Market Uncertainty Takes its Toll on Healthcare M&A in Q2
Activity is down nearly 10% compared with the first quarter
Results from the healthcare M&A market reveal activity declined sharply in the second quarter of 2025. Volume reached approximately 481 deals, a 9% decrease from activity in the first quarter of 2025, when 531 deals were announced. Compared with the second quarter of 2024, results are down approximately 6% in Q2:25.
Dealmakers and industry experts have hinted at this slowdown in the conversations we’ve had with them over the past few months. Market uncertainty is the number one headwind cited, ranging from shifting tariff and trade policies that harm hospital supply chains to looming Medicaid cuts and persistent interest rate challenges.
There is also a wave of state-level regulatory efforts, such as those in Massachusetts and California, as well as new oversight bills in Minnesota and Colorado, that are delaying deals due to expanded
on page 2
Top States for Physician M&A
Florida tops the list with more than 80 transactions
As the Physician Medical Group (PMG) market evolves, geography remains a key factor influencing deal activity across the United States. While much of the focus in healthcare M&A tends to center around active specialties or prolific buyers, geography also offers insights into a deeper understanding of the market.
There are several questions that come up when thinking about the importance of geography in terms of the M&A market. What states have seen the most activity? Do the most active states differ based on specialty? And how do regulations impact activity in each state?
According to data captured in the LevinPro HC database, since the start of 2024, there have been 661 PMG transactions reported in the
on page 11
disclosure, approvals and monitoring. These efforts primarily target private equity (PE) investments in healthcare, which has been one of the main drivers of M&A for the past five years. If PE investors are forced to turn away, that could reshape the landscape.
However, most dealmakers have noted that transactions are still happening behind the scenes, but negotiations are more protracted than usual. Buyers are much more stringent when valuating a target during the acquisition process, stretching out the due diligence phase. And sellers, especially PE firms, have pulled their assets or platform companies off the market due to less-thanideal bids and valuations.
Activity in most sectors declined by an average of 10%, but a few sectors took severe hits, including Medical Devices (a 59% decline) and Biopharma (a 21% decline). The escalating U.S. trade tensions and tariff threats heavily impacted medical device manufacturers, and
the Trump administration’s cuts across federal health agencies are creating challenges for the drug industry, particularly regarding drug approval and timelines.
Deals for healthcare properties have also been sluggish due to elevated borrowing costs, which have prolonged asset sales. Demand and long-term tailwinds can only drive so much activity, even for healthcare real estate deals.
Volume in the Physician Medical Group sector remained level, with 115 deals completed so far. PE buyers account for approximately half of these deals, but health systems and various strategic buyers have also entered the market.
Home Health & Hospice and Behavioral Health Care also declined in activity, hitting 25 deals in Q2. Demand for Hospitals has slowed this year; 10 deals were announced in the second quarter, down from 11 in the first quarter and 17 in Q2:24. These sectors depend heavily on Medicaid and Medicare, so it’s no surprise to find activity stifled by the expected slash in healthcare spending.
ISSN#: 2375-7612
Published monthly by: Irving Levin Associates LLC P.O. Box 1117, New Canaan, CT 06840
Phone: 800-248-1668 Fax: 203-846-8300 info@levinassociates.com
www.levinassociates.com
Editor: Dylan Sammut
Analyst: Kate Humphrey
Analyst: Avery Swett
Advertising: Cristina Blazek-Hearty
The full, annual subscription includes 51 weekly e-newsletters, 12 monthly issues, four quarterly reports
©2025 Irving Levin Associates, LLC All rights reserved. Reproduction or quotation in whole or part without permission is forbidden.
This publication is not a complete analysis of every material fact regarding any company, industry or security. Opinions expressed are subject to change without notice. Statements of fact have been obtained from sources considered reliable but no representation is made as to their completeness or accuracy.
