THE DENTAL TRANSITION NEWSLETTER

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Considering a Sale to DSO / Small Group

Deciding to sell your dental practice is one of the most important decisions of your career and is why you should seek guidance from a reputable dental practice broker. Each seller has goals and as a result the practice will be sold to an Individual, a practice seeking a Satellite Office, or a Dental Service Organization (DSO) / Small Group (SG). This article focuses on what to expect from Dental Service Organization (DSO) / Small Group (SG) transitions. What DSO/SG’s typically look for (minimum) in a dental practice.

  • Fee-for-Service (FFS) or PPO-Based Practices: Limited or no HMO or Medicaid participation.
  • Revenue Thresholds: Practices producing $700,000 or more in annual gross collections with adequate cash flow.
  • Adequate Facilities: A minimum of five operatories, ideally with room for expansion.
  • Prime Location: High traffic / visibility
  • Seller Commitment: A willingness for the seller to stay on as an associate dentist for 2–5 years after the sale.
  • Real Estate: it varies, some will purchase while others are satisfied with leasing.

Points To Consider

Freedom: when a seller wants to eliminate the day-today hassle of business ownership, be rewarded for the practice they have built, and continue to work for years to come. It may make sense to sell to a DSO/SG.

Deciding to sell your dental practice is one of the most important decisions of your career and is why you should seek guidance from a reputable dental practice broker.

Financial: It’s important to understand the math. With proper representation the seller will do well; entering into a DSO/SG transition without experienced representation is ill-advised and likely quite risky. The DSO/SG is in business to make a profit; it may turn out they are not as friendly as they seem.

Opportunity: Earn-outs, commissions, bonuses, equity…etc. It’s important not to be blinded by big figures and be able to recognize what is attainable.

Autonomy after being the boss are you prepared not to be? It’s important you align yourself with the correct DSO/SG.

Reduced Compensation Post-Sale the seller is typically paid only for the work they perform and receive nothing from hygiene. While ownership profits now go to the DSO, this shift in earning potential could mean the “premium” sale price isn’t as lucrative as it initially seems.

Long-Term Financial Outcomes A private sale in two to five years might bring comparable (or better) financial results without the strings attached to DSO/ SG agreements. It’s crucial to carefully analyze the long-term implications. of selling to a DSO/SG versus other buyers.

Why Work with a Dental Practice Broker?

Navigating the complexities of selling your practice… whether to a private buyer or a DSO/SG… is challenging. Engaging a dental practice broker will provide the necessary expertise and experience to safeguard your interests throughout the transaction.

A broker will help with…

  • Identifying/Attaining Seller Goals is the most important aspect of a transition and attracting the right type of buyer is key.
  • Preparation involves a thorough analysis of your practice to identify and address areas for improvement. Initiating this process three to five years prior to the anticipated sale date is optimal for maximizing revenue and achieving the highest possible market value.
  • Valuation: Accurately assess and articulate that value to the potential buyer and members of their team

Engaging a dental practice broker will provide the necessary expertise and experience to safeguard your interests throughout the transaction.

  • Marketing the Practice—which involves preparing marketing materials and identifying potential buyers—is an important but relatively minor component of the overall process. Navigating interactions with attorneys, lenders, advisers, appraisers, and contracts, among other aspects, can be complex and require considerable effort.
  • Optimizing Returns: deliver results, negotiate favorable terms, and minimize taxes and fees.
  • Guide the Entire Process: from start to finish, a reputable broker will ensure a seamless transaction and deliver results that align with the seller’s goals.

Selling to a DSO/SG is a perfect solution for some but not all. Working with a dental practice broker will help you prepare, maximize returns, attain your goals, and ensure a smooth transition. Contact us today to explore your options…1-800-745-1438!

What Our Clients Have To Say About Us Matters

“We had the pleasure of working with Hemmen & Associates, selling our dental practice, and we couldn’t be happier with the experience. The H&A Team is highly knowledgeable, and exceptionally well-connected – not just in Iowa but nationwide. They took the time to truly get to know us on a personal level and tailored the sale to meet each need and want. What really stood out was the network of professionals beyond dentistry, including legal, real estate, lenders, financial and accounting experts, which helped make the process smooth and efficient. The team kept us updated at every step, provided constant communication, and even stayed in touch after the sale to ensure everything was going well.

