urology, and other physician-led specialty practices outside the dental, veterinary, med spa, physical therapy, pharmacy, home health, addiction treatment, and behavioral health buckets where CGK has separate dedicated pages).
Reem decided between the top two LOIs. They were materially different. One was a slightly higher headline price from a regional Kentucky-based primary care group with roughly $190 million in revenue across 18 acquired Kentucky and Tennessee primary care practices, where the St. Matthews office and the two satellite consultation rooms would absorb into the operator’s central administrative playbook within ninety days, the three staff physicians would absorb under the operator’s standardized physician comp model (which sat below the comp model Reem had built), the four advanced practice providers would absorb under a different operations and scheduling rhythm, the concierge tier would be folded into the operator’s separate concierge brand within six months (effectively unwinding the operating brand Reem had built since 2019), and Reem would transition to a six-month medical-director-emeritus role with no continuing clinical-leadership presence. The other was a slightly lower headline price from a PE-backed primary care consolidator with approximately $680 million in revenue across more than 80 acquired primary care practices pre-acquisition, expanding its Kentucky and Mid-South footprint with Reem’s St. Matthews practice as the Louisville anchor and the base for further Kentucky-Indiana-Tennessee primary care roll-up, with a long-hold thesis (10-plus years, positioning for a 2030+ second-bite or strategic exit). Under that LOI, the practice would continue to operate under its original brand name with central admin, billing, insurance contracting, and IT support from the consolidator, the 22-person W-2 team would stay employed, the three staff physicians would absorb at or above their existing comp under the consolidator’s clinical-leadership compensation framework with formal three-to-five-year stay arrangements, the four advanced practice providers would retain their roles and pay structure, the six medical assistants and the five front-office staff and the three-person quality, compliance, and medical records team and the one phlebotomist would all retain their roles, the athenahealth practice management and EMR system would be retained for the practice through an 18-month integration window, the NCQA PCMH Level 3 recognition would be preserved through a continuity-of-survey arrangement, the concierge tier would be retained as a distinct brand with the original $2,400-per-year fee structure intact, the GE Appliances Park employer partnership would be honored through change-of-control language, and Reem would step into an 18-month transition consulting role at three days per week (focused on the concierge tier) and then move into a part-time clinical role flying back to St. Matthews three days per week for the concierge tier and one day per week for the primary-care general medicine. We walked Reem through what each LOI would actually deliver under realistic and pessimistic scenarios, including what the operational continuity would look like for her three staff physicians, her four advanced practice providers, her medical assistants, her front-office staff, her quality, compliance, and medical records team, and her phlebotomist under each acquisition structure, and what the long-tenure chronic disease management cohort would experience under each. The PE-backed consolidator deal was the better one for Reem. The 18-month transition consulting role and the part-time clinical structure gave her the structural off-ramp she needed to expand her involvement at Sts. Mary and Mina Coptic Orthodox Cathedral and to mentor pre-medical students from Louisville’s Egyptian Christian community on her own timeline. The team preservation kept her three staff physicians, her four advanced practice providers, her medical assistants, her front-office staff, and her quality team in the roles they had earned. The athenahealth EMR preservation through the 18-month integration window kept the daily clinical rhythm intact through the post-close transition. The concierge brand preservation kept the operating model she had built since 2019 intact rather than folding it into a generic operator concierge brand.
Through the whole process, the same CGK Managing Director who had taken Reem’s first call four months earlier was the person walking her through every conversation.
The deal Reem took to sell a medical practice.