Several notable deals occurred in the second quarter. Siemens AG paid $5.1 billion for Dotmatics, a health analytics company, and the health system Ascension announced two major deals. In April, Ascension spent $575 million on Cedar Park Regional Medical Center in Cedar Park, Texas, and made a significant push into the outpatient care market by acquiring AmSurg, which operates 257 ambulatory surgery centers across 34 states. The LevinPro HC team has been unable to confirm an official price, but reporting from Bloomberg suggests the transaction was valued at $3.9 billion.
At the end of 2024, many dealmakers were excited about 2025, expecting a wave of new deals and investments; however, so far, those predictions have not been realized. Investors are moving with caution, and there is an appetite for dealmaking; however, if the market remains this volatile, we expect a further slowdown in the second half of the year.
Top Stories of June 2025
Behind the Deal: Christie & Co Advises on U.K. Dental Transaction
Christie & Co, a specialist business property adviser, announced the sale of King Dental & Associates Limited to private buyers. The financial terms were not disclosed.
King Dental & Associates Limited is a four-provider NHS dental practice in Carnforth, England with five surgeons.
The seller was Anne King, and her husband, Derek. In 1997, King established a single-surgery dental practice. King later acquired a second practice in 2004, and in 2007, she merged the two practices to form King Dental & Associates.
The private buyers are Dr. Adam Kantharia and Dr. Ibrahim Matadar.
Based in London, England, Christie & Co works across a plethora of sectors including dentistry, pharmacy, home health and childcare. It was founded in 1935 and annually sells more than 1,000 businesses, from small independent practices to large groups.
The LevinPro HC team spoke with Olivia McMaster, Senior Business Agent – Dental at Christie & Co, who was able to provide insight into the transaction. Christie & Co acted as the lead business agent and oversaw the entire process, which took approximately 12 months.
“We were responsible for initiating the first meeting with the client, appraising the business, bringing it to market and sourcing a suitable buyer,” said McMaster. “Once a buyer was secured, we acted as the intermediary between all parties involved (the buyer, seller and their respective legal teams) to ensure the transaction progressed smoothly.”
King’s decision to sell was driven by several factors, notably she wanted to retire. McMaster noted that King had “built a strong and successful business model” and
that, under a new owner, there was “significant reach potential for further growth.”
“Additionally, the market for mixed/NHS dental practices is, and has consistently been, highly desirable,” said McMaster, “which made it an ideal time to sell with confidence in securing the right buyer.”
So, King’s decision to retire and sell her practice could not have come at a better time. Given the practice’s “dynamic operational model and its location” there were several buyers interested. But, Dr. Adam Kantharia and Dr. Ibrahim Matadar, beat out the other (primarily first-time) buyers because they aligned with King’s objectives and requirements.
“Given that the practice is owner-operated, it created an ideal opportunity for a pair of first-time buyers who were not only eager to engage directly in the practice but also willing to assume the hours previously dedicated by King,” said McMaster. “This alignment of aspirations and operational needs made them particularly wellsuited to take over the practice and continue its legacy of success.”
Moving forward, the new owners intend on expanding the practice’s range of services, particularly in cosmetic dentistry, Invisalign and dental implants.
“With Ibrahim’s advanced training in implantology and our shared experience with Invisalign, we’re able to offer more comprehensive, in-house treatment options without patients needing to be referred elsewhere,” said Kantharia.
According to data captured in the LevinPro HC database, there have been 215 Physician Medical Group (PMG) transactions in 2025. There have also been 108 transactions in the dental specialty, with 15 of them involving targets based in the United Kingdom.
According to McMaster, Christie & Co sold 125 practices in 2024. In the first quarter of 2025, it has brought 69 dental practices to market and advised on or sold 200 practices with a combined value of £268 million (more than $364.23 million USD).
When discussing the state of the PMG M&A market in the United Kingdom, McMaster highlighted several parallels with the U.S. healthcare landscape. A key commonality is the wave of physicians retiring and selling their practices. This has become widespread in both the United States and the United Kingdom and is contributing to a broader decline in the healthcare workforce.
“In the UK, there is a shortage of dentists wanting to work in NHS dentistry, with many moving over to treat privately,” McMaster noted.
