The healthcare system is changing – structurally, technologically and entrepreneurially. M&A creates opportunities for owners who want to hand over responsibility and secure care.
The healthcare sector is caught between demographic change, a shortage of skilled workers, increasing demand and growing pressure on funding. At the same time, medical progress, digitization and legislative reforms are rapidly changing the healthcare landscape. Hospitals, outpatient providers, care providers and medical service providers are coming under consolidation pressure – driven by the need for efficiency, staff shortages and complex regulation.
Particularly in the SME segment, many companies today are highly specialized, relevant to care – and at their staffing limits. Entrepreneurs, who are often medically trained themselves, bear a high level of responsibility for patients, employees and locations. In this situation, selling the company is not a retreat – but a conscious step to secure care in the long term, maintain structures and enable development.
At starkpartners, we have been assisting owners of medical facilities, specialized service providers, and healthcare companies in their transitions for many years – with expertise, sensitivity, and a deep understanding of the specific characteristics of this system. Whether it's a care group, outpatient surgery center, medical care center (MVZ), laboratory, rehabilitation clinic, MedTech manufacturer, or pharmaceutical service provider – we know the language, the ethical framework, and the operational reality of the healthcare sector.
Our strength lies in translating complex care models into comprehensible value arguments. We know what quality indicators mean, how billing systems work, what role health insurance negotiations, care contracts, care grades or cross-sector care play. Above all, we know that a sale in this environment is more than just a transaction – it is always also a transfer of responsibility.
The M&A market in the healthcare sector is lively, but highly regulated. Strategic buyers – from hospital groups to nursing home groups to investors with an industry focus – are specifically looking for companies with relevance to care, specialization and growth potential. Scalable facilities with regional roots, a qualified workforce and a stable payer environment are particularly in demand.
Private equity investors are also becoming increasingly important – particularly in the area of outpatient care, nursing, diagnostics, special logistics or pharmaceutical services. Nevertheless, access to this market requires discretion, empathy and a reliable structure. M&A in the healthcare sector is not a “deal”, but a process with far-reaching consequences – for patients, relatives, employees and society.
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Frequently asked questions about company succession in the healthcare segment
Whether it's valuation, succession, or sale – most entrepreneurs face similar questions when it comes to their healthcare company. We would like to provide you with an initial overview and clarify key points that become relevant in almost every project. For everything else, we are always available to assist you confidentially and personally.
The valuation of a healthcare company follows clearly defined industry-specific value drivers. In addition to classic valuation approaches based on EBITDA or revenue, the sustainability of revenue models, DRG or EBM dependencies, compensation and reimbursement systems, regulatory compliance (e.g., MDR, AMG), approval and licensing status, and the scalability of clinical and administrative processes are particularly important. Furthermore, factors such as IP substance, product and treatment pipelines, market and indication focus, and the stability of management and physician teams are included in the valuation.
The multiples that can be achieved in the healthcare segment vary significantly depending on the sub-segment and business model. Platform-based models such as MVZ structures, MedTech companies with their own IP, diagnostic services, or scalable healthcare IT generally achieve higher multiples than purely personnel-intensive service providers. The range is largely determined by regulatory and reimbursement logics (e.g., DRG, EBM, or selective contract structures), growth prospects, margin stability, and dependence on key individuals. In the medium-sized market environment, we typically observe EBITDA multiples in the range of approximately 6.0x to 8.0x, with premiums or discounts depending on the structure and risk profile.
For the support of a company sale, a multi-stage remuneration model is usually agreed: a monthly retainer to cover the ongoing consulting and process costs, as well as a success-based success fee, which is only due in the event of a successful completion. This ensures that both sides have a common interest in the success of the transaction. The amount of the retainer and the success fee depends on the size, complexity and transaction volume of the company and is agreed transparently at the beginning of the mandate.
The MA process takes an average of 6 to 12 months. It includes preparation (company valuation, project documentation), investor approach, due diligence and contract negotiations.
Discretion is paramount. Neither employees nor customers will learn about sales plans without prior agreement. We manage the process so that only vetted interested parties gain insight.
For a structured MA process in the healthcare environment, investors expect complete and reliable documentation. This includes current financial documents (BWA, annual financial statements, integrated planning statements), performance- and compensation-related overviews (e.g., DRG, EBM, or selective contract structures, payer distribution, utilization rates), contract and cooperation overviews (physician, care, lease, and supply agreements), anonymized information on the personnel structure (key individuals, skilled worker ratio, replacement risks), as well as regulatory and medical-technical documentation (approvals, licenses, MDR/AMG compliance, QM systems). In addition, corporate law documents, ongoing obligations, and a structured preparation in the virtual data room are essential to make the due diligence efficient and minimize transaction risks.
Typical investors in the healthcare segment are specialized private equity firms with buy–build or platform strategies, strategic healthcare service providers, MedTech and pharmaceutical companies, as well as international healthcare IT and diagnostics providers. In addition, family offices and long-term-oriented financial investors are increasingly appearing, addressing regulated revenue models, predictable cash flows, and structural growth in the healthcare market.
The investor reviews Financial, Legal, Tax, Commercial, and Tech/IT in a protected data room. Among other things, revenue and cost structures, KPIs (e.g., revenue quality, case numbers, DRG/EBM logics), contractual and service relationships, IP and licensing rights, tax matters, market and competitive positioning, pricing and compensation mechanisms, as well as IT systems, data protection, and information security are analyzed. Professional preparation of the documents accelerates the transaction process and strengthens the entrepreneur’s negotiating position.
Many investors want a transition period of 6–24 months. Whether and how long the entrepreneur stays on board is negotiable and depends on succession planning, team structure, and investor model.