During last night’s webinar, I alluded to sharing a list of questions practices should ask a prospective buyer (hospital, other practice, PE-back entity, etc).
Below is my stab at with (with input from @dbannett, @Chip, and @lholder)
I tried to group the questions into functional areas to make things easier to follow, etc…
What else should a practice ask a prospective buyer if they are discussing the sale/acquisition of a practice?
Functional Area | Question | |
---|---|---|
1 | Alignment | What are your expectations of the practice? |
2 | Alignment | What makes this practice so attractive to you? |
3 | Alignment | If the buyer sells the practice at some point in the future, how much say will the doctors have in the new sale? |
4 | Alignment | How will the buyer add value to the practice? |
5 | Alignment | What does success look like to the buyer? |
6 | Alignment | How does the buyer plan to expand/grow the practice? |
7 | Alignment | What additional service lines, if any, does the buyer plan to explore/consider adding? |
8 | Alignment | What are the buyer’s plans for geographic expansion? |
9 | Alignment | What is the biggest opportunity identified by the buyer in the practice’s geographic area? |
10 | Alignment | What vertical expansion plans do you have in mind for the practice? |
11 | Alignment | What horizontal expansion plans do you have in mind for the practice? |
12 | Alignment | Are you planning to acquire other practices in the area? Regional/Statewide? |
13 | Alignment | What is your “Why”? |
14 | Alignment | What is your mission? |
15 | Alignment | If this buyer is new to an area and you don’t have critical mass to negotiate reimbursements with the insurance companies yet, how can you pay competitive salaries? |
16 | Alignment | How do the providers walk away if the core business is not sustainable? |
17 | Background | What is the buyer’s track record of returns on investment with similar deals? |
18 | Background | What is the source of the buyer’s funds? |
19 | Background | Can the buyer share recent financials (P&L and balance sheet)? |
20 | Background | What is the general financial position of the buyer? |
21 | Background | What is the source of funds for the buyer? |
22 | Background | What are the buyer’s plans for paying down their own debt both in the short and long terms? |
23 | Decision Making | What authority will the practice retain and in what areas? |
24 | Decision Making | Will the practice have a voice in broader decision-making? |
25 | Decision Making | Who will be in charge of the new company and how much in put will doctors have in the decision making? |
26 | Financial | How long does the buyer typically hold the practice before selling it? |
27 | Financial | How will the buyer validate their financial position during due diligence? |
28 | Financial | How was the value of the practice determined by the buyer? |
29 | Financial | How will the existing vaccine inventory be paid for? |
30 | Financial | Will the buyer purchase the accounts receivables? If not, what happens to revenue from DoS prior to acquisition? |
31 | Financial | Are there CE opportunities provided by the buyer? |
32 | Financial | What types of data will the practice be required to share and how do they get it to you? |
33 | Financial | How many years’ worth of this data will you require to be shared? |
34 | Financial | Typically, how long is the process from signing the Letter of Intent to signing the agreement of sale and then ultimately to closing? |
35 | Human Resources | At what point will the buyer know which employee(s) to keep and what will happen to displaced staff? |
36 | Human Resources | Will the seller have a say in which employees are kept in the new venture? |
37 | Human Resources | How does the buyer plan to recruit employees in the future? |
38 | Human Resources | What will happen to the practice’s existing retirement plan (401k, etc)? |
39 | Human Resources | What will the employee benefit package look like? |
40 | Human Resources | What will the employee future PTO benefits look like? |
41 | Human Resources | How will employee tenure/seniority be accounted for post-acquisition? |
42 | Human Resources | What will the provider future PTO benefits look like? |
43 | Human Resources | What resources do you provide with regard to HR management? |
44 | Human Resources | How does the buyer provide opportunities for professional growth of staff and providers. |
45 | Human Resources | Will retained managers be given new job descriptions so they know what is expected of them after closing should they elect to stay with the company? |
46 | Management | Who will be involved with the managing of the practice? |
47 | Management | Will existing management be retained or replaced? |
48 | Management | What are the expectations of management teams in terms of financial goals and budgets? |
49 | Operations | Who manages the website going forward? |
50 | Operations | What will the practice marketing strategy be going forward? |
51 | Operations | How do the practice bills get paid? |
52 | Operations | What is the buyer’s preferred PEO / payroll processing solution? |
53 | Operations | How do you plan to negotiate managed care contracts going forward? |
54 | Operations | Will providers be involved in insurance contract negotiations or be notified of same? |
55 | Operations | Who will decide which insurance plans to join? |
56 | Operations | Who will be handling provider credentialing going forward? |
57 | Operations | What is expected referral pattern for subspecialties, procedures and hospitals? |
58 | Providers | Will there be any efforts made by the buyer to reach out to providers and staff after they’re notified of the sale to make them comfortable if not excited with the prospect of the buyer’s ownership or will that be left up to the practice? |
59 | Providers | What is the process to add another provider to the practice? |
60 | Providers | If physicians decide to leave after acquisition, what limitations will they face in terms of non compete agreement(s), etc.? |
61 | Providers | How does the buyer plan to recruit providers in the future? |
62 | Providers | What does provider base salary schedule and bonus program look like? |
63 | Providers | Will providers have paid CME benefits? If so, how much per year. |
64 | Providers | Will providers have other professional development support? |
65 | Providers | Will professional dues be paid by the practice? Limit? |
66 | Providers | Will providers at this practice be expected to rotate/work at other locations acquired by the buyer? |
67 | Providers | Does your organization require a certain percentage of providers to sign on to complete the deal and if so, what is that percentage? |
68 | Providers | Will existing ownership/management be included in the determination of compensation packages of existing providers? |
69 | Providers | Will you share the proposed providers’ contracts, restrictive covenant (assuming it’s still legal) and pay structure (current and future) with current ownership/management prior to signing the agreement of sale? |
70 | Providers | Given that most private practices pay lesser salaries as compared to the large institutions such as hospitals in the area, how will you determine retained providers’ salaries, and if they are competitive? |
71 | Providers | If salaries to recruit new providers increases, do you adjust the salaries for existing providers? How? Frequency? |
72 | Providers | What type of medical liability insurance does the buyer provide and if claims made, who’s responsible for tail coverage should a provider leave? |
73 | Providers | Is the buyer willing to escrow/pre-pay medical liability insurance tail premium for all providers in the event that the practice is unable to achieve its financial goals? |
74 | Providers | Will staff and/or providers be expected to cover other locations owned by the buyer but not part of the original practice that they came from? |
75 | Providers | Under what circumstances would buyer move the practice to a new location or merge it with another practice? Will providers have a say in these events? |
76 | Providers | What monthly/quarterly/annual reports will be available for the providers? |
77 | Providers | What is the extraction plan in the event that the parties are not happy with arrangements in 2-3 years? |
78 | Providers | Is there a time-limited buyback option if parties are unhappy? |
79 | Providers | How will buyer release medical records back to the providers if they leave the practice? |
80 | Providers | Will providers have a roll or say in capital improvements? |
81 | Providers | Will the purchaser buy the provider’s building/facilities? |
82 | Providers | In the event of purchaser insolvency, will providers have first dibs on purchase of the practice or a say in choice of new owner? |