The sentiment highlights the frustrations among providers with NHS compensation structures, which are often seen as inflexible and financially unrewarding compared to the private market.
Additionally, the strength of the current M&A market is encouraging more owners to consider divestment in the United Kingdom and the United States. High demand from investors is increasing valuations, giving practice owners a timely opportunity to capitalize on favorable deal terms. At the same time, the pressures on smaller practices are pushing many toward consolidation out of necessity, not just preference.
Best Buy Sells Current Health Back to CoFounder
Best Buy has sold Current Health, a remote patient monitoring (RPM) company it had acquired in October 2021 for $400 million.
Current Health co-founder Christopher McGhee is reacquiring the company, according to a June 24, 2025 LinkedIn post. Financial terms of the deal were not disclosed.
Founded in 2015, Current Health is a leading care-athome technology platform based out of Edinburgh. The company’s platform combines RPM, telehealth and patient engagement all into a single solution for healthcare organizations.
“I came back to build Current Health into a globally
significant company,” McGhee stated in a LinkedIn post. “We have so much to do, and the story is not finished. The future of healthcare is in the home and the community, and we have a role to play in that transformation.”
Best Buy has been reorganizing its Best Buy Health arm, including $109 million in restructuring costs in May mostly related to the business, after its hospital-at-home line underperformed.
“The strategy of the health business is enabling care at home for everyone. And that fundamental belief system for us remains,” Best Buy CEO Corie Barry said in a May earnings call. “The part that has been harder and taken longer to develop than we initially thought is some of the very discrete in-home health that we are providing in partnership with some of the healthcare industry.”
OneOncology Acquires Hematology Oncology Associates of the Treasure Coast
On June 30, OneOncology announced that it acquired Hematology Oncology Associates of the Treasure Coast (HOATC).
HOATC is a physician-owned oncology practice with six physicians treating patients at four clinics located throughout the St. Lucie and Martin Counties in Florida. The practice offers patients comprehensive care along the cancer care continuum, including clinical trials.
OneOncology is a national network of independent community oncologists who assist partner practices in expanding their cancer care services. The company's 1,000 cancer care providers care for approximately 615,000 patients at more than 339 sites nationwide. In April 2023, OneOncology was acquired by TPG Capital and Cencora from General Atlantic.
h/care Expands Presence in Arizona with Addition of American Premier
h/care , a national leader in home health and hospice care, announced the addition of American Premier, based in Phoenix, Arizona. The partnership
commenced in February 2025. American Premier is a trusted provider of home health, hospice and palliative care services across the Phoenix MSA, helping people heal, manage illness or find comfort at home.
h/care is a health care management organization operating through four brands: h/care Home Health, h/care Hospice, h/care Palliative Care and h/care Pediatric at Home
Through the partnership, h/care will oversee all care operations. American Premier will integrate into h/care’s national hub-and-spoke platform.
“Phoenix is one of the most dynamic aging markets in the country, and American Premier has earned its place as one of the most trusted names in the region,” Ryan Haller, CEO and co-founder of h/care, said in a statement. “This collaboration allows us to deepen our investment in Arizona and bring our unique model of supportive, technology-enabled and clinician-first care to a broader population.”
This deal follows h/care's recent acquisition of Visiting Nurse Association of Ohio, announced earlier in June 2025. Financial terms of the American Premier deal were not disclosed.
Ascension Acquires AmSurg in Major Push Into Outpatient Care
On June 17, Ascension announced that it had entered into an agreement to acquire AmSurg Corp, marking one of the largest pushes into the outpatient care market by a health system.
AmSurg, through its subsidiaries, provides ambulatory and physician services in the United States. It operates 257 ambulatory surgery centers (ASC) in 34 states and provides physician services to 450 healthcare facilities in 29 states. The centers specialize in gastroenterology, ophthalmology, orthopedics and other services.
Ascension is the largest nonprofit health system in the United States. Its healthcare division operates 151
hospitals and more than 50 senior living facilities. In Florida, it operates seven hospitals and more than 100 other sites of care.