How the deal looks when you sell a medical practice with CGK
This is the part of how to sell a medical practice that gets the least attention in the trade press and the most attention from physicians who have actually closed a transaction: the structure of the consideration package matters more than the headline number, and the structure for an in-network, PCMH Level 3, concierge-anchored, employer-partnership-backed primary care platform with a deep chronic disease management book is meaningfully different from the structure typical of every other healthcare segment CGK works in. Reem’s deal closed roughly seven and a half months after we restarted the engagement, a typical CGK primary care window because primary care M&A involves CMS and Kentucky Medicaid change-of-ownership review, payor credentialing transfer review across each commercial carrier and each Kentucky Medicaid managed care organization plus Medicare Part B, transfer of the athenahealth practice management and EMR licenses, transfer of approximately 3,800 active patient charts under HIPAA-compliant chart-transfer protocols, change-of-control consents on the GE Appliances Park employer-partnership arrangement, change-of-control consents on the Norton Healthcare-system telehealth chronic care management referral relationships, and a more involved pre-close due diligence cycle on the 280-patient concierge cohort retention curve and the per-clinic NCQA PCMH Level 3 survey-readiness binders than typical mid-band healthcare M&A. The buyer was the PE-backed primary care consolidator with approximately $680 million in revenue across more than 80 acquired primary care practices pre-acquisition, expanding its Kentucky and Mid-South footprint with Reem’s St. Matthews practice as the Louisville anchor and the base for further Kentucky-Indiana-Tennessee primary care roll-up, operating on a 10-plus year long-hold thesis with a 2030+ second-bite or strategic exit horizon. The acquisition structure was an asset purchase rather than a stock purchase, with the practice folding into the consolidator at close, the 22-person W-2 team staying employed across St. Matthews, Crestwood, and Anchorage, the three staff physicians absorbing at or above their existing comp with three-to-five-year stay arrangements, the four advanced practice providers retaining their roles and pay structure, the medical assistants and the front-office staff and the three-person quality, compliance, and medical records team and the phlebotomist all retaining their roles, the athenahealth practice management and EMR retained through an 18-month integration window, the NCQA PCMH Level 3 recognition preserved through a continuity-of-survey arrangement, the concierge tier retained as a distinct brand with the original $2,400-per-year fee structure intact, the GE Appliances Park employer partnership preserved through change-of-control consents, the original practice brand name retained with central consolidator support layered behind it, and Reem transitioning to an 18-month transition consulting role at three days per week (focused on the concierge tier) followed by a part-time clinical role.
The total deal economic value was approximately $6.8 million, roughly 6.2 times trailing EBITDA, a premium primary care multiple driven by the 280-patient concierge tier producing $672K in recurring annual revenue, the NCQA Patient-Centered Medical Home Level 3 recognition that placed the practice in the top 12 percent of US primary care providers, the 92 percent twelve-month patient retention rate against an industry average closer to 75 to 80 percent, the 45 percent major commercial in-network mix on top of a 30 percent Medicare Part B book, the GE Appliances Park employer partnership covering roughly 180 GE-employee primary-care patients, the in-office specialty consultation revenue lines (dermatology procedures, vascular ultrasound, ABI testing), the athenahealth practice management and EMR standardization, the nineteen-year operating history under a single physician founder, the bilingual English-Arabic intake capacity for the Louisville Egyptian Christian and Lebanese-American communities, and the documented concierge cohort retention curve, unified payor credentialing-and-renewal calendar, and refreshed NCQA PCMH Level 3 survey-readiness binders Reem had built during the four-month wait period. About 78 percent of it came as cash at closing, in line with what a sophisticated PE-backed primary care consolidator typically structures on a mid-band concierge-anchored primary care platform. About 9 percent was held back in escrow for 12 months, the typical CMS and Kentucky Medicaid change-of-ownership audit cycle. The remaining 13 percent was a rollover-as-equity stake into the consolidator’s holding company, with Reem’s existing equity converting into the consolidator’s holding-company partnership interests on a vesting schedule tied to her continued 18-month transition consulting role and her part-time clinical presence (primary care rollover percentages run 10 to 20 percent because the consolidators specifically tie part of the sale value to the founding physician’s continued clinical-leadership presence for cohort continuity and PCMH survey continuity). The numbers add up to one hundred. Wire hit on a Friday morning at 10:23 a.m. while Reem was at the St. Matthews office about to meet a 73-year-old patient she had been managing for fourteen years for diabetes and hypertension.
