Decreasing reimbursement and need to create / offer ancillary services for additional revenue
 

Due to decreasing reimbursement, see more and more patients and suffer decreased quality of care
 

Keep pace with increased coding, compliance, insurance, health care and regulatory issues – as well as quality of care mandates / measurements coming from the government – and add overhead, which increases costs but does not drive revenue growth
 

Lack of capital to support capital intensive services required such as labs, radiology, x-ray, urgent care etc…
 

Referral sources getting more difficult to retain as large groups with multiple locations are preferred by referring physicians (and in turn health plans)

Alternatives to typical buyers

• Hospitals are slow, have no clear decision makers, bureaucratic, and don’t provide reasonable liquidity

• Joining forces with doctors doesn’t create enough leverage with health plans and/or referral sources, and doesn’t provide any liquidity at capital gains tax rates

• Hiring doctors to effect a gradual transition of the business from the owners to the employees / doctors is a slow transition with risk and doesn’t provide any liquidity at capital gains tax rates