Jefferies LLC acted as the exclusive financial advisor to Ascension. Legal counsel was provided to Ascension by Sheppard, Mullin, Richter & Hampton LLP and Hall, Render, Killian, Heath & Lyman, P.C. Goldman Sachs & Co. LLC and Ducera Partners LLC served as financial advisors to AmSurg. Legal counsel was provided to AmSurg by Bass, Berry & Sims PLC and Milbank LLP.
Once finalized, the deal for AmSurg would add more than 250 ASC across 34 states to Ascension’s network. Under Ascension, AmSurg will keep its model of physician-led joint ventures and maintain its current governance structure.
Davis Healthcare Acquires Medical Outpatient Building Portfolio for $34 Million
Davis Healthcare Real Estate announced on June 26 that it acquired a medical outpatient building (MOB) portfolio with one location in Coralville, Iowa and one in Maplewood, Minnesota. The MOBs were purchased for a total of $34 million.
Coral West Medical Building is a three-story, 60,351-square-foot MOB in close proximity to the University of Iowa campus. Davis acquired the property for $24.15 million, or approximately $400 per square foot. At closing, the building was 97% leased with more than 65% of the space leased to the University of Iowa. Among the services provided by University of Iowa Healthcare are primary care and internal medicine, obstetrics and gynecology, neurology, imaging, rehab and dermatology, among others.
Birch Run Medical Building is fully leased, with MHealth occupying 86% of the building. The purchase price was $9.85 million, or approximately $352 per square foot. Prior to the acquisition, MHealth executed a long-term lease to bring a neurology group to the building. Other specialty areas within MHealth’s practice at the building include a spine center and a dental implant center.
Davis Healthcare Real Estate is a real estate firm for the healthcare industry. It is based in Minneapolis, Minnesota.
Davis Healthcare completed the transaction on behalf of its open-ended Davis Medical Investment Fund. With this acquisition, the fund now encompasses 17 single and multi-tenant, off-campus ambulatory care buildings totaling more than 750,000 square feet of space.
Eric Gunderson of Alerus Financial and Scott Sullivan of American National Bank provided financing for the acquisitions in Minnesota and Iowa, respectively.
Ivy Rehab for Kids Partners with Lakeside Comprehensive Rehabilitation
Ivy Rehab for Kids announced that it has partnered with Lakeside Comprehensive Rehabilitation. The addition of Lakeside Comprehensive Rehabilitation expands Ivy Rehab's presence in Michigan. Financial terms of the deal were not disclosed.
Lakeside Comprehensive Rehabilitation is a provider of rehabilitation services dedicated to delivering personalized care. The company has two locations in Hart, Michigan.
Ivy Rehab for Kids is a pediatric rehabilitation provider and part of the Ivy Rehab network. Founded in 2003, Ivy Rehab, a portfolio company of middle-market private equity firm Waud Capital Partners, is a network of outpatient physical, occupational and speech therapy and ABA clinics throughout the United States.
"We are excited to begin this new chapter with Ivy Rehab," said Deborah Windell, Owner of Lakeside Rehabilitation. "With Ivy Rehab, we look forward to expanding our services while maintaining the same personalized, compassionate approach our patients trust.”
New Day Healthcare Enters New Mexico With Acquisition of Heritage Home Healthcare
Texas-based New Day Healthcare announced on June
18 the acquisition of Heritage Home Healthcare in Albuquerque, New Mexico, marking its entrance into the state. With a team of more than 900 caregivers, Heritage Home Healthcare provides home care, hospice and skilled nursing services to more than 1,100 patients daily across New Mexico.
New Day Healthcare was formed in 2020 by G. Scott Herman and a group of home health, home care and hospice leaders. The company offers home health, hospice, pediatric, clinical decision support and personal care services in several Southwestern states. The company’s 10,000 team members help service nearly 180,000 patients annually.
“We are pleased to partner with the Heritage Home Healthcare team,” New Day Founder and CEO G. Scott Herman said in a statement. “We have been familiar with the company since 2016, and their reputation [for] high-quality care delivery and the constant pursuit of excellence, coupled with their ‘patient first’ culture, aligns perfectly with New Day Healthcare.”
