Pre-close · Healthcare Services

Cross-Border Structuring for Healthcare Services Independent Sponsors

When the deal is healthcare services and the question is Cross-Border Structuring, the structure decisions in the first 30 days outlast the next five years. This is where Jason Powell works.

EV range $15M to $120M EV EBITDA $3M to $20M Audience Buy & Sell-side
The deal context

Every healthcare services acquisition has its own gravity. Cross-Border Structuring is the workstream where independent sponsor counsel earns the seat.

The typical healthcare services platform sits at $15M to $120M EV with EBITDA in the $3M to $20M range. The thesis runs on roll-up of physician practices and ancillary service lines. Most off-market healthcare deals come through advisors who have seen the structure before. Have one in your call list.

The moves

How Cross-Border Structuring actually gets structured.

  1. Map jurisdictional tax exposure with US and foreign counsel before the LOI.

  2. Plan repatriation mechanics if cash is generated offshore.

  3. Address CFIUS review where foreign capital is in the LP base.

  4. Structure for treaty benefits where the operating geographies allow.

  5. In healthcare services, layer in PC/MSO structuring as part of the Cross-Border Structuring workstream.

The common mistake

Treating cross-border deals like US deals with extra steps. Tax, regulatory, and timing assumptions break differently.

Jason's take
"Cross-border deals need three sets of advisors at the table from day one. Bring them."
Jason Powell · Cross-Border Structuring
Capital after close

The deal is one thing. The capital that opens up after close is another.

Capital after close is where the IRR actually gets made. The right introductions at month nine through month thirty are where this practice works as hard as it does at the LOI.

MONTH 18
Senior refi
MONTH 24
Dividend recap
MONTH 36
Growth equity
YEAR 4–5
Strategic exit
WORK WITH JASON

Bring the healthcare services deal. Get Cross-Border Structuring done right.

Direct counsel from a securities and M&A attorney with billions in structured transactions, the independent-sponsor-native playbook, and the capital markets network that opens up post-close.