Multi-site physician services platform
M&A Infrastructure Build
One opportunistic deal became M&A infrastructure that carried 20+ launches and $100M+ in capital deployment
The situation
An email arrives from a retiring physician group. They want to sell. The platform has three growth pathways. None of them work for this. There’s no evaluation framework, no transaction sequence, no integration process. The deal walks if there isn’t a system.
Beyond this one inquiry, the underlying problem is structural: every new practice launch (across all pathways) requires coordinating 12+ departments across months of preparation. Without a system, execution depends on heroic individual effort that can’t scale with deal volume.
What I built
Deal evaluation
Structured criteria assessing strategic fit, financial viability, and operational risk
RAPID decision process defining who recommends, approves, and decides at each stage from initial assessment through LOI
Transaction execution
Due diligence request lists (financial, operational, legal), data room structure, valuation methodology
Deal sequencing from NDA through LOI acceptance, with third-party diligence coordination across legal, financial, and medical workstreams
Post-close integration
TSA preparation: corporate development (AR reporting, loan payoffs, liability resolution), finance (bank accounts, lease payments, legacy contract disposition), HR (employee census, compensation analysis, day-one coordination), and medical (equipment assessment and procurement)
Implementation countdown: department-by-department execution plan across five milestone windows (3 months, 2 months, 1 month, 1-2 weeks, go-live) with defined deliverables and owners for operations, IT, HR, finance, credentialing, medical, marketing, and ancillary services
Launch quality standards: explicit go/no-go criteria across every function before any practice opened
Post-implementation monitoring: structured debriefs at 30, 60, and 90 days with proficiency checklists and escalation protocols
Coordination infrastructure: weekly cross-functional standups, shared dashboards, milestone reviews
The three layers were interdependent. Deal evaluation without transaction execution produces approved deals that stall at LOI. Transaction execution without post-close integration produces closed deals that fail at launch. Post-close integration without evaluation discipline produces an operating model that absorbs bad deals. The infrastructure had to span all three to compound.
The result
20+ practice launches ran across four new markets over three years
Total capital deployment passed $100M
Time-to-operational-stability improved with each successive launch
Credentialing delays shrank, with buffers and earlier trigger points built into the system
Year 1 patient volume targets landed consistently
The retiring physician segment, previously unaddressable, entered the growth strategy
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