Heritage Home Healthcare will continue to operate under its current brand. New Day plans for “continued strong expansion across multiple service lines” for Heritage. The deal is expected to close in July 2025. Financial details were not disclosed.
This marks New Day Healthcare’s third acquisition of 2025. The company acquired Christian Senior Care Services in February, followed by Patient Recovery Home Healthcare Services in March.
Together Women’s Health Acquires MidSouth OBGYN
Together Women’s Health (TWH) announced on June 4 that it acquired MidSouth OBGYN for an undisclosed price.
MidSouth OBGYN is an obstetrics and gynecology (OB/ GYN) practice based in Memphis, Tennessee. According to its website, there are nine physicians on staff.
TWH is a management services organization (MSO)
backed by Shore Capital Partners. The MSO supports its affiliated practices and physician partners with strategic guidance, administrative resources (including revenue cycle management, marketing, human resources, finance, accounting and IT), operational expertise and capital. Currently, TWH's affiliate network comprises more than 20 practices with more than 175 providers offering women’s health services at more than 40 locations throughout Michigan, Illinois, Alabama, Colorado, Mississippi, Missouri, Tennessee and Georgia.
This deal brings TWH’s presence into Tennessee, the MSO’s eighth state. Following the completion of the transaction, MidSouth OBGYN will expand its services to include on-site mammography, providing convenient access to preventive breast health services.
VeraNorth Announces RN Express Acquisition & Fund Launch
VeraNorth Capital Management, LLC announced on June 10 its acquisition of RN Express Registry, LLC, a New York-based clinical staffing company. Founded in 2009, RN Express is a top provider of nursing personnel in Manhattan.
VeraNorth Capital Management is a Houston-based private equity firm specializing in control-oriented healthcare investments. The firm partners with founderled businesses to scale essential healthcare services while generating long-term value for investors.
Alongside the acquisition announcement, VeraNorth also announced the official launch of VeraNorth Healthcare Private Equity Fund, L.P., an evergreen, NAV-based liquidity fund employing a hybrid strategy of growth equity and control investing.
The new fund targets U.S. lower middle market healthcare services providers and aims to capitalize on demographic tailwinds, including rising demand for senior care and persistent staffing shortages, to drive scalable, long-term value. The fund will support RN Express’ organic growth while pursuing a roll-up strategy across sectors such as urgent care centers,
skilled nursing facilities, pharmacies and hospices. Financial terms of the deal were not disclosed.
Guardian Pharmacy Services’ Latest Acquisition Expands Pacific Northwest Footprint
Guardian Pharmacy Services announced on June 2 that it is expanding into the Pacific Northwest with the acquisition of Mercury Pharmacy Services. This acquisition marks Guardian’s first pharmacy location in Washington.
Mercury Pharmacy Services is a long-term care (LTC) pharmacy based in Mountlake Terrace, Washington. Founded in 2001, Mercury Pharmacy Services is among the largest providers of LTC pharmacy services in the Seattle-Tacoma MSA and serves residents and LTC communities across the state of Washington and adjoining areas.
Based in Atlanta, Guardian Pharmacy Services is one of the nation's largest LTC pharmacy companies. Guardian's pharmacies provide client services and resident care to LTC communities, including assisted living and skilled nursing, group home, behavioral health and to organizations that serve individuals with intellectual and developmental disabilities. It was founded in 2004.
All existing leadership and staff at Mercury Pharmacy Services will remain in place following the acquisition, continuing to operate under the same name.
This marks Guardian’s second transaction of 2025. In May, the company acquired Senior Care Pharmacy, an LTC specialty pharmacy based in Wichita, Kansas. Guardian also acquired Midwest LTC Pharmacy in July 2022, and Freedom Pharmacy in December 2024.
As with Guardian’s other acquisitions, Mercury Pharmacy Services will benefit from the company’s business model. This enables the local pharmacy teams to focus on customer service and the specialized needs of the communities and residents they serve, while Guardian’s centralized Corporate Support Team assists with the many complex behind-the-scenes
business functions, including data analytics, HR, IT, payor relations, national sales and more. Financial terms of the deal were not disclosed.
