Partnership, Affiliation, & Transaction Strategy

Pointed counsel to optimize structure and outcome.

We've spent over a decade advising on healthcare transactions across every major service line — hospital partnerships, joint ventures, ASC development, ancillary buildouts, complex affiliations, and every structure in between. We've been in the room for the difficult conversations, worked through the nuances that derail deals, and seen what separates transactions that create value from ones that don't.

That experience is what we put to work for you. Whether you're preparing a business for a transaction, designing a hospital relationship, structuring a joint venture, or negotiating terms — we bring the depth that comes from having done this across hundreds of situations, and we apply it to yours.

Focus Areas

Transaction Readiness

Preparing a healthcare business for a transaction means more than cleaning up financials — it means ensuring the organization, operations, and story hold up under scrutiny. We assess readiness across every dimension so nothing surfaces mid-process that shouldn't.

Hospital Relationship Design

PSAs, co-management arrangements, call coverage contracts, and employment models each carry their own structural and regulatory complexity. We help physician groups and health systems design relationships that align incentives, protect autonomy, and hold up over time.

Joint Ventures & Affiliations

Joint ventures and affiliations in healthcare require balancing clinical, economic, and governance considerations across multiple stakeholders. We structure and negotiate these arrangements to ensure they serve the long-term interests of all parties involved.

Ancillary Service Development

Building or acquiring ancillary service lines — imaging, lab, physical therapy, ASCs — can create significant value when structured correctly. We advise on the development, structuring, and integration of ancillary platforms within physician groups and health systems.

Buy-Side Diligence

Acquiring a healthcare business requires more than financial diligence — it requires understanding the operational mechanics, payor dynamics, provider economics, and organizational risks that determine whether a thesis holds up post-close. We provide the sector-specific lens that generalist diligence misses.

Partnership Track Design

The path from associate to partner is one of the most important structural decisions a physician group makes. We design partnership tracks that attract the right talent, align economic incentives, and support the long-term stability of the practice.

LOI Negotiation & Sell-Side Advisory¹

The terms set at the LOI stage define the trajectory of a transaction. We advise healthcare business owners on deal structure, negotiation strategy, and the sell-side process — ensuring the terms reflect the value of the business and protect the seller's position.

Our Approach

Assess

We start by understanding the business, the stakeholders, and the landscape — what's at play, what the objectives are, and what the right structure looks like given the specific circumstances.

Structure

We design the transaction, partnership, or affiliation framework that optimizes for the client's objectives — balancing economics, governance, regulatory considerations, and stakeholder dynamics.

Navigate

We work alongside the client through negotiation and execution — staying in the room through every turn until the outcome is achieved and the structure is in place.

Pointed counsel to optimize structure and outcome.

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