Hemmen & Associates made this an enjoyable experience in every aspect, and we are deeply grateful for their support and guidance. We highly recommend them if you’re considering transitioning your practice. “

– DRS. M&T 

Contact us TODAY to schedule a free consultation!

Preparing For A Sale

As practice brokers, we often receive calls the day a dentist decides to sell their practice. In some cases, this phone call is the first time the practice owner has given serious consideration to the value and marketability of their office. Unfortunately, the doctor’s lack of foresight and planning has resulted in making choices (or failing to make choices) that resulted in a substantial adverse impact on the value and/or marketability of the practice in the years leading up to the sale. Nobody enjoys telling someone that their “baby is ugly” but that is sometimes the position in which we find ourselves due to a lack of proper transition planning on the seller’s part.

It’s imperative to take the following steps to stand out from the pack and ensure that your office is as valuable and marketable as possible when looking for a buyer:

  1. Keep your foot on the gas. Your revenue level is one of the key factors impacting practice value. Revenue trends are also an important indicator of the overall health of your office. If you are planning to cut your work schedule, consider hiring a part-time associate doctor, or accelerating the date of your practice sale.
  2. Monitor and control your overhead. Profitability is a prerequisite for value, as net cash flow (revenue minus overhead) is the single most important driver of practice value in the minds of buyers, their advisors, and lenders. We all know that overhead seems to increase over time. If practice revenue is declining while overhead is increasing during the years leading up to a sale, it will cause massive erosion in the net cash flow and value/marketability of your practice. Contact a reputable dental practice broker to ensure your major overhead expenses are in line.
  3. Consider updating your office décor and equipment. The appearance of the office and age and quality of the equipment/technology is increasingly becoming a hot button among buyers. Is the appearance of your office congruent with the quality of your dentistry? Buyers and patients often believe this is the case. Therefore, if your time horizon for selling is more than three years away, it may be wise to invest in digital radiography, updating/upgrading your computers, server, and practice management software, going paperless, and reupholstering your patient chairs. If a practice sale is in the nearer future, you should forego any major equipment purchases but consider updating the aesthetic of your office (new paint, change carpet to laminate wood flooring, update furnishings/décor, etc.). Enhancing the “curb appeal” of your office can go a long way in improving its marketability.
  4. Evaluate and raise your fee schedule as needed. Your fee schedule plays a vital role in the profitability of your practice. Raising your fee schedule on an annual basis will help to combat rising overhead costs and allow you to maintain/increase the net cash flow of your practice.
  5. Clean up accounts receivable & credit balances. Many practices have a large balance of > 90 days accounts receivable due to uncollectable balances that have not been written off. It is important to clean up your accounts receivable and credit balances prior to beginning the transition process to avoid giving buyers the impression that your practice has an issue with collections.
  6. Reduce discretionary write-offs on practice tax returns. In the years leading up to a practice sale, it is wise to instruct your accountant to reduce aggressive tax write-offs so that potential buyers and their advisors can easily determine the true overhead and profitability of your practice.
  7. If you have an associate doctor, make sure you have an associate agreement with a non-compete in place. If you are planning to sell your practice to your associate, it may be time to establish a formal agreement regarding the future sale date and price for the practice.
  8. Consult your financial advisor and tax accountant. How much money do you need to retire? How much retirement savings do you currently have on hand? What are the tax consequences associated with the practice sale?
  9. Be realistic regarding the time it will take to sell your practice. Practices typically sell much faster in metropolitan areas versus rural areas (which can take 1-2 years or more).
  10. Meet with an experienced practice broker to discuss transition strategies and have a practice valuation completed. A practice valuation can serve as a valuable tool in identifying areas where you can increase the value of your office in the years leading up to the sale.

By planning ahead and taking the above steps, you can rest easy knowing that you will be in the position to maximize the value of your practice when it’s time to begin the transition process.