As we move through the first quarter of 2026, the healthcare acquisition landscape is showing a clear divergence across specialties. While deal activity remains active overall, not all sectors are participating equally. In fact, we are seeing a notable pause in certain areas—alongside strong momentum in others.
Headwinds in Primary Care and Pediatrics
Primary care and pediatric practices are currently facing increased scrutiny from both buyers and lenders. The primary driver behind this hesitation is reimbursement uncertainty.
Ongoing payer cuts and evolving reimbursement methodologies—particularly those tied to government programs—have introduced a level of unpredictability that investors are not comfortable underwriting at this time. In Florida specifically, the Agency for Healthcare Administration (AHCA) is still working through payment-related issues, further contributing to market hesitation.
As a result:
- Valuation multiples in these sectors have softened
- Many deals are being delayed or paused entirely
- Buyers are taking a “wait-and-see” approach until reimbursement stabilizes
This doesn’t mean these businesses lack long-term value—but in the current environment, uncertainty is suppressing transaction activity.
Dermatology Emerges as a Standout Performer
On the other end of the spectrum, dermatology has become one of the most attractive sectors in healthcare M&A.
We are seeing strong demand from private equity-backed groups actively pursuing acquisitions in:
- Traditional insurance-based dermatology practices
- Hybrid models that include med spa or aesthetic components
What makes dermatology particularly compelling right now:
- Favorable reimbursement dynamics compared to primary care
- Strong cash-pay components (especially in aesthetic services)
- High margins and scalable service lines
- Operational flexibility across different business models
Interestingly, size is not the primary driver of value in this space at the moment. Both small and mid-sized practices are commanding strong interest and, in many cases, higher valuation multiples than we’ve seen historically.
Why Some Practices Command Premium Valuations
Across all specialties—but especially in dermatology—there is a consistent theme among practices achieving the best outcomes in a sale:
Preparation and operational discipline matter.
Buyers are paying a premium for businesses that demonstrate:
- A strong culture of compliance
- Clean, well-organized financials
- Accurate and defensible profit and loss statements
- Consistent and transparent tax reporting
When these elements are in place, the transaction process becomes significantly smoother. More importantly, it reduces perceived risk for buyers—which directly translates into higher and more achievable purchase prices.
Deal Structures: Roll-Ups vs. Strategic Acquisitions
We are also seeing a mix of transaction structures in today’s market:
- Roll-Up Strategies: Private equity-backed platforms are continuing to aggregate practices, particularly in dermatology. These models focus on integration, operational efficiency, and scaling regional or national footprints.
- Outright Acquisitions: Strategic buyers and larger platforms are also executing full buyouts, especially when targeting high-performing or well-positioned practices.
Each structure comes with different implications for physicians—particularly around autonomy, equity rollover, and long-term upside—making deal structuring just as important as valuation.
Looking Ahead
The current M&A environment in healthcare is not slowing—it’s shifting.
- Sectors tied heavily to reimbursement uncertainty are experiencing temporary slowdowns
- Specialties with diversified revenue streams and strong margins are accelerating
For practice owners, this creates both a cautionary signal and an opportunity:
- Timing matters more than ever
- Positioning your business correctly can significantly impact valuation
- Being prepared operationally is no longer optional—it’s essential
As 2026 unfolds, we expect continued momentum in dermatology and similar specialties, while reimbursement clarity will be the key factor in unlocking stalled segments like primary care and pediatrics.
