North Texas Dentistry Volume 9 Issue 3 2019 ISSUE 3 DE | Page 14
practice models
PRACTICE ACQUISITION 101
by Amanda Mombert and Ben Mombert
ne of the biggest decisions that a dental professional
may grapple with is the decision to acquire an estab-
lished dental practice, or not. A big part of this deci-
sion entails understanding the financing options available to
make this dream a reality.
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There are a few main types of financial institutions to consider
for a dental loan: community banks or large national banks
and some – like us – that are community banks but with a
large national dental portfolio. It is important to understand
which option is a good fit for you and your long term goals on a
holistic level.
When considering the type of financial institution, think about
the following things when deciding who you want to start this
long-term relationship with:
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Does the banker and bank have experience in healthcare and
specifically, in the dental industry?
Where are the lending decisions being made?
Is there flexibility regarding repayment schedules? Are there
prepayment penalties?
Will the financial institution provide sufficient working
capital to you as you ramp up operations?
What are the rates, are they fixed or floating, and what is
the fee structure?
What other intangible benefits can they offer you?
Does the financial institution support your industry?
As you are weighing your options, you’ll want to understand
what the requirements are for the loan. Will they require liq-
uidity in the bank, a down payment, or the seller to finance
some of the purchase? How transparent are they in communi-
14 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
cating these requirements? Effective communication with your
banker through this process is critical. You will likely want to
ensure that your banking partner is accessible and consultative.
Once you’ve made a decision, there are several items that you
and your team of advisors (including your banker) will want to
review as you move forward in your due diligence process.
From a lending perspective, we are in the business of assessing
risk and mainly assessing risk in the cash flow that you will
expect to purchase. Here are some questions that will be evalu-
ated:
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How much cash flow is available to service the proposed debt,
your existing personal debt, and your living expenses?
How does the practice overhead stack up to industry standards?
How do you compare clinically, from a treatment planning
perspective and chairside manner, to the seller?
What opportunities are there for growth through either new
patients or keeping additional procedures in-house?
How do the demographics and competition stack up in the
area where you are looking to purchase?
What percentage of revenue comes from PPO, fee for service,
or Medicaid/HMO? Will you be able to be credentialed with
all the same plans and with the same fee schedule?
What does cash flow look like if there is patient attrition? This
sensitization exercise is a good way to understand the risk to
your future cash flows.
Is the staff aware of the sale and are they expected to remain
with the purchaser after the sale?
What type of future improvements will you need to invest in?