Guardian Pharmacy Services’ Latest Acquisition Expands Pacific Northwest Footprint
Centered Care, a wholly owned subsidiary of the Senior Living Transformation Company, announced that it acquired New York-based Troupe Health for an undisclosed price.
Troupe Health is a clinical delivery company specializing in AI-enabled care coordination for senior living communities. Founded by Redesign Health to address gaps in complex care journeys, Troupe Health has built a robust infrastructure that enables care teams to deliver more coordinated, accessible services to patients across the healthcare continuum.
Centered Care is a tech-enabled care delivery platform focused on advancing care outcomes for senior housing operators and the residents they serve. With a commitment to community-rooted, person-first care, Centered Care partners with payers, providers and senior living operators to support whole-person health across medical, behavioral and social domains.
The acquisition comes amid growing momentum for models that emphasize whole-person care, particularly for Medicare and dual-eligible populations. By combining Troupe Health's clinical expertise with Centered Care's platform, the unified organization will deliver more effective, connected care at a national level. Through this acquisition, the combined organization will accelerate value creation for seniors, providers, community operators and real estate owners alike.
Knight Therapeutics Acquires Endo's Pharmaceutical Businesses for up to $105 Million
Endo, Inc. , a generic and specialty branded pharmaceutical company, announced that it was selling its international pharmaceutical businesses
to Knight Therapeutics Inc. The businesses are primarily operated through Canada-based specialty pharmaceutical company Paladin Pharma Inc.
Total cash consideration for the sale is up to approximately $105 million, consisting of approximately $79 million paid at closing, approximately $11 million related to certain permitted holdbacks and up to $15 million in future payments contingent upon the achievement of certain milestones.
Knight Therapeutics Inc. is a specialty pharmaceutical company. In 2024, according to the company's latest financial reports, the company generated $365 million in revenue. It is based in Montreal, Canada.
Supernus Pharmaceuticals to Acquire Sage Therapeutics for $561 Million
Supernus Pharmaceuticals announced on June 16 that it has entered into an agreement to acquire Sage Therapeutics, based in Cambridge, Massachusetts.
Supernus is acquiring Sage through a tender offer for $8.50 per share in cash (or an aggregate of approximately $561 million), plus one non-tradable contingent value right (CRV) collectively worth up to $3.50 per share in cash (or an aggregate of approximately $234 million). The total consideration is $12.00 per share in cash (or an aggregate of up to approximately $795 million). The CVR is payable upon achieving certain net sales and commercial milestones.
Sage Therapeutics is a biopharmaceutical company committed to developing novel therapies with the potential to transform the lives of people with debilitating disorders of the brain. According to its May 8, 2025, financial report, the company reported $41.24 million in revenue for the full year (FY) 2024.
Supernus is a specialty pharmaceutical company focused on developing and commercializing products for the treatment of central nervous system diseases.
Its diverse neuroscience portfolio includes approved treatments for attention-deficit hyperactivity disorder,
dyskinesia in Parkinson’s disease (PD) patients receiving levodopa-based therapy, hypomobility in PD, epilepsy, migraine, cervical dystonia and chronic sialorrhea. According to its February 2025 financial report, the company reported $661.8 million in revenue for FY 2024.
The transaction will provide Supernus with an innovative marketed product: ZURZUVAE capsules CIV, the first and only FDA-approved oral medicine indicated for the treatment of adults with postpartum depression.
Moelis & Company LLC is acting as the exclusive financial advisor to Supernus. Goldman Sachs & Co. LLC is acting as the exclusive financial advisor to Sage.
Saul Ewing LLP is serving as legal counsel to Supernus. Kirkland & Ellis LLP is serving as legal counsel to Sage.
Acute Behavioral Health Acquires Oakwood Treatment Center
Acute Behavioral Health announced on June 23 its completed acquisition of Oakwood Treatment Center in Kinston, North Carolina.
