Practice Acquisitions News
Buyers are getting choosier as well-run practices get scarcer: dentist ownership has slipped to about 73%, and more than 20 PE-backed platforms are deep enough into their hold periods that recaps and exits look likely within a year.
Read the full story at Becker's Dental Review →
By the numbers
supported locations at Heartland, the first DSO to reach that mark
Source: Becker's Dental Review
The river
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The ADA wants the House to scale back Senate-passed security mandates such as MFA, encryption and penetration testing for small offices, noting the bill's grants largely skip independent practices.
A quick scorecard: quarterly deal counts keep sliding, while stronger platforms are still raising fresh capital.
Costs are rising faster than reimbursement, and labor tops the list of pressures, which makes a deep, stable team a bigger part of what a practice is worth.
Illinois, Maine, Vermont and Washington passed five laws this year that widen state review of private-equity and management-company deals, including MSO arrangements in dentistry.
Executives say buyers rebuild a padded trailing-12 margin themselves, expect a multi-year post-close commitment, and treat clean books as a sign of how a practice is really run.
Operators look back at deal-making when money was nearly free and say price now depends more on clean financials and how easily a practice can be integrated.
A DSO chief warns that equity that sellers rolled into heavily leveraged groups has in some cases been impaired or wiped out, so a buyer's debt load deserves as much attention as the headline offer.
The settlement covers appointment texts that kept going after patients opted out, a reminder that patient-messaging habits can surface as a liability in a sale.
The largest platforms keep growing through the slowdown: Heartland passed 2,000 supported offices after adding more than 100 this year, split roughly evenly between new builds and affiliations.
Staffing is expected to get tighter next year, and smaller offices are likely to keep losing the wage contest to larger groups.
An Imagen executive says PE-backed dentistry faces a multi-year reset, with seller expectations still running high and some promised second-bite recaps failing to pay out.
A roundtable of DSO leaders expects private equity to stay in dentistry, but to be pickier about what it buys and to lean harder on operations and AI.
What drove this year's deals: costlier financing after the September rate move and new SBA rules, DSOs buying other DSOs, choosier buyers, steady deal volume, and more state scrutiny.
Miami-based Guardian added FreshDental in Hickory, N.C., soon after buying New Jersey's Select Dental Management.
A roundup of federal moves touching practice owners, from program-integrity pushes on Medicaid billing to a House bill that would limit insurer fee-setting on non-covered services.
There's no standard definition of an 'active patient.' This column shows how the number gets inflated and what both sides should verify before it affects price.
The sell-side advisor's quarterly report covers DSOs moving into new states, tighter practice financing, and falling dentist ownership, and urges owners 55 and older to weigh full or partial sales.
Heartland, which describes itself as the largest DSO in the U.S., closed on a Southeast group with 33 practices in Georgia, Tennessee, South Carolina and Kentucky. It's another case of a DSO buying a DSO.
The specialty DSO affiliated with an oral surgery practice in Waterbury, Conn., and now reports 226 locations in 29 states.
A monthly list of named transactions. September included Lone Peak adding four pediatric and orthodontic practices in Alabama, plus a wave of DSO de novo openings.
Park Dental Partners affiliated with Sapphire Dental Care, a three-doctor practice in the Phoenix area. Terms weren't disclosed.
A founder-led pair of pediatric practices in central Ohio partnered with Chord as part of Chord's expansion into Ohio.
Colorado's dental board paused enforcement of Rule 1.7, which restricts dentist-DSO arrangements, while a legal challenge from the DSO trade group proceeds.
Sources: Becker's Dental Review, DrBicuspid, Group Dentistry Now, TUSK Practice Sales. Headlines and links belong to their publishers. Summaries are our own. DSO Brief is not affiliated with these publications or the companies mentioned.
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