From: Scott Becker <>
Subject: [Becker's ASC E-Weekly] Pricing by Tier in the Buying and Selling of ASCs; Risks of Highly Leveraged Investments in Healthcare; Key Steps to Effective Diligence in Healthcare Transactions; 5 Key Valuable Valuation Statistics
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July 10, 2008
Latest News & Analysis

1. Pricing by Tier in the Buying and Selling of ASCs. Click Here button

2. Highly Leveraged Investments in Health Care: Growing Concerns and Risks. Click Here button

3. The 2008 VMG Intellimarker will be available at the end of the month; in the meantime, e-mail Greg Koonsman to get a free copy of the 2007 Intellimarker: Click Here button

4. Stuart Katz: Physician-Owned Facilities Aren't "Bad Guys." Click Here button

5. Another New Alabama ASC Hits a Roadblock. Click Here button

6. New Jersey Hospitals in Severe Financial Crisis. Click Here button

7. Humana to Acquire Florida's Metcare Health Plans. Click Here button

8. Effective Diligence in Health Care Transactions: Core Challenges and Key Steps. Click Here button

9. 6 Steps to Become Better Prepared for Unannounced Surveys. Click Here button

10. VMG Health Has Become a Founding Sponsor for the Hospital Review; Learn More about VMG. Click Here button

11. HealthCare Appraisers Has Become a Founding Sponsor for the Hospital Review; Learn More about HealthCare Appraisers. Click Here button

12. Somnia Has Become a Founding Sponsor for the Hospital Review; Learn More About Somnia. Click Here button

13. NovaMed Acquires ASC in Louisiana. Click Here button

14. More than 75 great talks scheduled at the ASC Communications/Ambulatory Surgery Foundation fall conference, Improving Profits and Business, Legal and Strategic Issues for ASCs, including "Assessing the Profitability of Different Specialties in ASCs" and "10 Key Statistics to Review Every Week"; download the full brochure: Click Here button; register online: Click Here button

Credit Corp of Amer begin 0608
How Do You Recruit Physicians to Your ASC?

Physician recruitment in general is getting tougher and requiring more creativity, according to the recent according to the 2007 Retention Survey from the American Medical Group Association and Cejka Search, which conducted the survey of 43 physician groups representing 14,705 physicians.

What are you doing to recruit and retain physicians for practicing at your ASC? What is your best advice for recruiting physicians to buy into your ASC?

E-mail your thoughts to this question to Rob Kurtz at Be sure to include your name, title and business name. Shortly, we will publish a selection of the responses we receive and choose one response as our "featured answer."

MedNet 3x 0608
5 Valuable Valuation Statistics

The following data represents 13 respondents representing more than 300 ASCs throughout the country.

1. What valuation multiples (i.e., for minority interest buy-out) have you most typically observed in the marketplace during the past 12 months?

2.5 to 3.0 -- 2
3.0 to 3.5 -- 4
3.5 to 4.0 -- 2
4.0 or higher -- 4

2. What valuation multiples (i.e., for minority interest buy-in) have you most typically observed in the marketplace during the past 12 months?

2.5 to 3.0 -- 3
3.0 to 3.5 -- 4
3.5 to 4.0 -- 3
4.0 or higher -- 3

3. With respect to your acquisition strategy, do you prefer established facilities with immediate cash flow, turnaround situations at lower multiples/asset values, or de novo development opportunities?

Established, cash flowing centers -- 7
Turnarounds -- 5
De Novo (i.e., startups) -- 8

4. Your company generally prefers how many active physician owners?

1 to 5 -- 0
6 to 10 -- 2
11 to 15 -- 4
16 to 20 -- 7

5. Multiples paid to purchase a controlling interest have remained steady in 2007, with the majority of respondents (59 percent) observing 6.0x to 7.0x multiples of EBITDA and 33 percent of respondents observing 7.0x or higher multiples.

Source: HealthCare Appraisers' 2008 ASC Valuation Survey. Learn more about HealthCare Appraisers.

NovaMed (every other week/8 weeks)
Free Audio Conference for Paid Subscribers

For a limited time, subscribers have the opportunity to attend an audio conference free of charge: "Ambulatory Surgery Center Transactions: Successful Strategies for Mergers, Acquisitions, Divestitures and Restructuring." This offer is limited to 60 attendees. For more information on the audio conference, go here

To subscribe to the Becker's ASC Review go to

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Contact us toll-free: (800) 417-2035

Thank You to 10 Great Companies

1. Practice Partners in Healthcare. Specializing in de novo and turn-around situations, Practice Partners' physician base encompasses a wide array of surgeons with an emphasis in orthopedics. Learn more about Practice Partners.

2. Implantable Provider Group. Implantable Provider Group works with providers, facilities, manufacturers and commercial payors to fully manage all aspects of high-cost implantable medical devices. Read more about IPG.

3. Meridian Surgical Partners. Meridian acquires interests in established physician-owned surgical facilities, as well as partners with physicians seeking to grow their businesses locally through the development of new surgical facilities. Learn more about Meridian.

4. The Sanders Trust. The Sanders Trust owns, acquires and develops ASC buildings and medical office buildings nationwide. Read more about The Sanders Trust.

5. Alcon Laboratories. Offering the industry's most comprehensive portfolio of ophthalmic surgical products, Alcon leads the market by enabling surgeons to achieve the best possible outcomes for their patients. Learn more about Alcon.

6. American Medical Buildings. AMB Development Group specializes exclusively in the development of ambulatory care facilities nationwide, including surgery centers, medical office buildings, clinics, imaging centers and outpatient centers. Read more about AMB.

7. Kaye/Bassman International. Greg Zoch is a partner and managing director with Kaye/Bassman International, a 26-year-old executive search firm. Learn more about Mr. Zoch and Kaye/Bassman.

8. Physicians Endoscopy. Physicians Endoscopy develops and manages endoscopic ambulatory surgery centers in partnership with practicing GI physicians and hospitals. Read more about Physicians Endoscopy.

9. Affinity Insurance Services. Affinity Insurance Services is a part of Aon Corporation, a Fortune 250 Corporation and the No. 1 global insurance broker. Learn more about Affinity.

10. Access MediQuip. Access MediQuip is the largest and most experienced provider of outsourced implantable device management solutions to the healthcare industry. Read more about Access MediQuip.

Upcoming ASC Events
ASC Transactions: Successful Strategies for Mergers, Acquisitions, Divestitures and Restructuring
July 24, 2008
Audio Conference

ASC Benchmarking and Case Costing
Aug. 6, 2006
Audio Conference

Physician/Hospital Integration Efforts
Sept. 25, 2006
Audio Conference

15th Improving Profitability, and Business, Strategic, Clinical and Legal Issues for ASCs
Oct. 23 to 25, 2008

For a complete list of upcoming events, click here
Quick Links
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