Oakwood Treatment Center is a psychiatric residential treatment facility that had previously been part of the Nova Behavioral Health network of treatment programs. Oakwood provides out-of-home treatment services for boys and girls between 12-17 years old.
Acute Behavioral Health is a healthcare platform for young people, aligned with the Federal Family First Prevention Services Act, which promotes keeping children with their families by providing preventive services and community-based care to reduce the need for state custody placements for treatment.
Acute Behavioral Health was formed in 2021 with an initial investment from Petra Capital Partners and Harbert Credit Solutions in partnership with Elm Creek Partners and Granite Growth Health Partners.
Oakwood Treatment Center will continue to serve the Kinston community under a new name and ownership. Financial terms of the deal were not disclosed.
Cosentus Expands National Reach with UtahBased Alta Management Solutions
Cosentus announced in a June 16 press release that it has entered into an agreement to acquire Alta Management Solutions. The acquisition was officially signed on May 27, 2025.
Alta Management Solutions is a leading revenue cycle management (RCM) firm based in Bountiful, Utah. The company currently works with the following specialties: general surgery, family practice, plastic surgery, orthopedics, pediatrics, neonatology, ear, nose & throat, podiatry, ophthalmology, urology, anesthesia, radiology and mental health.
Cosentus is a healthcare services provider based in Irvine, California. The company provides outsourced solutions in RCM, technology, accounting and tax, recruiting, marketing and more.
Serving more than 2,000 clients across more than 14 countries, the Cosentus team is powered by more than 120 U.S.-based employees and more than 500 employees operating globally.
With this acquisition, Cosentus aims to expand its national footprint, strengthen its consulting capabilities and enhance its service offerings to clients across the United States.
As part of the acquisition, Alta’s leadership and team members will be integrated into Cosentus’ existing business infrastructure. Current Alta clients can expect continuity of service, along with the added benefit of expanded support and resources through the Cosentus’ platform. Financial terms of the deal were not disclosed.
Physician M&A by States...cont. from page 1
United States. Since the start of 2025, there have been 206 PMG deals.
Dental practices have been the top physician specialty targeted by investors and dealmakers, with 323 transactions on the books in the past 18 months, followed by internal medicine at 43 deals.
In this article, we're examining some of the most active states and markets for investments in the physician space, exploring the unique dynamics shaping dealmaking. The article also explores certain challenges each state presents for investors.
FLORIDA
In the past 18 months, activity has been strongest in the Florida market, with 85 deal announcements, driven by a demographic shift over the past few years. Not only is the state seeing a significant surge in population growth, but an estimated 22% of Florida residents are 65 and over, promising constant utilization for providers.
Additionally, Medicare Advantage (MA) enrollment is high in Florida, which has a two-fold effect. Larger physician groups are better equipped to manage the demands associated with MA patients, due to the increased access to administrative resources.
As a result, independent physician practices often face operational disadvantages, giving them strong motivation to sell and align with a larger organization. And these larger physician groups that manage MA populations under value-based care models are especially attractive to investors due to their potential higher revenue streams.
Furthermore, in 2019, Florida scaled back large portions of its Certificate of Need (CON) program, specifically for specialty hospitals, according to an article written by Arnall Golden & Gregory, LLC. With looser CON laws in place, there is an increase in the ability to buy medical practices, further drawing investors into the state.
Of the 85 deals announced in Florida, 40 of them have been in the dental specialty with buyers such as Heartland Dental (eight deals) and Parkview Dental Partners (three deals). Eye care had nine transactions with Eye Health America (three deals) and Florida Eye Specialists (two deals). Orthopaedic was also active with six transactions. Cardiology and dermatology also had four acquisitions each.
One of the biggest deals in Florida was Eye Health America’s, founded by LLR Partners, Clemson Eye and The Eye Associates, purchase of Quigley Eye Specialists in February 2025, adding 20 physicians to its network. Quigley Eye Specialists, based in Bonita Springs, Florida provides a full range of ophthalmology and optometry services across southwest Florida. The practice was founded in 1988 and has 10 locations in Florida.
