Weekly roundup
Here’s what you missed last week!
🏛️ Policy & Payers
STRATA and CMS expand access to excimer-laser therapy for inflammatory skin conditions.
Senators push price transparency with a new “actual rates” bill.
Payers & providers lean on AI to tighten value-based care alignment.
📈 Business & Tech
Providers are turning data analytics into dollars across finance and ops.
Leaders say AI in RCM must plug into EHRs and payers to matter.
DIY voice agents can book visits and slash phone time.
AI is unlocking value in unstructured EHR data.
Epic rolled out platform-wide AI features for charting, ops, and RCM.
🩺 Clinical
Value-based care runs on connected, clean data.
Athenahealth is piloting an AI interoperability model to guide care and revenue.
Medicare patients are seeing more mobile dermatology care.
Azure’s healthcare AI models target routine clinical tasks and documentation.
Self-triage can route patients correctly and free capacity.
💡 Marketing & Growth
Ascension pushed NPS >80 by fixing consumer pain points.
Patients are using generative AI to find doctors alongside reviews.
⭐ Just for Fun
The Deep Dive
The Dermatologist’s Guide to a Defensible Valuation
Standardize documentation, tidy AR, and lock in EBITDA that withstands diligence.
Thinking about selling? Most buyers start with one number: EBITDA. That stands for earnings before interest, taxes, depreciation, and amortization. It’s a way to look at your practice’s day-to-day earnings without the noise of financing and tax choices, or non-cash accounting items. In short, it’s a clean, common yardstick for comparing practices.
Clean up your EBITDA. Before anyone puts a price on your practice, they’ll “normalize” EBITDA with a Quality of Earnings (QoE) review. This independent report adjusts for one-time costs, owner perks, and above-market owner pay, so buyers see steady, repeatable earnings. Doing a sell-side QoE first can speed diligence and help you defend value.
Know what moves the multiple. Buyers usually value you as a multiple of normalized EBITDA. The multiple goes up with durable revenue and goes down with risk. Common drivers: payer mix, stable referrals, depth of providers, ancillaries (Mohs, path, cosmetics), and growth runway. Private-equity–backed groups are active in dermatology; research has linked PE acquisitions to modest price increases for routine derm visits, which is useful context at the negotiating table.
Don’t forget about compliance guardrails.
Patient records and HIPAA | Patients keep access rights. HIPAA allows sharing and transferring records for treatment, payment, and health care operations, including due diligence and a practice sale, with specific privacy limits. Plan a patient notice and document records custody in the contract. |
Corporate Practice of Medicine (CPOM) | Many states limit non-physician ownership of medical practices. Deals often use a physician-owned entity plus an MSO to stay compliant. Know your state’s rules before you sign. |
Stark Law and Anti-Kickback Statute (AKS) | Any post-sale compensation, equity, or referral arrangement must fit these rules. Get a fair-market-value opinion and legal review. |
Noncompetes | The FTC issued a rule to ban most noncompetes, but a federal court blocked enforcement; as of August 2025, the rule remains on hold while litigation continues. State law still rules the day, so draft narrowly. |
Expect two price levers in the deal.
Working-capital “peg.” | Earn-out. |
Price assumes a normal level of receivables and payables at closing. If closing working capital is below the peg, the price usually ticks down; if above, you get the difference. Define what counts in writing. | A contingent payment you receive later if the practice hits agreed targets. Helpful to bridge a valuation gap, but read the fine print on how “earn-out EBITDA” is calculated and what the buyer must do (or not do) during the period. |
Your to-do list.
Clean up your numbers. Start with EBITDA. It’s a simple way to show what your practice earns from everyday operations, without financing or tax noise. Think of it as your “core earnings.” Then make a short “before/after” worksheet of expenses that won’t continue after the sale (often called add-backs) like a one-time legal bill or the owner’s car lease. These help show the true earning power of the practice under new ownership.
Get a financial checkup (QoE). Ask a CPA firm for a Quality of Earnings (QoE) review. It’s a buyer-style checkup that confirms your earnings are steady, points out one-time items, and highlights cash flow. Doing it before you talk to buyers can speed diligence and support your price.
Tidy your documentation + back office operations. Make sure every visit and procedure is documented, coded, and billed the same way across the team. Work old unpaid claims and clean up your accounts receivable. Buyers pay more for clean, predictable cash coming in. Work though any existing payer audits, and ensure you have a plan to notify patients. If you need help, don’t be afraid to work with an expert.
Talk to more than one buyer. Different buyers value practices differently. A local dermatology group may value fit and referrals. A private-equity–backed group may care more about growth and add-on sites. Get multiple offers so you can compare price and terms, not just one number. Decide if you want to target a stock or asset deal. What other companies do they own? Are they in the healthcare realm? Ask to interview or speak with a couple of those companies to get their perspective on how it has been for them. Are goals aligning? (You’re not committing by having a few conversations.)
Put key deal terms in plain writing.
Working capital target (or “peg”): agree on a normal level of cash-like items you’ll leave in the business at closing (things like receivables minus payables). If you deliver less than that target, the price usually adjusts down; more can adjust up.
Earn-out: part of the price you get later if the practice hits agreed goals (often revenue or EBITDA). Helpful to bridge a gap, but define the goals and how they’re measured so there are no surprises.
Also spell out who handles patient records and your post-sale role for a smooth handoff. (Your attorney will slot in the right HIPAA and state language.)
Bottom line: Buyers pay for today’s normalized EBITDA and discount for future risk. Keep the math clean, the compliance tight, and the definitions clear. That’s how you protect price (and your legacy).
The Toolkit
Things to check out this week
📄 Article You Need: Read Health Affairs’ study on private equity in dermatology showing routine-visit prices rose ~3–5% post-acquisition; handy context for negotiations and “multiple” talk.
🛠️ Tool You Should Try: Use the CMS Physician Fee Schedule Look-Up Tool to model how changes to Medicare impact on your top derm CPTs before you enter valuation talks.
🎧 Event Alert: MGMA: Mastering Medical Practice KPIs (Aug 28, 2025)—practical revenue-cycle levers you can apply Monday.
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That’s it for this week.
This one was super fun. Hope you enjoyed it too.
