Close · Healthcare Services

Healthcare Services Deals: Working Capital Adjustments Done Right

Negotiating Working Capital Adjustments on healthcare services deals, with the structure protection and capital connectivity an independent sponsor actually needs.

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

Every healthcare services acquisition has its own gravity. Working Capital Adjustments 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 Working Capital Adjustments actually gets structured.

  1. Set the peg based on a trailing 12-month average, normalized for seasonality.

  2. Define each line item in the schedule, especially deferred revenue and accrued vacation.

  3. Cap the dispute resolution timeline at 30 days post-close.

  4. Build a true-up payment mechanism funded out of escrow.

  5. In healthcare services, layer in PC/MSO structuring as part of the Working Capital Adjustments workstream.

The common mistake

Using an unadjusted average that ignores seasonality. You pay twice for the same cash.

Jason's take
"Working capital is where deals are won or re-traded after LOI. Read every line of the schedule."
Jason Powell · Working Capital Adjustments
Capital after close

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

Most independent sponsors solve the closing capital and then run into the post-close capital problem alone. The capital markets relationships that matter at month 18 are part of this practice.

MONTH 18
Senior refi
MONTH 24
Dividend recap
MONTH 36
Growth equity
YEAR 4–5
Strategic exit
ENGAGE THE PRACTICE

Working Capital Adjustments for Healthcare Services, on independent sponsor terms.

Independent sponsor counsel that already speaks fluent deal-by-deal economics, structures clean LPAs, and travels with capital markets relationships for what comes after close.