Steven - Healthcare M&A Guy

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Steven - Healthcare M&A Guy

Steven - Healthcare M&A Guy

@HCareAdvisorGuy

Partner and Founder @ OakBridge Advisory. Financial due diligence pro (QoE) specializing in all things healthcare. Ex-B4 and IB with 15+ years of experience.

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Steven - Healthcare M&A Guy
Steven - Healthcare M&A Guy@HCareAdvisorGuy·
Over the past few weeks, I've walked through, in detail, key steps in the financial due diligence process. Below is where you can find each. I'll pin this post on my profile so you can go back and find it easily. Headline purchase price (HPP) vs. Cash Paid x.com/HCareAdvisorGu… Quality of earnings x.com/HCareAdvisorGu… Proof of cash x.com/HCareAdvisorGu… Why EBITDA? x.com/HCareAdvisorGu… Finding adjustments to EBITDA x.com/HCareAdvisorGu… Net Working Capital Guide x.com/HCareAdvisorGu… Debt and debt-like items x.com/HCareAdvisorGu… Purchase agreement support x.com/HCareAdvisorGu… One of these days, @CoFoundersNik and I will create the foremost ETA guide with templates to take you through the whole sourcing, valuing, diligence, and closing process but until then... accept this as my humble offering.
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Steven - Healthcare M&A Guy
Steven - Healthcare M&A Guy@HCareAdvisorGuy·
A lot of folks calling BS on this one. This was 2018 and, yes, deals at the multiple were very real. I came out of X retirement to type this and now, like Michael Buble after Christmas time, I will go back to the recesses of my cave and provide best-in-class healthcare financial due diligence to my amazing clients. Thanks @mhp_guy for blowing up my emails, LinkedIn and X accounts.
Chris Koerner@mhp_guy

Your regular reminder that a small handful of autism clinics sold for $64m - a 32x run rate multiple. $2m profit 64 patients $64m exit 23 months from founding to exit New locations broke even in 1.5 months These autism clinics and deals aren't nearly as controversial as you'd think: - Insurance usually pays for it - Parents are largely happy - Business owner and employees do well ABA Therapy is life changing for these kids. My good friend is an M&A advisor that worked this deal

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Chris Koerner
Chris Koerner@mhp_guy·
Your regular reminder that a small handful of autism clinics sold for $64m - a 32x run rate multiple. $2m profit 64 patients $64m exit 23 months from founding to exit New locations broke even in 1.5 months These autism clinics and deals aren't nearly as controversial as you'd think: - Insurance usually pays for it - Parents are largely happy - Business owner and employees do well ABA Therapy is life changing for these kids. My good friend is an M&A advisor that worked this deal
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Steven - Healthcare M&A Guy
Steven - Healthcare M&A Guy@HCareAdvisorGuy·
“The go-to QofE firm on the HBS search fund What’s App group chat” This feedback of how someone found us had me rolling. If you'd like us to be the go-to QofE firm for your (Insert B-school name here) search fund What's App group chat - feel free to drop us a line.
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Clint Fiore 🦬 DM for Biz Deals
Clint Fiore 🦬 DM for Biz Deals@ClintFiore·
@mhp_guy You’ll love the CT. They have completely changed the game for rural America, tradesman, and farmers. Everyone agrees they’re the next evolution of capability for the blue collar red blooded American. 🇺🇸
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Chris Koerner
Chris Koerner@mhp_guy·
It was a good run…but I’m selling my Model S & leasing a Cybertruck for 2 years. I never thought I’d be the leasing type, but these things depreciate like a rock & I don’t see that improving soon. From $115k to $40k in 3 years. It’s hard to live on acreage without a truck.
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Christien Louviere
Christien Louviere@CLouvi·
Who do you recommend for a CPA in Texas? It’s a small audit job to start but will grow.
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Stephen Olmon
Stephen Olmon@stephenolmon·
A homeschool co-op we are apart of hoped to have 2-3 new families join this year 53 families joined Data point
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Chris Koerner
Chris Koerner@mhp_guy·
I'm making $20k to fly my family to Europe to speak at a conference about implementing AI into physician's practices Have I ever implemented AI into a doctor's office? No But I'm 100% sure that this talk will crush & provide way more than $20k of value. Ignorant confidence FTW
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Bryant
Bryant@SullyBusiness·
Are we still rucking? Is Rucking still cool?
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Chris Koerner
Chris Koerner@mhp_guy·
My 11 year old boy overheard I was on my first million. For the rest of the night he followed me around the house, smiling, shaking his head and repeating “My first million huh? Hehe wow. Wow!” “Have you ever even heard of that podcast buddy?” “No! But now I KNOW that we’re millionaires! I KNEW IT! This is proof! This is awesome!” 😂😂
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Tabish Jesrai
Tabish Jesrai@tabishjesrai·
@HCareAdvisorGuy @ApexJones22 I can’t get behind Duncan being ahead of both Shaq and Kobe when he never repeated as a champ. Same goes for Bird. Russell won a bunch when the league sucked. I can def get behind curry being 10th!
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Apex Jones
Apex Jones@ApexJones22·
LeBron cried about players with less titles being excluded because he's passive-aggressively complaining about his 4-6 not being enough. It's always about him. But he's full of it. I have SIX players with FEWER titles than LeBron ranked ahead of him all time. So no, it's not the "A-all B-all" (dumbass) that he frames it as.
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Tabish Jesrai
Tabish Jesrai@tabishjesrai·
@ApexJones22 Trash ass list. How is Shaq not in your top 5? And as much as I hate Bron…he’s at the very least top 5. Bird & Russell not top 5. Kobe is too low at 8. Love Dream but he’s not above Kobe or TD. The logo & Dr J ahead of Shaq & Bron is criminal. Russell ahead of Magic?! TRASH.
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Steven - Healthcare M&A Guy
Steven - Healthcare M&A Guy@HCareAdvisorGuy·
I agree with John and this has been my experience as an FDD advisor working 100s of deals. Deals die when: - Financial expectations don't align with reality. PSA: most pro formas die in a rollforward. - There isn't full disclosure in the operations of the business.
John Caple@BigJohn043

I find that most deals are lost to due diligence issues. The biggest issue is that the financials are not reflective of reality. We also often find basic issues like customer concentration or unions are not disclosed. Just looked at a deal where the seller tried to claim that Wal-Mart and Sam's Club are two different customers....

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AI Dental Guy
AI Dental Guy@peterboulden·
Houston is a great market. Have you seen the financials? One thing I've been noticing is that people are reporting EBITDA without the cost of labor for the founding doctors replaced. Or them being replaced for less than market . My advice was just make sure you have someone who's done a lot of dental deals doing Q of E
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Steven - Healthcare M&A Guy
Steven - Healthcare M&A Guy@HCareAdvisorGuy·
I had an analyst come in to my office to tell me that he was taking another job. I congratulated him and wished him well. Stunned, he asked if I had a counter offer. I said, "No, sounds like a great opportunity and I don't do counters. If you wanted to stay, we could've worked something out but you explored the market, got an offer, and what is going to prevent you from doing that again if I counter?"
The Random Recruiter@randomrecruiter

Is it smart to take a counter offer? In most cases, probably not. Let’s see what ChatGPT says:

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Insurance Broker
Insurance Broker@Ins_Brkr·
I think this may be the first time I've experienced 1st hand people on twitter not understanding the concept of a joke
Insurance Broker@Ins_Brkr

@HCareAdvisorGuy Or, hear me out, or: Negotiate a counter offer with him, send him contract to sign (without company signature filled in), once he signs tell him another candidate offered to take the same roll for less and ask if he'll counter

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