Reem stayed on as a transition consultant for the consolidator’s Kentucky-Indiana-Tennessee region for 18 months after closing, three days per week (focused on the concierge tier), so she could personally introduce each of the three staff physicians and the four advanced practice providers to the consolidator’s central clinical-leadership team, walk her quality, compliance, and medical records team through the consolidator’s central compliance, billing, insurance contracting, and IT playbook for primary care, oversee the integration of the athenahealth practice management and EMR onto the consolidator’s national clinical-data infrastructure on a managed timeline, oversee the NCQA PCMH Level 3 survey continuity arrangement through the next survey cycle, and shape the consolidator’s Kentucky-Indiana-Tennessee expansion strategy across two adjacent metro markets the consolidator was actively in conversation with in Lexington and Indianapolis. After 18 months, Reem stepped into a part-time clinical role at three days per week for the concierge tier and one day per week for the primary-care general medicine, with the rollover-as-equity stake in the consolidator’s holding company continuing to vest on a multi-year schedule tied to the platform’s overall performance and her continued clinical-leadership presence.
What happened to Reem’s people and her patients.
The people-side of how to sell a medical practice usually weighs heavier on the founding physician than the financial-side, even when the financial-side is what triggers the call to a broker in the first place. Reem cared most about her three staff physicians (the two board-certified internal medicine doctors and the board-certified family medicine doctor), her four advanced practice providers (the two nurse practitioners and the two physician assistants), her six medical assistants (including her bilingual English-Arabic medical assistant Salma who was the connector for the Louisville Egyptian Christian and Lebanese-American immigrant patient base), her five administrative, billing, and scheduling staff, her three-person quality, compliance, and medical records team that owned the NCQA PCMH Level 3 survey readiness, the HIPAA documentation, the medical records governance, and the payor credentialing rhythm, and her one phlebotomist. She also cared about the patient base: roughly 3,800 active patients across the practice, the 280 concierge patients producing $672K in annual recurring revenue, the long-tenure chronic disease management cohort that had been with the practice for ten-to-fifteen years, the GE Appliances Park employer-partnership cohort, the bilingual English-Arabic patient base, and the parish families from Sts. Mary and Mina Coptic Orthodox Cathedral who had become patients over the nineteen-year arc of the practice. The PE-backed consolidator buyer was a long-hold operator that intended to actually preserve the operational rhythm of the St. Matthews office through the integration window, operating the practice under its original brand name with central admin, billing, insurance contracting, and IT support layered behind it rather than absorbing it into a single national identity. That made the people part substantially cleaner than it would have been under the higher-headline-price regional Kentucky operator deal that wanted to absorb the practice into a single central administrative playbook within ninety days and fold the concierge tier into the operator’s separate concierge brand within six months.
The buyer kept all 22 W-2 employees, honored the existing pay structure across staff physicians, advanced practice providers, medical assistants, front-office staff, quality team, and the phlebotomist, and committed to retaining the three staff physicians under three-to-five-year stay arrangements, the four advanced practice providers continuing in the chronic disease management and same-day-sick-visit roles, the six medical assistants continuing on rooming, vitals, and clinical-support work, the five administrative, billing, and scheduling staff continuing in their roles, the three-person quality, compliance, and medical records team continuing on the NCQA PCMH Level 3 survey readiness, the HIPAA documentation, the medical records governance, and the payor credentialing rhythm, and the one phlebotomist continuing on in-office blood draws. The 3,800 active patient panel transferred under HIPAA-compliant chart-transfer protocols on a managed timeline, with continuity of care language preserved across the consolidator’s central clinical platform. The 280-patient concierge cohort transferred under the original $2,400-per-year fee structure with the concierge brand preserved as a distinct identity. The athenahealth practice management and EMR system was retained for the practice through an 18-month integration window before any consolidation onto the consolidator’s national clinical-data infrastructure. The NCQA PCMH Level 3 recognition transferred under a continuity-of-survey arrangement that preserved the practice’s top-12-percent recognition through the next survey cycle. The GE Appliances Park employer partnership transferred under change-of-control consents that preserved the 180-patient employee-health arrangement through the rebrand-free integration window. The Norton Healthcare-system telehealth chronic care management referral relationships transferred under change-of-control consents. The per-location real-property leases on Shelbyville Road, Crestwood, and Anchorage transferred cleanly under the consolidator’s real-estate group. The bilingual English-Arabic intake capacity stayed intact because the team and the technology and the brand and the operational rhythm stayed in place.
