How does valuation work for healthcare provider companies?

Let’s say is a plastic surgery rollup. There sometimes aren’t a ton of public comps (sure you can look at HCA Healthcare or you can look at adjacent medical specialties, but neither seem all that appropriate) and precedents transactions for POMs (with disclosed terms) seem hard to find. How do you figure out an appropriate entry valuation range? (e.g., 8-10x EBITDA? 10-12x? 6x EBITDA for each tuck-in?) Rookie question, maybe, but curious if anyone has any thoughts. 

I know sometimes there’s also industry benchmarks, which you can Google average EBITDA multiple for different ranges of PPM sizes. 

Not sure if there’s a best practice. 

2 Comments
 

Seems kind of crazy to base the entry EBITDA multiple for the acquisition of  some plastic surgery rollup off of US Physical Therapy, for example. But that’s the closest, publicly traded company I could find. 

And then I didn’t find any precedent transactions at all

 

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