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.