Reem was at the St. Matthews office on a Friday morning when the wire confirmation came through. She walked over to her concierge consultation room where she was about to meet a 73-year-old patient she had been managing for fourteen years for diabetes and hypertension. She did not interrupt the patient meeting. She finished it. Then she drove home to her family house in Anchorage, Kentucky, where Marcos was working from home that day. She said in Arabic: “خَلَصت.” It is complete. Marcos closed his laptop, kissed her forehead, and said in English: “Now we go to Egypt for Easter.” They sat at the kitchen table and drank Turkish coffee and started actually planning the parish-and-family cadence week by week for the first time. Catherine called from Lexington that afternoon to ask about the closing. Mina called from Columbus that evening from his JPMorgan office. Maryam called from Cleveland later in the week between cardiology shifts at the Cleveland Clinic. The three of them already knew about the Coptic Easter trip to Cairo and Alexandria.
What Reem told us afterward.
Why physicians who sell a medical practice with CGK keep coming back
Most physicians who sell a medical practice do not call the broker again in the first year. The ones who do call usually want to talk about the parts of the engagement that, in retrospect, mattered more than they realized at the time. About six months after closing, while she was back in St. Matthews for a concierge clinic week, Reem called the Managing Director who had run her engagement. She said two things that the Managing Director still tells new sellers about.
The first was about the four-month wait. She said: “Three of the buyers who had been calling me were ready to sign LOIs in forty-five days, and two different healthcare M&A consultants I had talked to before you told me they could take me to market right then with the concierge cohort retention curve still undocumented, with the payor credentialing-and-renewal calendar still scattered across each major commercial carrier and each Kentucky Medicaid managed care organization, and with the NCQA PCMH Level 3 survey-readiness binders still uneven across St. Matthews, Crestwood, and Anchorage. The reason I sold with you is that you told me the truth about how my 280-patient concierge tier, my PCMH Level 3 recognition, my 92 percent patient retention rate, my 45 percent commercial in-network mix on top of a 30 percent Medicare Part B book, and my GE Appliances Park employer partnership were actually being valued by a sophisticated PE-backed primary care consolidator underwriter, the truth about what the documented concierge cohort retention curve would buy me in LOI conversations four months later, the truth about what the unified payor credentialing-and-renewal calendar would buy me in management-presentation conversations, and the truth about what the refreshed PCMH Level 3 survey-readiness binders would buy me in investment-committee approval. You told me what would happen to the price if I went out without fixing those things. I would have left more than a million dollars on the table, my three staff physicians would have folded into a worse comp tier under a different operator, my four advanced practice providers would have absorbed under a different operations and scheduling rhythm, my concierge tier would have been folded into a generic operator concierge brand within six months, and my quality, compliance, and medical records team would have absorbed under a buyer with a tighter integration timeline.”
The second was about who she sold to. She said: “I almost signed with the higher-headline-price regional Kentucky primary care group because the number on the top line was bigger and they told me they could close in ninety days. The fact that you walked me through what each buyer would actually do with my three staff physicians, my four advanced practice providers, my medical assistants, my front-office staff, my quality, compliance, and medical records team, my phlebotomist, the practice I had built across nineteen years, the concierge tier I had launched in 2019 and grown from 40 patients to 280 patients, the PCMH Level 3 recognition I had spent three years earning, the GE Appliances Park employer partnership I had spent five years building, and the 45 percent commercial in-network mix I had spent nineteen years building one contract at a time, what each buyer’s clinical-and-administrative integration thesis would mean for the long-tenure chronic disease management cohort three and five years out, and how a PE-backed consolidator with a brand-preservation thesis was structurally different from a regional operator with a ninety-day full-absorption thesis that would unwind the concierge brand within six months, is a conversation I never even thought to have until you raised it. I sold to a buyer who is actually going to keep the operational rhythm and the brand and the team and the concierge model intact through the long-hold window, and the 18-month transition consulting role and the part-time clinical structure you negotiated is what is letting me expand my involvement at Sts. Mary and Mina Coptic Orthodox Cathedral and mentor the pre-medical students from Louisville’s Egyptian Christian community on my own timeline. That was not on the original LOI. You pushed for it.”
