Healthcare M&A in 2026

In Episode 6.14, host David Mandell interviews Matthew Phillips, Managing Director at City Capital Advisors, to discuss the evolving landscape of healthcare mergers and acquisitions. With more than 25 years of legal and corporate finance advisory experience, Phillips shares insights into how physician-owned practices can navigate growth, capital raises, acquisitions, and potential sales in today’s selective and risk-averse market environment.

Phillips explains that while capital remains abundant in healthcare, buyers are far more disciplined than in past years. Investors are prioritizing operational rigor, compliance, predictable cash flow, and cultural alignment over aggressive growth projections. He emphasizes the importance of competitive deal processes, proper due diligence, and maintaining leverage on the physician side when exploring private equity partnerships.

The conversation also introduces ExitMinded, Phillips’ advisory platform designed to help practices prepare for a future transaction well before going to market. By conducting a buyer-lens, risk-based assessment, ExitMinded helps identify operational, structural, financial, and compliance gaps that could erode value. Whether physicians plan to sell or remain independent, this proactive preparation strengthens practice performance and preserves long-term optionality.

Key Takeaways:

1. Today’s healthcare M&A market is capital-rich but highly selective, favoring well-prepared and professionally managed practices.s.
2. Physicians must conduct reverse due diligence on private equity partners to ensure cultural alignment and long-term strategic fit.
3. Preparing years in advance for a potential exit improves valuation, reduces transaction risk, and strengthens independence—even if a sale never occurs.

Insights:

• • Practice size alone does not determine valuation—ancillaries, specialty mix, payer mix, and operational efficiency play significant roles.
  • Professionalizing management (hiring experienced non-physician executives) is critical for both independence and transaction readiness.
  • Many physicians misunderstand the difference between fair market compensation and return on equity.
  • Inbound private equity calls often create false confidence; structured competitive processes preserve leverage.
  • Cultural alignment often matters more than headline valuation in successful private equity partnerships.
  • Compliance, operational control, and financial transparency are now core underwriting priorities for investors.
  • Growth capital and tuck-in acquisitions are viable alternatives to full practice sales.
  • Exit readiness can take 12 to 48 months depending on operational complexity.
  • Preparing for an exit enhances practice performance regardless of whether a transaction ultimately occurs.

Links & Bios:

• Guest, Matthew Phillips | Bio
• Host, David B. Mandell | Bio