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Growth After a Pandemic, Considerations for Medical Practices

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Many business owners have experienced innumerable challenges since the start of 2020. As the world begins to open, we are now faced with challenges of supply chains, the rising cost of materials, and a changing workforce. Yet, throughout the pandemic, practices did their best to keep operations moving forward. With things “returning to normal,” now is the time to plan for business growth. Whether through technology upgrades, identifying new sources of capital, improving efficiencies, or retaining key personnel, the goal is to set your company up for long-term success through sustainable, methodical growth despite current market forces.

Measuring value in a healthcare practice

Assets like cars or real estate are easier to value because there is an active secondary market for them, and there are comparable sales to help determine what they are worth. But there is no widespread secondary market for business interests, and practices are seldom similar enough for comparable sales to help an appraiser. That is why appraisers must turn to other methodologies to approximate the value of a business. It is accepted that there are three basic ways to describe the value of a business: fair market value, investment value, and liquidation value.

  • Fair market value. The hypothetical cash exchange price that a willing buyer and seller would agree upon as payment for the business with mutual knowledge of all the relevant facts.
  • Investment value. The value the business represents to a specific investor — a successor in a family business or a competitor looking to buy — and incorporates specific considerations above and beyond the fair market value cited above.
  • Liquidation value. This value is based on the assumption that the business is no longer viable — worth more dead than alive — and the owner is compelled to sell its assets piecemeal.

Creating value in a business

Value is not determined solely by present-day cash flow. In fact, the prospect of future cash flows matters more; so do prospects for future growth. Investors value investments based on the returns they can expect over the lifespan of the investment.

Value comes from different areas in a practice; for example, cash flow can include dividends, salaries and benefits for owners, and projected sale or liquidation proceeds. That is why those who evaluate deals — including investment bankers, valuation professionals, and equity analysts, as well as business owners and operators who acquire businesses — use expected future cash flows to estimate the current value of a company. Many factors affect the value of the cash flow stream: the current cost of capital, the timing of the cash receipts, the expected growth or decline of the cash stream over time, and the risk that the expected cash flow stream will not be achieved.

Valuation specialists consider many other factors while deciding on potential future cash flows, including:

  • Earnings history and nature of the business
  • Industry and general economic conditions
  • Company financial condition, net worth, value of non-operating assets, and intangible value
  • Current and estimated future market share
  • Earnings capacity of the subject company and similar companies
  • Dividend capacity of the subject company and similar companies
  • Size of the interest offered by the subject company

What Now?

When COVID-19 exposed significant worldwide supply chains and operations problems, business owners were forced to rethink their supply chain processes. Whether it be from outsourcing and shipping to end-patient delivery, a clear and resilient strategy is crucial. Transformative solutions that lower costs, reduce risks, improve the use of capital, and support efficiencies are vital steps to growing the value of a practice. In addition, technology, including automation and data analytics, can aid in the goals of every business owner.

Our specialized experts provide a comprehensive path to increase your practice’s growth. Maner Costerisan can eliminate headaches and pain points in the valuation process while providing critical information on a timely basis to help leaders make decisions.

Tim Bograkos, Director of Business Development - Maner Costerisan

Tim Bograkos

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