Real Exits. Real Math.

What actually happens when you have
someone in your corner.

Three real exits we coordinated. Names changed, math intact.

Case Study 01

"The $2.4M Offer"

Practice Profile
Practice type Solo GP
Collections $1.6M
EBITDA margin 32%
Market Suburban Midwest
Headline DSO Offer
$2.4M
Before coordination. Before we looked at the terms.
What we found
  • 38% of the deal was a contingent earnout — payable only if production targets were hit post-sale
  • 27% tax drag with no installment structure or entity optimization in place
  • Undefined working capital adjustment that could have clawed back $80K–$140K post-close
  • No charitable structure — $40K in near-term deductions left on the table
Final Net — Negotiated Path
$1.97M
Cash-equivalent after restructure + alternative buyer

The $2.4M headline number felt like a win — until we modeled what would actually clear. After restructuring the earnout terms, bringing in a competitive buyer, and layering an installment strategy that cut the effective tax rate significantly, the doctor cleared $1.97M in cash-equivalent proceeds. Less than the headline. More than they would have walked away with. The difference was knowing what to ask for before signing an LOI.

What we found
  • Rollup equity offered at 0.6× mark — with no liquidity event guaranteed for 5 years
  • Founder forced into a clinical earnout requiring 40+ hours/week post-close
  • No clean exit path — equity stake in the acquirer's vehicle with no secondary market
  • Advisor team had not modeled the aggregator's consolidation history or liquidity track record
Final Net — Negotiated Path
$4.2M
Cash + clean 18-month consulting agreement, no clinical floor

Three locations, $4.1M in collections — and the aggregator knew it had leverage. The original offer buried the real payout inside equity that might be worth something in 5 years, maybe. We reframed the deal structure, introduced a cash-heavy competing offer, and negotiated a clean consulting arrangement that gave the founder 18 months of transition income with no production minimums. The $5.8M stayed a headline. The $4.2M is what cleared.

Case Study 02

"The Multi-Location Squeeze"

Practice Profile
Practice type 3-Location Group
Collections $4.1M
EBITDA margin 26%
Market Southeast
Headline Aggregator Offer
$5.8M
Mostly equity. Mostly illiquid. Mostly not what it seemed.

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Case Study 03

"The Late-Career Exit"

Practice Profile
Practice type Solo GP
Collections $1.1M
EBITDA margin 41%
Timeline Retire in 24 months
Market West Coast
Headline Broker Valuation
$1.3M
What the broker said it was worth at close.
What we found
  • Missed §1202 QSBS angle — qualified small business stock treatment that no one had flagged
  • No installment sale structure modeled — the entire proceeds would have hit as ordinary income in year one
  • Heir-protection gap: estate plan didn't reflect the proceeds, leaving a significant exposure on transfer
  • 24-month runway made it possible to implement all three fixes before close
Final Net Realized
$1.42M
After-tax + estate-protected — 9% more than the broker's number

At 62 with 24 months on the clock, there was still time to move. The §1202 QSBS structure cut the effective capital gains rate significantly on a portion of the proceeds. The installment arrangement spread the remainder across five years, dropping the year-one tax load. And the estate plan got updated to protect the wealth transfer — not just the transaction. The broker said $1.3M. We structured $1.42M after-tax into a protected estate. That's the window that mattered.

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