Partnership with Earn-In + Absentee Transition Strengths
Strategic acquisition structures for hormone therapy practice growth and transition
1. Partnership with Earn-In + Absentee Transition
Strengths:
Aligns seller's motivation to exit day-to-day early
Enables you to build a scalable system around hormone memberships
Keeps the seller engaged but frees you from operational bottlenecks
Seller adds 200 hormone patients/month = organic growth potential
Considerations:
How long is the earn-in period? Is it clearly defined?
Do you have a timeline and milestones for full absentee transition?
What's the seller's mindset on equity dilution or salary tradeoff?
2. Hybrid Partial Buyout + Earn-Out on Equity
Strengths:
Immediate partial liquidity for seller (cash + reduced equity)
Seller stays motivated to grow through earn-out
You get skin in the game for scaling to $100M EV
2.5-3x EBITDA multiple seems fair given owner-op status
Considerations:
Define earn-out metrics clearly (patient growth, revenue, EBITDA)
What percentage equity buyout are you proposing?
How long is earn-out period? And what if team underperforms?
3. Full Buyout + Variable Seller Note & Earn-Out
Strengths:
Clear exit for seller, clean ownership for you
Variable note protects you if transition fails
Penalizes solicitation, protecting goodwill and patients
Earn-out aligns seller to train replacement team
Considerations:
Is the variable seller note formula crystal clear and enforceable?
How do you monitor and enforce solicitation restriction?
What's the downside if seller refuses to cooperate?
Overall Assessment:
This offers cover the spectrum: partnership → partial buyout → full buyout, which is smart for seller flexibility.
By focusing on
seller motivation and transition
, which is a safe and fair transition strategy
The
2.5-3x EBITDA multiple
is on the generous side for an owner-operated business, but justified by growth potential and your platform's scale.
The variable seller note tied to performance and solicitation is a sharp way to mitigate risk and aligns with "terms over price" philosophy.
What I'd add or tweak to the above:
Quantify milestones and timelines for absentee transition and team ramp-up in all options.
Include a Debt Service Cover Ratio (DSCR) analysis to ensure your debt/service capacity supports the structure.
Consider offering the seller a minority rollover equity in option 2 or 3 to keep alignment long-term.
Build in clear clawback provisions on the earn-outs or variable notes if seller solicits or otherwise damages business value.