Private equity investors looking to exit physician practice management platforms may be able to borrow a playbook already tested in urgent care, according to a Sept. 15 blog post from VMG Health.
VMG Health argues that breaking a platform into regional pieces, rather than selling it whole, could give sponsors a path to liquidity as traditional exits grow harder to find.
Here are six things to know:
1. Traditional PE exits are getting harder to execute. Hold periods for physician practice platforms keep stretching, IPOs remain rare, and many PPM platforms haven’t attracted the acquirer interest sponsors expected, according to the post.
2. Urgent care already tested a regional exit model. Private equity built large urgent care platforms starting around 2010, and some have since been sold off in regional pieces to health systems rather than as single enterprise sales. In 2025, Ardent Health acquired 18 NextCare centers across Oklahoma and New Mexico, and Bon Secours Mercy Health acquired 10 Greater Midwest Urgent Care locations.
3. Regional buyers can pay more than a single acquirer would. A national platform has a limited pool of logical buyers, but splitting it into regional assets lets multiple health systems bid on pieces that fill their own strategic or geographic gaps, potentially making the parts worth more than the whole platform, per the post. The trade-off is that carve-ups can sacrifice the consolidation premium a single enterprise buyer might pay and leave shared MSO infrastructure behind.
4. The strategy translates unevenly across specialties. Site-based, referral-driven, density-sensitive practices, the profile urgent care fits, separate into regional lots most easily, the authors wrote. Platforms built around shared ancillaries, ASC economics or hospital call coverage may be harder to divide without losing value.
5. PPM carve-outs carry more structural complexity than urgent care deals did. Untangling a regional cluster from a platform’s PC-MSO structure can complicate payer contracts and non-competes, and corporate-practice-of-medicine restrictions can create added hurdles for nonprofit health system buyers, according to the post.
6. VMG Health pointed to reports that Optum is exploring the sale of portions of its physician portfolio in New York as an early sign that health systems, payviders, private equity investors and physician groups are reassessing which assets best support their long-term strategies.
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