This is what we mean when we say we sit with you in the decision, not just the transaction. Reem is one composite story, but the pattern is real. The physicians we work with who decide to sell a medical practice usually find their way to us through versions of Reem’s situation, and the relationships start with a long listening session and a free walkthrough, not a pitch.
Ready to sell a medical practice? Where are you in Reem’s story?
If you are starting to think about how to sell a medical practice, we should talk. There is no commitment and no pressure. The first conversation is free. The valuation walkthrough that follows is free when you are seriously thinking about selling, whether that is in a year, five years, or longer. We only charge for formal written valuations, and only when you actually need one for a partnership buyout, estate planning, or another documentary purpose. Submit the form and a senior CGK Managing Director will reach out within one business day.
If you are Reem at month 1: just exploring
You are not sure if you want to sell yet. The primary care M&A landscape keeps shifting under CMS Medicare physician fee schedule revisions, commercial payor reimbursement compression, and the structural rise of value-based care contracting, your concierge or DPC tier is meaningful but the cohort retention curve is undocumented, your PCMH recognition is real but the per-location survey-readiness binders are uneven across the main office and any satellite consultation rooms, your patient retention rate is meaningful but the cohort behavior is undocumented by year-of-enrollment cohort and enrollment channel, your in-network payor mix is meaningful but the unified credentialing-and-renewal calendar is scattered, your athenahealth or Epic or other EMR data hygiene is uneven across the trailing thirty-six months, fifteen-or-more years of running the practice is starting to tell you something, your family circumstances are pulling you toward a different cadence, you are curious about how a buyer would value your concierge versus primary care versus in-office specialty mix, or maybe a PE-backed primary care consolidator (One Medical, Privia Health, Oak Street Health, Aledade, Agilon Health, or one of their tier) or a regional primary care group has been calling you. Most of our best engagements start here. Submit the form and we will schedule a working session. You walk away with a real number and a clear sense of what to do next, with no obligation to do anything.
If you are Reem at month 4: ready to go
You have done the work to clean up the practice. The financials are tight. Your concierge or DPC cohort retention curve is documented by year-of-enrollment cohort, by enrollment channel, and by patient demographic. Your unified payor credentialing-and-renewal calendar is documented across each commercial carrier, each state Medicaid managed care organization, and Medicare Part B. Your NCQA PCMH (or equivalent quality-recognition) survey-readiness binders are refreshed to a uniform standard across the main office and each satellite consultation room. Your patient panel reporting is documented by physician, by advanced practice provider, by program, and by payor. Your in-office specialty consultation revenue is broken out by procedure category. Your employer-partnership attribution analysis (if applicable) is documented. Your athenahealth or Epic or other EMR data is pulled into a buyer-grade report for the trailing thirty-six months. Your physician and advanced practice provider succession plan is named and pre-negotiated. Maybe a buyer is already in the conversation. You want to run a real process. Submit the form and we will be in touch within a business day to talk about timing, scope, and what your first 30 days as a CGK seller would look like.
If you are not sure where you are
Most physicians are not sure. Submit the form and start with the conversation. We will figure out together where you are. We are equally happy to tell you to wait twelve months as we are to take you to market in six weeks.
Or call us directly at (888) 858-7191.