CALIFORNIA
The state with the second-highest activity since January 1, 2024, is California, with 66 PMG transactions. While California is the most populated state (it has an estimated 39.5 million people, as of May 2025), it recently went through a period of population decline due to high mortality rates from COVID-19, a slowdown of international migration, and high cost of living, which caused people to move out. Despite this, California still has a large senior population that needs medical care.
In addition, a bill was reintroduced in February 2025 to strengthen the Corporate Practice of Medicine (CPOM) doctrine in California. CPOM prevents corporations and other non-physicians from owning or controlling medical practices.
Private equity groups and their portfolio companies accounted for nearly 53% (35 deals) of the transactions in the state for just the last 18 months. There were 26 deals done by independently owned dental offices, including dental services organizations. There were two health system deals; the buyers were Montage Health and Cedars-Sinai Health System. If this bill does go into effect, one can only wonder how PMG activity in the state will be impacted. It’s likely that activity will
slow down significantly, or we will see various investors move into the market.
Dental was the most active specialty in California (36 transactions) over the last 18 months, with buyers such as MB2 Dental Solutions (10 deals), U.S. Oral Surgery Management (six deals) and Silver Creek Dental Partners (seven deals).
Dermatology practices were targeted in seven deals, including four announced by Golden State Dermatology. PhyNet Dermatology LLC also reported two acquisitions in California. There were also three transactions each for eye care and plastic surgery groups.
Over the last 18 months, only one PMG transaction was announced in California that had a disclosed price. That deal was Cardinal Health. Inc’s acquisition of Integrated Oncology Network LLC (ION) for $1.1 billion. Cardinal Health is a multinational healthcare services company that provides pharmaceutical and medical products and services in the United States and worldwide.
ION is a radiation oncology management and cancer center development company that partners with hospitals and physicians. It has operations in more than 30 countries and approximately 48,000 employees globally. ION includes more than 50 practice sites in 10 states, representing more than 100 providers.
TEXAS
Texas was the third most active state for PMG deals, totaling 49 acquisitions from the last 18 months. This is driven, once again, by a surge in population growth but also strong economic opportunities and low cost of living incentivizing people to live in the state.
But also, in contrast to California, Texas is much more business-friendly when it comes to regulations, incentivizing investors to push in. While Texas does have Corporate Practice of Medicine, there are several exceptions that allow corporations to buy in the state.
For example, if a company partners with a physician
or management services group, it can buy physician practices in Texas. Additionally, Texas has no ban on corporate practices of medicine, meaning private equity and other corporations can directly employ physicians or medical practices.
Texas’ willingness to work with companies in the medical field can be directly seen in its statistics. Out of the 49 PMG deals in the last 18 months, 32 of them were completed by private equity firms and/or their portfolio companies. The rest are independently owned practices. No health systems have announced PMG purchases in Texas since before January 1, 2024.
There were 24 dental transactions reported in Texas, led by MB2 Dental Solutions (four deals), Specialized Dental Partners (five deals) and Straine Dental Management (two deals). There were four dermatology transactions with DermCare Management, LLC, accounting for three of the deals and Epiphany Dermatology with one. There were three eye care and three management service organization transactions.
The largest deal in Texas by purchase price was Cencora, Inc. 's $4.6 billion acquisition of Retina Consultants of America (RCA). Cencora, formerly known as AmerisourceBergen, is a drug wholesale company and a contract research organization that was formed by the merger of Bergen Brunswig and AmeriSource in 2001.
RCA is a specialty platform created by the acquisition and merger of Retina Consultants of Houston, Retina Group of Florida, Long Island Vitreoretinal Consultants and Retinal Consultants (Northern California). It has more than 50 physicians on staff, at time of closing.
The target with the most physicians on staff was Urology America, which GI Alliance purchased in April 2025. Urology America, based in Austin, has more than 50 physicians on staff. It was acquired alongside Potomac Urology Center, based out of five locations in Washington, D.C., with 11 physicians on staff.
