Selling an ASC has never been more complex, according to an April 23 blog post from VMG Health, and the difference between a premium valuation and a disappointing one often comes down to a handful of mistakes.
Here’s what ASC leaders get wrong before they go to market, according to the post:
1. Neglecting revenue cycle management. RCM is the single most critical factor influencing both valuation and deal success. Bloated accounts receivable, high denial rates and inconsistent collections are among the first things buyers scrutinize. Weak RCM can directly reduce your sale price or kill a deal entirely.
2. Waiting too long to clean up compliance gaps. Buyers now routinely deploy clinical and life-safety experts during diligence. Unresolved CMS certification issues or infrastructure deficiencies become negotiating leverage against you.
3. Over-relying on one physician or founder. Physician alignment is a major deal driver. If your case volume is concentrated in one or two individuals, buyers see a liability. Centers with broad, stable physician bases and clear succession planning command stronger offers.
4. Ignoring operational infrastructure. Centers that can’t demonstrate scalable leadership and disciplined processes struggle to attract and close serious buyers.
5. Underestimating how long diligence takes. Buyers are more disciplined than ever. Going to market unprepared means a longer, messier process that can erode deal momentum.
6. Assuming your specialty sells itself. Orthopedics, gastroenterology, and retina remain the most active specialties, and cardiology is drawing growing interest, but even in high-demand areas, physician comfort with the ASC setting still limits how quickly deals move.
7. Leaving valuation upside on the table. Most ASCs trade at 7–8x EBITDA, but best-in-class centers with strong strategic demand have achieved double-digit multiples. The gap between average and premium comes down to operational fundamentals not market conditions.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.