Start your own story
A senior CGK Managing Director will respond within one business day. Strictly confidential. For physician-owners of primary care, internal medicine, family medicine, pediatrics, OB/GYN, cardiology, dermatology, urology, and other physician-led specialty practices doing $1.5M+ in annual revenue, including concierge and direct primary care operators, NCQA PCMH-recognized practices, and combined operators running primary care plus in-office specialty plus telehealth chronic care management lines. The first conversation and the valuation walkthrough that follows are free for any physician seriously thinking about selling, on any horizon.
Confidential. No obligation. Direct routing to a named CGK business broker, not a junior screener.
One of these eight people would lead your engagement.
When you decide to sell a medical practice with CGK, one named senior Managing Director stays with you from the first call through the wire transfer, just like Reem’s Managing Director stayed with her for four months and then for the engagement that followed. Our Managing Directors come from Wall Street investment banks, hedge funds, Fortune 500 corporate finance, and operating-business leadership. Cornell MBA. U Chicago Booth MBA. CFA. CMT. Naval Academy. Goldman Sachs. Merrill Lynch. Deutsche Bank. AIG. T. Rowe Price.
What sellers say after they sell a medical practice (and other businesses) with CGK
I could not be happier with the experience I had selling my business with CGK. Greg did a detailed analysis of my business and helped me price and position it right for the market. After receiving multiple offers at full asking price, the rest of the process went very smoothly, and we closed in less than two months.
Hanna M.Selling my business was a once-in-a-lifetime experience, and I’m incredibly grateful to have had Wes by my side throughout the process. He brought perspective, pushed when necessary, and always had my best interests in mind. His experience and strategic approach allowed me to maximize the sale price while minimizing long-term risk and obligations. If I had to do it all over again, I wouldn’t hesitate to choose him as my broker.
Adam NevilleDerik located multiple interested strategic buyers that produced more than one serious offer. The negotiations were tough but Greg and Derik’s experience helped us overcome. We got a great result for our employees and for the owners. We would recommend them without reservation.
Bob TaylorWe sold a business that was 47 years old and being run by second generation within a year of working with Wes. CGK has a system that attracts serious prospects to review opportunities. Wes was able to make the overwhelming feeling of selling easy and to a certain extent enjoyable. I never felt alone or in the dark throughout the entire process.
Jennifer WilliamsWe decided to sell our company in 2025. Talked to another M&A company in the Louisville area. We felt very comfortable with Greg and Matthew at CGK. Could not have made a better choice. From day 1 till final closing and even after 30+ days, they have been here helping us with documents and support during the transition. Thanks can not be said enough.
Rickey ThomasInside the Blueprint, on Bloomberg TV and Fox Business News.
Reem’s husband Marcos, the senior project manager at GE Appliances Park in Louisville, was the one who first sent her a clip of CGK on Bloomberg. He had been watching the segment in the kitchen on a Saturday morning while Catherine was studying for a pharmacy school exam, and he recognized the firm name from a healthcare M&A trade article about how to sell a medical practice that Reem had read a few months earlier. He texted her the link with a note that read “Look at this. This is the firm. Same one from your trade article.” CGK Business Sales is featured on Inside the Blueprint, the syndicated business television series. Our episode aired on Bloomberg TV and Fox Business News. Watch the segment, then start a confidential conversation.
The CGK office Reem called was the CGK Louisville office. Yours might be one of these.
When you sell a medical practice with CGK, whichever office you reach, you get the entire firm. Reem worked with a CGK Managing Director based out of the firm’s Louisville office covering the broader Kentucky and Mid-South metro, but her deal benefited from a buyer pool we sourced firm-wide, including the PE-backed primary care consolidator that ultimately won the engagement and is now using the St. Matthews practice as its Louisville anchor and the base for further Kentucky-Indiana-Tennessee primary care roll-up. Click any city to learn about our local presence and the named Managing Director leading that market.
Other Questions Reem and Other Medical Practice Sellers Ask Us
Practical answers to what comes up before, during, and after the kind of engagement Reem went through, when you sell a medical practice with CGK.